Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has been well documented that long-term abuse of alcohol leads to dysfunction of multiple organ systems of the body. The liver, which is the primary organ responsible for alcohol metabolism, is also a major target for damage. Cirrhosis of the liver is the seventh leading cause of death in the United States. The radiologist plays an important role in the evaluation and possibly in the treatment of the conditions which result from alcohol abuse. The advantages and limitations of various radiologic diagnostic modalities in the evaluation of alcoholic liver disease are presented and discussed.
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PMID:Radiologic evaluation of the liver in the alcoholic patient. 298 19

One hundred and fifty-one inpatients with a history of chronic heavy alcohol intake were examined for evidence of muscle disease. Ninety-two patients (60 per cent) had histologically abnormal biopsies of the quadriceps muscle. The most common abnormality, which was often severe, was type II muscle fibre atrophy. Seven patients (5 per cent) had histological evidence of acute myopathy, one of whom presented with the full clinical picture of acute rhabdomyolysis. Twenty-three patients had cirrhosis, 36 were significantly malnourished and 98 had evidence of a peripheral neuropathy. None of these features, however, were sufficient to account for the muscle abnormalities. There was no clear relationship between musculo-skeletal symptoms and muscle biopsy histology. Serum creatine kinase activity was elevated in only 23 subjects and was an insensitive indicator of subclinical acute myopathy and of chronic alcoholic myopathy. Follow-up studies after abstinence from alcohol invariably showed both objective and subjective improvement of muscle function - often in the absence of any clinical recovery from the peripheral neuropathy. Continued alcohol consumption was accompanied by persistence and often deterioration of muscle fibre atrophy. It is concluded that chronic skeletal myopathy is a frequent consequence of alcohol abuse and may result from a direct toxic effect of ethanol on muscle fibres.
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PMID:Alcoholic skeletal myopathy, a clinical and pathological study. 299 70

A case-control study of risk for hepatocellular carcinoma (HCC) was carried out in our Department from December 1980 to December 1983. One hundred and twenty consecutive inpatients with HCC were compared with 360 controls pair-matched by sex and age (within years). For each case three different controls were selected from inpatients at the same hospital: one patient with liver cirrhosis; one patient with solid tumor and one patient with chronic illness other than neoplasm or liver disease. We report here the results on alcohol consumption, smoking habit and hepatitis B virus infection. The risk factors investigated are distributed similarly in HCC and cirrhosis. The prevalence of alcohol abuse in HCC is similar to that in cirrhosis and is significantly higher than in other neoplastic or otherwise chronically ill patients (odds ratio 2 X 3 and 3 X 2 respectively). Thus alcohol abuse is probably a risk factor for HCC as a cause of cirrhosis. Smoking habits were similar among the various disease groups and independent of alcohol consumption. The prevalence of heavy smoking was comparable in cases and controls. HbsAg negative-HCC with an ultrasonographic pattern of 'diffuse' alteration was more frequent in heavy smokers.
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PMID:Assessment of some risk factors for hepatocellular carcinoma: a case control study. 299 96

Two hundred thirty-four autopsy cases of liver cirrhosis were examined to correlate the tissue HBV markers and excess alcohol intake with the type of liver cirrhosis, and the incidence of hepatocellular carcinoma (HCC). The following four groups were classified as follows: (1) HBV marker-positive alcoholic group A, (2) HBV marker-negative alcoholic group B, (3) HBV marker-positive non-alcoholic group C, and (4) HBV marker-negative non-alcoholic group D. Macronodular cirrhosis predominated in groups, A, C, and D, while in group B macronodular and micronodular cirrhosis were almost of the same frequency. The mean age at death of the patients with macronodular cirrhosis of HBV-positive alcoholic group A was similar to that of HBV-positive non-alcoholic group C but lower than that of HBV-negative alcoholic group B, suggesting a longer survival of alcoholics without HBV infection than that with HBV infection, when patients had macronodular cirrhosis at autopsy. In HBV-negative alcoholic group B, patients with macronodular cirrhosis had a higher mean age than those with micronodular cirrhosis, while in HBV-positive alcoholic group A, the mean age of patients with either cirrhosis was similar. This suggested that in the absence of HBV infection, macronodular cirrhosis in alcoholics may be related to the increased life span that allows a conversion of micronodular cirrhosis into macronodular one, and in HBV-positive alcoholics it may arise in relation to HBV infection. HCC was frequently associated with macronodular cirrhosis, regardless of the presence or absence of alcohol abuse or HBV infection, but rare in micronodular cirrhosis.
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PMID:Correlation of morphologic subtypes of liver cirrhosis with excess alcohol intake, HBV infections, age at death, and hepatocellular carcinoma. A study on 234 autopsy cases in Japan. 301 43

The biological characteristics of hepatocellular cancer vary appreciably in different parts of the world, but especially between regions with very high and low incidences of the tumour. Hepatocellular cancer is multifactorial in origin, and the pattern of its aetiological associations differs between populations at high and low risk. In Africans and Chinese, who have the highest incidences of hepatocellular cancer, the hepatitis B virus is the most important causal association. The viral carrier state is acquired during early childhood, and carries a relative risk for the development of the tumour of over 200. Integration of hepatitis B virus DNA probably acts as a genotoxic initiator in the multistep process of hepatocarcinogenesis, although the precise mechanisms involved have not been determined. Aflatoxin ingestion may also have an aetiological role in high incidence regions, probably as a genotoxic or epigenetic promoter to hepatitis B virus-initiated carcinogenesis. In low risk populations cirrhosis is the most important causal association of hepatocellular cancer. The cirrhosis is often the result of alcohol abuse, but the tumour may complicate all aetiological forms of this disease. Whether neoplasia is an inevitable consequence of the hyperplasia of cirrhosis, or the increased hepatocyte turnover rate acts as a promoter is not known. Hepatitis B virus infection plays a lesser part, and aflatoxin no part at all.
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PMID:The development of hepatocellular cancer in humans. 304 Feb 42

Several major physiological changes or disease states occur more frequently in alcohol abusers or prolonged high users. These include: cancer, immunosuppression, and nutritional deficiencies. They interact with potential enhancement of cancer growth or survival. Clearly alcohol abuse yielding cirrhosis is associated with immunosuppression of cellular immune functions. Severe, prolonged ethanol consumption frequently is associated with one or more nutrient deficiency. Such deficiencies are more common when there are other major problems such as liver or pancreas damage and in prolonged alcohol abusers should influence the host defenses against pathogens and tumors. The amount and frequency of nutritional and immunological deficiencies with "binge" or less severe alcohol abuse is less clear, but animal studies suggest they are frequently present. Clearly, nutrient deficiencies are common in alcohol abusers and could play significant roles in ethanol associated problems including immunosuppression. Data summarized suggest that immunosuppression caused by nutritional deficiencies and/or direct effects of ethanol and its' metabolites on lymphoid cells is a potential component of cancer in alcohol abusers. However the frequent occurrence of nutritional deficiencies, immunosuppression, and certain cancers in severe, prolonged ethanol abusers is an association, not proven cause and effect.
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PMID:Ethanol, immunomodulation and cancer. 305 95

Heterogeneity in the clinical symptoms of alcohol abuse was examined in 243 men and 305 women from families of hospitalized alcoholics, who had demonstrated different patterns of inheritance of susceptibility to alcoholism. Discriminant analysis was utilized to identify nine alcoholic symptoms that distinguished male relatives of alcoholic men from those of alcoholic women. Inability to abstain from alcohol, fighting and reckless driving while intoxicated, and alcohol treatment other than Alcoholics Anonymous were more prevalent in families of male probands. Male relatives of female probands experienced later onset of loss of control over drinking associated with benders, and cirrhosis and feelings of guilt. Female relatives of alcoholic men and women showed a marked predominance of the latter (Type 1) features, whereas male relatives had different clinical features, depending on the associated mode of inheritance.
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PMID:Alcohol-related symptoms in heterogeneous families of hospitalized alcoholics. 306 14

Local alcohol ordinances were studied in the state of Tennessee where 28% of the population resides in jurisdictions that forbid the sale of alcohol to the public. Local alcohol ordinances range from "dry" (total prohibition) to "wet" (sale of alcohol permitted through both liquor stores and bars). Two alcohol-related variables (type of alcohol ordinance and number of alcohol outlets per 100,000 population) and four population variables (population size, percent change, percent residing in urban areas, percent non-White) were studied in relationship to four dependent variables (mortality rates resulting from motor vehicle crashes, liver disease and cirrhosis, suicide, and homicide). The results of the analysis suggest that these alcohol availability measures do play a role, directly and indirectly, in causing some socially deleterious behaviors and conditions. However, we would point out that the correlations between our alcohol availability measures and some of the socially injurious behaviors were very weak. The analyses reveal that complex inter-relationships exist between the variables studied such that no easy generalizations are warranted as to the social desirability of one type of alcohol ordinance policy over another since various population and demographic variables strongly interact with the alcohol availability measures in determining their social impact.
Am J Drug Alcohol Abuse 1988
PMID:Dry, damp, and wet: correlates and presumed consequences of local alcohol ordinances. 306 84

The present review concentrates on environmental factors which influence the outcome of peptic ulcer disease by acting from the outside. Endogenous risk factors, such as acid output, pepsin secretion and serum pepsinogen, gastritis and mucosal defense, blood group, and secretor status, are only dealt with when they help to explain the mechanism by which exogenous risk factors affect the upper gastrointestinal mucosa. After outlining the wax and wane of peptic ulcer, it is concluded that these changes resulted from similar temporal patterns of occupational workload in the general population. Cross sectional studies also support the contention of occupational workload being a risk factor in peptic ulcer, explaining several characteristic features of peptic ulcer, such as its sex, race, and social class distribution, increased incidence in immigrant workers, seasonal variation, healing by bed rest, and urban versus rural distribution. Susceptible subjects may react to a rise in occupational workload and acute exposure to stressful life events by increased gastric secretion which, in turn, leads to ulceration and symptoms. Cigarette smoking, intake of aspirin and related drugs, dietary salt, and alcohol abuse represent additional environmental risk factors, which form the etiologic link of the association of peptic ulcer with chronic lung disease, rheumatoid arthritis, hypertensive disease, and liver cirrhosis, respectively.
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PMID:Factors which influence the incidence and course of peptic ulcer. 307 62

Two major trends regarding alcohol use and consequences of alcohol abuse in the United States are showing significant improvement. Continued declines are evident in age-adjusted rates of liver cirrhosis mortality, and per capita alcohol consumption is at its lowest level in 15 years. Two other trends, however, are less clear. After declining in 1982 and continuing through 1984, alcohol-related morbidity--as measured by principal diagnoses listed on short-stay, community hospital discharges--showed a slight increase in 1985. Similarly, after declining every year but one since 1981, alcohol-related motor vehicle fatalities showed a significant increase in 1986. The downward trends suggest that progress is being made in efforts to reduce alcohol-related deaths and morbidity, but there are no easy explanations for any of the trends. Reductions in liver cirrhosis death rates may reflect coding changes in liver disease categories, less chronic heavy drinking, or better medical care. Lower per capita alcohol consumption may indicate the public's increased awareness of drinking risks or the aging of the U.S. population. Ironically, the recent increase in alcohol-related motor vehicle fatalities may reflect stronger enforcement of drunk driving laws and increased BAC (blood alcohol content) testing.
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PMID:Trends in alcohol-related morbidity and mortality. 314 52


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