Sunday, October 3, 2010

Beer and Wiesn

'Tis the season of beer. Last week I went over to an Oktoberfest event to celebrate with some sweet treats and bitter libations. The fact that there was a German band singing American cover songs in German just made it all that much more enjoyable. So I decided to type the search term "oktoberfest" into both PubMed and Web of Science to see what popped up. The first return was something dealing with the pancreas -- nah. The second, however, was just the kind of thing I was looking for.

Web of Science returned an article from the Archives of Toxicology titled "Munich Oktoberfest experience: remarkable impact of sex and age in ethanol intoxication." Bingo!

Oktoberfest traditionally starts in the third weekend in September and ends the first Sunday of October. So today is the last day to celebrate, make it a good one. According to Munich's Oktoberfest History Page, when Crown Prince Ludwig (later King Ludwig I) married Princess Therese of Saxony-Hildburghausen on October 12, 1810 the citizens of Munich were invited to attend the festivities. These festivities were held on the fields in front of the city gates, fields that were later renamed Theresienwiese, or "Theres'a Fields," (now just called "Wiesn") to honor the princess. The royal family attended horse races at the close of the event, and the decision to repeat the races annually gave rise to the tradition of Oktoberfest. In subsequent years other attractions and activities were added such as an agricultural show, carosels and swings, and beer stands. Today Oktoberfest is the largest celebration in the world!

According to the article, approximately 6 million individuals visited Oktoberfest in Munich in 2004. About 5,000 of these individuals had to undergo medical treatment for various reasons. Intoxication, as you probably surmised, is one of the biggest concerns when a patient seeks medical attention. This study took a look at the large number of individuals suffering from alcohol intoxication with the goal to identify risk factors and optimize patient management.

The researchers collected data on 405 intoxicated individuals (with no other trauma or complications). Such data included age, gender, and a medical examination. The Glasgow Coma Score (GCS) was used both at check-in and check-out to assess level of consciousness. Then patients received an intravenous (IV) infusion of either 500 ml Ringer-Lactate solution (a fluid and electrolyte replenisher) or 10% glucose solution depending on the results of a blood glucose test. Then blood pressure (mean, systolic, and diastolic), heart rate, body temperature, respiratory rate, blood glucose, oxygen saturation, and acid-base balance were monitored.

The results showed that the higher the GCS level the more likely the patient was to be hospitalized. Not all that surprising since the higher the GCS the lower the consciousness. They also found a that men have a strongly increased risk of hospitalization when compared to women. Age was also a factor with individuals between 20-29 years old having a higher risk than all other age groups. The researchers called these results surprising, but, well, I've been in enough bars to call them rather unrevealing.

However, there was one point in their paper that I found rather interesting. Although the 20-29 male age group were found to be at the highest risk they actually showed lower blood ethanol concentrations when compared to men aged 30-39 years and 40-49 years. The 20-29 year old men's blood ethanol concentratrions also did not differ significantly from that of 20-29 year old women. Why? Its hard to say. The researchers were unable to exclude higher biological susceptibility to alcohol toxicity from their study, although this particular age group is known for their "general robustness" (*snigger*). The authors conclude that "a plausible explanation might be that young individuals, especially young men, tend to ignore their individual critical limits of ethanol intoxication. Peer pressure and lack of experience may be responsible for this behaviour." I probably didn't need a scientific study to tell me that.

Here's the paper:
Binner, C., et al. (2008) Munich Oktoberfest experience: remarkable impact of sex and age in ethanol intoxication. Archives of Toxicology: 82, 933-939. (DOI: 10.1007/s00204-008-0373-z)

Hope you had a great Oktoberfest!
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