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Query: UNIPROT:Q86TM3 (cage)
 29,987 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Substance abuse frequently accompanies and complicates serious traumatic brain injury (TBI). An important prerequisite to providing assistance to TBI patients is the ability to identify substance abuse accurately. The authors prospectively evaluated 10 consecutive admissions to a TBI program using four substance abuse screening tools: the CAGE questions, the Brief Michigan Alcohol Screening Test (BMAST), the Substance Abuse Subtle Screening Inventory, and the Addiction Severity Index. The CAGE questions and the BMAST were found to be easy to administer and very sensitive as well as specific for substance abuse in this population. The authors conclude that all patients with traumatic brain injuries should be screened for substance abuse by using either the CAGE questions or the BMAST.
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PMID:Screening patients with traumatic brain injuries for substance abuse. 804 35

The study examines the prevalence of high consumption of alcohol among the patients of a large university hospital, and the ability of physicians to detect heavy drinking. According to self-report, the results of CAGE questionnaire or the physicians' opinion, 25% of the male and 11% of the female patients were heavy drinkers. The physicians identified 43% and 26% of the men and women who screened positively either according to CAGE or self-report. On the other hand, 17% of the men and 14% of the women who were identified by the physicians as heavy drinkers had a negative screening result. Heavy drinking was most often connected with psychiatric disorders, but it was present in all specialties. A wide range of diagnoses were found among abusers. It is concluded that all patients in all clinics should be asked about their drinking habits instead of relying solely on the physician's instinct or on the patient's self-report or CAGE. More individual interviews should be done to make possible early intervention in heavy drinking.
Addiction 1993 Oct
PMID:Heavy drinking in hospital patients. 825 75

This is the second of a two-part report on a study aimed at investigating novel indicators of drinking problems among women drinkers. The study was motivated by the suspicion that most measures of drinking problems grew out of studies of male populations with the likelihood that such measures would be less relevant for female drinkers. The first part of this report describes the background for the study and the steps that were taken to generate a short list of "novel" indicators which were then incorporated into an instrument for a general population survey. Using several measures of alcohol consumption as criteria for evaluating the indicators, this paper reports on which indicators may uncover dimensions of alcohol problems not already subsumed by a standard population screen, the CAGE. In particular, results suggest that indicators of "high capacity for alcohol", "seeking out a 'wet' environment", and "planning opportunities to drink" are promising for both women and men, with more qualified support for less "frequent illness" (for women) and "excessive behavior" (for men). These results must be viewed within the context of an exploratory study and indicate avenues for further research.
Addiction 1996 Jul
PMID:Combining methods to identify new measures of women's drinking problems. Part II: The survey stage. 868 18

Based on a weighted aggregation of three biological alcohol markers (gamma-glutamyltransferase, blood alcohol and mean corpuscular volume), this study presents a screening instrument for alcohol problems in trauma patients. The sex-specific performance of this instrument was explored on 1088 male and 352 female patients, 18 years or older, admitted with blunt or penetrating trauma during a 30-month period to a regional level one trauma center in Seattle, Washington (USA). The sum of the differentially weighted alcohol markers ("WAM"), determined from one blood sample, formed a "score continuum" ranging from 0 to 24. The WAM scores distributed themselves across the trauma population with higher WAM scores being correlated to higher screening instrument scores for alcohol problems. By using two of the best established screening tests for alcohol problems (CAGE and SMAST) to define cut-off points for likely "alcohol abuse/dependence", the WAM score of > or = 7 in males showed 75% sensitivity and 83% specificity, whereas the WAM score of > or = 6 for females displayed 85% sensitivity and 85% specificity. We conclude that a weighted combination of biological alcohol markers (WAM score) is a useful tool for identifying alcohol problems among trauma patients. Representing an alternative or addition to a more extensive interview, it could be used as a routine part of the care of trauma patients.
Addiction 1996 Feb
PMID:The "WAM" score: sensitivity and specificity of a user friendly biological screening test for alcohol problems in trauma patients. 883 80

Unlike the pure opioids such as morphine and heroin, opium is a complex and variable mixture of substances reflecting differences in both the starting material and the traditional practices of the regions in which it is produced. Analytical methods have improved greatly in recent years, to the point that the source of a preparation can often be identified by its opioid content and its impurities. Daily amounts used, both by smoking and by mouth, vary widely from less than a gram to 30 g, equivalent to 75-3000 mg of morphine. The effects of opium are essentially those of morphine but unexpected toxicities, such as oesophageal cancer associated with "dross opium" and polyneuropathy due to deliberate addition of arsenic, are problems in some specific regions. Prevalence of use in different areas and countries is governed by the same factors of ease of availability, price and social acceptance that apply to the use of alcohol and other drugs in western countries. The risk of addiction to opium smoking appears to be somewhat less than to parenteral use of heroin, but appreciably greater than to alcohol. Even in countries where its use is traditional, opium smoking carries substantial risks of harm to health and social functioning.
Addiction 1997 Mar
PMID:Opium revisited: a brief review of its nature, composition, non-medical use and relative risks. 921 89

The objective of this study was to assess the perceptions and reported practices of osteopathic physicians in the diagnosis and treatment of addiction. Copies of survey questions were sent to the 344 members of the West Virginia Osteopathic Society. A total of 176 (51.2%) physicians responded; of these responses, 166 surveys were used for analysis. Respondents included 130 practicing physicians and 36 physicians in internship or residency training programs. Of those responding, 133 were men and 33 were women, and ages ranged from 24 to 81 years with a mean of 41.6 years. Respondents who were graduates of the West Virginia School of Osteopathic Medicine numbered 132 (79.5%), and 99 (59.6%) were in family practice. Characteristics most commonly attributed to addiction were a chronic nature and psychological or physical dependence. More than half of the test subjects did not consider addiction to be a primary disease independent of other factors or psychiatric conditions. Respondents reported a mean addiction prevalence of 20.4%, with the most common substances reported as tobacco, alcohol, and benzodiazapines, respectively. Individual prevalence reports varied from 0% to 95% (SD +/- 20.4%). The most commonly used diagnostic tools were the CAGE (Cut down, Annoyed, Guilty, and Eye-opener) test, DSM III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised) or DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) criteria, and quantity and frequency questions. Medical sequelae such as jaundice or emphysema were the most likely reasons for the respondents to address a substance abuse problem. For referral resources, respondents were most likely to use inpatient or outpatient treatment. A mean success rate of 27.7% was reported by the 133 physicians responding. The wide variance in reported prevalence and the low success rate reported in comparison to that demonstrated in published treatment studies indicate that there is a need for further education of both physicians in training and those presently in practice. Medical sequelae are frequently irreversible signs of late-stage addiction, and physicians should be urged to include such tools as the CAGE test in each regular physical to facilitate earlier intervention.
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PMID:Perceptions and reported practices of osteopathic physicians in diagnosing and treating addiction. 1052 83

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

The aim of this project was to approach subjects who committed parasuicide but did not primarily receive or accept a recommendation for care through the regular routines after referral to a general hospital. Three hundred and twenty-nine consecutive parasuicides in 10- to 89-year-olds (162 men and 167 women) were studied. One hundred were subsequently hospitalized in the departments of psychiatry, 130 were followed up at outpatient facilities, and 96 left without any follow-up. A psychiatric liaison consultation was made in 57% of the total sample. The 96 subjects without follow-up were compared with the subjects who received follow-up. The sample was somewhat younger and included slightly more men. They were single in 54% and unemployed in 43% of the cases. According to the DSM-IV, 27% had a concurrent depression. According to the CAGE questions, 57% had indication of substance addiction. Fifty-four per cent had currently low global functioning, less than 50 points on the GAF. They had not been in contact with psychiatric care previously to the same extent as the others. About 34% of these who did not receive or rejected follow-up initially after a second approach agreed to follow-up when contacted by the project team, referring them to appropriate authorities such as social welfare offices, family counselling, or psychosocial staff within psychiatry or primary care. This may imply that the group delineated is at risk for eventual suicide and that the acceptance of follow-up should be interpreted as an indication that a substantial number needs help and can be successfully encountered by means of a case manager approach.
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PMID:Parasuicides without follow-up. 1183 22

Receiver operating characteristics analysis and sensitivity analysis were used to compare the diagnostic accuracy of the Addiction Acknowledgement Scale (AAS; Weed, Butcher, McKenna, & Ben-Porath, 1992) and Addiction Potential Scale (APS; Weed et al., 1992) of the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to that of the MacAndrew Alcoholism Scale-Revised (Butcher et al, 1989), the CAGE (Mayfield, McLeod, & Hall, 1974), and Svanum's scale (Svanum & McGrew, 1995) in a sample of 338 university students. The AAS was the most accurate of these 5 scales at identifying current alcohol dependence (as measured by a structured diagnostic interview) and appears to offer considerable promise as an alcohol screening instrument. In contrast, the APS performed the most poorly of the 5 scales being evaluated, yielding results that would be of minimal clinical utility. Factor analysis yielded a 2-factor solution for the AAS (Acknowledgement of Alcohol/Drug Problems; Positive Alcohol Expectancies) and a 4-factor solution for the APS (Satisfaction with Self; Cynicism/Pessimism; Impulsivity; Risk-Taking).
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PMID:Diagnostic accuracy and factor structure of the AAS and APS scales of the MMPI-2. 1251 Oct 21

Ten percent of the population abuses drugs or alcohol, and 20 percent of patients seen by family physicians have substance-abuse problems, excluding tobacco use. These patients can be identified by relying on regular screening or a high index of suspicion based on "red flags" that can be noted in various clinical situations. The modified CAGE questionnaire is an excellent screening instrument, but several alternatives are available. The best screening test is one that the physician will routinely use well. Laboratory indicators such as gamma-glutamyl transpeptidase, mean corpuscular volume, and carbohydrate-deficient transferrin are nonspecific but can add to the evidence of alcohol abuse. If problem alcohol use is diagnosed, even brief physician advice can be helpful. If the problem has progressed to addiction, referral to an addiction specialist or treatment center is recommended. Special issues arise in dealing with substance abuse in adolescents, elderly patients, and patients with mental illness, but the family physician can play an important role in recognizing this common problem.
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PMID:Recognition of alcohol and substance abuse. 1272 54


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