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Alcohol Use Disorder Diagnosis

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1. What is the most accurate and cost-effective direct test (ELF test, hyaluronic acid, P3NP, Fibroscan or ARFI elastography) for detecting and staging liver fibrosis and/or cirrhosis in patients with diagnosed or suspected non-alcoholic fatty liver disease,

What is the most accurate and cost-effective direct test (ELF test, hyaluronic acid, P3NP, Fibroscan or ARFI elastography) for detecting and staging liver fibrosis and/or cirrhosis in patients with diagnosed or suspected non-alcoholic fatty liver disease, SHTG Evidence note | 1 Evidence Note Number 82 July 2018 In response to an enquiry from the Scottish Clinical Biochemistry Managed Diagnostic Network What is the most accurate and cost-effective direct test (ELF test™, hyaluronic acid, P3NP (...) liver disease, alcohol-related liver disease or viral hepatitis? Interest in direct serum biomarker tests (ELF test™, hyaluronic acid, P3NP) lies in the value they could add when used for further investigations in secondary care following referral based on indirect tests, or as replacements for indirect tests in the care pathway (figure 1) if the diagnostic accuracy and cost- effectiveness of these biomarker tests proves greater than that of indirect tests. Due to the need for specialist equipment

2018 Evidence Notes from Healthcare Improvement Scotland

2. Use of a metabolomic approach to non-invasively diagnose non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus (Abstract)

Use of a metabolomic approach to non-invasively diagnose non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus To assess the utility of existing metabolomics scores to classify liver disease in patients with type 2 diabetes mellitus (T2DM).A total of 220 patients with T2DM were recruited. Patients underwent routine laboratory tests, liver proton magnetic resonance spectroscopy (1 H-MRS), a 75-g oral glucose tolerance test, and liver biopsy if 1 H-MRS findings indicated non (...) -alcoholic fatty liver disease. A serum sample was blindly provided to OWL Metabolomics on which to run the OWLiver Care and OWLiver tests.When compared with liver biopsy, the OWLiver Care and OWLiver tests had a suboptimal performance in patients with T2DM (areas under the receiver-operating characteristic [AUROC] curve both <0.70). Given the discordance of these results in this heterogeneous, multiethnic cohort compared with those of a previous report in predominantly white patients without diabetes

2018 EvidenceUpdates

3. Usefulness of the Alcohol Use Disorders Identification Test-Korean Revised Version in Screening for Diagnostic and Statistical Manual of Mental Disorders 5th Edition Alcohol Use Disorder among College Students Full Text available with Trip Pro

Usefulness of the Alcohol Use Disorders Identification Test-Korean Revised Version in Screening for Diagnostic and Statistical Manual of Mental Disorders 5th Edition Alcohol Use Disorder among College Students There is a distinction in alcohol consumption behavior between adults and college students. This study aims to verify the usability and the optimal cutoff point of Alcohol Use Disorders Identification Test-Korean revised version (AUDIT-KR) for screening alcohol use disorder in college (...) students when the diagnostic and statistical manual of mental disorders (DSM), 5th edition diagnostic criteria is applied.A total of 922 college students living in Daejeon were enrolled and divided into two groups based on how many items they corresponded to among DSM-5 alcohol use disorder diagnostic criteria: those who corresponded to ≥2 of the 11 items were classified into the patient group (107 males, 89 females) while the others into the control group (311 males, 415 females). The participants

2018 Korean journal of family medicine

4. Ultrasonography for diagnosis of alcoholic cirrhosis in people with alcoholic liver disease. Full Text available with Trip Pro

clinical signs used for diagnosis of fibrosis in alcoholic liver disease, should be carefully selected to achieve maximum diagnostic accuracy on ultrasonography. (...) by 1.6 times. Liver transplantation is the only radical method that may change the prognosis of a person with alcoholic liver disease; however, besides the difficulties of finding a suitable liver transplant organ, there are many other factors that may influence a person's survival.Ultrasound is an inexpensive method that has been used for years in clinical practice to diagnose alcoholic cirrhosis. Ultrasound parameters for assessing cirrhosis in people with alcoholic liver disease encompass among

2016 Cochrane

5. The Standardization of Diagnostic Criteria for Fetal Alcohol Spectrum Disorder (FASD): Implications for Research, Clinical Practice and Population Health

of existing gaps in research on the conditions and factors that influence fetal vulnerability to damage from exposure. This discordance has led to variability in research findings, inconsistencies in government messaging, and misdiagnoses or missed diagnoses. The objective measurement of the timing and level of prenatal alcohol exposure is key to bridging these gaps; however, there is conflicting or limited evidence to support the use of existing measures. Publication Type: Journal Articles Year (...) The Standardization of Diagnostic Criteria for Fetal Alcohol Spectrum Disorder (FASD): Implications for Research, Clinical Practice and Population Health Institute of Health Economics | Toggle navigation MENU / Advanced Search The Standardization of Diagnostic Criteria for Fetal Alcohol Spectrum Disorder (FASD): Implications for Research, Clinical Practice and Population Health May 22, 2018 Objective: Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol

2018 Institute of Health Economics

6. Non-alcoholic Fatty Liver Disease, Diagnosis and Management

Non-alcoholic Fatty Liver Disease, Diagnosis and Management The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance From the American Association for the Study of Liver Diseases Naga Chalasani, 1 Zobair Younossi , 2 Joel E. Lavine, 3 Michael Charlton, 4 Kenneth Cusi, 5 Mary Rinella, 6 Stephen A. Harrison, 7 Elizabeth M. Brunt, 8 and Arun J. Sanyal 9 Preamble This guidance providesadata-supportedapproachto the diagnostic, therapeutic, and preventive aspects (...) ) Because this guidance document is lengthy, to make it easier for the reader, a list of all guidance statements and recommendations are pro- videdinatabularformasSupportingTableS1. De?nitions Forde?ningNAFLD,theremustbe(1)evidence of hepatic steatosis (HS), either by imaging or histology, and (2) lack of secondary causes of hepatic fat accumu- lation such as signi?cant alcohol consumption, long- term use of a steatogenic medication, or monogenic hereditary disorders (Table 1). In the majority

2018 American Association for the Study of Liver Diseases

7. Diagnosis, Assessment, and Treatment of Fetal Alcohol Spectrum Disorders: A Review of Clinical and Cost-Effectiveness and Guidelines

-disciplinary diagnosis based on criteria related to facial features, prenatal alcohol exposure, and neurodevelopmental effects. Tags pediatrics, diagnosis, fetal alcohol syndrome, needs assessment, Assessment, Diagnostic, Treating, FASD, Screening, Treatment Files Rapid Response Summary with Critical Appraisal Published : May 3, 2017 Related Content Follow us: © 2019 Canadian Agency for Drugs and Technologies in Health Get our newsletter: (...) Spectrum Disorders: A Review of Clinical and Cost-Effectiveness and Guidelines Published on: May 3, 2017 Project Number: RC0880-000 Product Line: Research Type: Other Diagnostics Report Type: Summary with Critical Appraisal Result type: Report Question What is the diagnostic test accuracy of tools or tests for the diagnosis and/or assessment of fetal alcohol spectrum disorder in individuals of any age? What is the clinical utility of diagnosis and/or assessment of fetal alcohol spectrum disorder

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

8. Diagnosis and treatment of alcohol use disorder in patients with end-stage alcoholic liver disease. (Abstract)

Diagnosis and treatment of alcohol use disorder in patients with end-stage alcoholic liver disease. Between 14%-30% of the world's population is affected by alcohol use disorder (AUD), and excessive alcohol consumption represents the most common cause of liver disease in the western world. The clinical picture of alcoholic end-stage liver disease is rendered extremely complex, as manifestations such as alcohol withdrawal syndrome, craving and physical dependence, as well as extrahepatic alcohol (...) -related diseases merge with the complications of advanced cirrhosis. This makes AUD recognition and assessment difficult and its management arduous as many drugs commonly used to treat complications such as alcohol withdrawal syndrome are often contraindicated by the presence of hepatic encephalopathy or hepatorenal syndrome. Reaching and maintaining abstinence represents the mainstay of managing patients with AUD and end-stage liver disease. Psychosocial interventions are an essential component

2018 Hepatology

9. Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review. (Abstract)

Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review. Alcohol consumption is associated with 88 000 US deaths annually. Although routine screening for heavy alcohol use can identify patients with alcohol use disorder (AUD) and has been recommended, only 1 in 6 US adults report ever having been asked by a health professional about their drinking behavior. Alcohol use disorder, a problematic pattern of alcohol use accompanied by clinically significant impairment or distress, is present (...) of pharmacogenetics to personalize AUD treatments.Alcohol consumption is associated with a high rate of morbidity and mortality, and heavy alcohol use is the major risk factor for AUD. Simple, valid screening methods can be used to identify patients with heavy alcohol use, who can then be evaluated for the presence of an AUD. Patients receiving a diagnosis of the disorder should be given brief counseling and prescribed a first-line medication (eg, naltrexone) or referred for a more intensive psychosocial

2018 JAMA

10. Alcohol-use disorder

, and disulfiram, can be successfully utilised for selected patients to improve their chances of maintaining abstinence. Nalmefene is no longer available in the US. Definition Alcohol-use disorder is a term used to refer to the misuse of alcohol. Several specifically defined conditions better categorise patterns of alcohol misuse. Problematic alcohol use is classified in the American Psychiatric Association's Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5) as alcohol-use disorder (...) Organization's tenth edition of the International statistical classification of diseases and related health problems (ICD-10) defines alcohol-use disorders in a similar manner. World Health Organization. International statistical classification of diseases and related health problems. 10th ed. Geneva, Switzerland: WHO; 2016. http://apps.who.int/classifications/icd10/browse/2016/en#/ Alcohol-use disorder is diagnosed when, over a 12-month period, the patient's drinking has caused clinically significant

2018 BMJ Best Practice

11. Baclofen for alcohol use disorder. Full Text available with Trip Pro

Baclofen for alcohol use disorder. Alcohol use disorder (AUD) and alcohol-related impairments belong to the most widespread psychiatric disorders leading to specific psychophysical, affective and cognitive symptoms and consequences for psychosocial well-being and health. Alcohol consumption is increasingly becoming a problem in many developing regions and AUD prevalence is estimated at 4.1% worldwide, with highest prevalence in European countries (7.5%), and the North America (6.0 (...) articles. The date of the most recent search was 30 January 2018.Randomised controlled trials (RCTs) of at least four weeks' treatment duration and 12 weeks' overall study duration comparing baclofen for relapse prevention of AUD with placebo, no treatment or other treatments.We used standard methodological procedures expected by Cochrane.We included 12 RCTs (1128 participants). All studies but three recruited fewer than 100 participants. Participants had a diagnosis of alcohol dependence according

2018 Cochrane

12. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence

Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence Alcohol-use disorders: diagnosis, Alcohol-use disorders: diagnosis, assessment and management of harmful assessment and management of harmful drinking and alcohol dependence drinking and alcohol dependence Clinical guideline Published: 23 February 2011 nice.org.uk/guidance/cg115 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice (...) for the public 41 6 Related NICE guidance 42 7 Updating the guideline 43 Appendix A: The Guideline Development Group and National Collaborating Centre 44 Guideline Development Group 44 Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (CG115) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 50Appendix B: The Guideline Review Panel 47 Changes after publication 48 About

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

13. Opioid Use Disorder - Diagnosis and Management in Primary Care

are listed as a health benefit for First Nations and Indigenous peoples in BC. Refer to to find out where to access and how to distribute and educate patients about kits and other harm reduction supplies in your care setting. Diagnostic Criteria for Opioid Use Disorder (OUD) Diagnose OUD using the DSM-5 13 diagnostic criteria outlined below. The presence of at least 2 of the criteria listed below indicates OUD, with the exception of patients who are taking opioids for chronic pain. Severity depends (...) is taken to relieve or avoid withdrawal symptoms. *Note: For patients who are prescribed opioids under appropriate medical supervision, the presence of tolerance and withdrawal alone does not indicate OUD; additional criteria are required for diagnosis. Due to risk of overdose death when untreated, offer patients diagnosed with opioid use disorder (including youth) immediate induction of opioid agonist treatment, if suitable (refer to Management section below). There is often a “window” when patients

2018 Clinical Practice Guidelines and Protocols in British Columbia

14. Stress Reactivity as a Determinant in Co-occurring Alcohol Use and Anxiety Disorder: Diagnosis and Alcohol Use Outcomes

and relapse in co-occurring AUD+AnxD. Condition or disease Alcohol Use Disorder Anxiety Disorder/Anxiety State Stress Disorder Hypothalamic Pituitary Adrenal Drinking to Cope Detailed Description: The objectives of the proposed research are to 1) evaluate the effect of co-occurring AnxD on the severity of biological stress-mood system dysregulations in AUD inpatients at pre-treatment, 2) evaluate the effect of co-occurring AnxD on the persistence of stress-mood system dysregulations in AUD inpatients (...) informed consent Between the ages of 18 and 65 Diagnostic and Statistical Manual diagnosis of a Panic Disorder, Generalized Anxiety Disorder, or Social Anxiety Disorder within the past 30 days (AUD+AnxD group only). Primary alcohol use disorder diagnosis and alcohol use in the 30 days preceding the study (AUD alone and AUD+AnxD groups only). Inpatient treatment at Lodging Plus primarily for alcohol (vs. other drug with nicotine accepted) dependence (AUD alone and AUD+AnxD groups only). A minimum

2017 Clinical Trials

15. Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study. Full Text available with Trip Pro

Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study. Recent European guidelines for non-alcoholic fatty liver disease (NAFLD) call for reference values for HOMA-IR. In this study, we aimed to determine: (1) the upper limit of normal HOMA-IR in two population-based cohorts; (2) the HOMA-IR corresponding to NAFLD; (3) the effect of sex and PNPLA3 genotype at rs738409 on HOMA-IR; and (4) inter-laboratory variations in HOMA-IR.We identified (...) healthy individuals in two population-based cohorts (FINRISK 2007 [n = 5024] and the Programme for Prevention of Type 2 Diabetes in Finland [FIN-D2D; n = 2849]) to define the upper 95th percentile of HOMA-IR. Non-obese individuals with normal fasting glucose levels, no excessive alcohol use, no known diseases and no use of any drugs were considered healthy. The optimal HOMA-IR cut-off for NAFLD (liver fat ≥5.56%, based on the Dallas Heart Study) was determined in 368 non-diabetic individuals (35

2017 Diabetologia

16. Transient elastography for diagnosis of stages of hepatic fibrosis and cirrhosis in people with alcoholic liver disease. Full Text available with Trip Pro

to diagnose hepatic fibrosis. We could not identify the optimal cut-off values for the fibrosis stages. The definition of the diagnosis of alcoholic liver disease was not provided in one study and was not clearly defined in two studies, but it was clear in the remaining 11 studies. The study authors used different liver stiffness cut-off values of transient elastography for the hepatic fibrosis stages.There was only one study (103 participants) with data on hepatic fibrosis stage F1 or worse, with a cut (...) for assessing and staging hepatic fibrosis.To determine the diagnostic accuracy of transient elastography for diagnosis and staging hepatic fibrosis in people with alcoholic liver disease when compared with liver biopsy. To identify the optimal cut-off values for differentiating the five stages of hepatic fibrosis.The Cochrane Hepato-Biliary Group Controlled and Diagnostic Test Accuracy Studies Registers, The Cochrane Library, MEDLINE (OvidSP), EMBASE (OvidSP), and the Science Citation Index Expanded (last

2015 Cochrane

17. Screening, Diagnosis, and Management of Patients With Alcohol Use Disorders at Bwindi Community Hospital, Uganda Full Text available with Trip Pro

Screening, Diagnosis, and Management of Patients With Alcohol Use Disorders at Bwindi Community Hospital, Uganda Introduction: The harmful use of alcohol is a growing global public health concern, with Sub-Saharan Africa at particular risk. A large proportion of adults in Uganda consume alcohol and the country has a high prevalence of alcohol use disorders (AUD), almost double that for the African region as a whole. Bwindi Community Hospital, in rural western Uganda, recently introduced (...) a program of screening, diagnosis and management of AUD and we assessed how this worked. Methods: This was a cross-sectional study in three departments (out-patients, adult in-patients and sexual & reproductive health) of Bwindi Community Hospital assessing numbers of patients screened, diagnosed and treated with AUD between January 2014 and June 2017. Data sources included the hospital electronic data base and departmental case files. Frequencies and proportions are reported and odds ratios used

2018 Frontiers in public health

18. Diagnosis and treatment of acute alcohol intoxication and alcohol withdrawal syndrome: position paper of the Italian Society on Alcohol. (Abstract)

Diagnosis and treatment of acute alcohol intoxication and alcohol withdrawal syndrome: position paper of the Italian Society on Alcohol. The chronic use of alcohol can lead to the onset of an alcohol use disorder (AUD). About 50% of subjects with an AUD may develop alcohol withdrawal syndrome (AWS) when they reduce or discontinue their alcohol consumption and, in 3-5% of them, convulsions and delirium tremens (DTs), representing life-threatening complications, may occur. Unfortunately, few (...) physicians are adequately trained in identifying and treating AWS. The Italian Society on Alcohol has, therefore, implemented a task force of specialists to draw up recommendations for the treatment of AWS with the following main results: (1) while mild AWS may not require treatment, moderate and severe AWS need to be pharmacologically treated; (2) out-patient treatment is appropriate in patients with mild or moderate AWS, while patients with severe AWS need to be treated as in-patients; (3

2018 Internal and emergency medicine

19. Restriction of salt, caffeine and alcohol intake for the treatment of Ménière's disease or syndrome. Full Text available with Trip Pro

Restriction of salt, caffeine and alcohol intake for the treatment of Ménière's disease or syndrome. Ménière's disease or syndrome is a chronic inner ear disorder that results in sporadic attacks of vertigo, sensorineural hearing loss, aural fullness and tinnitus.There is no definitive treatment for Ménière's disease and treatment options range from dietary modification through medication to surgery.Modification of diet, including restriction of salt, caffeine and alcohol intake (...) and additional sources for published and unpublished trials. The date of the search was 28 March 2018.Randomised controlled trials of dietary modification, specifically salt, caffeine and alcohol restriction or substitution (or both), compared to no modification of these agents or a placebo intervention, in adult patients with Ménière's disease or syndrome.We used the standard methodological procedures expected by Cochrane. Our primary outcomes were control of vertigo or decrease in vertigo attacks

2018 Cochrane

20. Serum C16:1n7/C16:0 ratio as a diagnostic marker for non-alcoholic steatohepatitis Diagnosis of NASH using serum fatty acid. (Abstract)

Serum C16:1n7/C16:0 ratio as a diagnostic marker for non-alcoholic steatohepatitis Diagnosis of NASH using serum fatty acid. Accurate diagnosis of nonalcoholic steatohepatitis (NASH) from nonalcoholic fatty liver disease (NAFLD) is clinically important. Therefore, there is a need for easier ways of diagnosing NASH. In this study, we investigated the serum fatty acid composition and evaluated the possibility of using the serum fatty acid composition as a diagnostic marker of NASH.The subjects (...) were 78 NAFLD patients (nonalcoholic fatty liver (NAFL): 30, NASH: 48) and 24 healthy individuals. Fatty acids extracted from the liver tissue and serum were identified and quantified by gas chromatography. In addition, we evaluated the relationship between serum and liver tissue fatty acid composition, patient background, and liver histology. The diagnostic performance of NASH was evaluated by calculating the area under the receiver operating characteristic (AUROC).The results of the fatty acid

2019 Journal of gastroenterology and hepatology

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