scholarly journals Prevalence of Alcohol Consumption in Emergency department presentations (PACE) in Queensland, Australia, using alcohol biomarkers ethanol and phosphatidylethanol: an observational study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e047887
Author(s):  
Kim A Vuong ◽  
Silvia Manzanero ◽  
Jacobus P J Ungerer ◽  
Gary Mitchell ◽  
Brett McWhinney ◽  
...  
Keyword(s):  
Emergency Department ◽  
Alcohol Use ◽  
Alcohol Intake ◽  
Trauma Centre ◽  
Medium Term ◽  
Secondary Use ◽  
Human Research Ethics ◽  
Key Stakeholders ◽  
Collection Period ◽  
Royal Australasian College

IntroductionAlcohol use in patients presenting to the emergency department (ED) is a significant problem in many countries. There is a need for valid and reliable surveillance of the prevalence of alcohol use in patients presenting to the ED, to provide a more complete picture of the risk factors and inform targeted public health interventions. This PACE study will use two biomarkers, blood ethanol and phosphatidylethanol (PEth), to determine the patterns, presence and level of alcohol use in patients presenting to an Australian ED.Methods and analysisThis is an observational prevalence study involving the secondary use of routinely collected blood samples from patients presenting to the Royal Brisbane and Women’s Hospital (RBWH) Emergency and Trauma Centre (ETC). Samples will be tested for acute and medium-term alcohol intake using the two biomarkers blood ethanol and PEth respectively, over one collection period of 10–12 days. Descriptive statistics such as frequencies, percentages, means, SD, medians and IQRs, will be used to describe the prevalence, pattern and distribution of acute and medium-term alcohol intake in the study sample. The correlation between acute and medium-term alcohol intake levels will also be examined.Ethics and disseminationThis study has been approved by the RBWH Human Research Ethics Committee (reference, LNR/2019/QRBW/56859). Findings will be disseminated to key stakeholders such as RBWH ETC, Australasian College for Emergency Medicine, Royal Australasian College of Surgeons, Statewide Clinical Networks, and used to inform clinicians and hospital services. Findings will be submitted for publication in peer-reviewed journals and presentation at appropriate conferences.

scholarly journals Identifying alcohol problems among suicide attempters visiting the emergency department

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jinhee Lee ◽  
Seongho Min ◽  
Joung-Sook Ahn ◽  
Hyun Kim ◽  
Yong-Sung Cha ◽  
...  
Keyword(s):  
Emergency Department ◽  
Alcohol Use ◽  
Biochemical Markers ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Alcohol Problems ◽  
Self Report ◽  
Risky Drinking ◽  
Psychiatric Interview ◽  
Suicide Attempters

Abstract Background Many suicide attempters brought to our emergency department (ED) have been found to have alcohol problems, and this should be taken serious consideration because alcohol use disorder is a risk factor for suicide reattempt. In this study, we aimed to estimate the effectiveness of alcohol-related biochemical markers and Alcohol Use Disorder Identification Test Consumption (AUDIT-C) in suicide attempters who visited our ED based on the gold standard for clinical diagnosis used by psychiatrists for alcohol use disorder. Moreover, we aimed to search for a significant standard when clinicians make correct predictions about alcohol use disorder using these markers. Methods Among the subjects who visited ED following a suicide attempt, a total of 203 subjects were selected. Following a psychiatric interview, the subjects who met the criteria for alcohol abuse or alcohol dependence according to DSM-IV-TR in the past year were defined as the “alcohol use disorder” group. Although some subjects did not meet these criteria, men with a weekly alcohol intake of ≥14 drinks and women with a weekly alcohol intake of ≥7 drinks were classified as the “risky drinking” group. AUDIT-C was used as a self-report; further, aspartate aminotransferase, gamma-glutamyltransferase (GGT), and carbohydrate-deficient transferrin (CDT) were assayed using standard methods, and GGT–CDT was calculated using this formula: 0.8 × ln(GGT) + 1.3 × ln(%CDT). Results In total, 88 subjects met the criteria for alcohol use disorder and 115 were included in the reference group. In the screening for alcohol use disorder, the AUC of AUDIT-C was 0.89 for men and 0.87 for women. In the screening for risky drinking, the AUC of AUDIT-C was 0.99 for men and 0.93 for women. Compared with other biochemical markers, AUDIT-C showed the highest AUC value for screening for both alcohol use disorder and risky drinking, with the trend being more prominent in men. Conclusions Among the biochemical markers, AUDIT-C yielded the highest sensitivity, specificity, and accuracy in diagnosing alcohol use disorder among suicide attempters in ED. Comparison of results revealed that the use of AUDIT-C with biochemical markers or its use alone can help screen for alcohol use disorder or risky drinking in clinical settings.

mTORC and PKCε in Regulation of Alcohol Use Disorder

2020 ◽  
Vol 20 (17) ◽  
pp. 1696-1708 ◽  
Author(s):  
Athirah Hanim ◽  
Isa Naina Mohamed ◽  
Rashidi M. Pakri Mohamed ◽  
Srijit Das ◽  
Norefrina Shafinaz Md Nor ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Potential Role ◽  
Synaptic Proteins ◽  
Cellular Mechanisms ◽  
Kinase C ◽  
Protein Kinase C Epsilon ◽  
Seeking Behavior

Alcohol use disorder (AUD) is characterized by compulsive binge alcohol intake, leading to various health and social harms. Protein Kinase C epsilon (PKCε), a specific family of PKC isoenzyme, regulates binge alcohol intake, and potentiates alcohol-related cues. Alcohol via upstream kinases like the mammalian target to rapamycin complex 1 (mTORC1) or 2 (mTORC2), may affect the activities of PKCε or vice versa in AUD. mTORC2 phosphorylates PKCε at hydrophobic and turn motif, and was recently reported to be associated with alcohol-seeking behavior, suggesting the potential role of mTORC2-PKCε interactions in the pathophysiology of AUD. mTORC1 regulates translation of synaptic proteins involved in alcohol-induced plasticity. Hence, in this article, we aimed to review the molecular composition of mTORC1 and mTORC2, drugs targeting PKCε, mTORC1, and mTORC2 in AUD, upstream regulation of mTORC1 and mTORC2 in AUD and downstream cellular mechanisms of mTORCs in the pathogenesis of AUD.

Nalmefene against alcohol use disorder: A report of one case

2017 ◽  
Vol 41 (S1) ◽  
pp. s866-s866
Author(s):  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
L. Sánchez Blanco ◽  
R. Landera Rodríguez ◽  
M. Gómez Revuelta ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Opioid Receptor ◽  
Treatment Option ◽  
Withdrawal Syndrome ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Family Relationship ◽  
Heavy Drinking ◽  
Alcohol Withdrawal Syndrome

IntroductionAlcohol consumption represents a significant factor for mortality in the world: 6.3% in men and 1.1% in women. Alcohol use disorder is also very common: 5.4% in men and 1.5% in women. Despite its high frequency and the seriousness of this disorder, only 8% of all alcohol-dependents are ever treated. One potentially interesting treatment option is oriented toward reducing alcohol intake.AimsTo describe one case who has improved his alcohol consumption after starting treatment with nalmefene, an opioid receptor antagonist related to naltrexone.MethodsA 35-year-old male with alcohol use disorder since 2001 came to our consult in November 2015. He was in trouble with his family and he had a liver failure. We offer a new treatment option with nalmefene 18 mg to reduce alcohol consumption.ResultsBefore to start nalmefene he drank 21 drinks/week. Six-month later, he decreased alcohol intake until 5 drinks/week with better family relationship and liver function. After starting nalmefene he complained of nausea, so we recommend to take the middle of the pill for next 7 days. After this time he returned to take one pill with good tolerance and no more side effects or withdrawal syndrome.ConclusionsNalmefene appears to be effective and safe in reducing heavy drinking and in preventing alcohol withdrawal syndrome due to its opioid receptor antagonism. This case suggests nalmefene is a potential option to help patients, who do not want or cannot get the abstinence, in reducing their alcohol consumption.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A narrative review of chronic alcohol-induced atrial fibrillation

2021 ◽  
Author(s):  
Rea Mittal ◽  
Lilly Su ◽  
Devyani Ramgobin ◽  
Ashwani Garg ◽  
Rahul Jain ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Alcohol Use ◽  
Alcohol Intake ◽  
Cardiovascular Complications ◽  
Chronic Alcohol ◽  
Higher Alcohol ◽  
Dependent Relationship ◽  
Increased Risk ◽  
Low Levels ◽  
Dose Dependent

Alcohol use disorder (AUD) is highly prevalent and can lead to many cardiovascular complications, including arrhythmias. Chronic alcohol use has a dose-dependent relationship with incidence of atrial fibrillation (AF), where higher alcohol intake (>3 drinks a day) is associated with higher risk of AF. Meanwhile, low levels of chronic alcohol intake (<1 drink a day) is not associated with increased risk of AF. Mechanistically, chronic alcohol intake alters the structural, functional and electrical integrity of the atria, predisposing to AF. Increased screening can help identify AUD patients early on and provide the opportunity to educate on chronic alcohol use related risks, such as AF. The ideal treatment to reduce risk of incident or recurrent AF in AUD populations is abstinence.

Complexities of Cocaine Users Presenting to the Emergency Department with Chest Pain: Interactions Between Depression Symptoms, Alcohol Use, and Race

2007 ◽  
Vol 1 (4) ◽  
pp. 213-221 ◽  
Author(s):  
John M. Wryobeck ◽  
Maureen A. Walton ◽  
Geoffrey M. Curran ◽  
Lynn S. Massey ◽  
Brenda M. Booth
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Alcohol Use ◽  
Depression Symptoms ◽  
Cocaine Users

Harmful alcohol use among injured adult patients presenting to a Ghanaian emergency department

2017 ◽  
Vol 23 (3) ◽  
pp. 190-194 ◽  
Author(s):  
Andrew Gardner ◽  
Paa Kobina Forson ◽  
George Oduro ◽  
Doreen Djan ◽  
Kwame Ofori Adu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Alcohol Use ◽  
Adult Patients ◽  
Harmful Alcohol

scholarly journals Pre-injury alcohol use and road traffic injury among patients at Mulago National Referral Hospital, Kampala, Uganda: Cross-sectional study

2019 ◽  
Vol 30 (4) ◽  
pp. 17-25 ◽  
Author(s):  
Claire Biribawa ◽  
Olive Kobusingye ◽  
Possy Mugyenyi ◽  
Ezekiel Baguma ◽  
Emmanuel Bua ◽  
...  
Keyword(s):  
Emergency Department ◽  
Alcohol Use ◽  
Road Traffic ◽  
Alcohol Intoxication ◽  
Referral Hospital ◽  
High Rate ◽  
Traffic Injury ◽  
Mulago National Referral Hospital ◽  
Injured Patients ◽  
National Referral Hospital

Background: Uganda has a high rate of road traffic injuries (RTI). Alcohol use increases traffic injury risk and severity through impairment of road-use skills and hazard perception. Few studies have examined this problem in Uganda. We therefore assessed the prevalence and determinants of pre-injury alcohol use among road traffic injured patients at Mulago National Referral Hospital, Kampala Uganda. Methods: We enrolled 330 eligible adult RTI patients consecutively in a crosssectional study, at the emergency department in Mulago National Referral Hospital from March-May, 2016. We assessed pre-injury alcohol use using BACtrack professional Breathalyzer, alcohol intoxication assessment tool and alcohol use selfreport covering the period of 6 hours before the injury. We assessed injury severity using Glasgow Coma Scale and Kampala Trauma Score. We estimated prevalence ratios [PR] using modified Poisson regression. Results: Prevalence of pre-injury alcohol use among injured patients was 29.7%. Pedestrians (44%) had the greatest percentage of alcohol use when compared to other road users. Pre-injury alcohol use was associated with mortality at the Emergency Department, PR: 2.33 [1.39 – 3.9]. Conclusion and recommendations: Pre-injury alcohol use is high among pedestrians and yet prevention efforts target mostly motorists. Pre-injury alcohol use also resulted into increased mortality at Emergency Department. We recommend prevention efforts to not only target motorists but also pedestrians.

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