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The purpose of this study was to examine the effects of alcohol hangover on simulated highway driving performance.Driving performance of forty-two social drinkers was tested the morning following an evening of consuming on average 10.2 (SD = 4.2) alcoholic drinks (alcohol hangover) and on a control day (no alcohol consumed). Subjects performed a standardized 100-km highway driving test in the STISIM driving simulator. In addition to the standard deviation of lateral position (SDLP; i.e., the weaving of the car), lapses of attention were examined. Self-reported driving quality and driving style were scored, as well as mental effort to perform the test, sleepiness before and after driving, and hangover severity.Driving performance was significantly impaired during alcohol hangover as expressed by an SDLP increase of +1.9 cm (t (1,41) = 2.851, p = 0.007), increased number of lapses relative to the control day (7.7 versus 5.3 lapses, t (1,41) = 2.125, p = 0.019), and an increased total lapse time (182.7 versus 127.3 s, p = 0.040). During alcohol hangover, subjects reported their driving quality to be significantly poorer (t (1,41) = 4.840, p = 0.001) and less safe (t (1,41) = 5.078, p = 0.001), wise (t (1,41) = 4.061, p = 0.001), predictable (t (1,41) = 3.475, p = 0.001), and responsible (t (1,41) = 4.122, p = 0.001). Subjects further reported being significantly more tense while driving (t (1,41) = 3.280, p = 0.002), and more effort was needed to perform the driving test (t (1,41) = 2.941, p = 0.001). There was a significant interaction with total sleep time and hangover effects on SDLP and the number of lapses.In conclusion, driving is significantly impaired during alcohol hangover, as expressed in an elevated SDLP and increased number of lapses. Total sleep time has a significant impact on the magnitude of driving impairment.

Alcohol is frequently used in combination with 3,4-methylenedioxymethamphetamine (MDMA). Both drugs affect cardiovascular function, hydration and temperature regulation, but may have partly opposing effects. The present study aims to assess the acute physiologic effects of (co-) administration of MDMA and ethanol over time. A four-way, double blind, randomized, crossover, placebo-controlled study in 16 healthy volunteers (9 male and 7 female) between the ages of 18 and 29. MDMA (100 mg) was given orally and blood ethanol concentration was maintained at pseudo-steady state levels of 0.6‰ by a three-hour 10% intravenous ethanol clamp. Cardiovascular function, temperature and hydration measures were recorded throughout the study days. Ethanol did not significantly affect physiologic function, with the exception of a short lasting increase in heart rate. MDMA potently increased heart rate and blood pressure and induced fluid retention as well as an increase in temperature. Co-administration of ethanol with MDMA did not affect cardiovascular function compared to the MDMA alone condition, but attenuated the effects of MDMA on fluid retention and showed a trend for attenuation of MDMA-induced temperature increase. In conclusion, co-administration of ethanol and MDMA did not exacerbate physiologic effects compared to all other drug conditions, and moderated some effects of MDMA alone.

Violence and drug use are significant public health challenges that are strongly linked. It is known that alcohol plays a major role in the causation of unnatural deaths and that stimulants like cocaine and amphetamine are often implicated in aggressive acts or violence. However, a clear causal relationship between these substances and aggression, and more specifically a blood concentration threshold at which intoxicated aggression emerges is lacking. In case of a crime and subsequent law enforcement, knowledge about dose-response relationships could be of pivotal importance when evaluating the role of alcohol and drugs in aggressive offences.The present review aimed to determine whether there is a causal relation between intoxication with these psychoactive substances and aggression, and to define blood concentration thresholds above which these substances elicit aggression.Empirical articles published between 2013 and 2017 and review papers containing the predefined search strings were identified through searches in the PubMed and Embase databases and additional reference list searches. The complete search query yielded 1578 publications. Initially all articles were manually screened by title and abstract. Articles with irrelevant titles, given the selected search terms and review aims were discarded. Remaining articles were carefully studied and those that did not comply with the main objectives of this review were discarded. At the end of this process, 167 titles were found eligible for review.While placebo-controlled experimental studies clearly showed a causal link between alcohol and aggression, it is evident that such a link has not yet been established for cocaine and amphetamines. In case of alcohol, it is clear that there are various individual and contextual factors that may contribute to the occurrence of an aggressive act during intoxication. A clear threshold blood alcohol concentration has not been defined yet for alcohol, but a statistically significant increase of aggression has been demonstrated at a dose of 0.75 g/kg and higher. Future studies into intoxicated aggression should include multiple doses of alcohol and stimulants and take into account individual and contextual factors.

We analyzed the role of primary and postoperative low linear energy transfer radiotherapy in 538 patients treated for salivary gland cancer in centers of the Dutch Head and Neck Oncology Cooperative Group, in search for prognostic factors and dose response.The tumor was located in the parotid gland in 59%, submandibular gland in 14%, oral cavity in 23%, and elsewhere in 5%. In 386 of 498 patients surgery was combined with radiotherapy, with a median dose of 62 Gy. Median delay between surgery and radiotherapy was 6 weeks. In the postoperative radiotherapy group, adverse prognostic factors prevailed. Elective radiotherapy to the neck was given in 40%, with a median dose of 50 Gy. Primary radiotherapy (n = 40) was given for unresectable disease or M(1), with a dose range of 28-74 Gy.Postoperative radiotherapy improved 10-year local control significantly compared with surgery alone in T(3-4) tumors (84% vs. 18%), in patients with close (95% vs. 55%) and incomplete resection (82% vs. 44%), in bone invasion (86% vs. 54%), and perineural invasion (88% vs. 60%). Local control was not correlated with interval between surgery and radiotherapy. No dose-response relationship was shown. Postoperative radiotherapy significantly improved regional control in the pN(+) neck (86% vs. 62% for surgery alone). A rating scale for different sites, T stage, and histologic type may be applied to calculate the risk of disease in the neck at presentation, and so indicate the need for elective neck treatment. A marginal dose-response was seen, in favor of a dose > or =46 Gy. A clear dose-response relationship was shown for patients treated with primary radiotherapy. Five-year local control was 50% with a dose of 66-70 Gy.Postoperative radiotherapy with a dose of at least 60 Gy is indicated for patients with T(3-4) tumors, incomplete or close resection, bone invasion, perineural invasion, and pN(+). In unresectable tumors, a dose of at least 66 Gy is advisable.

Background: Impairments in decision making are a consistent finding in substance use disorder (SUD) populations. However, decision‐making deficits are not specific for SUDs and are also reported in the context of other psychiatric disorders such as antisocial and borderline personality disorders (PDs). Given the frequent comorbidity between SUD and cluster B PD, it might be questioned whether the decision‐making impairments typically reported in SUD populations reflect the addictive disorder, the cluster B PD, or a combination of the 2.Methods: In the current study, we compare the decision‐making performance of non–substance‐abusing controls (n=53) on the Iowa Gambling Task (IGT) with the decision‐making performance of 3 abstinent alcohol‐dependent samples, i.e., alcoholic patients without any PD (n=38), alcoholic patients with a cluster A or C PD (n=19), and alcoholic patients with a cluster B PD (n=23).Results: Overall, all 3 alcohol‐dependent subsamples performed inferior compared with controls. Between alcoholic subsamples, the alcoholic patients with a cluster A or C PD had the highest IGT score, followed by the alcoholic patients without a PD, while the cluster B alcoholic patients were the most impaired.Conclusion: These findings suggest that impairments in decision making underlie both alcohol dependence and cluster B PD, and alcoholic patients with a comorbid cluster B PD are particularly impaired in their decision making. These deficits may underlie the severe problems that characterize cluster B alcoholic patients specifically in inappropriate behaviors (e.g., poly substance abuse, legal, and professional dysfunction).

The mitigation of volatile organic compound (VOC) vapors in the unsaturated zone largely relies on the active removal of vapor by ventilation. In this study we considered an alternative method involving the use of solid potassium permanganate to create a horizontal permeable reactive barrier for oxidizing VOC vapors. Column experiments were carried out to investigate the oxidation of trichloroethylene (TCE), toluene, and ethanol vapors using a partially saturated mixture of potassium permanganate and sand grains. Results showed a significant removal of VOC vapors due to the oxidation. We found that water saturation has a major effect on the removal capacity of the permeable reactive layer. We observed a high removal efficiency and reactivity of potassium permanganate for all target compounds at the highest water saturation (Sw=0.6). A change in pH within the reactive layer reduced oxidation rate of VOCs. The use of carbonate minerals increased the reactivity of potassium permanganate during the oxidation of TCE vapor by buffering the pH. Reactive transport of VOC vapors diffusing through the permeable reactive layer was modeled, including the pH effect on the oxidation rates. The model accurately described the observed breakthrough curve of TCE and toluene vapors in the headspace of the column. However, miscibility of ethanol in water in combination with produced water during oxidation made the modeling results less accurate for ethanol. A linear relationship was found between total oxidized mass of VOC vapors per unit volume of permeable reactive layer and initial water saturation. This behavior indicates that pH changes control the overall reactivity and longevity of the permeable reactive layer during oxidation of VOCs. The results suggest that field application of a horizontal permeable reactive barrier can be a viable technology against upward migration of VOC vapors through the unsaturated zone.

Excessive alcohol intake frequently results in gastrointestinal discomfort. It is an empirical fact that the severity of gastrointestinal discomfort induced by alcohol abuse is subject to interindividual variation. The aim of this study was to determine whether genetic polymorphism in alcohol dehydrogenase 3 (ADH3) and cytochrome P450 2E1 (CYP2E1), important first-pass enzymes in the metabolism of ethanol, predispose to the development of gastrointestinal symptoms in alcoholics, Blood samples were obtained from 92 adult alcoholics admitted for detoxification. The samples were analyzed for genetic polymorphism in ADH3 and CYP2E1 by polymerase chain reaction followed by restriction fragment length polymorphism analyses. During an interview on the first day of hospital admission, patient characteristics and gastrointestinal symptoms in the week before admission were assessed. A total of 75 of 92 alcoholics (83%) reported symptoms: 66 patients had upper gastrointestinal symptoms (72%), 70 patients had lower gastrointestinal symptoms (76%), and 59 patients reported alarming symptoms (64%). Patients with gastrointestinal symptoms less often abused beer in comparison to those without gastrointestinal symptoms (P = 0.05). The numbers of patients with the homozygous y1y1 genotype, the heterozygous y1y2 genotype, and the homozygous y2y2 genotype in ADH3 who reported gastrointestinal symptoms were 20 (83%), 34 (76%), and 15 (88%), respectively. The number of patients with the heterozygous c1c2 CYP2E1 genotype (5%) and the heterozygous DC CYP2E1 genotype (14%) was low and also unrelated to gastrointestinal symptoms. Our data suggest that the ethanol concentrations of the consumed beverages, and not interindividual variations in the activities of first-pass alcohol-metabolizing enzymes, are associated with gastrointestinal symptoms in alcoholics.