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https://www.readbyqxmd.com/read/29336434/acg-clinical-guideline-alcoholic-liver-disease
#1
Ashwani K Singal, Ramon Bataller, Joseph Ahn, Patrick S Kamath, Vijay H Shah
Alcoholic liver disease (ALD) comprises a clinical-histologic spectrum including fatty liver, alcoholic hepatitis (AH), and cirrhosis with its complications. Most patients are diagnosed at advanced stages and data on the prevalence and profile of patients with early disease are limited. Diagnosis of ALD requires documentation of chronic heavy alcohol use and exclusion of other causes of liver disease. Prolonged abstinence is the most effective strategy to prevent disease progression. AH presents with rapid onset or worsening of jaundice, and in severe cases may transition to acute on chronic liver failure when the risk for mortality, depending on the number of extra-hepatic organ failures, may be as high as 20-50% at 1 month...
January 16, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29317849/is-medical-treatment-of-alcohol-withdrawal-syndrome-a-stag-hunt-challenges-and-opportunities-in-managing-risk-and-uncertainty-in-addiction-cessation
#2
Roger Lee Mendoza
Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them. Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider...
2018: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/29302560/benzodiazepine-maintenance-for-alcohol-dependence-a-case-series
#3
Shivanand Kattimani, Balaji Bharadwaj, Anand Babu Arun
Alcohol addiction is a chronic relapsing syndrome. Benzodiazepines remain as the mainstay for detoxification, taking care of the acute withdrawal syndrome. There is fear of dependence and abuse of benzodiazepines on prolonged use. Here, we selectively interviewed ten cases who were on longer duration of benzodiazepines to elicit their potential perceived benefits, attitudes, and any adverse effect. Three patients experienced adverse effects. None of them had features of benzodiazepine dependence. We opine that in select cases, benzodiazepine use should persist beyond detox period, and its benefits continue beyond the acute withdrawal phase while monitoring their safety/adverse effects...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29276297/patient-outcomes-associated-with-phenobarbital-use-with-or-without-benzodiazepines-for-alcohol-withdrawal-syndrome-a-systematic-review
#4
Drayton A Hammond, Jordan M Rowe, Adrian Wong, Tessa L Wiley, Kristen C Lee, Sandra L Kane-Gill
Purpose: Benzodiazepines are the drug of choice for alcohol withdrawal syndrome (AWS); however, phenobarbital is an alternative agent used with or without concomitant benzodiazepine therapy. In this systematic review, we evaluate patient outcomes with phenobarbital for AWS. Methods: Medline, Cochrane Library, and Scopus were searched from 1950 through February 2017 for controlled trials and observational studies using ["phenobarbital" or "barbiturate"] and ["alcohol withdrawal" or "delirium tremens."] Risk of bias was assessed using tools recommended by National Heart, Lung, and Blood Institute...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29274671/incidence-rates-of-admissions-associated-with-alcohol-withdrawal-syndrome-in-spain-analysis-of-minimum-basic-data-set-1999-2010
#5
Raquel Gómez-Méndez, Rafael Monte-Secades, Pablo Ventura-Valcárcel, Ramón Rabuñal-Rey, Héctor Guerrero-Sande, Antonio J Chamorro-Fernández, Sonia Pértega-Díaz
BACKGROUND: There are no data on the incidence of admissions associated with alcohol withdrawal syndrome (AWS) or about its trend over time in Spain. OBJECTIVE: To analyze the characteristics, incidence rates and trends over time of hospital admissions associated with AWS in Spanish public hospitals. MATERIAL AND METHOD: Analysis from the Spanish public hospitals minimum basic data set of hospital admissions with AWS (CIE9-MC 291.81), alcohol withdrawal delirium (CIE9-MC 291...
December 20, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29219048/sodium-oxybate-therapy-for-the-treatment-of-alcohol-withdrawal-syndrome-and-the-maintenance-of-alcohol-abstinence
#6
Carmen Mannucci, Simona Pichini, Elvira Ventura Spagnolo, Fabrizio Calapai, Sebastiano Gangemi, Michele Navarra, Gioacchino Calapai
BACKGROUND: Gamma-hydroxybutyrate (GHB or sodium oxybate) is both an exogenous and endogenous molecule with neuromodulator properties. In the United States, GHB is an approved drug for the treatment of narcolepsy and narcolepsy with cataplexy in adults. In some European Union countries, sodium oxybate is applied for the treatment of opioid and alcohol withdrawal. OBJECTIVE: The aim of the present review was to describe the state of art of the pre-clinical research and the clinical evidence related to GHB used alone or in combination with other treatments in alcohol withdrawal syndrome and alcohol abstinence maintenance...
December 7, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/29200566/opioid-withdrawal-presenting-as-delirium-and-role-of-buprenorphine-a-case-series
#7
Sourav Das, Divyashree Sah, Shiladitya Nandi, Payel Das
Opioid withdrawal is very rarely characterized by delirium unlike alcohol or benzodiazepine withdrawal. PubMed search through October 2016 reveals only two case series on delirium as feature of withdrawal in opioid dependence syndrome. We report two cases of opioid withdrawal (heroin) presenting with delirium when low-dose buprenorphine (2 mg/day) was added. Both the cases had no other substance abuse history and nil contributory past and family history. Both of them were improved after increasing the buprenorphine dosage to 6-8 mg/day...
September 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/29200055/the-addition-of-dexmedetomidine-as-an-adjunctive-therapy-to-benzodiazepine-use-in-alcohol-withdrawal-syndrome-a-literature-review
#8
(no author information available yet)
No abstract text is available yet for this article.
October 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/29200045/the-addition-of-dexmedetomidine-as-an-adjunctive-therapy-to-benzodiazepine-use-in-alcohol-withdrawal-syndrome-a-literature-review
#9
Tarenne A Ferenchak
Alcohol withdrawal syndrome (AWS) is commonly encountered in the intensive care unit population. Currently, the mainstay treatment for AWS is the use of benzodiazepines. However, some patients are refractory to benzodiazepine treatment due to heavy alcohol abuse. In addition, escalating doses of benzodiazepines can lead to respiratory depression, requiring intubation and mechanical ventilation. Intubation and mechanical ventilation increase both intensive care unit and hospital length of stay. The addition of pharmacological agents to reduce the amount of benzodiazepine use in AWS has recently been studied...
October 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/29191394/medications-for-alcohol-use-disorders-an-overview
#10
REVIEW
Mohammed Akbar, Mark Egli, Young-Eun Cho, Byoung-Joon Song, Antonio Noronha
Patients who suffer from alcohol use disorders (AUDs) usually go through various socio-behavioral and pathophysiological changes that take place in the brain and other organs. Recently, consumption of unhealthy food and excess alcohol along with a sedentary lifestyle has become a norm in both developed and developing countries. Despite the beneficial effects of moderate alcohol consumption, chronic and/or excessive alcohol intake is reported to negatively affect the brain, liver and other organs, resulting in cell death, organ damage/failure and death...
November 27, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29189171/inappropriate-sinus-tachycardia
#11
Mohammed Ruzieh, Abdelmoniem Moustafa, Ebrahim Sabbagh, Mohammad M. Karim, Saima Karim
Definition and diagnosis: Inappropriate Sinus Tachycardia (IST) is a clinical syndrome characterized by a sinus heart rate inexplicably higher than one hundred beats per minute at rest that is associated with symptoms like palpitations, dyspnea or dizziness in the absence of primary causes of tachycardia. The diagnosis requires exclusion of other causes of tachycardia including medications/substances (such as anti-cholinergic, beta-blocker withdrawal, caffeine, and alcohol) or medical conditions (such as panic attacks, pulmonary embolism, fever, hyperthyroidism, hypovolemia, anemia, and pain)...
November 29, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29177883/non-competitive-nmda-receptor-antagonist-hemantane-reduces-ethanol-consumption-in-long-term-alcohol-experienced-rats
#12
L G Kolik, A V Nadorova, S B Seredenin
Activity of hemantane, an amino adamantane derivative, exhibiting the properties of lowaffinity non-competitive NMDA receptor antagonist, was evaluated in experimental in vivo models of alcoholism. Hemantane had no effects on the formation and manifestation of behavioral sensitization to ethanol in DBA/2 mice. Under conditions of free choice between 10% ethanol and water, hemantane (20 mg/kg/day for 14 days, intraperitoneally) significantly reduced the daily ethanol intake in random-bred male rats with formed alcohol motivation (>4 g/kg of ethanol)...
November 27, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29160944/ketogenic-diet-suppresses-alcohol-withdrawal-syndrome-in-rats
#13
Ditte Dencker, Anna Molander, Morgane Thomsen, Chantal Schlumberger, Gitta Wortwein, Pia Weikop, Helene Benveniste, Nora D Volkow, Anders Fink-Jensen
BACKGROUND: Alcohol use disorder is under-diagnosed and under-treated, and up to 50% of alcohol abstinent patients diagnosed with alcohol dependence relapse within the first year of treatment. Current treatments for the maintenance of alcohol abstinence in patients with alcohol use disorder have limited efficacy, and there is an urgent need for novel treatment strategies. Decreased cerebral glucose metabolism and increased brain uptake of acetate was recently reported in heavy drinkers, relative to controls...
November 21, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/29145260/reversible-severe-fatty-liver-induced-by-capecitabine-a-case-report
#14
Yiyan Jiang, Qiancheng He, Suxia Li, Chang Shi, Xiaolei Yang
RATIONALE: Capecitabine (CAP) is a chemotherapeutic agent used to treat breast and gastrointestinal cancers. The most common adverse reactions of CAP primarily included gastrointestinal and dermatological effects. Whereas, the CAP-induced fatty liver had never been reported. PATIENT CONCERNS: In this study, a-69-year old female presented a history of hypertension with regulated blood pressure, whereas diabetes mellitus, hyperlipidemia, and hepatitis were excluded...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135112/symptom-triggered-alcohol-vapor-inhalation-for-postoperative-alcohol-withdrawal-syndrome-in-patients-with-gastroesophageal-carcinoma
#15
Fengwei Kong, Miao Zhang, Heng Wang, Dong Liu, Ying Wu, Ning Chai, Wenbin Wu
PURPOSE: The purpose of this study was to investigate the feasibility and efficacy of alcohol vapor inhalation during fasting time for cancer patients with alcohol withdrawal symptoms (AWS) after surgery. METHODS: The data of 51 patients after esophagectomy or gastrectomy for gastroesophageal carcinoma in two hospitals from January 2011 to December 2016 was retrospectively analyzed. These patients were diagnosed with AWS with Clinic Institute Alcohol Withdrawal Syndrome Scale (CIWA-Ar) score ≥ 9 in two hospitals during fasting time from January 2011 to December 2016, and they were accordingly divided into alcohol vapor group (n=25) and diazepam group (n=26)...
September 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29045753/association-between-the-rs1229984-polymorphism-in-the-alcohol-dehydrogenase-b-adh1b-gene-and-risk-for-restless-legs-syndrome
#16
Félix Javier Jiménez-Jiménez, Javier Gómez-Tabales, Hortensia Alonso-Navarro, Martín Zurdo, Laura Turpín-Fenoll, Jorge Millán-Pascual, Teresa Adeva-Bartolomé, Esther Cubo, Francisco Navacerrada, Ana Rojo-Sebastián, Lluisa Rubio, Mónica Díez-Fairén, Pau Pastor, Marisol Calleja, José Francisco Plaza-Nieto, Belén Pilo-de-la-Fuente, Margarita Arroyo-Solera, Esteban García-Albea, José A G Agúndez, Elena García-Martín
Background/Objective: Several studies have raised the possibility of an association between alcohol consumption and the risk of developing restless legs syndrome (RLS). Moreover, an important percentage of patients under alcohol detoxification therapy develop RLS symptoms fulfil the criteria for idiopathic RLS during alcohol withdrawal. We have aimed to establish the possible association between 2 common single nucleotide polymorphisms (SNPs) in the alcohol-dehydrogenase 1B (ADH1B) gene, and the risk for RLS...
October 16, 2017: Sleep
https://www.readbyqxmd.com/read/29033486/topiramate-induced-acute-liver-injury-a-rare-adverse-effect
#17
Archish Khivsara, Jeffrey Pradeep Raj, Divya Hegde, Mangala Rao
Idiosyncratic drug-induced liver injury (DILI) is damage to liver occurring at recommended dose of a drug in contrast to toxic or predictable DILI. Although it is common in first-generation antiepileptic drugs (AEDs), it is rare in newer AEDs such as topiramate. Topiramate commonly causes neurological adverse effects such as psychomotor slowing and somnolence. Hepatotoxicity by topiramate is rare and has been previously reported in combination with other drugs such as valproate and carbamazepine. Here, we report a case of topiramate-induced asymptomatic elevation of liver enzymes in an adult man diagnosed with alcohol dependence syndrome and alcohol withdrawal complicated with seizures...
May 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28981333/evaluation-of-the-appropriate-use-of-a-ciwa-ar-alcohol-withdrawal-protocol-in-the-general-hospital-setting
#18
Amanda S Eloma, Jason M Tucciarone, Edmund M Hayes, Brian D Bronson
BACKGROUND: The Clinical Institute Withdrawal Assessment-Alcohol, Revised (CIWA-Ar) is an assessment tool used to quantify alcohol withdrawal syndrome (AWS) severity and inform benzodiazepine treatment for alcohol withdrawal. OBJECTIVES: To evaluate the prescribing patterns and appropriate use of the CIWA-Ar protocol in a general hospital setting, as determined by the presence or absence of documented AWS risk factors, patients' ability to communicate, and provider awareness of the CIWA-Ar order...
October 5, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28936822/-posterior-reversible-encephalopathy-syndrome-triggerred-by-alcohol-withdrawal
#19
Tuğçe Mengi, Yaprak Seçil, Aysel Çoban, Yeşim Beckmann
INTRODUCTION: Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity characterized by headache, altered mental status, epileptic seizures, visual disturbances and typically transient changes in posterior cerebral circulation areas. In this article, we present a case of alcohol withdrawal accompanied by PRES. CASE PRESENTATION: A 53-year-old male patient presented to the emergency department with visual hallucinations and meaningless speech...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28931433/role-of-gabaa-receptors-in-alcohol-use-disorders-suggested-by-chronic-intermittent-ethanol-cie-rodent-model
#20
REVIEW
Richard W Olsen, Jing Liang
GABAergic inhibitory transmission is involved in the acute and chronic effects of ethanol on the brain and behavior. One-dose ethanol exposure induces transient plastic changes in GABAA receptor subunit levels, composition, and regional and subcellular localization. Rapid down-regulation of early responder δ subunit-containing GABAA receptor subtypes mediating ethanol-sensitive tonic inhibitory currents in critical neuronal circuits corresponds to rapid tolerance to ethanol's behavioral responses. Slightly slower, α1 subunit-containing GABAA receptor subtypes mediating ethanol-insensitive synaptic inhibition are down-regulated, corresponding to tolerance to additional ethanol behaviors plus cross-tolerance to other GABAergic drugs including benzodiazepines, anesthetics, and neurosteroids, especially sedative-hypnotic effects...
September 20, 2017: Molecular Brain
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