Transferrina carbohidrato deficiente, gammaglutamil transferasa y volumen corpuscular medio en la evaluación de la ingesta alcohólica reciente de bebedores excesivos / Carbohydrate deficient transferrin for the assessment of recent alcohol intake in excessive drinkers

Background: There are no reliable markers to detect heavy drinking or as a tool to control abstinence compliance in alcoholic treatments. The Mean Corpuscular Volume (MCV), and the gammaglutamyl transpeptidase (GGT), are widely used although their predictive value is somewhat limited due to their low specificity. On the other hand, the Carbohydrate-deficient transferrin (CDT) described in the eighties is highly specific and would be of value in early detection of problem drinking. Aim: To compare the sensitivity and specificity of CDT, GGT, and MCV in order to evaluate their single and combined use as markers for detection of heavy drinking behaviour. Patients and Methods : CDT, GGT, and MCV values were determined in blood samples from (a) alcoholics (drinking more than 100 9 alcohol/day; n=47) and (b) healthy volunteers, teetotalers from the Church of Saints of Later Days (n=34). At the time of sampling alcoholics were presently drinking or had been abstinents for no more than six weeks. ROC curves were used to determine the best cut-off point for each marker. Results: Sensitivity was found to be similar for all three markers. Specificity was found higher for GGT (90.9 percent) and CDT (91.0 percent). The combined use of MCV, GGT and CDT, that is, when at least one of the markers is altered, was shown to detect 83 percent of the patients. No correlation was observed between the markers and the level of alcohol intake. Conclusions: CDT could be of value as a marker to detect heavy drinking when used with GGT and MCV values combined. CDT is particularly higher in drinking alcoholics and remains significantly high for at least six weeks after they stop drinking

Estudio del volumen y de la cinética del vaciamiento vesicular en mujeres nuligestas en embarazadas y puérperas / Study of gallbladder volumen and emptying kinetics in non-pregnant, in pregnant and in puerperium women

Gallbladder stats apparently plays an important role in the pathogenesis of cholelithiasis during pregnancy. On the other hand, gallstones diagnosed immediatly after delivery disappear spontaneously during late puerperium in one third of these patients. Gallbladder emptying was assessed by biliary scintigraphy and ultrasonography in normal, multiparous volunteers. The two methods had an excellent correlation: thence, we used ultrasonography to determine gallbladder volume and contraction in pregnant and puerperal women. Fasting and postpandrial residual volumes were significantly larger during pregnancy, while the kinetics of gallbladder emptying was similar in nulliparous and pregnant women. During puerperium, gallbladder volume returned to the values observed in nulliparae; but the kinetics of emptying was significantly faster, suggesting an increased sensitivity of gallbladder muscle to physiologic stimuli