How Brewery Fermentation Syndrome Can Teach Database Searching Lessons



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How Brewery Fermentation Syndrome Can Teach Database Searching Lessons

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Gut Fermentation Syndrome and a DUI Law Case Overturned:

A Lesson in How to do a Better Search

David Dillard

The Journal of Legal Nurse Consulting

Volume 27 Number 1 Spring 2016

http://www.aalnc.org/page/the-journal-of-legal-nurse-consulting

https://view.flipdocs.com/?ID=10004296_434248


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There was news report on CNN about a judge overturning a DUI
conviction because the high blood alcohol in the defendant
was caused by Gut Fermentation Syndrome. This article quickly
became more than a very interesting law case as curiosity caused
me to look further into this rare medical condition. My explorations
turned up some interesting lessons in database searching technique.

 

 

This is an excerpt of the CNN news report.

 

 

Woman Claims Her Body Brews Alcohol, Has DUI Charge Dismissed

 

By Sandee LaMotte

 

CNN

 

Updated 5:59 PM ET, Thursday December 31, 2015

 

 

http://tinyurl.com/gqys4vr

 

 

“(CNN) Imagine being charged with a DUI when it's been hours
since you've had a drink, only to later discover that your body
brews its own alcohol.

 

.

 

That's what happened to an upstate New York woman when she
blew a blood alcohol level more than four times the legal limit.
Just before Christmas in Hamburg, New York, a judge dismissed
the charges after being presented with evidence the woman suffers
from "auto-brewery syndrome."

 

.

 

"I had never heard of auto-brewery syndrome before this case,"
attorney Joseph Marusak told CNN on the condition his client's
identity remain anonymous. "But I knew something was amiss
when the hospital police took the woman to wanted to release her
immediately because she wasn't exhibiting any symptoms."

 

.

 

"That prompts me to get on the Internet and see if there is any sort
of explanation for a weird reading," adds Marusak. "Up pops
auto-brewery syndrome and away we go."

 

.

 

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Auto-brewery syndrome

 

From Wikipedia

 

https://en.wikipedia.org/wiki/Auto-brewery_syndrome

 

Auto-brewery syndrome, also known as gut fermentation syndrome,
is a rare medical condition in which intoxicating quantities of ethanol
are produced through endogenous fermentation within the digestive
system. One gastrointestinal organism, Saccharomyces cerevisiae,
a type of yeast, has been identified as a pathogen for this condition.

 

Claims of endogenous fermentation of this type have been used as a
defense against drunk driving charges.

 

One case went undetected for 20 years.

 

It has also been investigated, but eliminated, as a possible cause of
sudden infant death syndrome.

 

A variant occurs in persons with liver abnormalities that prevent
them from excreting or breaking down alcohol normally. Patients with
this condition can develop symptoms of auto-brewery syndrome even
when the gut yeast produces a quantity of alcohol that is too small to
intoxicate a healthy individual.

 

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In observing search results for “gut fermentation syndrome”,
a synonym for this condition, “auto brewery syndrome”, was also
discovered with an interesting lesson to be relearned and emphasized.
This exploration underscored the importance of including all possible
words and phrases when searching concepts, conditions or topics. 
Using synonyms increases and improves the reliability of search results. 
Below are links to each of these two phrases for this condition.

 

 

 

Gut Fermentation Syndrome FROM Google Scholar

 

http://tinyurl.com/zkoadpn

 

.

 

Gut Fermentation Syndrome FROM Google Books

 

http://tinyurl.com/jgpavvy

 

.

 

Gut Fermentation Syndrome FROM Google Domain Limited Web Search (PUBMED)

 

http://tinyurl.com/o2u3pkt

 

.

 

Auto-Brewery Syndrome FROM Google Domain Limited Web Search (PUBMED)

 

http://tinyurl.com/o4egupk

 

.

 

Auto-Brewery Syndrome FROM Google Scholar

 

http://tinyurl.com/jz7ju53

 

Sample Citations

 

Auto-brewery syndrome in a child with short gut syndrome:

case report and review of the literature

Author:  Dahshan, A

Journal:  Journal of pediatric gastroenterology and nutrition

ISSN:  0277-2116

Date:  2001  Volume: 33  Issue: 2  Page: 214

 

Jansson-Nettelbladt, E., Meurling, S., Petrini, B., and Sjin, J.

(2006). Endogenous ethanol fermentation in a child with short bowel syndrome.

Acta Paediatrica, 95(4), 502-504.

 

 

Production of ethanol from infant food formulas by common yeasts

Author:  BIVIN, W.S.

Journal:  Journal of applied bacteriology

ISSN:  0021-8847

Date:  04/1985  Volume: 58  Issue: 4  Page: 355-357

DOI:  10.1111/j.1365-2672.1985.tb01473.x

 

"The quantities of ethanol produced suggest a possible explanation
for patients exhibiting the 'Auto-Brewery Syndrome' and raises
interest in the role auto-produced ethanol could have in explaining
the etiology of Sudden Infant Death"

 

.

 

Auto-Brewery Syndrome FROM Google Books

 

https://www.google.com/search?tbm=bks&hl=en&q=%22AUTO+BREWERY+syndrome%22+

 

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Gut Fermentation Syndrome FROM Penn State Summon Search

 

http://tinyurl.com/yc8kcywa

 

64 results

 

Newspaper Article (16)

Journal Article (5)

Magazine Article (2)

Transcript (1)

 

.

 

Auto-Brewery Syndrome FROM Penn State Summon Search

 

http://tinyurl.com/yckule6o

 

233 results  

 

Source Type

 

    Audio Recording (1)

    Book / eBook (23)

    Book Chapter (1)

    Book Review (2)

    Conference Proceeding (1)

    Dissertation (1)

    Journal Article (33)

    Magazine Article (2)

    Newspaper Article (75)

    Reference (1)

    Streaming Video (2)

    Transcript (1)

    Web Resource (1)

 

 

A reader finding the CNN article about the woman in New York
at the top of this post may have never heard of this medical
disorder and want to learn more.  If that reader found the auto
brewery syndrome alternative name for this condition and ignored it,
he would have this result in Google Scholar regarding sudden death. 
Even a search of gut fermentation syndrome in the Wikipedia leads
the reader to the article on Auto Brewery Syndrome.

 

http://tinyurl.com/hnucdqc

 

Google Scholar

 

“Your search - "gut-fermentation syndrome" AND
("sudden death" OR "sudden infant death") - did not match any articles.”

 

http://tinyurl.com/jyjppa2

 

Failure to add additional synonymous terminology into a search can
limit ones findings and miss important content. 
Searching "AUTO BREWERY syndrome" AND
("sudden death" OR "sudden infant death") in Google Scholar finds
30 results. Furthermore two of these articles are “cited by” 
from 22 to 25 other articles which may lead to further research studies
that discuss this syndrome in conjunction with sudden infant death
syndrome.  This is why it is very important to include and text search
all found variants of terminology for a topic on which one is doing research.

 

The search strategy:

 

"AUTO BREWERY syndrome" AND ("sudden death" OR "sudden infant death")

 

Link to this search:

 

http://tinyurl.com/gwfpyok

 

Some of the sources found:

 

Endogenous alcohol production by intestinal fermentation in sudden infant death

P Geertinger, J Bodenhoff, K Helweg-Larsen - Zeitschrift f , 1982 - Springer

... N, Hisamura M, Murao M, Toshida T, Takahashi K (1976) The auto-brewery syndrome m the

repeated attacks of alcohol intoxication due to the over- growth of Candida albicans in the

gastrointestinal tract. Materia Med Pol 29 : 1-7 4. Geertinger P (1968) Sudden death in infancy. ...

Cited by 22 Related articles All 4 versions Cite Save

 

 

 

[PDF] from hindawi.com

Dysautonomia in autism spectrum disorder: case reports of a family with review of the literature

D Lonsdale, RJ Shamberger - Autism research and , 2011 - hindawi.com

... JN Barker, F. Jordan, DE Hillman, and O. Barlow, Phrenic nerve thiamin and neuropathy in

Sudden Death Infants, in Thiamin: Twenty Years of ... at Publisher  View at Google Scholar  View

at PubMed; H. Kaji, Y. Asanuma, and H. Ide, The auto brewery syndrome: the repeated ...

Cited by 3 Related articles All 11 versions Cite Save More

 

 

 

[PDF] from lsu.edu

DEVELOPMENT OF THE NEONATAL RAT AS A MODEL
FOR SUDDEN INFANT DEATH SYNDROME: CARDIORESPIRATORY EFFECTS OF

RW Stout - 2003 - etd.lsu.edu

... Utilizing weanling gnotobiotic rats, combinations of nasal bacterial isolates obtained from

SIDS cases caused sudden death, with lesions similar ... overgrowth of gastrointestinal yeast

in a condition known as Auto-Brewery Syndrome (Kaji et al., 1976). ...

Related articles Cite Save More

 

 

 

[HTML] from comprehensivephysiology.com

Exercise and type 1 diabetes (T1DM)

P Galassetti, MC Riddell - Comprehensive Physiology, 2013 - Wiley Online Library

... Easy fatigability. Lack of energy. Neck or jaw discomfort. Shoulder pain with a history similar

to bursitis and related to activity. The most feared risk of initiating a physical activity regimen

is sudden death secondary to an arrhythmia or an ischemic event. ...

Cited by 24 Related articles All 4 versions Cite Save More

 

 

 

[HTML] from stevensponauglewordpress.com

[HTML] stevensponauglewordpress. com

J Douglas, S Staff, RM from This - stevensponauglewordpress.com

Related articles Cite Save More

 

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Furthermore, one may search this topic using both phrases in Summon,
perhaps because this research is being conducted for use for medical or
legal cases and needs to be vetted for source quality.  If one limits the
Summon search to journal articles of which there are 35, one can then
limit those found articles to the ones that are peer reviewed and learn
that 29 of these 35 articles are in fact peer reviewed according to Summon. 
One can then search these article titles, if desired, in Google Scholar to
learn what additional sources have cited these peer reviewed journal
articles.

 

Peer Reviewed Auto-Brewery Journal Articles FROM Penn State Summon Search

 

http://tinyurl.com/yd3stu5j

 

.

 

This article was found in the peer reviewed results in the Summon search.

 

Auto-Brewery Syndrome in a Child With Short Gut Syndrome

 

This link finds Google Scholar search results for a title search of this article:

 

"Auto-Brewery Syndrome in a Child With Short Gut Syndrome:
Case Report and Review of the Literature"

 

About 30 results

 

http://tinyurl.com/ogjt5kk

 

.

 

Searching without the article subtitle leads to this result.

 

"Auto-Brewery Syndrome in a Child With Short Gut Syndrome"

 

About 35 results

 

This is a case where too much information diminishes the amount
of content one finds in the search result. Excluding subtitles in title
searches can produce more search results. Some citing sources may
not have included article subtitles in citing a sources.

 

A search of these concepts in the TRIP database found a null result
and so there is no evidence based sources to be found using TRIP on
this subject as described by these two phrases for the auto-brewery topic

.

.

 

One can, however, add “evidence based” to the search in Google Scholar
and get this result of three found sources.:

 

.

 

"AUTO BREWERY syndrome" AND ("sudden death" OR "sudden infant death")
AND "EVIDENCE BASED"

 

3 results

 

Endogenous ethanol production in patients
with Diabetes Mellitus as a medicolegal problem

M Simic, N Ajdukovic, I Veselinovic, M Mitrovic -
Forensic science , 2012 - Elsevier

... Abnormal gut fermentation: the Auto-Brewery Syndrome. Can. ...
Endogenous alcohol production by intestinal fermentation in sudden
infant death. ... Evidence-based survey of the elimination rates of
ethanol from blood with applications in forensic caseworks. Forensic Sci. ...

Cited by 7 Related articles All 8 versions Cite Save

 

.

 

Dysautonomia in autism spectrum disorder: case reports
of a family with review of the literature

D Lonsdale, RJ Shamberger - Autism research and , 2011 - hindawi.com

... as demonstrated in the phrenic nerve of a victim of
Sudden Infant Death Syndrome (SIDS ... behavior from yeast presence
has been referred to as the auto-brewery syndrome [65], also ...
Hillman, and O. Barlow, Phrenic nerve thiamin and neuropathy
in Sudden Death Infants, in ...

Cited by 3 Related articles All 11 versions Cite Save More

 

.

 

Exercise and type 1 diabetes (T1DM)

P Galassetti, MC Riddell - Comprehensive Physiology, 2013 - Wiley Online Library

... Sudden death may be more likely to occur when underlying coronary disease is undiagnosed,

and undiagnosed CAD is particularly common in persons with T1DM who have been living ... A

pertinent evidence-based review on screening procedures was published recently (254). ...

Cited by 24 Related articles All 4 versions Cite Save More

 

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Looking at these results, one might become interested as well
in looking at the relationship between this syndrome and
diabetes, a chronic illness.

 

Here is a link to what Google Scholar has to offer:

 

http://tinyurl.com/nlyqocq

 

(80 results)

 

.

 

A Google Domain Limited Web Search (PUBMED) of these names
for this condition in conjunction with diabetes turns up a far

greater output, over 600 results.

 

("Gut Fermentation Syndrome" OR "AUTO BREWERY syndrome")

AND diabetes AND SITE: PUBMED

 

http://tinyurl.com/hooehv6

 

.

 

Penn State Summon Search finds only 39 sources in a search
of the name of this syndrome, but one source listed in the
results uses the phrase ”Endogenous ethanol production in
patients” in the article title.

 

http://tinyurl.com/yaqhs9t8

 

As in this example:

 

Endogenous ethanol production in patients with Diabetes
Mellitus as a medicolegal problem

by Simic, M; Ajdukovic, N; Veselinovic, I; more...

Forensic Science International, 03/2012, Volume 216, Issue 1-3

 

Searching this new phrase in Google Scholar leads to this link
to a set of 14 results that are cited by over 100 more sources.

 

http://tinyurl.com/qx4l2rl

 

Returning to our lesson about too much information, searching
just the phrase “Endogenous ethanol production” and dropping
“in patients” finds 242 results. Here again, less is much more in
a phrase search.

 

The auto-brewery condition, to the extent it causes diabetes as
well as any other debilitating diseases, is a serious concern for
being a root cause for creating some increase in the number and
perhaps the earlier onset of long term care cases, even though this
is considered a rare disease. Also one might know a great deal less
about this condition if one only uses one phrase as its name  to learn
about it.  Apply these methods of synonym use and keeping phrases
to their shortest essential wording to your future searching and you
will probably learn significantly more about the subject you are
investigating. It will also expand your knowledge if you find sources
that cite an article or book you decide is very useful in your research.

 

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David Dillard

Temple University

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jwne@temple.edu

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