History Of Excessive Alcohol Consumption Research Articles

Dual alcohol and metabolic-related liver disease: Results from a population of liver transplant patients.

If alcohol-related liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) are now the two main indications for liver transplantation (LT), it has been recognized that both conditions can coexist in varying degrees and the concept of dual-aetiology fatty liver disease (DAFLD) has been proposed. This retrospective study aimed to evaluate, in a cohort of patients transplanted for ALD and NAFLD, the prevalence of DAFLD before LT and the impact on liver graft outcome. From 1990 to 2010, all patients who underwent LT for the so-called ALD or NAFLD in our centre were included. Before LT, DAFLD was defined as patients with a history of excessive alcohol consumption and obesity associated with either diabetes or hypertension. Before LT, patients were separated into three groups: DAFLD, ALD, and NAFLD. Fatty liver graft disease was classified according to the FLIP algorithm. Out of 907, adult LT recipients were identified: 33 DAFLD patients, 333 ALD patients, and 24 NAFLD patients. After LT, ALD patients experienced significantly more alcohol relapse than DAFLD patients, who had twice more post-LT metabolic syndrome. Out of 926, post-LT biopsies, DAFLD patients had significantly more fatty liver graft disease due to metabolic syndrome features than ALD patients. Our results support that DAFLD recently emerged as an indication of LT. In the future, this particular population needs to be identified as a specific entity since post-LT outcome on the graft is different from ALD and more similar to NAFLD patients.

Effects of (20 R)-Panaxadiol on NAFLD using non‑targeted metabolomics in stool

Non-alcoholic fatty liver disease (NAFLD) is a clinical syndrome characterized by hepatocyte steatosis and adipose accumulation with the main lesion in the hepatic lobule, but without a history of excessive alcohol consumption. NAFLD ranges from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), and may further accumulate fibrosis leading to cirrhosis. Many studies have found that ginseng can treat NAFLD. (20 R)-Panaxadiol (PD) is a panax ginseng diol type compound, has been proved that can treat the obesity. This study wants to investigate the effect of PD on non-alcoholic liver disease. We used 20 ob/ob mice and 10 C57BL/6 J mice. C57BL/6 J mice as CONTROL group, ob/ob mice were divided into model group and PD group. In PD group, ob/ob mice were treated with PD for eight weeks(10 mg/kg, the CON and OB group was given the same amount of sodium carboxymethyl cellulose), detected the weight, food intake and serum index, observed the HE staining of liver and intestine, performed the 16 S rRNA and untargeted metabolomics analysis used mice feces, and verify the results by detect the expression of TNF-α, MDA and SOD. In vivo results, PD can improve abnormal glucose and lipid metabolism and liver function. In 16 S rRNA result, we found beneficial bacteria Muribaculaceae and Lactobacillus increased; in untargeted metabolomics analysis, inflammatory metabolites prostaglandin (PG) and lipopolysaccharide (LPS) decreased, antioxidant metabolites FAD and lipoic acid increased. Then, we proceeded the association analysis of gut microbiota and metabolites, the result showed gut microbiota have strongly associated with anti-inflammatory and antioxidant metabolites. In addition, PD improves intestinal wall integrity. Meanwhile, the expression of TNF-α、MDA and SOD were detected, it was verified that PD has the effect of antioxidant and anti-inflammation. Our study showed that PD, as an active ingredient of ginseng, can play an anti-inflammatory and antioxidant role by improving intestinal metabolites, thereby preventing and treating non-alcoholic fatty liver disease to a certain extent.

Rifaximin-α for liver fibrosis in patients with alcohol-related liver disease (GALA-RIF): a randomised, double-blind, placebo-controlled, phase 2 trial

Alcohol is the leading cause of liver-related mortality worldwide. The gut-liver axis is considered a key driver in alcohol-related liver disease. Rifaximin-α improves gut-barrier function and reduces systemic inflammation in patients with cirrhosis. We aimed to compare the efficacy and safety of rifaximin-α with placebo in patients with alcohol-related liver disease. GALA-RIF was an investigator-initiated, randomised, double-blind, placebo-controlled, single-centre, phase 2 trial done at Odense University Hospital in Denmark. Eligible participants were adults (aged 18-75 years) who had current or previous alcohol overuse (at least 1 year with ≥24 g of alcohol per day for women and ≥36 g of alcohol per day for men), biopsy-proven alcohol-related liver disease, and no previous hepatic decompensation. Patients were randomly allocated (1:1) through a web-based randomisation system to receive oral rifaximin-α (550 mg) twice daily or matched placebo for 18 months. Randomisation was done in blocks of four and stratified according to fibrosis stage and alcohol abstinence. Participants, sponsor, investigators, and nurses involved in the study were masked to the randomisation outcome. The primary endpoint was a histological decrease from baseline to 18-month treatment of at least one fibrosis stage, according to the Kleiner fibrosis score. We also assessed the number of patients with progression by at least one fibrosis stage from baseline to 18 months. Primary analyses were done in the per-protocol and modified intention-to-treat populations; safety was assessed in the full intention-to-treat population. The per-protocol population was defined as all randomly assigned patients who did not present serious protocol violations, who ingested at least 75% of the treatment, and who were not withdrawn from the study due to non-adherence (interruption of treatment for 4 weeks or more). Participants receiving at least one dose of the intervention were included in the modified intention-to-treat analyses. This completed trial is registered with EudraCT, number 2014-001856-51. Between March 23, 2015, and Nov 10, 2021, we screened 1886 consecutive patients with a history of excessive alcohol consumption and no previous hepatic decompensation, of whom 136 were randomly assigned to either rifaximin-α (n=68) or placebo (n=68). All patients were White (100%), 114 (84%) were men, and 22 (16%) were women. 133 (98%) patients received at least one dose of the intervention and were included in the modified intention-to-treat analysis; 108 (79%) completed the trial per protocol. In the per-protocol analysis, 14 (26%) of 54 patients in the rifaximin-α group and 15 (28%) of 54 patients in the placebo group had a decrease in fibrosis stage after 18 months (odds ratio 1·10 [95% CI 0·45-2·68]; p=0·83). In the modified intention-to-treat analysis, 15 (22%) of 67 patients in the rifaximin-α group and 15 (23%) of 66 patients in the placebo group had a decrease in fibrosis stage at 18 months (1·05 [0·45-2·44]; p=0·91). In the per-protocol analysis, increase in fibrosis stage occurred in 13 (24%) patients in the rifaximin-α group and 23 (43%) patients in the placebo group (0·42 [0·18-0·98]; p=0·044). In the modified intention-to-treat analysis, increase in fibrosis stage occurred in 13 (19%) patients in the rifaximin-α group and 23 (35%) patients in the placebo group (0·45 [0·20-1·02]; p=0·055). The number of patients with adverse events (48 [71%] of 68 patients in the rifaximin-α group; 53 [78%] of 68 in the placebo group) and serious adverse events (14 [21%] in the rifaximin-α group; 12 [18%] in the placebo group) was similar between the groups. No serious adverse events were deemed related to treatment. Three patients died during the trial, but none of the deaths were considered treatment related. In patients with alcohol-related liver disease, rifaximin-α might reduce progression of liver fibrosis. These findings warrant confirmation in a multicentre phase 3 trial. The EU Horizon 2020 Research and Innovation Program and The Novo Nordisk Foundation.

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Theabrownin ameliorates liver inflammation, oxidative stress, and fibrosis in MCD diet-fed C57BL/6J mice.

Nonalcoholic steatohepatitis (NASH), also known as metabolic steatohepatitis, is a clinical syndrome with pathological changes like alcoholic hepatitis but without a history of excessive alcohol consumption. NASH is closely related to metabolic disorders such as obesity, insulin resistance, type 2 diabetes mellitus, and hyperlipidemia. Its main characteristics are hepatocyte steatosis with hepatocyte injury and inflammation. In severe cases, it can develop into liver cirrhosis. At present, there is no special treatment for NASH. Theabrownin (TB) is the main pigment substance in fermented tea. Theabrownin has beneficial effects on lipid metabolism and intestinal flora. However, the effect of theabrownin on NASH has not been studied. This study was aimed at exploring the effects of theabrownin from Fuzhuan brick tea on NASH. 8-week-old mice were randomly assigned to three groups and fed with chow diet (CD), methionine and choline sufficient (MCS) diet (MCS Ctrl), which is a Methionine/choline deficient (MCD) control diet, and MCD diet. After 5 weeks of feeding, the MCD group mice were randomly divided into two groups and were gavaged with double distilled water (MCD Ctrl) or theabrownin (MCD TB) (200mg/kg body weight, dissolved in double distilled water) every day for another 4 weeks respectively, while continuing MCD diet feeding. We found that theabrownin treatment could not improve liver mass loss and steatosis. However, theabrownin ameliorated liver injury and decreased liver inflammatory response. Theabrownin also alleviated liver oxidative stress and fibrosis. Furthermore, our results showed that theabrownin increased hepatic level of fibroblast growth factor 21 (FGF21) and reduced the phosphorylation of mitogen-activated protein kinase p38 in MCD diet-fed mice.

Pulmonary embolism risk in hospitalized patients with nonalcoholic fatty liver disease: A case-control study.

Abundant research has associated nonalcoholic fatty liver disease (NAFLD) with atherosclerosis, but very few reports have evaluated the association between NAFLD and venous thromboembolism. We aimed to investigate the association between NAFLD and pulmonary embolism (PE) in hospitalized patients. In this retrospective case-control study, we included consecutive patients from 2 university-affiliated hospitals who were referred for CT pulmonary angiograms for a suspected PE. Patients with a history of excessive alcohol consumption, chronic liver diseases or cirrhosis were excluded. The imaging studies of the entire cohort were reviewed by 2 expert radiologists who confirmed the diagnosis of PE and examined the liver to detect and grade hepatic steatosis. Accordingly, patients were categorized into NAFLD patients and non-NAFLD controls. Patient demographics, medical history, hospitalization details as well as patients' outcomes were documented. Multivariate analysis was performed to identify predictors for developing PE and hazard ratios with corresponding 95% confidence intervals were estimated. A total of 377 patients (101 with NAFLD and 276 controls) were included. NAFLD patients had significantly higher BMI values (33.16 ± 6.78 vs 26.81 ± 5.6; P < .001) and prevalence of diabetes (41 (40%) vs 85 (30.8%); P = .03). The prevalence of PE was significantly higher in the NAFLD group (80 (79.2%) vs 147 (53.3%), P < .001). In a multivariate analysis, older age, recent surgery or trauma, active malignancy, smoking, and NAFLD (HR ratio = 4.339, P < .0001 and 95% CI = 2.196-8.572) were independently associated with PE development. Patients with NAFLD were associated with an increased risk of developing PE independent of other classical risk factors for PE.

PMON187 Worsening Hypertriglyceridemia in an Adolescent Female with Type 1 Diabetes Mellitus despite Improvement in Glucose Control

Abstract Background Chylomicronemia syndrome with severe hypertriglyceridemia may be the result of genetic abnormalities, aggravating factors or a combination of both. Clinical case The patient is a 17-year-old overweight female (BMI of 90th percentile) with a history of type 1 diabetes mellitus (T1D) for eleven years, PCOS, vitamin D deficiency and hypertriglyceridemia. Her father has a history of hypertriglyceridemia that improves with dietary modifications. Her mother and younger sister (who also has T1D) have normal serum lipid levels. Although the patient has a history of poor compliance (HbA1c ranging between 9-11%), glucose control had been improving (HbA1c most recently between 8.1-8.6%). Her serum triglyceride level had been slightly abnormal for the past few years (200-300 mg/dL; normal range: &amp;lt; 90 mg/dL) and had increased to 413 mg/dL, despite the improvement in glucose control. She subsequently started taking omega-3, 1000 mg daily. At that time, she also began treatment with combined oral contraceptives (COCs) for PCOS. The serum triglyceride level three months later increased to 1,322 mg/dL. She consistently denied alcohol or recreational drug use. The omega-3 dose was increased to 4 gm daily. Atorvastatin 10 mg daily was also started and COCs were discontinued. Three weeks later, a repeat triglyceride level was found to be 2,813 mg/dL. Fenofibrate 160 mg daily was added. Atorvastatin was discontinued and she began a low-fat diet. After further questioning, patient admitted to heavy alcohol intake during the weekends. She reported specifically drinking grain alcohols to avoid carbohydrates. Three weeks after cessation of alcohol, her triglyceride level declined to 302 mg/dL. Clinical lesson: This patient had multiple risk factors for chylomicronemia syndrome including poorly controlled T1D, overweight and estrogen containing contraceptive therapy. Although alcohol abuse was a problem at the time hypertriglyceridemia worsened, the history of excessive alcohol consumption was not given until many other treatments had been initiated. This case highlights the importance of screening for alcohol abuse in patients with hypertriglyceridemia who do not respond to standard therapies, especially in adolescent patients who may be reticent about discussing alcohol abuse with their physicians. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Hepatocellular Carcinoma in Patients With Liver Cirrhosis Secondary to Autoimmune Hepatitis: A Case Series and Literature Review.

Autoimmune hepatitis (AIH) is a known risk factor for the development of hepatocellular carcinoma (HCC). However, the current clinical guidelines do not offer a systematic approach to the surveillance and follow-up of patients with AIH to help with the diagnosis and treatment of HCC in this patient population. In this case series, we describe the clinical presentation and management of eight patients who were diagnosed with HCC secondary to underlying AIH at the University of Florida Health Shands Hospital. Throughout their treatment course, all eight patients were identified to have either histological or radiological evidence of liver cirrhosis. Furthermore, all of them tested negative for chronic viral hepatitis serologies and denied any history of excessive alcohol consumption. The median time interval between AIH diagnosis and HCC development in this cohort was48 months. All demographic, clinical, and laboratory findings were summarized and compared to the relevant data in the existing literature. Our findings suggest that patients diagnosed with AIH would benefit from liver cirrhosis screening and, if present, they should adhere to a regular HCC surveillance schedule.

The Pathogenesis of HCC Driven by NASH and the Preventive and Therapeutic Effects of Natural Products.

Nonalcoholic steatohepatitis (NASH) is a clinical syndrome with pathological changes that are similar to those of alcoholic hepatitis without a history of excessive alcohol consumption. It is a specific form of nonalcoholic fatty liver disease (NAFLD) that is characterized by hepatocyte inflammation based on hepatocellular steatosis. Further exacerbation of NASH can lead to cirrhosis, which may then progress to hepatocellular carcinoma (HCC). There is a lack of specific and effective treatments for NASH and NASH-driven HCC, and the mechanisms of the progression of NASH to HCC are unclear. Therefore, there is a need to understand the pathogenesis and progression of these diseases to identify new therapeutic approaches. Currently, an increasing number of studies are focusing on the utility of natural products in NASH, which is likely to be a promising prospect for NASH. This paper reviews the possible mechanisms of the pathogenesis and progression of NASH and NASH-derived HCC, as well as the potential therapeutic role of natural products in NASH and NASH-derived HCC.

Alcoholic Cardiomyopathy: A Literature Review

Background: Cardiomyopathy is a heart muscle disorder so which the heart cannot contract optimally. Alcoholic cardiomyopathy is a type of cardiomyopathy that dilates due to long-term alcohol consumption. The prevalence of alcoholic cardiomyopathy is higher in men than women. The age group with the most alcoholic cardiomyopathy was 45 to 74 year. Death from alcoholic cardiomyopathy had an autopsy result marked muscle dilatation. A toxicological examination can show the level of alcohol consumed. The cause of death in alcoholic cardiomyopathy is muscle dilatation due to chronic ethanol abuse (Dolinak, 2005). Islam expressly forbids something that makes losing mind, like alcohol. Alcohol has many disadvantages for the consumer in the form of loss of mind and turning away from Allah. Objective: This report aims to learn more about the definition, pathophysiology, clinical manifestation, and treatment of Alcoholic Cardiomyopathy. Also, Knowing and explaining Alcoholic Cardiomyopathy in terms of death and Islamic views. Methods: The design of this research is a literature review or library review, which is a systematic, direct, and reproducible research method by identifying, evaluating, and synthesizing published research. Result: Alcoholic cardiomyopathy is a clinical diagnosis made in a patient with a set of findings that include a history of excessive alcohol consumption, possible physical signs of alcohol abuse (e.g., parotid disease, telangiectasia or spider angiomata, altered mental status, cirrhosis), heart failure, and other evidence consistent with dilated cardiomyopathy. People who frequently consume alcohol can cause nutritional disorders, especially vitamin B1 deficiency can cause cardiomyopathy. Alcohol will also cause abnormalities in the structure and function of mitochondria in heart cells. These abnormalities include enlarged mitochondrial structure, decreased metabolism, lack of several enzymes decreased ion transport, increased calcium flow, glycogen accumulation, and decreased ATP production. Conclusion: Cardiomyopathy is a heart muscle function disorder characterized by the loss of the ability of the heart muscle to pump blood so that the blood supply is not optimal and results in death. The most common cause is chronic alcohol consumption, which causes dilatation of the heart muscle. At the same time, alcohol is an ingredient that is forbidden to be consumed by Muslims because of its more significant impact.

A diagnosis at hand

A 45-year-old man was found unconscious on the sidewalk and brought to the Emergency Department. He could not provide anamnestic information, but the hospital electronic archive revealed he was homeless and had a history of excessive alcohol consumption (250–300 g daily intake). He suffered from depressive disorder and had attempted suicide 9 years before by caustic ingestion, which led to total gastrectomy and esophagojejunal anastomosis. Physical examination revealed a Glasgow Coma Scale score of 8 with no focal neurological signs.

Research Progress of Multi-Target Drugs in the Treatment of Non-Alcoholic Steatohepatitis

Non-alcoholic steatohepatitis is a clinical syndrome with pathological changes similar to alcoholic steatohepatitis without a history of excessive alcohol consumption, and is a key stage of reversible progression to liver fibrosis, which can further develop into malignant diseases such as cirrhosis or even liver cancer if preventive measures are not taken. The pathogenesis of NASH is complex, and there are no any effective drugs for NASH. It is difficult for single-target drugs to achieve good therapeutic effects, and are accompanied by strong side effects, and many of them are terminated in the clinical trial stage. Multi-target drugs are not easy to produce drug resistance, and can exert synergistic effects on multiple targets to maximize drug efficacy and minimize adverse side effects, and has a good effect on the treatment of complex diseases. This article summarizes the multi-target drugs for the treatment of NASH, and provides a reference for finding new drugs for the treatment of NASH.

Non-Alcoholic Fatty Liver Disease Is Associated With Reduced Glomerular Filtration Rate in Patients With Chronic Plaque Psoriasis.

Chronic plaque psoriasis has been associated with metabolic comorbidities, including non-alcoholic fatty liver disease (NAFLD). A causal relationship between NAFLD and chronic kidney disease (CKD) is debated. To assess whether NAFLD is associated with impaired renal function in patients with psoriasis. A multicenter, retrospective, observational study including 337 patients with moderate-to-severe chronic plaque psoriasis, who had no history of excessive alcohol consumption or other secondary causes of chronic liver and renal diseases was conducted. NAFLD was diagnosed by ultrasonography, and CKD stage ≥2 or stage ≥3 were defined by an estimated glomerular filtration rate (e-GFR) of <90 ml min-1 1.73 m-2 or <60 ml min-1 1.73 m-2, respectively. Logistic and linear regression analyses were undertaken to assess the independent association of NAFLD with CKD or eGFR levels. Patients with NAFLD (n = 212, 62.9% of total) had significantly lower e-GFR levels (83.4 ± 18.0 vs. 93.5 ± 15.8 ml min-1 1.73 m-2, P<.001) and a remarkably higher prevalence of both CKD stage ≥2 (56.1% vs. 30.4%, P<.0001) and CKD stage ≥3 (10.4% vs. 3.2%, P<.0001) compared with their counterparts without NAFLD. Multivariable logistic regression analysis showed that NAFLD was associated with a nearly 2.5-fold increased risk of prevalent CKD stage ≥2 (adjusted-odds ratio= 2.60 95% confidence intervals 1.4-4.8, P=.02), independently of components of metabolic syndrome, psoriasis severity, and psoriatic arthritis. Ultrasound-diagnosed NAFLD is strongly associated with a reduced eGFR in patients with moderate-to-severe psoriasis, independently of cardiometabolic risk factors and psoriasis-related variables.

Characterization and quantification of alcohol-related polyneuropathy by magnetic resonance neurography.

We characterized and quantified peripheral nerve damage in alcohol-dependent patients (ADP) by magnetic resonance neurography (MRN) in correlation with clinical and electrophysiologic findings. Thirty-one adult patients with a history of excessive alcohol consumption and age-/sex-matched healthy controls were prospectively examined. After detailed neurologic and electrophysiologic testing, the patient group was subdivided into ADP with alcohol-related polyneuropathy (ALN) and without ALN (Non-ALN). 3T MRN with anatomical coverage from the proximal thigh down to the tibiotalar joint was performed using dual-echo 2-dimensional relaxometry sequences with spectral fat saturation. Detailed quantification of nerve injury by morphometric (cross-sectional area [CSA]) and microstructural MRN markers (proton spin density [ρ], apparent T2-relaxation-time [T2app ]) was conducted in all study participants. MRN detected nerve damage in ADP with and without ALN. A proximal-to-distal gradient was identified for nerve T2-weighted (T2w)-signal and T2app in ADP, indicating a proximal predominance of nerve lesions. While all MRN markers differentiated significantly between ADP and controls, microstructural markers were able to additionally differentiate between subgroups: tibial nerve ρ at thigh level was increased in ALN (p<0.0001) and in Non-ALN (p=0.0052) versus controls, and T2app was higher in ALN versus controls (p<0.0001) and also in ALN versus Non-ALN (p=0.0214). T2w-signal and CSA were only higher in ALN versus controls. MRN detects and quantifies peripheral nerve damage in ADP in vivo even in the absence of clinically overt ALN. Microstructural markers (T2app , ρ) are most suitable for differentiating between ADP with and without manifest ALN, and may help to elucidate the underlying pathomechanism in ALN.

Characteristics, management and outcomes of patients with hepatocarcinoma in a low-income country.

e16166 Background: Worldwide, every year, there are nearly 905,000 patients diagnosed with liver cancer; it is the sixth most common malignancy and the third most lethal malignancy. Almost three quarters of new patients live in areas with low and medium-income country. Guatemala has the highest mortality and incidence of liver cancer. Objectives: Describe the clinical characteristics, main risk factors, treatment and outcomes of patients with hepatocarcinoma (HCC) in Guatemala. Methods: A retrospective review was performed among patients with HCC from January 2002 to December 2019 in the Instituto Guatemalteco de Seguridad Social (IGSS). Kaplan Meier curves, Cox regression and log-rank test were used to calculate overall survival (OS) and mortality. Results: 140 patients with HCC were analyzed, 114 women and 26 men with a median age of 60 years (20 - 99), 102 patients (73%) have history of excessive alcohol consumption and 11 (8%) has history of chronic hepatitis B or C virus infection. All of the patients have liver cirrhosis, Child-Pugh A 100 patients (71%), B 34 (24%) and C 6 (5%). 10 patients (7%) have HCC BCLC A, 0 (0%) BCLC B, 121 (81%) BCLC C and 9 (6%) BCLC D. All patients with HCC BCLC A received surgical treatment with a median OS of 123 months (95% CI 89 - 156 p &lt; 0.001). 122 patients (89%) received target therapy with Sorafenib with a median OS of 17 months (95% CI 12 - 21 p &lt; 0.001) and 8 patients (6%) underwent to chemoembolization with a median OS of 32 months (95% CI 12 - 52 p &lt; 0.001). At this time, 111 patients (79%) died from the disease, 11 (8%) are alive with the disease and 8 (6%) are alive without disease. Conclusions: The most frequent risk factor for HCC is the excessive alcohol consumption, survival of patients with HCC are associated with treatment at the beginning of the disease.

Alkolün Karaciğer Görünür Difüzyon Katsayısı Değerleri Üzerine Etkileri: Tek Merkez Çalışması

Background and Aims: This study aimed to investigate the relationship between liver apparent diffusion coefficient values and potential early-stage liver injury by comparing apparent diffusion coefficient values obtained by liver diffusion-weighted magnetic resonance imaging between individuals with a history of excessive alcohol consumption and healthy volunteers. Materials and Methods: This study enrolled 35 individuals with a history of excessive alcohol consumption and 32 healthy volunteers. In all cases, blood samples were taken to measure biochemical parameters and complete blood count. Upper abdominal magnetic resonance imaging including liver diffusion-weighted imaging was performed. Results: In total, 19 individuals with a history of excessive alcohol consumption and 20 healthy volunteers were included in the study. The mean apparent diffusion coefficient values obtained by high b value (b 1000) diffusion-weighted imaging in individuals with a history of excessive alcohol consumption were lower than those in healthy volunteers. Although no significant difference was observed between the two groups in terms of biochemical parameters, hepatic apparent diffusion coefficient values in both groups were positively correlated with international normalized ratio values and negatively correlated with gamma-glutamyl transferase and alkaline phosphatase levels (r = 0.002, r = −0.007, r = −0.049, respectively). Conclusion: Diffusion-weighted imaging is a noninvasive imaging technique that can be used for the detection and follow-up of liver fibrosis induced by alcohol consumption.

Food insecurity is associated with magnetic resonance–determined nonalcoholic fatty liver and liver fibrosis in low-income, middle-aged adults with and without HIV

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in the United States. Food-insecure individuals often depend on low-cost, energy-dense but nutritionally poor foods, resulting in obesity and chronic diseases related to NAFLD. To determine whether food insecurity is associated with NAFLD in a cohort of HIV and hepatitis C virus (HCV) infected and uninfected adults. We conducted a cross-sectional analysis of low-income, middle-aged adults from the Miami Adult Studies on HIV (MASH) cohort without a history of excessive alcohol consumption. Food security was assessed with the USDA's Household Food Security Survey. MRIs were used to assess liver steatosis and fibrosis. Metabolic parameters were assessed from fasting blood, anthropometrics, and vitals. Of the total 603 participants, 32.0% reported food insecurity. The prevalences of NAFLD, fibrosis, and advanced fibrosis were 16.1%, 15.1%, and 4.6%, respectively. For every 5 kg/m2 increase in BMI, the odds of NAFLD increased by a factor of 3.83 (95% CI, 2.37-6.19) in food-insecure participants compared to 1.32 (95% CI, 1.04-1.67) in food-secure participants. Food insecurity was associated with increased odds for any liver fibrosis (OR, 1.65; 95% CI, 1.01-2.72) and advanced liver fibrosis (OR, 2.82; 95% CI, 1.22-6.54), adjusted for confounders. HIV and HCV infections were associated with increased risks for fibrosis, but the relationship between food insecurity and liver fibrosis did not differ between infected and uninfected participants. Among low-income, middle-aged adults, food insecurity exacerbated the risk for NAFLD associated with a higher BMI and independently increased the risk for advanced liver fibrosis. People who experience food insecurity, particularly those vulnerable to chronic diseases and viral infections, may be at increased risk for liver-related morbidity and mortality. Improving access to adequate nutrition and preventing obesity among low-income groups may lessen the growing burden of NAFLD and other chronic diseases.

Chronic Consumption of Alcohol-induced Multiple Organ Dysfunction Syndromes with the Involvement of Five Organ Damages: A Fatal Case Report

: Multiple organ dysfunction syndromes are defined as damage to one or more organs and failure of homeostasis between anti-inflammatory and pro-inflammatory reactions. This leads the precipitation and activation of inflammatory cytokines and damages tissues results in MODs. The risk factors includes acute severe pancreatitis, sepsis, shock, stroke and alcohol consumption. These multivariable risk factors may precipitate MOD. We presented 25 years of male patients presented with MOD with a history of excess alcohol consumption and associated acute severe pancreatitis, sepsis and renal failure. The laboratory parameters reveal elevated WBC, neutrophil, bilirubin, AST, ALT, serum amylase and lipase, renal function tests and a significant reduction in lymphocytes and platelets counts. Patients died after the 16th day of treatment due to multiple organ failures. Our study concluded that chronic excessive alcohol consumption may lead to MODS and even rarely death.Key words: Multiple Organ Dysfunction Syndromes (MODS), Multiple Organ Failure, Acute Severe Pancreatitis, Excess Alcohol Consumption, Fetal Case Report.

Diagnosis and Severity Assessment of Alcohol-Related Liver Disease

A diagnosis of alcohol-related liver disease (ALD) requires information on the history of excessive alcohol consumption (average intake of 40 g or more in men and 20 g or more in women a day). Furthermore, blood tests, such as GGT, AST, ALT, and mean corpuscular volume, and imaging studies, including abdominal ultrasound or transient elastography, are also useful. A liver biopsy can be useful for confirming the diagnosis and has prognostic value. ALD includes alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis, and in most cases, clinical manifestations can overlap. The prognostic scoring systems of ALD are limited mainly to alcoholic hepatitis, and the early mortality and treatment response can be predicted using various scoring systems. This review summarizes how to diagnose and evaluate the severity of ALD in clinical practice.

COVID-19 and Alcoholism: A Dangerous Synergy?

The 2019 novel coronavirus disease (COVID-19) has triggered the world’s worst public health challenge in the last 100 years. In response, many countries have implemented disease control measures such as enforced quarantine and travel restrictions. These measures have inadvertent adverse effects on the mental health and psyche of populations. Long-term social isolation is associated with alcohol use and misuse, creating a potential public health crisis. Alcohol and its intermediate products of metabolism have a multisystemic effect with an impact on the liver, heart, lungs as well as other organs in the body. Similarly, COVID-19 mediate a damaging effect on organ systems through cytopathic effects and cytokine storm. Alcoholism potentially increases the risk of cardiac injury, acute respiratory distress syndrome, pulmonary fibrosis, and liver damage in synergy with COVID-19; thereby worsening disease prognosis and outcome. We conclude that the history of excessive alcohol consumption needs to be factored into the clinical management of COVID-19 patients. Similarly, epidemiologists and public health experts need to create public awareness on the need for cessation of alcohol abuse while instituting public health measures to control the spread of the infection.