Abstract: OBJECTIVE: Most studies on alcohol as a risk factor for injuries have been mechanism specific, and few have considered several mechanisms simultaneously or reported alcohol-attributable fractions (AAFs)-which was the aim of the current study. METHOD: Data from 3,592 injured and 3,489 noninjured patients collected between January 2003 and June 2004 in the surgical ward of the emergency department of the Lausanne University Hospital (Switzerland) were analyzed. Four injury mechanisms derived from the International Classification of Diseases, 10th Revision, were considered: transportation-related injuries, falls, exposure to forces and other events, and interpersonal violence. Multinomial logistic regression models were calculated to estimate the risk relationships of different levels of alcohol consumption, using noninjured patients as quasi-controls. The AAFs were then calculated. RESULTS: Risk relationships between injury and acute consumption were found across all mechanisms, commonly resulting in dose-response relationships. Marked differences between mechanisms were observed for relative risks and AAFs, which varied between 15.2% and 33.1% and between 10.1% and 35.9%, depending on the time window of consumption (either 6 hours or 24 hours before injury, respectively). Low and medium levels of alcohol consumption generally were associated with the most AAFs. CONCLUSIONS: This study underscores the implications of even low levels of alcohol consumption on the risk of sustaining injuries through any of the mechanisms considered. Substantial AAFs are reported for each mechanism, particularly for injuries resulting from interpersonal violence. Observation of a so-called preventive paradox phenomenon is discussed, and prevention or intervention measures are described.

Abstract: Study aim: To describe the clinical characteristics of Ecstasy (3,4-Methylenedioxymethamphetamine, MDMA) toxicity. Methods: Retrospective case-study of 52 selfreported Ecstasy intoxications presenting to our Emergency Department (ED) between January 2001 and December 2003. Results: Most patients ingested Ecstasy together with other substances, including alcohol (51.9%) or other illicit drugs (71.1%). Medical problems leading to ED presentation were collapse or loss of consciousness (36.5%), palpitations (19.2%), dizziness or weakness (15.4%), and anxiety (13.5%). When other drugs were used in combination with Ecstasy the clinical presentation significantly changed. Panic reactions were observed in 4 of 13 patients with cocaine co-use (30.7%), compared to 3 of 39 patients without cocaine use (7.7%). Deep coma was found in 11 of 16 patients with co-use of gamma-hydroxybutyrate (GHB) or opiates (68.8%) but in none of the 36 patients who took Ecstasy without these drugs. Most patients were monitored in the ED. Six patients (11.5%) were transferred to an intensive care unit. Medical complications were severe in five patients and included cardiac arrest, hyperthermia, rhabdomyolysis, disseminated intravascular coagulation, renal insufficiency and liver failure, seizures, and one fatal outcome. Conclusions: The clinical picture of Ecstasy related problems is complicated by multiple drug ingestion. Co-use of cocaine induces panic reactions. Co-use of GHB or opiates results in depressed levels of consciousness.

Abstract: Happy hours, soirées tout à cinq francs, ladies nights ou deux consommations pour le prix d’une: les offres promotionnelles des cafés, bars et restaurants incitent les clients à boire davantage pour moins cher. Elles attirent notamment les jeunes consommateurs, sensibles aux prix. Addiction Info Suisse demande donc une stricte interdiction de toutes les réductions de prix sur l’ensemble des boissons alcooliques.

Abstract: Il porte un nom de médicament et il est vendu comme “sel de bain” ou “engrais”. C’est en fait un puissant stupéfiant.