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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Forensic Medicine</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Forensic Medicine</journal-title><trans-title-group xml:lang="ru"><trans-title>Судебная медицина</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2411-8729</issn><issn publication-format="electronic">2409-4161</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">709</article-id><article-id pub-id-type="doi">10.17816/fm709</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Original study articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Оригинальные исследования</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="zh"><subject>原创研究</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Alcohol and children: clinical and forensic study</article-title><trans-title-group xml:lang="ru"><trans-title>Алкоголь и дети: клиническое и судебно-медицинское исследование</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>酒精和儿童：临床和法医研究</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0232-0425</contrib-id><contrib-id contrib-id-type="spin">4347-1925</contrib-id><name-alternatives><name xml:lang="en"><surname>Plis</surname><given-names>Semyon S.</given-names></name><name xml:lang="ru"><surname>Плис</surname><given-names>Семен Сергеевич</given-names></name><name xml:lang="zh"><surname>Plis</surname><given-names>Semyon S.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>SSPlis.work@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6704-1830</contrib-id><contrib-id contrib-id-type="spin">7043-7743</contrib-id><name-alternatives><name xml:lang="en"><surname>Kovalenko</surname><given-names>Liliya A.</given-names></name><name xml:lang="ru"><surname>Коваленко</surname><given-names>Лилия Анатольевна</given-names></name><name xml:lang="zh"><surname>Kovalenko</surname><given-names>Liliya A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>к.м.н.</p></bio><email>lyla72@mail.ru</email><xref ref-type="aff" rid="aff2"/><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9486-5421</contrib-id><contrib-id contrib-id-type="spin">9188-2988</contrib-id><name-alternatives><name xml:lang="en"><surname>Veselkina</surname><given-names>Olesya V.</given-names></name><name xml:lang="ru"><surname>Веселкина</surname><given-names>Олеся Валерьевна</given-names></name><name xml:lang="zh"><surname>Veselkina</surname><given-names>Olesya V.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ves-olesya@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0274-7461</contrib-id><name-alternatives><name xml:lang="en"><surname>Dolginov</surname><given-names>Dmitry M.</given-names></name><name xml:lang="ru"><surname>Долгинов</surname><given-names>Дмитрий Маркович</given-names></name><name xml:lang="zh"><surname>Dolginov</surname><given-names>Dmitry M.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>к.м.н.</p></bio><email>ddm2@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7578-911X</contrib-id><contrib-id contrib-id-type="spin">5446-6252</contrib-id><name-alternatives><name xml:lang="en"><surname>Ostapenko</surname><given-names>Yury N.</given-names></name><name xml:lang="ru"><surname>Остапенко</surname><given-names>Юрий Николаевич</given-names></name><name xml:lang="zh"><surname>Ostapenko</surname><given-names>Yury N.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>к.м.н.</p></bio><email>rtiac@mail.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5203-549X</contrib-id><contrib-id contrib-id-type="spin">9178-2868</contrib-id><name-alternatives><name xml:lang="en"><surname>Vlassov</surname><given-names>Vasily V.</given-names></name><name xml:lang="ru"><surname>Власов</surname><given-names>Василий Викторович</given-names></name><name xml:lang="zh"><surname>Vlassov</surname><given-names>Vasily V.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>д.м.н., профессор</p></bio><email>vvlassov@hse.ru</email><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5693-4054</contrib-id><contrib-id contrib-id-type="spin">2015-6548</contrib-id><name-alternatives><name xml:lang="en"><surname>Klevno</surname><given-names>Vladimir A.</given-names></name><name xml:lang="ru"><surname>Клевно</surname><given-names>Владимир Александрович</given-names></name><name xml:lang="zh"><surname>Klevno</surname><given-names>Vladimir A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>д.м.н., профессор</p></bio><email>vladimir.klevno@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Moscow Regional Research and Clinical Institute</institution></aff><aff><institution xml:lang="ru">Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского</institution></aff><aff><institution xml:lang="zh">Moscow Regional Research and Clinical Institute</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Filatov N.F. Children’s City Hospital</institution></aff><aff><institution xml:lang="ru">Детская городская клиническая больница имени Н.Ф. Филатова</institution></aff><aff><institution xml:lang="zh">Filatov N.F. Children’s City Hospital</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Russian Medical Academy of Continuous Professional Education</institution></aff><aff><institution xml:lang="ru">Российская медицинская академия непрерывного профессионального образования</institution></aff><aff><institution xml:lang="zh">Russian Medical Academy of Continuous Professional Education</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Russian Centre of Forensic Medical Expertise</institution></aff><aff><institution xml:lang="ru">Российский центр судебно-медицинской экспертизы</institution></aff><aff><institution xml:lang="zh">Russian Centre of Forensic Medical Expertise</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">Research and Applied Toxicology Centre</institution></aff><aff><institution xml:lang="ru">Научно-практический токсикологический центр</institution></aff><aff><institution xml:lang="zh">Research and Applied Toxicology Centre</institution></aff></aff-alternatives><aff-alternatives id="aff6"><aff><institution xml:lang="en">Higher School of Economics</institution></aff><aff><institution xml:lang="ru">Национальный исследовательский университет «Высшая школа экономики»</institution></aff><aff><institution xml:lang="zh">Higher School of Economics</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2022-08-26" publication-format="electronic"><day>26</day><month>08</month><year>2022</year></pub-date><pub-date date-type="pub" iso-8601-date="2022-09-15" publication-format="electronic"><day>15</day><month>09</month><year>2022</year></pub-date><volume>8</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>13</fpage><lpage>22</lpage><history><date date-type="received" iso-8601-date="2022-03-24"><day>24</day><month>03</month><year>2022</year></date><date date-type="accepted" iso-8601-date="2022-07-25"><day>25</day><month>07</month><year>2022</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2022, Plis S.S., Kovalenko L.A., Veselkina O.V., Dolginov D.M., Ostapenko Y.N., Vlassov V.V., Klevno V.A.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2022, Плис С.С., Коваленко Л.А., Веселкина О.В., Долгинов Д.М., Остапенко Ю.Н., Власов В.В., Клевно В.А.</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2022, Plis S., Kovalenko L., Veselkina O., Dolginov D., Ostapenko Y., Vlassov V., Klevno V.</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="en">Plis S.S., Kovalenko L.A., Veselkina O.V., Dolginov D.M., Ostapenko Y.N., Vlassov V.V., Klevno V.A.</copyright-holder><copyright-holder xml:lang="ru">Плис С.С., Коваленко Л.А., Веселкина О.В., Долгинов Д.М., Остапенко Ю.Н., Власов В.В., Клевно В.А.</copyright-holder><copyright-holder xml:lang="zh">Plis S., Kovalenko L., Veselkina O., Dolginov D., Ostapenko Y., Vlassov V., Klevno V.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2025-01-01"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://for-medex.ru/jour/article/view/709">https://for-medex.ru/jour/article/view/709</self-uri><abstract xml:lang="en"><p><italic><bold>BACKGROUND:</bold> </italic>This study aimed to evaluate the differences in the clinical pictures in the group of alcohol intoxication (without the loss of conscious) and alcohol poisoning (with the loss of conscious).</p> <p><bold><italic>AIMS:</italic> </bold>This study aimed to investigate the clinical differences in the groups of alcohol intoxication (without loss of consciousness) and alcohol poisoning (with loss of consciousness) and determine the level of blood ethanol concentrations in children and adolescents from alcohol intake that causes a loss of consciousness, which means ethanol poisoning occurrence, and finally, offer practical recommendations for forensic doctors in cases of alcohol poisoning in children.</p> <p><bold><italic>MATERIALS AND METHODS: </italic></bold>The total amount of data was a combination of two studied populations: population No. 1 from the archive of the Bureau and population No. 2 from the Children’s Clinical Hospital No. 13 named after N.F. Filatov. The study is a retrospective population-based and prospective (observational) cross-sectional study. Data were grouped as (1) persons whose alcohol intake did not cause significant health disorders (alcohol intoxication) and (2) persons whose alcohol intake caused the onset of coma, respiratory arrest, or death (alcohol poisoning). Urine screening for psychoactive and narcotic substances was conducted using liquid chromatography-tandem mass spectrometry.</p> <p><italic><bold>RESULTS:</bold> </italic>The data set included 67 minors aged 11–17 years. Blood and urine ethanol levels of males and blood of females were significantly higher than in patients with alcohol intoxication. The objective status of patients was the same. No differences were found in alcohol pharmacokinetics (resorption and elimination), as well as the instrumental parameter readings. The present study revealed that alcohol intoxication and poisoning were not associated with dangerous changes in such parameters as systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate.</p> <p><bold><italic>CONCLUSION:</italic></bold> The results showed that ethanol poisoning in children aged 11–17 years old developed at an ethanol concentration of 2.61 g/L in the blood and 3.01 g/L in the urine. Additionally, no significant differences were found in the instrumental parameters.</p></abstract><trans-abstract xml:lang="ru"><p><bold><italic>Обоснование.</italic> </bold>Согласно клиническим рекомендациям, состояние, не сопровождающееся потерей сознания после употребления этилового спирта, расценивается как алкогольное опьянение.</p> <p><italic><bold>Цели исследования</bold> ― </italic>изучить различия клинической картины в группах алкогольной интоксикации (без утраты сознания) и отравления алкоголем (с утратой сознания); определить, при каких концентрациях этанола в крови у детей и подростков вследствие приёма алкоголя развивается утрата сознания, а значит, наступает отравление этанолом.</p> <p><bold><italic>Материал и методы.</italic></bold> Совокупный объём данных представлял собой сочетание двух исследуемых популяций: для популяции № 1 данные получены из архива Бюро, для популяции № 2 ― в ДГКБ № 13 имени Н.Ф. Филатова. Исследование имело комбинированный дизайн и состояло из ретроспективного популяционного и проспективного (обсервационного) поперечного исследования. Данные были сгруппированы по категориям: (1) лица, у которых приём алкоголя не вызвал значительных расстройств здоровья (алкогольная интоксикация); (2) лица, у которых приём алкоголя обусловил наступление комы, остановки дыхания или смерти (отравление алкоголем). Образцы исследовались с использованием хроматографов; скрининг мочи на психоактивные и наркотические вещества проводился с использованием тандемной масс-спектрометрии.</p> <p><bold><italic>Результаты.</italic> </bold>Набор данных совокупно включал в себя сведения о 67 несовершеннолетних в возрасте от 11 до 17 лет. В группе отравления алкоголем значительно преобладали лица мужского пола. Концентрация этанола в крови и моче у лиц мужского, а также в крови у лиц женского пола при отравлении была значительно выше, чем при алкогольной интоксикации. Каких-либо значимых различий в объективном статусе пациентов, помимо нарушения сознания, не наблюдалось. Различий в фазе фармакокинетики алкоголя (резорбция, элиминация) не получено. Значимых различий в инструментальных показателях также не наблюдалось. Алкогольная интоксикация и отравление алкоголем в нашем исследовании не сопровождались опасными изменениями таких показателей, как систолическое и диастолическое артериальное давление, частота сердечных сокращений и дыхательных движений. Отравление развивалось в среднем при концентрации этанола в крови 2,61 г/л, в моче ― 3,01 г/л, тогда как значительных отклонений в здоровье не наблюдалось при средней концентрации этилового спирта 1,38 г/л в крови и 1,96 г/л в моче.</p> <p><bold><italic>Заключение.</italic></bold> Нами сформулированы практические рекомендации для врачей – судебно-медицинских экспертов по случаям отравления детей алкоголем.</p></trans-abstract><trans-abstract xml:lang="zh"><p><bold>研究现实性：</bold>根据临床指南，饮酒后不伴有意识丧失的状态被视为酒精中毒。</p> <p><bold>目的：</bold>研究酒精中毒（无意识）和酒精中毒（无意识）组临床模式的差为了确定血液中乙醇的浓度，在儿童和青少年中，由于摄入酒精，会出现意识丧失，这意味着发生乙醇中毒。在儿童酒精中毒的情况下为法医提供实用的建议。</p> <p><bold>材料与方法</bold>。累积数据集是两个研究人群的组合：人口1–从局档案中获得的数据，人口2–在N.F. 菲拉托娃第13号国家安全局收到的数据。该研究采用组合设计，包括一项基于人群的回顾性研究和一项前瞻性（观察性）横断面研究。数据分组： (1) - 饮酒不会导致严重健康障碍（酒精中毒）的人； (2) - 饮酒导致昏迷、呼吸停止或死亡（酒精中毒）的人。使用液相色谱-串联质谱法对精神活性物质和麻醉物质进行了尿液筛查。</p> <p><bold>结果</bold>。该数据集共包括 67名11至17岁的未成年人。在该组中，酒精中毒以男性为主。男性和女性中毒时血液和尿液中乙醇的浓度明显高于酒精中毒。除了意识障碍外，患者的客观状态没有显著差异。酒精的药代动力学阶段（吸收、消除）没有差异。仪器指标也没有显著差异。在我们的研究中，酒精中毒和酒精中毒没有伴随着收缩和舒张血压、心率和呼吸运动等指标的危险变化。平均而言，血液中乙醇浓度为 2.61 克/升，尿液中乙醇浓度为 3.01 克/升。而在血液中的平均浓度为 1.38克/升和尿液中的平均浓度为 1.96克/升时，没有观察到健康的显着偏差。</p> <p><bold>结论。</bold>除了光反应外，我们没有获得关于患者客观状态差异的令人信服的数据。仪器指标也没有显著差异。酒精中毒儿童组和酒精中毒儿童组血液和尿液中乙醇浓度有显著差异。</p></trans-abstract><kwd-group xml:lang="en"><kwd>toxicology</kwd><kwd>children</kwd><kwd>alcohol intoxication</kwd><kwd>ethanol</kwd><kwd>infant</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>токсикология</kwd><kwd>дети</kwd><kwd>отравление алкоголем</kwd><kwd>этанол</kwd><kwd>несовершеннолетние</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>毒理学</kwd><kwd>儿童</kwd><kwd>酒精中毒</kwd><kwd>乙醇</kwd><kwd>未成年人</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">Federal clinical guidelines “Toxic effect of alcohol”. 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