ABSTRACT
Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis, fibrosis, and cirrhosis to hepatocellular carcinoma. Forty-four per cent of all deaths from cirrhosis are attributed to alcohol. Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation (LT). The vast majority of transplant programmes (85%) require 6 mo of abstinence prior to transplantation; commonly referred to as the "6-mo rule". Both in the case of progressive end-stage liver disease (ESLD) and in the case of severe acute alcoholic hepatitis (AAH), not responding to medical therapy, there is a lack of evidence to support a 6-mo sobriety period. It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking. The "Group of Italian Regions" suggests that: in a case of ESLD with model for end-stage liver disease < 19 a 6-mo abstinence period is required; in a case of ESLD, a 3-mo sober period before LT may be more ideal than a 6-mo period, in selected patients; and in a case of severe AAH, not responding to medical therapies (up to 70% of patients die within 6 mo), LT is mandatory, even without achieving abstinence. The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist. Patients have to participate in self-help groups.
Subject(s)
Hepatitis, Alcoholic/surgery , Liver Cirrhosis, Alcoholic/surgery , Liver Transplantation/standards , Alcohol Abstinence , Comorbidity , Hepatitis, Alcoholic/diagnosis , Hepatitis, Alcoholic/mortality , Humans , Italy/epidemiology , Liver Cirrhosis, Alcoholic/diagnosis , Liver Cirrhosis, Alcoholic/mortality , Patient Care Team/standards , Patient Selection , Risk Assessment , Risk Factors , Self-Help Groups/standards , Severity of Illness Index , Time Factors , Treatment Outcome , Waiting ListsABSTRACT
It has been established that alcohol consumption is associated with elevated cancer incidence and mortality. Recently the International Agency for Cancer Research (World Health Organization) stated that acetaldehyde associated with alcoholic beverages is carcinogenic to humans and confirmed the Group 1 classification of alcohol consumption and of ethanol in alcoholic beverages. Alcohol causes cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum, liver and female breast. Very little is known about safe margins of alcohol consumption. There is a dose-response relationship between alcohol and cancer risk for men and women, with studies showing that the risk of cancer increases with increasing consumption of alcohol on a regular basis.
Subject(s)
Alcohol Drinking/adverse effects , Neoplasms/etiology , Digestive System Neoplasms/epidemiology , Digestive System Neoplasms/etiology , Female , Humans , Male , Neoplasms/epidemiology , Risk Assessment , Risk FactorsABSTRACT
At present, medicine is aimed to the treatment of lesions. Instead, it would be right to develop the maintenance of normal health. A number of authorities have recently recommended increases in intake of omega-3 fatty acids and astaxanthin for the health of general population. Omega-3 are necessary to provide the optimal function of cellular membrane in health and in disease states. It is well known how at least two servings of fish a week, or dietary supplementation of fatty acids omega-3, should be taken to obtain the health benefits of this essential nutrient. Astaxanthin is a powerful biological antioxidant. This property has been implicated in its various biological activities demonstrated in both experimental animals and clinical studies. For the recent evidence of the contemporary presence of omega-3 and astaxanthin in oil of Wild Pacific Salmon Sockeye, a review has been effected for the evaluation of a possible role of such association for the health promotion.
