Alcoholism: a controlled trial of "treatment" and "advice".

Edwards, Griffith; Orford, Jim; Egert, Stella; Guthrie, Sally K.; Hawker, Ann; Hensman, Celia; Mitcheson, Martin; Oppenheimer, Edna; Taylor, Colin

doi:10.15288/jsa.1977.38.1004

Cited by 451 publications

(144 citation statements)

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“…This correspoiids to the 1952 definition of alcoholism by the World Health Organisation and the terin "alcohol-related disabilities" used by Edwards et al (7). These subjects are hereafter referred to äs alcoholics.…”

Section: Introductionmentioning

confidence: 58%

Radioimmuntest zur Bestimmung von Humanmyoglobin: Untere Nachweisgrenze, Präzision, Verlaufskontrolle beim myoglobinurischen Nierenversagen

Kreuzfelder¹,

Kuwert²,

Windeck³

et al. 1984

Clinical Chemistry and Laboratory Medicine

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Zusammenfassung: Bei einem Radioimmunoassay zur Bestimmung menschlichen Myoglobins wurde die Sensitivität als untere Nachweisgrenze mit Hilfe von 4 Verfahren bestimmt. Von den verwendeten Verfahren stellen 2 (90%-und 3s-Methode) "Präzision von Tag zu Tag"-Bestimmungen und die beiden übrigen (95%-Vertrauensbereich-und Methode von Markowetz & Münz) "Präzision in der Serien-Bestimmungen dar. Die untere Nachweisgrenze nach Markowetz & Münz ist die niedrigste Myoglobinkonzentration, die bei 15-facher Messung weder einen Bindungsweit mit denen der nächst größeren Konzentration noch einen Aktivitätswert mit denen des Bindungsbezugswertes gemeinsam hat. Diese Methode ist sowohl aus theoretischer ("Präzision in der Serie") als auch praktischer Sicht (Bestimmung der unteren Nachweisgrenze in einem Testansatz) am besten geeignet, die Sensitivität als untere Nachweisgrenze zu bestimmen. Es bleibt allerdings abzuwarten, inwieweit sich diese Aussage verallgemeinern läßt. radioimmunoassay for human myoglobin: Lower detection limit, precision, and use infollowing the course of myoglobinuric kidney failure Summary:The lower detection limit of a radioimmunoassay for human myoglobin was determined by two "precision from day to day" methods (90% and 3 s methods), and by two "precision in series" methods (95% confidence ränge and the method of Markowetz & Münz). According to Markowetz & Munz> the lower detection limit (äs a measure of sensitivity) is the lowest myoglobin concentration which, in 15-fold assays, shows no binding value in common with that of the next highest concentration, and no activity value in common with that of the reference binding value. On theoretical grounds (precision in series) and from a practical standpoint (determination of the lower deteetion limit using one sample assay), this method is the most suitable for the determination of ithe lower detection limit äs a measure of sensitivity. It remains to be seen whether this is a valid generalization for other methods.

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Section: Introductionmentioning

confidence: 58%

Radioimmuntest zur Bestimmung von Humanmyoglobin: Untere Nachweisgrenze, Präzision, Verlaufskontrolle beim myoglobinurischen Nierenversagen

Kreuzfelder¹,

Kuwert²,

Windeck³

et al. 1984

Clinical Chemistry and Laboratory Medicine

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“…For the combination γ-glutamyltransferase, aspartate aminotransferase, MCV, creatinine and urea and a limit of 3 positive findings, 96% of the non-alcoholics are included (see specificity) and 51% of ics and non-alcoholics (tab. [3][4][5][6][7][8][9][10][11]. The effects on efficiency, sensitivity and specificity of a change in the decision limit are shown in table 3-12.…”

Section: Combinations Of Fivementioning

confidence: 99%

“…[3][4][5][6][7][8][9][10][11][12][13][14][15]. Efficiency can be increased to 171 for 6 parameters, no ratio, or 174 for 6 parameters with ratio (tab.…”

Section: Exclusion Of Alcoholismmentioning

confidence: 99%

“…Efficiency can be increased to 171 for 6 parameters, no ratio, or 174 for 6 parameters with ratio (tab. [3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: Exclusion Of Alcoholismmentioning

confidence: 99%

“…This definition is consistent with the 1952 definition of the World Health Organizatioii and with the term "alcohol-related disabilities" used by Edwards et äl. (3). The development of alcohol dependence is intentionally not discussed in this paper.…”

Section: Introduction and Description Of The Problemmentioning

confidence: 99%

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Detection and Exclusion of Alcoholism in Men on the Basis of Clinical Laboratory Findings

Stamm

Hansert²,

Feuerlein³

1984

Clinical Chemistry and Laboratory Medicine

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Summary:Alcoholism is a common disease; it is found in 10% to 15% of all patients admitted to general hospitals. There is no single characteristic finding, but on the other band, changes s compared with normal values have been reported in the literature for more than 30 frequently assayed clinical chemical and haematological parameters. In the project reported here all 24 clinical chemical parameters and all 8 haematological parameters frequently assayed were studied in each of 82 hospitalized inen with a confirmed diagnosis of alcoholism.The diagnosis of alcoholism was made on the basis of the Munich Alcoholism Test (MALT) together with the following standardized assessments and examinations: past history, an alcohol questionnaire, general physical examination and neurological examination. All forms were filled in completely.All Steps in the clinical laboratory investigations were standardized, and all were subject to ongoing reliability control. The clinical problem is usually not to differentiate alcohol abusers or alcoholics from healthy persons but rather to identify the alcoholics among a population of patients with a variety of illnesses.For this reason 70 patients from two hospitals who were clearly neither alcohol abusers nor alcoholics were studied in exactly the same manner s the alcoholics.In this combined group of 152 hospitalized patients significant differences were found in the distribution of the values for the alcoholics and the non-alcoholics for the following clinical chemical and haematological parameters: at the 0.1% level γ-glutamyltransferase, aspartate minotransferase, urea, creatinine and mean corpuscular volume (MCV), and at the 1% level glutamate dehydrogenase, alanine aminotransferase and alkaline phosphatase. From these eight parameters those combinations of between two and six parameters were selected that discriminated best between the alcoholics and the non-alcoholics. Using conventional decision limits the following was found: Fpr the alcoholics two or more of the res lts for the following five parameters were outside the decision limits given in parentheses: γ-glutamyltransferase (^28 U/l), aspartate aminotransferase (^18 U/l), alanine aminotransferase (^22 U/l), MCV (^96 fl), creatinine (^66.3 μπιοΐ/ΐ). The diagnostic sensitivity (alcoholics) is 85%, the diagnostic specificity (non-alcoholics) is 64%.For the non-alcoholics three or fewer results were outside the decision limits given in parentheses: γ-glutamyltransferase (<28 U/l), aspartate aminotransferase (<18 U/l), MCV (<96 fl), creatinine (>66.3 μιηοΐ/ΐ), urea-N (>5.0 mmol/1 With the decision limits given above and this combination of parameters the diagnostic specificity (non-alcoholics) is 96% and the diagnostic sensitivity (alcoholics) is 50%.This procedure thus enables the detection and exclusion of alcoholism in men on the basis of clinical laboratory findings. By optimizing the decision limits, the diagnostic test criteria sensitivity, specificity and efficiepcy can be iniproved. Optimized decision limits for the di...

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Improvement of Physical Health and Quality of Life of Alcohol-Dependent Individuals With Topiramate Treatment<subtitle>US Multisite Randomized Controlled Trial</subtitle>

Johnson

Rosenthal²,

Capece³

et al. 2008

Arch Intern Med

115

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Background: Topiramate can improve drinking outcomes via a hypothesized mechanism of facilitating ␥aminobutyric acid function and inhibiting glutaminergic pathways in the corticomesolimbic system. We sought to determine whether topiramate's antidrinking effects are bolstered by improvements in physical and psychosocial well-being.Methods: In a 17-site, 14-week, double-blind, randomized controlled trial, we compared the effects of topiramate (up to 300 mg/d) vs placebo on physical health, obsessional thoughts and compulsions about using alcohol, and psychosocial well-being among 371 alcoholdependent subjects who received weekly adherence enhancement therapy.Results: Topiramate was more efficacious than placebo in reducing body mass index (calculated as weight in kilograms divided by height in meters squared) (mean difference, 1.08; 95% confidence interval [CI], 0.81-1.34; PϽ.001), all liver enzyme levels (PϽ.01 for all comparisons), plasma cholesterol level (mean difference, 13.30 mg/dL; 95% CI, 5.09-21.44 mg/dL; P = .002), and sys-Author Affiliations are listed at the end of this article. Group Information: The members of the Topiramate for Alcoholism Advisory Board and the Topiramate for Alcoholism Study Group are listed on page 1198.

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Alcoholism: a controlled trial of "treatment" and "advice".

Cited by 451 publications

References 0 publications

Radioimmuntest zur Bestimmung von Humanmyoglobin: Untere Nachweisgrenze, Präzision, Verlaufskontrolle beim myoglobinurischen Nierenversagen

Radioimmuntest zur Bestimmung von Humanmyoglobin: Untere Nachweisgrenze, Präzision, Verlaufskontrolle beim myoglobinurischen Nierenversagen

Detection and Exclusion of Alcoholism in Men on the Basis of Clinical Laboratory Findings

Improvement of Physical Health and Quality of Life of Alcohol-Dependent Individuals With Topiramate Treatment<subtitle>US Multisite Randomized Controlled Trial</subtitle>

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