Facolta di Medicina e Chirurgia , Universita degli Studi di Torino, Italia.

Instituto de Medicina Tropical, Instituto Príncipe Leopoldo, Ambéres, Bélgica.

Universidad Católica del Sagrado Corazón , Roma Italia. Hospital Agostino Gemelli, Roma, Italia. Centre Hospitalier Universitaire Vaudois, Lausanne, Suiza. Gerontología Pontificia Universidad Católica de Chile. Diploma AIH. Academia Internacional de Homotoxicología.Alemania Clínica de Asma y Alergia Reparto Serrano #12 Email: jhsdoctor@hotmail.com Tel. 2278 1169, 2 270 3359, 8946-5022, 8882 5513. Luchar Contra la adicción al Alcohol. Aparecieron las Guias NICE, y se trata el problema en un grupo de edad ( 10-17 ) , para muchos de nosotros problema inédito. Pido al lector en español disculpas por no hacer este documento bilingüe , pero , a medida que podamos lo iremos enriqueciendo con documentos en español.

Trastornos por uso del Alcohol. DSM V
Alcohol Use Disorder A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 (or more) of the following, occurring within a 12-month period: 1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household) 2. recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use) 3. continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights) 4. tolerance, as defined by either of the following: …..

Alcohol Units Definitions:

Clínica de Asma y Alergia. Tel 2278 1168, 2270 3359, C 8946 5022, M8882 5513. viernes, 03 de febrero de 2012

Units of alcohol are a measure of the volume of pure alcohol in an alcoholic beverage. Such units are used in some countries as a guideline for a drinker's alcohol consumption. One unit of alcohol is defined as 10 millilitres in the United Kingdom, and as 10 grams (12.7 ml) in Australia. In both countries, a so-called standard drink contains one unit of alcohol (according to the country's own definition). The definition of a "standard drink" varies significantly in other countries. In the United Kingdom, the number of units contained in a typical serving of an alcoholic beverage is publicised and printed on bottles.

Imagenes del British Liver Trust:

Clínica de Asma y Alergia. Tel 2278 1168, 2270 3359, C 8946 5022, M8882 5513. viernes, 03 de febrero de 2012

Campaign on alcohol units:

NHS campaing on alcohol units :

Clínica de Asma y Alergia. Tel 2278 1168, 2270 3359, C 8946 5022, M8882 5513. viernes, 03 de febrero de 2012

Tools for Screening
1. 2.

Alcohol use or Misuse.

Severity Alcohol Dependence Questionaire ( SADQ). Leeds Dependance Questionnaire ( LDQ)

3. Alcohol Problem Questionaire. ( APQ) 4. Mini Mental State Exammination (MMSE). 5. Alcohol Use Disorder Identification Test ( AUDIT )
REVISIÓN CRÍTICA DE LA PRÁCTICA CLÍNICA Papel del test AUDIT(Alcohol Use Disorders IdentificationTe s t ) para la detección de consumo excesivo de alcoholen Atención Primaria Vol. 11 – Núm. 9 – Octubre-Noviembre 2001 MEDIFAM 2001; 11: 553-557 The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care S e c o n d E d i t i o n, Thomas F. Babor, John C. HigginsBiddle John B. Saunders, Maristela G. Monteiro.

Test AUDIT español, imprimir y evaluar al paciente.
Clínica de Asma y Alergia. Tel 2278 1168, 2270 3359, C 8946 5022, M8882 5513. viernes, 03 de febrero de 2012

Alcohol Dependence: Dependencia al Alcohol .
Alcohol dependence is characterised by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking). Alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders. Although alcohol dependence is defined in ICD-10 and DSM-IV in categorical terms for diagnostic and statistical purposes as being either present or absent, in reality dependence exists on a continuum of severity. However, it is helpful from a clinical perspective to subdivide dependence into categories of mild, moderate and severe. People with mild dependence (those scoring 15 or less on the Severity of Alcohol Dependence Questionnaire; SADQ) usually do not need assisted alcohol withdrawal. People with moderate dependence (with a SADQ score of between 15 and 30) usually need assisted alcohol withdrawal, which can typically be managed in a community setting unless there are other risks. People who are severely alcohol dependent (with a SADQ score of more than 30) will need assisted alcohol withdrawal, typically in an inpatient or residential setting. In this guideline these definitions of severity are used to guide selection of appropriate interventions.

Guías Británicas NICE
NHS National Institute for Health and Clinical Excellence. Clinical guidelines, CG115 - Issued: February 2011
This clinical guideline offers evidence-based advice on the diagnosis, assessment and management of harmful drinking and alcohol dependence in adults and in young people aged 10–17 years. This is one of three pieces of NICE guidance addressing alcohol-related problems and should be read along with:
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Quick reference guide (PDF) NICE Guideline (PDF)

Clínica de Asma y Alergia. Tel 2278 1168, 2270 3359, C 8946 5022, M8882 5513. viernes, 03 de febrero de 2012

Full Guideline

Favor considerar para vuestras presentaciones:
CG115 Alcohol dependence and harmful alcohol use: slide set 31 August 2011

Alcohol-use disorders: preventing the development of hazardous and harmful drinking. NICE public health guidance 24 (2010) - public health guidance on the price, advertising and availability of alcohol, how best to detect alcohol misuse in and outside primary care, and brief interventions to manage it in these settings. Alcohol-use disorders: diagnosis and clinical management of alcoholrelated physical complications. NICE clinical guideline 100 (2010) clinical guideline covering acute unplanned alcohol withdrawal including delirium tremens, alcohol-related liver damage, alcohol-related pancreatitis and management of Wernicke’s encephalopathy.

Alcohol-use disorders: physical complications
Clinical guidelines, CG100 - Issued: June 2010 The advice in the NICE guideline covers: The care of adults and young people (aged 10 years and older) who have any of the following physical health problems that are completely or partly caused by alcohol use:

acute alcohol withdrawal (which occurs if a ‘dependent’ drinker suddenly stops drinking) lack of thiamine (also called vitamin B1) in the body, which can cause a condition called Wernicke’s encephalopathy liver disease inflammation of the pancreas (called pancreatitis). Quick reference guide (PDF) NICE Guideline (PDF)

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Clínica de Asma y Alergia. Tel 2278 1168, 2270 3359, C 8946 5022, M8882 5513. viernes, 03 de febrero de 2012

Full Guideline (PDF)

Favor considerar estas diapositivas para vuestras presentaciones… CG100 Alcohol-use disorders: physical complications: slide set 31 August 2011

Por el momento , no tenemos otro material en español , favor enriquecer el album. Desde Nicaragua. Dr. Juan Herrera Salazar. Clínica de Asma y Alergia

Clínica de Asma y Alergia. Tel 2278 1168, 2270 3359, C 8946 5022, M8882 5513. viernes, 03 de febrero de 2012