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Alcohol Tremor

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141. Hereditary Hemochromatosis

be elevated among patients with nonalcoholic fatty liver disease and in those with alcoholic liver disease. These diagnoses are more common than HH among patients with elevated serum ferritin who are not C282Y homozygotes or C282Y/H63D compound heterozygotes. A secondary cause for liver disease should be excluded among patients with suspected iron overload who are not C282Y homozygotes. Phlebotomy remains the mainstay of therapy, but emerging novel therapies such as new chelating agents may have a role (...) with either abnormally low levels of hepcidin ( ) or decreased binding of hepcidin to ferroportin (FPN), the transmembrane protein that exports iron outside the cell ( ). Secondary iron overload may be considered as any condition of acquired hepcidin deficiency from disorders of erythropoiesis or increased red blood cell (RBC) turnover or due to other chronic liver disease or excess alcohol intake ( ). Over time, iron deposition can lead to dysfunction and failure in multiple organs including the liver

2019 American College of Gastroenterology

142. Assessment and Management of Patients at Risk for Suicide

both drug and non-drug poisoning.[8] Other means include, but are not limited to, overdose of licit or illicit drugs, alcohol or combinations thereof, hanging, poisoning (with chemical compounds such as industrial cleaners or pesticides), carbon monoxide inhalation, suffocation (with plastic hoods or inert gasses), electric shock, immolation, drowning, exsanguination, and evisceration. Hanging deaths have increased in the past decade, with evidence of suicide contagion stemming from the deaths

2019 VA/DoD Clinical Practice Guidelines

145. Clearing the Smoke on Cannabis: Regular Use and Cognitive Functioning

psychoactive substance in Canada, led only by alcohol. According to the 2018 National Cannabis Survey (second quarter), 16% of Canadians aged 15 years and older reported using cannabis in the past three months. The use of cannabis is generally more prevalent among young people, with 33% of individuals between the age of 15 to 24 reporting use in the past three months compared to 13% of those aged 25 or older (Statistics Canada, 2018). Given the proportion of Canadians using cannabis and in light (...) , time distortion, deficits in attention span and memory, body tremors, increased heart rate and blood pressure, and impaired motor functioning. Over the past few decades, there has been an increase in the concentrations of THC (and decrease in CBD levels) in illicit cannabis, increasing from 4% in 1995 to 12% in 2014 (ElSohly et al., 2016). Canada legalized the use of cannabis for non- medical purposes for individuals over 18 years of age (19 in some provinces) on October 17, 2018. A review

2019 Canadian Centre on Substance Abuse

146. Management of Atopic Eczema

) Methotrexate 2.5 - 5 mg/kg daily in two divided doses Hypertension, hepatoxicity, tremor, paraesthesia, hypertrichosis, oedema, acne, gingival hypertrophy, hyperkalaemia, increased susceptibility to infections, nephrotoxicity, seizures Limit use to two years to prevent increased risk of malignancy Avoid excessive sunlight exposure Pregnancy and breast feeding Screen for Hepatitis B, C and HIV before commencement Monitor FBC, RP and LFT two weeks after commencement and as needed subsequently 10 - 25 mg (...) weekly (0.2 - 0.5 mg/kg); not to exceed 30mg weekly (Off-label use) Gastrointestinal disturbances (e.g. diarrhoea, nausea, vomiting), bone marrow depression, aplastic anaemia, hepatotoxicity, renal failure, skin reactions (e.g. photosensitivity, toxic epidermal necrolysis) alopecia, dizziness, neurotoxicity, encephalopathy, seizure, infections Chronic liver disease, alcoholic liver disease, breast-feeding, hypersensitivity to methotrexate, evidence of immunodeficiency syndrome, pre-existing blood

2019 Ministry of Health, Malaysia

147. AIM Clinical Appropriateness Guidelines for Interventional Pain Management

, motor dysfunction (eg, weakness, tremor, dystonia), or trophic changes (eg, hair, nail, skin) ? At least 1 sign at time of evaluation in at least two (2) of the following categories: o Sensory: Evidence of hyperalgesia (to pinprick), allodynia (to light touch, temperature sensation, deep somatic pressure, or joint movement) o Vasomotor: Evidence of temperature asymmetry (>1°C), skin color changes or asymmetry o Sudomotor/edema: Evidence of edema, sweating changes, or sweating asymmetry o Motor (...) /trophic: Evidence of decreased range of motion, motor dysfunction (eg, weakness, tremor, dystonia), or trophic changes (eg, hair, nail, skin) o No other diagnosis better explaining the signs and symptoms ? In addition, all of the following are required: o Level of pain and disability in the moderate to severe range o Failure of at least two (2) weeks of conservative management o Documentation of ongoing participation in a comprehensive pain management program The performance of an initial diagnostic

2019 AIM Specialty Health

149. Clearing the Smoke on Cannabis: Regular Use and Cognitive Functioning

psychoactive substance in Canada, led only by alcohol. According to the 2018 National Cannabis Survey (second quarter), 16% of Canadians aged 15 years and older reported using cannabis in the past three months. The use of cannabis is generally more prevalent among young people, with 33% of individuals between the age of 15 to 24 reporting use in the past three months compared to 13% of those aged 25 or older (Statistics Canada, 2018). Given the proportion of Canadians using cannabis and in light (...) , time distortion, deficits in attention span and memory, body tremors, increased heart rate and blood pressure, and impaired motor functioning. Over the past few decades, there has been an increase in the concentrations of THC (and decrease in CBD levels) in illicit cannabis, increasing from 4% in 1995 to 12% in 2014 (ElSohly et al., 2016). Canada legalized the use of cannabis for non- medical purposes for individuals over 18 years of age (19 in some provinces) on October 17, 2018. A review

2019 Canadian Centre on Substance Abuse

150. Systemic anticancer therapy-induced peripheral and central neurotoxicity: ESMO–EONS–EANO Clinical Practice Guidelines for diagnosis, prevention, treatment and follow-up

) have been proposed as strong independent risk factors [3]. However, concurrent exposure to other neurotoxic agents and pre-existing neuropathy, as well as diseases/deficiencies per se predisposing to neuropathy and should be considered as potential risk factors [alcohol abuse, renal insufficiency, hypothyroidism, vitamin deficiency, infections like Human immunodeficiency virus (HIV) and autoimmune rheumatologic conditions] [IV, B] [4-6]. Smoking seems to increase the risk of long-term prevalent (...) . Involvement of motor fibres (associated with reduction or absence of deep tendon reflexes or even distal weakness, atrophy of small feet muscles, tremor, cramps) or autonomic or cranial nerve symptoms appear much more seldom than sensory damage. Autonomic involvement which is typical for small fibre damage in vincristine and bortezomib use can lead to abdominal pain, constipation, postural hypotension, disturbances of bladder, delayed gastric emptying and reduced variability of heart rate. Practical

2020 European Society for Medical Oncology

151. Management of Major Depressive Disorder (2nd Ediiton)

• chronic diseases • obesity • chronic pain (e.g. backache, headache) • impoverished home environment • financial constraint • experiencing major life changes • pregnant or postpartum period • socially-isolated • multiple vague symptoms • sleep disturbance • substance abuse (e.g. alcohol, illicit drugs) • loss of interest in sexual activity • old age • There is insufficient evidence to perform screening for depression in the general population. The common tools used in Malaysia for screening (...) measurement to evaluate future suicide risk among patients who self-harm. 25, level II-2 Hence, measurement of this risk should be included during the risk assessment and can be done using specific tools (e.g. Beck Suicide Intent Scale). The suicide risk factors are: 21 • loss of relationship • financial or occupational difficulties • poor social support • past suicide attempt • family history of suicide • alcohol abuse/dependence • other medical co-mordibities • suicidal ideations • severity

2019 Ministry of Health, Malaysia

152. Dental Management of Pediatric Patients Receiving Chemotherapy, Hematopoietic Cell Transplantation, and/or Radiation Therapy

be gently flossed daily. If pain or exces - sive bleeding occurs, the patient should avoid the affected area, but floss the other teeth. 1 Patients with poor oral hygiene and/or periodontal disease may use chlorhexidine rinses daily until the tissue health improves or mucositis develops. 13 The high alcohol content of commercially-available chlorhexidine mouthwash may cause discomfort and dehydrate the tissues in patients with mucositis; thus, an alcohol-free chlorhexidine solution is indicated (...) in this situation. Diet: Dental practitioners should discuss the importance of a healthy diet to maintain nutritional status with an empha- sis on foods that do not promote caries. Patients and parents should be advised about the high cariogenic potential of di- etary supplements rich in carbohydrates and oral pediatric medications rich in sucrose. 6 They should also be instructed that sharp, crunchy, spicy, and highly acidic foods and alcohol should be avoided during chemotherapy, radiation, and HCT. 1

2018 American Academy of Pediatric Dentistry

153. Alcohol withdrawal syndrome

6 to 24 hours after the last drink. It can last for up to one week. To be classified as alcohol withdrawal syndrome, patients must exhibit at least two of the following symptoms: increased hand tremor, insomnia, nausea or vomiting, transient hallucinations (auditory, visual or tactile), , anxiety, , and . The severity of symptoms is dictated by a number of factors, the most important of which are degree of alcohol intake, length of time the individual has been using alcohol, and previous history (...) of alcohol withdrawal. Symptoms are also grouped together and classified: Alcohol hallucinosis: patients have transient visual, auditory, or tactile hallucinations, but are otherwise clear. Withdrawal seizures: seizures occur within 48 hours of alcohol cessations and occur either as a single generalized tonic-clonic seizure or as a brief episode of multiple seizures. Delirium tremens: hyperadrenergic state, disorientation, tremors, diaphoresis, impaired attention/consciousness, and visual and auditory

2012 Wikipedia

154. Short-term effects of alcohol

using alcohol-related phenotypes in a Native American community sample". American Journal of Medical Genetics Part B: Neuropsychiatric Genetics . 165 (8): 673–683. : . Dodge NC, Jacobson JL, Jacobson SW (2014). . Neurotoxicol Teratol . 41 : 43–50. : . . . , H.-P. Krüger, J. Kazenwadel and M. Vollrath, Center for Traffic Sciences, University of Wuerzburg, Röntgenring 11, D-97070 Würzburg, Germany , Indiana U. (Researchgate link) Mostile G, Jankovic J (2010). "Alcohol in essential tremor and other (...) Short-term effects of alcohol Short-term effects of alcohol consumption - Wikipedia Short-term effects of alcohol consumption From Wikipedia, the free encyclopedia (Redirected from ) Results of the 2010 study ranking the levels of damage caused by drugs, in the opinion of drug-harm experts. When harm to self and others is summed, alcohol was the most harmful of all drugs considered, scoring 72%. The short-term effects of (also known formally as ) consumption – due to drinking beer, wine

2012 Wikipedia

155. Long-term effects of alcohol

of alcohol abuse. The syndrome is a combined manifestation of two eponymous disorders, and . Wernicke's encephalopathy is the acute presentation of the syndrome and is characterised by a state while Korsakoff's psychosis main are and . " ", intravenous fluid containers containing vitamins and minerals (bright yellow due to the vitamins), can be used to mitigate these outcomes. Essential tremor [ ] —or, in the case of essential tremors on a background of family history of essential tremors, familial (...) tremors—can be temporarily relieved in up to two-thirds of patients by drinking small amounts of alcohol. Ethanol is known to activate aminobutyric acid type A (GABAA) and inhibit N-methyl-D-aspartate (NMDA) glutamate receptors, which are both implicated in essential tremor pathology and could underlie the ameliorative effects. Additionally, the effects of ethanol have been studied in different animal essential tremor models. (For more details on this topic, see .) Sleep [ ] Main article: Chronic use

2012 Wikipedia

156. A Guideline for the Clinical Management of Opioid Use Disorder

elimination half-life), and potential for interactions with alcohol and other drugs does increase the relative risk of toxicity and adverse events. For example, in the United States, after controlling for the total number of prescriptions dispensed, methadone-re- lated emergency room visits occur at a rate that is approximately 6 and 23 times higher than the prescription opioids oxycodone and hydrocodone, respectively. 58 Moreover, although methadone accounts for fewer than 5% of all opioid prescriptions (...) been consistently associated with risk of methadone-involved overdose are non-prescribed, diverted and illicit use (including illicit use when prescribed methadone dose is insufficient to control withdrawal symptoms); unsupervised or non-witnessed doses; combined use with alcohol and benzodiazepines; and when methadone is prescribed for pain management, as opposed to treatment of opioid use disorder where doses are witnessed and titration schedules are strictly enforced. 60-64 Witnessed dosing

2017 Clinical Practice Guidelines and Protocols in British Columbia

157. Gastroesophageal Reflux Disease (GERD) - Guidelines for Prescribing H2RAs and PPIs

; lifestyle changes are unlikely to be very effective in severe GERD but are still recommended as they contribute to general good health. Avoid foods / beverages that worsen or trigger symptoms (e.g. caffeine, chocolate, onions, peppermint, tomatoes, high-fat foods, over-indulgence in alcohol) Eat small meals and chew food well Don’t lie down for 2 -3 hours after eating Avoid tight clothing Encourage smoking cessation Elevate head of bed frame (i.e. not extra pillows) Achieve ideal body weight Over (...) or longer) can rarely cause hypomagnesemia. If a patient has taken a PPI daily for more than 1 year and is experiencing muscle cramps, palpitations, tremor, and/or dizziness, consider recommending rmagnesium levels be checked Other possible long-term safety issues of PPIs include pneumonia, osteoporosis, Clostridium difficile, and vitamin B12 malabsorption, but risk is very low Detailed information on contraindications, cautions, adverse effects and interactions is available in individual drug

2018 medSask

158. Treatment for Bipolar Disorder in Adults: A Systematic Review

conditions, BD is the most likely to co-occur with alcohol or drug abuse disorders. 7 Treatment of BD generally begins with the goal of bringing a patient with mania or depression to symptomatic recovery and stable mood. Once the individual is stable, the goal progresses to reducing subthreshold symptoms and preventing relapse into full-blown episodes of mania and depression. Drug treatments have several purposes. Some drugs aim to reduce symptoms associated with acute manic or mixed mania/depression

2018 Effective Health Care Program (AHRQ)

159. Depression: Adult and Adolescent

of depression • Women with a history of domestic violence • Individuals with chronic health conditions (e.g., diabetes, heart disease, asthma, COPD, cancer, arthritis, chronic pain, terminal illness, or neurological disorders such as stroke or Parkinson’s disease) • Individuals with a history of drug or alcohol misuse • Individuals who identify as lesbian, gay, bisexual, or transgender (LGBT) • Adolescents who have been subjected to bullying Common presentations of depression include: • Feeling down (...) health and substance use concerns by integrating behavioral health into primary care clinics. The goal of BHI is to create a welcoming environment for patients to address common problems— alcohol and substance use disorders as well as depression— with their primary care teams. A major element of BHI is transitioning primary care social workers to a new role—that of integrated behavioral health specialist—in which they will work as provider extenders to address patient needs without disrupting patient

2017 Kaiser Permanente Clinical Guidelines

160. Clearing the Smoke on Cannabis: Maternal Cannabis Use during Pregnancy ? An Update

neurodevelopment leading to adverse effects on cognition and academic achievement. • There are also effects on behaviour in children and young adults, including attention deficits, increased hyperactivity and impulsivity, and increased likelihood of substance use. • Information on the effects of cannabis use during pregnancy is essential to help healthcare providers advise patients about the impact of cannabis use and improve the health and well-being of patients and their children. Background After alcohol (...) , cannabis (also referred to as marijuana) is the most widely used psychoactive substance in Canada. According to the 2015 Canadian Tobacco, Alcohol and Drugs Survey (CTADS), 12.3% of Canadians aged 15 years and older reported using cannabis at least once in 2015 (Statistics Canada, 2016a), an increase from 10.6% in 2013. The use of cannabis is generally more prevalent among young people, with 20.6% of youth aged 15 to 19 and 29.7% of young adults aged 20 to 24 reporting past-year use in 2015

2018 Canadian Centre on Substance Abuse

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