Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:Q86TM3 (cage)
 29,987 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

150 males imprisoned for drunken driving were assessed by means of a questionnaire and medical examination. The objectives were to study alcohol consumption and frequency of alcohol-related problems. Half of the assessed persons were less than 30 years of age. 62% had a blood alcohol concentration > 1.50%. 36% had previously been convicted for drunken driving. Average alcohol consumption was 58 gram per day. 40% of the convicted persons reported a consumption of more than 40 gram alcohol per day. Corrected for under-reporting the consumption was even higher. The CAGE questionnaire was positive in 54%, indicating an alcohol-related problem. GGT (gamma-glutamyltransferase) was elevated in 23% and CDT (carbohydrate deficient transferrin) in 35%. This study indicates that 50-60% of convicted drunken drivers were excessive drinkers or/and had alcohol-related problems. Imprisonment and fines seem to have a limited impact on occurrence of drunken driving. Other strategies are discussed.
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PMID:[Alcohol consumption among convicted drivers]. 146 98

Alcohol is a major cause of morbidity and mortality in Britain. Consultation, questionnaires and laboratory tests may all be used to help identify alcohol abuse and thereby prevent and treat alcohol-related problems. Consultation which can identify 80% of alcohol abusers involves recording the findings of alcohol and general histories and physical examination. The accuracy of the assessment depends on the reliability of the respondent and the respondent's relations and friends, and on the skill of the investigator; however, thorough assessment is time-consuming and expensive. Questionnaires may identify up to 80% of alcoholics. They are generally based on the Michigan Alcohol Screening Test and CAGE questionnaires and are simple, rapid to complete, inexpensive and not dependent on skilled investigators; however, the principal disadvantage of using questionnaires is that a personal relationship is not developed with the subject. Finally, simple and complex laboratory tests may be used. Of the simple laboratory tests, raised GGT or MCV levels are the most useful and when these values are combined, 90% of alcoholics may be identified correctly. Complex laboratory tests may exhibit greater sensitivity and specificity and provide useful additional information; however, their restricted availability limits their widespread use. The value of each of these methods depends on the objective of the assessment. For population surveys, questionnaires are of greatest relative value and consultation and laboratory tests may be used to confirm the presence of alcohol abuse. In general practice and the hospital setting, it is imperative to include questions on alcohol intake and alcohol-related problems in all interviews with patients. Laboratory tests may be used to confirm suspected alcohol abuse and questionnaires may provide useful screening tools. Finally, in the specialist alcohol unit, consultation, questionnaires and laboratory investigations are all important for identifying alcohol abuse. In this setting, consultation is of particular importance and the alcohol history and physical examination should be recorded by a skilled investigator and the results confirmed with relatives and close friends. Questionnaires are useful as initial screening or assessment tools and computer-based systems may facilitate data collection. Simple and complex laboratory tests may be used to confirm the diagnosis and help ascertain the extent of disease. By assuming that 'all patients have alcohol-related problems until proven otherwise', and through the appropriate application of consultation, questionnaires and laboratory tests, identification of excessive alcohol consumption and the prevention of its sequelae will be facilitated.
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PMID:The relative value of consultation, questionnaires and laboratory investigation in the identification of excessive alcohol consumption. 208 52

The purpose of this paper was to study the frequency of alcohol abuse among injured patients between 15 and 64 years of age. This prospective study was made during a 6-week period in the autumn of 1983. The sample consisted of 166 patients (6.8 per cent of the total number of injured patients during the period of study). The patients were interviewed and one part of the questionnaire took the form of four CAGE questions. Among these 166 patients, 31.3 per cent were CAGE positive. Of these alcohol abusers, four-fifths were male and one-fifth female. CAGE-positive patients had elevated S-GGT and S-ASAT in 44 per cent of cases and elevated S-ALAT in 24 per cent. The large number of heavy drinkers found are an important target of alcohol education.
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PMID:The assessment of alcohol abuse among injured patients. 377 Sep 41

Chemical dependence is a leading cause of morbidity and death in the United States. At least 20% of patients seen by primary care physicians in both the outpatient and inpatient setting are chemically dependent. Up to 90% of these patients go undiagnosed by their primary physicians. Chemical dependence is defined as a chronic, progressive illness characterized by the repeated and persistent use of alcohol or drugs despite negative health, family, work, financial, or legal consequences. Primary care physicians are in an ideal position to detect chemical dependence at its earliest stages, when irreversible medical consequences and death are most likely preventable. Alcohol is the most common drug of abuse. Improving the rate of recognition of chemical dependence depends on being familiar with the constellation of physical, mental, and social indicators. Early medical manifestations of alcoholism common in the primary care setting include: gastric complaints, elevated blood pressure, palpitations, traumatic injuries, headaches, impotence, and gout. Early psychosocial manifestations common in both alcohol and drug dependence include anxiety, depression, insomnia, persistent relationship conflicts, work or school problems, and financial or legal problems. Particularly useful laboratory indicators of alcoholism include elevated levels of GGT and MCV, both displaying high specificity, with the GGT level being the most sensitive. Similarly specific laboratory tests for drug dependence are not available. Any patient presenting with any of the above medical, psychosocial, or laboratory manifestations should be screened for chemical dependence. The CAGE questionnaire for alcoholism, a four-question test, is particularly well suited to the primary care setting, where it can be administered in fewer than 60 seconds. The CAGE has demonstrated high sensitivity (in the 80% range) and specificity (approximately 85%) for alcoholism. Comparably convenient instruments do not yet exist for drug dependence, although a 28-item instrument, the DAST (Drug Abuse Screening Test), has demonstrated high sensitivity and specificity for drug abuse.
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PMID:Early recognition of chemical dependence. 846 47

Naltrexone (NTX) has been shown to be a useful drug for the treatment of alcohol dependence (AD). Carbohydrate-deficient transferrin (CDT) in serum is a new biologic marker of alcohol abuse. To evaluate the efficacy of NTX (50 mg/d) in AD, a group of 20 alcoholics with CDT > 20 U/l was studied using monthly laboratory tests (CDT, ESR, AST, ALT, GGT) and specific psychological testing (CAGE). After the second month statistically significant differences in CDT levels were found. By the end of the study, 13 patients (responders) had normalized their CDT levels. There was no correlation between CDT values and the other laboratory markers. The difference in routine laboratory markers between responders and non responders was not significant. NTX was well tolerated by all the patients and significant alcohol abstinence was achieved. CDT was demonstrated to be a effective marker for the evaluation of alcoholic abstinence during treatment with NTX. Superior results were obtained in comparison with the routine customary markers for AD.
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PMID:[Evaluation of the efficacy of naltrexone in alcoholism by the determination of serum carbohydrate-deficient transferrin]. 867 1

In the US, about 11% to 20% of patients presenting to general medical clinics are diagnosed as suffering from alcohol abuse or dependence. Alcohol screening in primary care settings, whether in the US or Singapore, can utilise various strategies for the early detection of alcohol problems. This paper briefly reviews several self-reports and screening procedures to assist general practitioners in identifying problem drinkers. The use of CAGE questionnaire, MAST, and its variation, SAAST and the AUDIT, are discussed and evaluated. Likewise, useful biochemical markers of excessive alcohol consumption like the liver enzymes (AST, ALT, GGT), MCV, CDT are described. They can be combined with each other to improve validity or used in conjunction with self-report screening tests for more accurate detection of problem drinkers. In particular, use of the AUDIT for routine screening of alcohol problems in primary care settings is recommended. Selective administration to those with at least two drinks per setting can overcome time constraints. Alternatively, sequential screening utilising the TRAUMA questionnaire with frequency and quantity questions administered to higher frequency drinkers can circumvent concerns about direct questioning. Use of self-reports and when possible, biochemical screening for alcohol problems should be a standard part of primary care practice.
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PMID:What you need to know: detecting alcohol problems in general medical practice. 955 5

We evaluated the diagnostic usefulness of carbohydrate-deficient transferrin (CDT) for detecting alcohol-related problems (ARP) in hospitalized patients, assessed potential differences according to gender and age, and compared this value to the other screening measures conventionally used, namely the CAGE questionnaire and standard biological markers MCV (mean corpuscular volume) and GGT (gamma-glutamyltransferase). CDT sensitivity for detecting ARP was 70%, specificity 75% and area under the receiver operating characteristic curve 0.76%. Its sensitivity was shown to be lower both in the female group (65 vs 71%) as well as in the younger-age group whereas its specificity was lower in the liver-damaged group (55%). CDT diagnostic value did not exceed that of CAGE (sensitivity 78% and specificity 99%), MCV (sensitivity and specificity 74%) or GGT (sensitivity 82% and specificity 53%) but was better than those of other biochemical measures. We conclude that CDT is an effective biological marker for the detection of ARP among hospitalized patients, but that its diagnostic usefulness does not exceed that of some other alternative measures commonly used.
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PMID:Diagnostic usefulness of carbohydrate-deficient transferrin for detecting alcohol-related problems in hospitalized patients. 1137 66

Chronic alcohol abuse is of significant clinical and economic relevance. A major part of internal medical pathology is associated with chronic alcoholism. 50% of all accidents with subsequent traumatic injuries are related to alcohol intake. Patients who are chronic alcohol abusers have prolonged hospital stays and substantial increases in postoperative morbidity. A sophisticated diagnosis of alcoholism within standard clinical routine is often difficult, and in most cases the treatment of alcohol-related diseases and complications is protracted and requires increased energy expenditure by the treating physicians. In surgical patients, chronic alcohol abuse is associated with a 3- to 4-fold risk of infections, sepsis, cardiac and bleeding complications. Therefore, the patients themselves, along with the general practitioner and an in-hospital interdisciplinary team should cooperate in medical and operative treatment in order to attain better clinical outcome. Each patient history should include a detailed assessment of the quantity of daily alcohol intake. Alcoholic diagnostic regimens including questionnaires (i.e. CAGE, AUDIT) in combination with specific laboratory markers (CDT, GGT, MCV), if implemented, could prove valuable, especially in cases where major surgical procedures are considered. Strict abstinence by alcoholic patients with organ pathology in medical and elective surgical settings as well as the prophylactic treatment of pre-operative alcohol withdrawal appear to be useful strategies to reduce the risk of complications. Short-term interventions are associated with reduced alcohol intake and decreased incidence of re-trauma. Considering the clinical relevance of alcohol abuse, sufficient screening, interventions, and open approaches to address alcohol problems should be important components of the daily clinical routine in outpatient clinics, emergency rooms, in GPs' offices and in general hospitals.
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PMID:[The alcoholic patient in the daily routine]. 1460 33

The alcohol misuse is associated with a wide range of medical and social problems. This is why it is very important to detect early-stages alcohol misuse. The early detection and the diagnosis of chronic alcohol consumption require simple to use, relevant tools. Alcoholisation behaviours are classified according to 5 categories: no use, use, and three types of misuse, at risk drinking, abuse or harmful drinking, and dependence. This screening of early-stage alcohol misuse is at first based on the clinical interview with the patient. It evaluates the alcohol consumption reported by the patient, specially the number of drinking days, the number of drinks per drinking day, the lapses, the type of alcoholic drinks, the way of drinking, and the events that influence it. Screening questionnaires can be usefull: CAGE and especially AUDIT. They can be used as auto-questionnaires. Three biological markers can be helpful to detect chronic alcohol consumption: GGT, MCV and CDT.
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PMID:[Classification, detection and diagnosis of chronic alcohol disorders]. 1683 1

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


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