Liver transplant outcomes in a Canadian First Nations population.

BACKGROUND: A higher incidence of autoimmune disorders may predispose First Nations (FN) individuals to higher rates and more severe episodes of rejection, graft loss and mortality following liver transplantation for advanced liver disease. METHODS: A retrospective review of patient outcomes in a single centre providing long-term follow-up care for FN and non-FN patients transplanted for advanced liver disease was conducted. RESULTS: A total of 20 FN and 129 non-FN charts were available for review. FN subjects were younger at transplantation (mean [± SD] age 32.4±4.1 years versus 46.3±1.4 years; P=0.00005), less often male (35% versus 58%; P=0.05), more commonly transplanted for autoimmune hepatitis (30% versus 4.7%; P=0.006), less often from urban residences (25% versus 74%; P=0.0001) and less compliant with medical care (20% versus 80%; P=0.007). After a mean follow-up period of 11.0±1.5 years and 8.4±0.5 years in FN and non-FN subjects, respectively, the incidence and severity of rejection, graft and patient survival were similar between cohorts. CONCLUSION: Although demographic profiles, nature of the underlying disease and compliance differed, the rates and severity of rejection, graft and patient survival were similar in FN and non-FN patients who underwent liver transplantation for advanced liver disease.

The incidence and case-fatality rates of acute biliary, alcoholic, and idiopathic pancreatitis in California, 1994-2001.

OBJECTIVE: To better define the epidemiology of acute pancreatitis in a racially diverse population. METHODS: Analysis of all patients hospitalized in California with first-time acute pancreatitis for the period between January 1994 and September 2001. Subtypes were classified based on the presence or absence of predisposing conditions. RESULTS: There were 70,231 patients hospitalized for first-time acute pancreatitis; 32.6% had biliary tract disease alone, 20.3% had alcohol abuse alone, and 36.6% were idiopathic. The age-standardized incidence increased by 32% from 33.2 to 43.8 cases per 100,000 adults for the period between 1994 and 2001, with the largest increase in the biliary group (52%). The standardized incidence rate of alcoholic and idiopathic pancreatitis was highest in African Americans, whereas biliary pancreatitis was highest in Hispanics. There was no change over time in the percentage of patients dying in the first 14 or 91 days; and in a risk-adjusted model, patients with alcoholic pancreatitis had the highest risk of dying. CONCLUSIONS: The incidence rate of acute pancreatitis rose for the period between 1994 and 2001. However, there was no reduction in the 14- or 91-day case-fatality rate. Further research is needed to explain both the rise in the incidence rate of pancreatitis and the absence of any improvement in the early case-fatality rate.

[The prevalence and structure of biliary tract diseases in the rural population of northern regions of Siberia]. / Rasprostranennost' i struktura zabolevanii zhelchevyvodiashchikh putei u sel'skogo naseleniia severnykh regionov Sibiri.

Biliary tracts were investigated in 3420 migrants and 1445 aborigines (Evens, Evenkis) living in Evenkia and Yakutia. Acalculous chronic cholecystitis and cholelithiasis were found in 8.5 and 8.8% of the migrants, respectively. In aborigines these diseases occurred in 4.5 and 1.5%, respectively. The risk to develop biliary disease for migrants grows after 4-5 years of stay in the Far North. It is concluded that biliary pathology in the Far North population was related to ethnic and geographical factors.

[The effect of socioeconomic status on the prevalence of biliary tract diseases in the Evens and Evenki]. / Vliianie sotsial'no-ékonomicheskogo ststusa na rasprostranennost' zabolevanii zhelchevyvodiashchikh putei u évenov i évenkov.

An epidemiological survey demonstrated that biliary disease detection in aborigines of the Far North is more frequent in subjects with nontraditional way of life. Chief biliary disease factors different in importance for Evens and Evenks are as follows: prior viral hepatitis, obesity, alcohol abuse. Incidence rate for different biliary diseases is not uniform in Far North native population. This may be explained by specificity of biliary functions.

[A mass study of hepatobiliary system function in workers and collective farmers in southern Tadzhikistan]. / Massovoe issledovanie sostoianiia gepatobiliarnoi sistemy u rabochikh i kolkhoznikov iuga Tadzhikistana.

A total of 4085 persons living in the Parkhar District of Kulyab Province of the Tadzhik SSR underwent examination for the cholelithiasis incidence among 3 large groups (Koreans, Tadzhiks and Uzbeks) populating that territory. It has been established that as compared with Tadzhiks and Uzbeks, cholelithiasis turned out to occur rarely in Korean women. This is likely to be due to the metabolism of bile acids in the liver, the lack of genetic predisposition, noticeable disorders in the kinetics of the gallbladder as well as to the presence in the diet of the Korean community of a large amount of food plant fiber and soybean products which ameliorate to a certain degree the chemical composition of the bile and enhance the kinetics of the gallbladder.