Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.6.1.2 (alanine aminotransferase)
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It is well-known that early diagnosis in addiction leads to a better outcome and prevents psychosocial and medical illness and disability as well as costs. It would be important to have a gold standard for the diagnosis for alcoholism because of the consequences of this diagnosis for both the patient and the physician. In the last 15 years there were world-wide efforts to find biological markers for alcoholism and alcohol abuse. The results, however, were rather poor. With the exception of the relatively new and expensive CDT TEST (Carbohydrate-deficient transferrin) and some changes in established questionnaires (shortenings) we have used the same screening tests for decades. The relationship between the patient and the physician, a detailed medical history and experience of the physician cannot be replaced by tests. The Plinius Major Society recommends in its Guidelines the CAGE questionnaire. In medical settings and in primary care the MALT or AUDIT are more informative. As laboratory markers the Plinius Major Society still recommends: gamma-GT, MCV, GOT/GPT (ASAT/ALAT) and CDT. These tests are only useful if normal values of the particular laboratory are given.
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PMID:[Markers for excessive alcohol use (screening)]. 1080 74

By means of a case/control study, an attempt was made to identify the different questionnaires and biological tests which might be used in the General Practice consulting room for the detection of alcoholic patients. A comparison was made between the CABE, MALT, and Skinner questionnaires, and the MCV, AST, ALT, GGT triglyceride, cholesterol, uric acid, bilirubin and glycemia biological tests. Sensitivity, specificity, predictive value and diagnostic efficiency were studied in a group of 37 confirmed alcoholics and 25 controls making up a population with a high prevalence of alcoholism. Later we analysed the changes which affect the values of the different tests when applied to a population with a low prevalence of alcoholism, in other words, the utility of the tests in general practice was evaluated. The study concludes that the diagnostic performance of the questionnaires together with case history is higher than that of biological tests in general practice, and that the routine application tests in general practice, and that the routine application of the CAGE questionnaire and to a lesser extent of the Skinner questionnaire make it possible to identify those patients suspected of alcoholism and to improve the predictive value of the biological tests applied thereafter. Nevertheless further study is necessary to confirm the diagnostic effectiveness of these questionnaires in the general population of health centre patients.
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PMID:[A comparison between three questionnaires and laboratory tests for the detection of alcoholism in general practice]. 1698 53

A not moderate alcohol consumption or its abuse have relevant consequences not only on the health of the general population but also on the possibility to carry out any work in safety conditions. These behaviours have focused the attention of the institutions, which have promoted in the last years a growing number of preventive and informative actions and have adopted specific laws that have significantly involved the figure of occupational physician. Over the clinical implications, in fact, those behaviours, in the employment context, are associated with an increased risk of injuries (from 10 to 30% of total), an increase in the number of absences from work, with greater precariousness, with the possible interaction and/or strengthening of other occupational toxics and with the progressive reduction of working capacity. Diagnostic tools available for the detection of alcohol abuse or dependency consist, in acute cases by direct measuring of alcohol on blood, saliva and exhaled air, while in the chronic situations in addiction to the more traditional indicators (AST, ALT, GGT, MCV) there are recently introduced marker (CDT)--or in validation (ethyl glucuronide)--that representing, also with specific questionnaires (AUDIT, MAST, MALT, CAGE), useful integrated tools in the clinical-diagnostic path. The role and contribution of occupational medicine in the management of alcohol related problems is vital and relevant. Must be clear however that these are problems associated with a particular behaviour of the person and not with risks present on work-site.
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PMID:[Acute and chronic alcohol abuse and work]. 1928 91