[Use of the CAGE questionnaire for detecting alcohol use disorders in the emergency room]. / Emprego do questionário CAGE para detecção de transtornos de uso de álcool em pronto-socorro.

BACKGROUND: Alcoholism is seldom detected among emergency room outpatients, which is attributed to the non-adoption of diagnostic routines, to the difficulty of doing a special anamnesis for diagnosing alcoholism, and to the lack of sensitivity and specificity of the laboratory tests. This study has the purpose to determine whether the CAGE assay (composed by 4 questions of easy memorization) is able to supply this difficulty in detecting alcoholism. MATERIAL AND METHODS: We did a transversal study with consecutive sampling among outpatients of the Internal Medicine Department at Cajuru University Hospital emergency room. They were submitted to a standardized interview constituted by the CAGE and the CIDI assays (Composite International Diagnostic Interview, "demographics" and "disorders resulting from the use of alcohol" sections). From the sample obtained (n=374), we correlated the prevalence of alcoholism according to both questionnaires, considering the CIDI (DSM-IV criteria) to be the gold standard. RESULTS: The prevalence of alcohol dependence according to the DSM-IV criteria was 15.77%. We verified that the CAGE has 84.74% of sensitivity and 73.33% of specificity, with a cut point of 2 positive responses. CONCLUSIONS: We concluded that the CAGE is an instrument of easy application and good sensitivity and specificity when used at the emergency room, being able to supply the difficulties of alcoholism detection. We suggest that the CAGE be adapted as a routine at emergency rooms, increasing the alcoholism detection rate.

Emprego do questionário CAGE para detecçäo de transtornos de uso de álcool em pronto-socorro / Use of the CAGE questionnaire for detecting alcohol use disorders at the emergency room

OBJETIVO: Determinar se o questionário CAGE (composto por quatro perguntas de fácil memorizaçäo) é capaz de suprir a dificuldade de detecçäo do alcoolismo. MATERIAL E METODO: Realizamos um estudo transversal com amostragem consecutiva em pacientes da Clínica Médica do pronto-socorro do Hospital Universitário Cajuru, os quais foram submetidos a uma entrevista padronizada constituída pelo questionário CAGE e pelo CIDI (Composite International Diagnostic Interview, seções "demografia" e "desordens resultantes do uso de ßlcool"). Da amostra obtida (n=374), correlacionamos a prevalência de alcoolismo segundo ambos os questionários, considerando o CIDI (critérios do DSM-IV) como sendo o padräo-ouro. RESULTADOS: A prevalência de dependência de álcool segundo os critérios do DSM-IV foi de 15,77 por cento. Nós verificamos que o CAGE possui sensibilidade igual a 84,74 por cento e especificidade igual a 73,33 por cento para um ponto de corte igual a duas respostas afirmativas. Conclusöes: Concluímos que o questionário CAGE é um instrumento de fácil aplicaçäo e boa sensibilidade e especificidade quando usado no ambiente de pronto-socorro, podendo suprir as dificuldades de detecçäo do alcoolismo. Sugerimos que o questionário CAGE seja adotado como rotina no pronto-socorro, permitindo que o Ýndice de detecçäo de alcoolismo aumente

Production and characterization of a bacterial single-chain Fv fragment specific to human truncated midkine.

The production (and characterization) of a monoclonal antibody against human truncated midkine (tMK), and the detection of tMK in G401 cells, a Wilms' tumor cell line, as well as in Wilms' tumor patient specimens, have been reported (Paul et al., Cancer Lett. 163 (2001) 245-251). Here we report the molecular cloning and expression of this monoclonal antibody as a single-chain Fv fragment (scFv) in Escherichia coli. The scFv protein, purified by immobilized metal affinity chromatography, showed a specific affinity to recombinant tMK and native tMK in G401 cells as detected by enzyme-linked immunosorbent assay and immunofluorescence microscopy, respectively. The binding of this protein to recombinant tMK was competitive with the parental monoclonal antibody. These results suggest that this scFv can also be used for Wilms' tumor detection.