scholarly journals Patterns of alcohol consumption after liver transplantation

Gut ◽  
1998 ◽  
Vol 43 (1) ◽  
pp. 140-145 ◽  
Author(s):  
H Tang ◽  
R Boulton ◽  
B Gunson ◽  
S Hubscher ◽  
J Neuberger

Background—Uncertainty exists about the extent and consequences of a return to alcohol consumption after liver transplantation for alcoholic liver disease (ALD).Aims—To determine the prevalence and consequences of alcohol consumption in patients transplanted for ALD.Methods—A retrospective case controlled study of all patients transplanted for ALD at the Queen Elizabeth Hospital, Birmingham, between 1987 and 1996.Results—Seventy patients with ALD were transplanted, of which 59 survived more than three months; 56 were interviewed. Twenty eight had consumed some alcohol after transplantation; for the nine “heavy drinkers” (HD), the median time to resumption of alcohol intake was six months and for the 19 “moderate drinkers” (MD) it was eight months. There was no significant difference in episodes of acute rejection or compliance with medication between those who were abstinent, MD, or HD. Histological evidence of liver injury was common in ALD patients who had returned to drink. Mild fatty change was found in 1/11 biopsy specimens from abstinent patients but moderate to severe fatty change and ballooned hepatocytes were seen in 3/5 MD and 2/5 HD specimens. Two HD patients had early fibrosis. One HD patient has died of alcohol related complications.Conclusions—Moderate to heavy alcohol consumption occurs in patients transplanted for ALD. Patient recall of abstinence advice is unreliable, and patients return to alcohol mainly within the first year after liver transplantation. Return to alcohol consumption after liver transplantation is associated with rapid development of histological liver injury including fibrosis.

Author(s):  
Austin J. Kulp ◽  
Xihe Zhu

Background/Purpose: Before school exercise programs (BSEPs) give students time for breakfast and add time to their daily physical activity. However, the effects of BSEP on physical fitness and academic achievement in the classroom remain unclear. The purpose of this study is to examine the effects of BSEP on cardiorespiratory fitness and academic performance among fourth- and fifth-grade students. Method: A retrospective case-controlled design was used in this study. Fourth and fifth graders (N = 84) were participants, half signed up for BSEP that met once a week for 10 weeks. A retrospectively case-controlled comparison group was generated from the classmates of those in BSEP in the same school. All students took PACER and statewide academic performance assessments. Multivariate analysis of covariance for student cardiorespiratory fitness, and mathematics and reading, were conducted, adjusting for pretest performances. Analysis/Results: There were improvements for both groups in academic performances and cardiorespiratory fitness. The cardiorespiratory fitness and reading test improvements were greater in the BSEP group than those in the comparison group, controlling for their pretests. However, there was no significant difference in student mathematics test performances. Conclusion: Students in BSEP group benefited from participating in the program with greater improvement in cardiorespiratory and reading test performances than the comparison group. These findings suggested that providing a BSEP once a week for 45 min may be beneficial to fourth and fifth graders.


2009 ◽  
Vol 91 (5) ◽  
pp. 414-416 ◽  
Author(s):  
M Bhatia ◽  
B Singh ◽  
N Nicolaou ◽  
KJ Ravikumar

INTRODUCTION Concern exists regarding potential damage to the rotator cuff from repeated corticosteroid injections into the subacromial space. PATIENTS AND METHODS In this retrospective, case-controlled study, 230 consecutive patients presenting to three orthopaedic units with subacromial impingement and investigated as an end-point with magnetic resonance imaging (MRI) of the shoulder were divided into groups having received less than three or three or more subacromial injections of corticosteroids. RESULTS With no significant difference in age and sex distribution, analysis by MRI showed no significant difference between the two groups in the incidence of rotator cuff tear (P < 1.0). CONCLUSIONS This suggests that corticosteroid use in patients with subacromial impingement should not be considered a causative factor in rotator cuff tears.


2002 ◽  
Vol 16 (10) ◽  
pp. 672-676 ◽  
Author(s):  
Geneviève Tessier ◽  
Edith Villeneuve ◽  
Jean-Pierre Villeneuve

BACKGROUND: Acute liver failure is a rare condition in which massive liver injury is associated with the rapid development of hepatic encephalopathy. Although viral hepatitis and drug-induced liver injury are the most common causes, no specific etiology is found in a substantial proportion of cases reported from Europe and the United States.AIM: To determine the etiology and outcome of patients with acute liver failure in the authors’ institution.PATIENTS AND METHODS: The charts of 81 consecutive patients admitted to Saint-Luc between 1991 and 1999 were reviewed.RESULTS: The etiology was viral in 27 cases (33.2%), toxic or drug-induced in 22 (27.2%), of unknown origin in 22 (27.2%) and due to various causes in 10 (12.3%) (autoimmune, vascular, cancer). Of the 81 patients, 16% survived without liver transplantation, and 84% died or underwent liver transplantation. Survival without liver transplantation differed according to the mode of presentation: the survival rate was 27% in patients with hyperacute liver failure, 7% in those with acute liver failure and 0% in those with subacute liver failure. Among the 38 patients who underwent liver transplantation, survival one year after transplantation was 71%. In the 30 patients who died without liver transplantation, the main causes of death were cerebral edema and sepsis.CONCLUSIONS: Acute liver failure is associated with a high mortality, and liver transplantation is the treatment of choice. In a significant proportion of cases, the etiology remains undetermined and is probably related to yet unidentified hepatotropic viruses.


Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S12.1-S12
Author(s):  
Jacob I. McPherson ◽  
Patrick Sparks ◽  
Mohammad Nadir Haider ◽  
Barry Stewart Willer ◽  
John J. Leddy

ObjectiveTo determine if concussed adolescents with positive cervical findings on examination provided with early cervical treatment demonstrate recovery time and incidence of persistent post-concussive symptoms (PPCS, recovery = 30 days) comparable to those without cervical findings.BackgroundCervical impairments resulting from concussive injury are historically associated with longer recovery times. Concomitant cervical injuries may result in symptoms that overlap with concussion, including headache, dizziness, tinnitus, sleep disturbances, and blurred vision. Current recommendations include assessment of the cervical spine; however, there is limited evidence for the effect of immediate cervical intervention on recovery.Design/MethodsRetrospective case-controlled study. Patients included adolescents with acute concussion presenting with (n = 132, 14.99 ± 1.9 years, 58% male, 5.70 ± 3.3 days since injury) and without (n = 138, 14.85 ± 1.8 years, 65% male, 6.13 ± 3.4 days since injury) cervical findings on physical exam. Patients were assessed with the Buffalo Concussion Physical Examination (BCPE), Neck Disability Index (NDI) and Post-Concussion Symptom Scale (PCSS) instruments. Groups were separated based on positive or negative cervical findings on the BCPE. Cervical impairments were addressed by physicians specializing in concussion management using a clinical algorithm. Mild impairments were managed conservatively (over-the-counter analgesics, warm/cold compresses, and/or neck stretching exercises). Patients with moderate or greater impairments were assessed by a physical therapist at the initial clinic encounter and given specific cervical interventions.ResultsPhysician-observed cervical findings had moderate agreement with self-reported function on the NDI (? = 0.414, p < 0.001). Patients with cervical findings reported greater symptom severity on the PCSS (37.9 ± 22.1 vs 30.8 ± 20.2, p = 0.011); however, there was no significant difference in recovery time (34.44 ± 33.2 vs 34.81 ± 39.0 days, p = 0.933) or incidence of persistent symptoms (39% vs 35%, p = 0.511).ConclusionsIn this group of adolescents, cervical impairment managed early after concussion was not associated with prolonged recovery. Early management of cervical impairments may reduce the development of PPCS. Prospective evaluation is warranted.


2021 ◽  
Author(s):  
Fengming Tian ◽  
Wen Song ◽  
Liang Wang ◽  
Qiang Zeng ◽  
Zhenyu Zhao ◽  
...  

Abstract Pulmonary hypertension (PH) is one of the common complications in chronic obstructive pulmonary disease (COPD). The study aimed to evaluate the predicting ability of N-terminal pro brain natriuretic peptide (NT-pro BNP) in patients with AECOPD-PH and its relationship with the severity of PH. A large retrospective case-controlled study (n=1072) was performed in the First Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2020, and patients were divided into stable COPD (n=178), AECOPD (n=688) and AECOPD-PH group (n=206). In unadjusted analysis and PSM (model 1, 2, 3), red cell distribution width (RDW), total bilirubin (TBIL), and NT-pro BNP were higher in patients with AECOPD-PH than those in AECOPD group. Logistic regression analysis showed that RDW had no statistic difference. When the range of NT-proBNP was 271-1165 pg/mL (OR: 0.293; 95%CI: 0.184-0.467; P<0.001) and NT-proBNP > 1165pg/mL (OR: 0.559; 95%CI: 0.338-0.926; P=0.024), the morbidity risk of PH in AECOPD patients was increased, so did TBIL. In receiver operating characteristic (ROC) curves, at the cut-off value of NT-proBNP was 175.14 pg/mL, AUC was 0.651 (P<0.001), which was better than TBIL (AUC: 0.590, P<0.001). As for the results of rank correlation analysis, TBIL had no significant difference, and NT-proBNP had a weak correlation with severity of PH with AECOPD (r=0.299, P=0.001).Our findings suggest that NT-proBNP has a diagnostic efficacy in AECOPD-PH and NT-proBNP has a weak correlation with severity of PH with AECOPD.


1985 ◽  
Vol 30 (1) ◽  
pp. 8-14 ◽  
Author(s):  
N. Irvine ◽  
P. R. Ward ◽  
A. C. F. Kenmure

The case records of 50 consecutive male patients aged 40 years or under who were investigated by selective coronary arteriography after myocardial infarction were reviewed. Fourteen patients had normal coronary vessels and 36 patients had significant occlusive disease. Eighteen were considered to be in need of surgical treatment. The features of myocardial infarction on the ECG were less marked in the group of patients with normal coronary arteriograms. Many of these patients were asymptomatic and had complete resolution of the ECG changes. As well as having normal coronary arteries, many also had normal left ventricular angiograms. Cigarette smoking was very common in the whole group, 86 per cent of patients being moderately heavy cigarette smokers. Five of the 14 patients in the ‘non-occlusive’ group were non-smokers and only two of the 36 patients in the ‘occlusive’ group were non-smokers (P<0.01). The fasting serum cholesterol was significantly lower in the ‘non-occlusive’ group than in the ‘occlusive’ group. There was no significant difference between the two groups regarding blood pressure, family history of ischaemic heart disease, obesity or alcohol consumption. There was, however, a high incidence of heavy alcohol consumption amongst patients who subsequently required coronary artery surgery. Many of the patients in the ‘non-occlusive’ group were considered to have had smaller, more localised myocardial infarctions and a lesser degree of coronary disease which may not be detected by coronary arteriography. Others, with more widespread cardiac damage, could be explained on the basis of thrombosis and subsequent recanalisation.


2019 ◽  
Vol 73 (3) ◽  
pp. 6-10
Author(s):  
Daniel Majszyk ◽  
Antoni Bruzgielewicz ◽  
Ewa Osuch-Wójcikiewicz ◽  
Anna Rzepakowska ◽  
Kazimierz Niemczyk

Objectives: The aim of the study was the analysis of the epidemiology of laryngeal cancer over 10 years in relation to known risk factors and to assess the current survival rates in this group of patients. Methods: The data were retrospectively collected from patients’ medical records, then entered in the database using dedicated software and a statistical analysis was performed. Results: 512 subjects - 443 men (86.5%) and 69 women (13.5%) were enrolled into the study. The male-to-female ratio was 6.4:1. There were 97.1% smoking women and 98% smoking men, however the history of more than 20 cigarettes per day smoking admitted 81.1 % of women and 94.6% of men. Heavy alcohol consumption was the case in 14 (20.3%) women and in 307 (69.3%) men. For both the size of heavy alcohol consumption and the size of excessive tobacco use, there was found statistically significant difference between women and men with laryngeal cancer (p<0.05). In the majority of male and female subjects, the tumour was located in the supraglottis/glottis area. Apparently this tumour location was much more common among women, accounting for 60.9% of cases , while in men was confirmed in 39.3% of cases. The stages of the laryngeal cancer were similarly of high advancement for both the men and women - stages III and IV were confirmed in 82.6% of women and in 77.6% of men. The over 5-year survival rate was 39.1% among women and 37.2% among men. Conclusions Contradictory to decreased exposure to risk factors and the shorter period for diagnosis, the higher stages of cancer were observed in women. Although in women the advancement was higher and the majority of cases were located in unfavourable supraglottic area, the survival rates were higher. Key words: laryngeal cancer, epidemiology, men and women, risk factors


2020 ◽  
Author(s):  
Md Jafrul Hannan ◽  
Mosammat Kohinoor Parveenl ◽  
Alak Nandy ◽  
Md Samiul Hasan

STRUCTURED ABSTRACTBackgroundOwing to the widespread use of general anesthesia, administration of spinal anesthesia in pediatrics is not widely practiced. Yet there is ample positive evidence demonstrating its safety, effectiveness and success.ObjectiveThe objective of this study is to demonstrate that laparoscopic appendectomies are successful under spinal anesthesia and elicit clear advantages over general anesthesia.MethodsThis was a retrospective analysis of 77 pediatric (5-8 year old) laparoscopic appendectomies that took place in a Hospital in Chittagong, Bangladesh in 2019. Approximately half of the patients underwent spinal anesthesia while the other half underwent general anesthesia. Variables such as surgery and operation theatre times, pain score, incidence of post-surgery vomiting, analgesic usage, discharge times and hospital costs were recorded. Statistical analysis was used to analyze the data as a function of form of anesthesia.ResultsThe probability of vomiting when using spinal compared to general anesthesia was much lower within the first 5 hours (P < .001) and after 6 hours (P = .008) of operation. Highly significant difference (P < .001) was observed in the total costs of the procedures. A significantly higher likelihood of patients being discharged the same day of the procedure was noted if spinal anesthesia was used (P = .008).ConclusionsSpinal anesthesia is superior to general anesthesia for pediatric laparoscopic appendectomies. Patient comfort is improved through a significant decrease in vomiting. This enables more rapid hospital discharges and a significant cost saving, without compromising the outcome of the procedure.MINI-ABSTRACTSpinal anesthesia is seldom used for laparoscopy in children. This retrospective case-controlled study compared spinal anesthesia with general anesthesia in children between 5 and 8 years of age. Spinal anesthesia proved to be safer and cost-effective for laparoscopy in children.


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