Binge drinking episode causes acute, specific alterations in systemic and hepatic inflammation-related markers.

BACKGROUND: Frequent binge drinking is a known contributor to alcohol-related harm, but its impact on systemic and hepatic inflammation is not fully understood. We hypothesize that changes in immune markers play a central role in adverse effects of acute alcohol intake, especially in patients with early liver disease. AIM: To investigate the effects of acute alcohol intoxication on inflammation-related markers in hepatic and systemic venous plasma in people with alcohol-related liver disease (ArLD), non-alcoholic fatty liver disease (NAFLD) and healthy controls. METHODS: Thirty-eight participants (13 with ArLD, 15 with NAFLD and 10 healthy controls) received 2.5 mL of 40% ethanol per kg body weight via a nasogastric tube. Seventy-two inflammation-related markers were quantified in plasma from hepatic and systemic venous blood, at baseline, 60 and 180 min after intervention. RESULTS: Alcohol intervention altered the levels of 31 of 72 and 14 of 72 markers in the systemic and hepatic circulation. All changes observed in the hepatic circulation were also identified in the systemic circulation after 180 min. Only FGF21 and IL6 were increased after alcohol intervention, while the remaining 29 markers decreased. Differences in response to acute alcohol between the groups were observed for 8 markers, and FGF21 response was blunted in individuals with steatosis. CONCLUSION: Acute alcohol intoxication induced changes in multiple inflammation-related markers, implicated in alcohol metabolism and hepatocellular damage. Differences identified between marker response to binge drinking in ArLD, NAFLD and healthy controls may provide important clues to disease mechanisms and potential targets for treatment. CLINICAL TRIAL NUMBER: NCT03018990.

Building a Handoff Communication Virtual Experience for Nursing Students Using Virtual Humans.

Effective communication among healthcare professionals is critical to delivering safe, high-quality patient care. One important real-world skill that nursing students must acquire is generating accurate handoff communication reports. The central aim of this study was to build, assess, and revise a virtual experience simulation that allows nursing students to observe a standardized clinical situation in an immersive environment and then practice the situation-background-assessment-recommendation communication method. This between-groups experimental study, which was modified in light of COVID-19 concerns, evaluated how well 69 prelicensure nursing students understood a handoff communication report after viewing a virtual human patient and nurse interact during a triage assessment scenario. Results indicate student comprehension levels did not differ based on which of two metacognitive learning strategies was used. Participants in both study groups were able to accurately complete a situation-background-assessment-recommendation instrument based on the virtual experience. Further, they believed that watching a virtual nurse perform a triage assessment would help them perform one themselves in a similar virtual environment. There was also an unexpected study finding related to patient safety within the context of the simulation. This finding warrants further research that will lead to revision of the virtual experience used to train future nurses.