Articles Posted in Liver disease

livercancer-300x173Summer tipplers may want to steer away from that second glass of  sangria, or rethink that next round of beers.  That’s because there’s yet more bad news about Americans and booze abuse: Liver disease deaths are spiking, with fatalities tied to cirrhosis jumping by 65 percent between 1999 and 2016, while those connected with liver cancer doubled in the same time span.

Americans 25- to 34-years-old saw the steepest increases in alcohol-related liver disease, with the number of annual deaths in seven years, as studied by Michigan experts, nearly tripling.

“Alcohol misuse and its complications” is striking down a new generation of Americans, Elliot Tapper, a University of Michigan liver expert and lead author of a newly published study on liver cancer, told the Washington Post.

Collinslab-150x150Mukamal-144x150The National Institutes of Health, perhaps the world’s leading medical research institution, has moved fast to try to fix self-inflicted damage to its reputation caused by a controversial $100-million study on alcohol and its harms.

NIH Director Francis Collins halted the study, and an advisory group backed his action, lambasting researchers for soliciting funding and counsel from the alcohol industry for a work that purported to answer key and fundamental questions about booze but from its outset leaned toward seeing benefit in moderate drinking.

The New York Times deserves credit for digging into the dubious  actions by researchers supported by the National Institute on Alcohol Abuse and Alcoholism, an arm of NIH.

Even as the nation struggles with alcohol and drug abuse, it’s clear that more public health effort needs to be directed at helping expectant mothers understand how much substances they ingest can harm their kids.

The New York Times reported that a new study published in the JAMA medical journal has conservatively estimated that “fetal alcohol spectrum disorders affect 1.1 to 5 percent of children in the country, up to five times previous estimates.”

booze-256x1024It’s more than happy hour chardonnays with office mates or malt liquors  at a summer barbecue.

Public health experts are warning that alcohol drinking is rising sharply, and in especially worrisome fashion for women, seniors, African Americans, Latinos, and Americans of Asian descent. As the nation struggles with addiction crises—especially a plague of opioid drug abuse—booze woes may be getting less than their deserved attention.

Our heavy and increasing alcohol consumption, as captured in a sizable and regular survey of Americans’ tippling habits, should be of big concern. That’s because experts note that it can “portend increases in many chronic co-morbidities in which alcohol use has a substantial role.”

Champagne_1050x700-300x200Here’s hoping the holidays are going well for one and all. But, even as they fly away, moderation and some common sense about the seasonal celebrations is worth keeping in mind.

It can pay, for example, to be careful about what you eat in this festive time. Researchers at the RAND Corporation have just issued a study that finds that consumers are “more likely to choose unhealthy foods from November to December, and the subsequent holiday pounds they gain account for 60 percent to 70 percent of the weight they gain per year.” We’re all too inclined, the researchers said, to feast on “nutritionally undesirable foods” such as sugar-sweetened beverages, chocolates, cookies, candy, and ice cream, leading to added pounds that, alas, don’t go away quickly or easily. Bah, humbug, perhaps to these findings based on information on eating habits of 400,000 South Africans who were followed for four years? Or maybe the calorie-conscious might want to consider the Washington Post’s menu of party options and alternatives?

Or how about following the New York Times’ timely report on how the holidays—with their increased eating and drinking and staying up late or sleeping in—confuse our livers, those vital organs that researchers say closely follow circadian rhythms as they help to filter the blood and to regulate critical body chemistries to process food and liquids, including alcohol.

hep-c-imageAlthough the partisan wrangling over what’s next with American health care seems to ignore the maddening realities confronting patient-consumers,  a new look at the plight of poor Kentuckians provides a harsh look at the collision of many major health policy controversies including soaring drug prices, the Affordable Care Act, and the prescription drug abuse crisis.

Stat, the online health news site, deserves credit for the grim picture it painted of health care dysfunction in the nation’s heartland. Kentucky has been ravaged not only by opioid drug abuse, including record numbers of overdose deaths, it also is struggling with a stark, related rise in diseases.  In particular, cases of Hepatitis C have skyrocketed by 364 percent in Kentucky and surrounding states. Infections are growing most among young, rural whites, and to the growing concern of public health officials, Kentucky is recording increasing numbers of cases in which pregnant moms are infecting their babies.

Hepatitis C, a viral infection that damages the liver and is a factor in 19,000 Americans’ death annually, can lurk in the body for long periods before becoming deadly. As many as 4 million Americans may carry it and not know it until their liver damage becomes severe. The virus (depicted in the illustration above) spreads among addicts of pain-killing medications because they too often progress from prescription pill-popping to shooting up other increasingly powerful opioids like fentanyl and heroin.

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Although food-related health risks likely will be dipping a little with Americans’ outdoor feasting winding down with the summer-ending Labor Day holiday, state and federal health officials have confirmed they are investigating an outbreak of hepatitis A in Virginia, Maryland, West Virginia, and North Carolina.

At least 70 infections have been linked to tainted frozen strawberries used in frozen smoothies served in various locations of the Tropical Smoothie Café chain. The firm has apologized publicly for any issues created by its products and said it voluntarily pulled the berries as soon as it learned of their contamination.

Although hepatitis A is not the most severe from of the viral liver infection, half of the 44 consumers infected in Virginia were sickened sufficiently to require hospitalization.

cdc-hepc-testCalifornians have gotten an unpleasant taste of the policy complexities caused when Big Pharma sets sky-high prices for life-changing drugs: State health officials say they need to set aside $1 billion to pay for increasing numbers of qualified patients on the state’s Medi-Cal program to receive a costly new treatment for Hepatitis C.

Two drugs, Sovaldi and Harvoni, have been hailed for their positive outcomes in treating Hep C, a blood-borne liver destroying disease. Until recently, it was chronic, largely untreatable, and often led to the deaths of patients who often acquired their infection due to sharing needles for illegal drug use.

California has 14,300 hepatitis C patients on Medi-Cal, the state’s Medicaid program, and they’re eligible for therapies because they’re enrolled in managed care programs in which the state pays commercial insurers sums for care. California and the federal government will join in paying for the Hep C drugs and treatment.

339-CloseupWeighBeamHuman failings vex doctors, too, and their biases against the overweight, especially women, may be detrimental to quality of  care. White practitioners also may benefit from racial bias, earning significantly more than their colleagues of color.

Stat, the online health news site, delves into the less discussed issue of physicians’ prejudice against patients who are heavy, if not obese, resulting, as one clinician says, in “inadequate health care, and preventative advice, and counseling, and support, and treatment—because the focus is on weight instead of managing risk factors.”

Doctors, like patients themselves, may be perplexed and frustrated that some patients carry lots of pounds and can’t seem to shed them, adding to an array of proven health issues, including heart, lung, liver, and kidney problems, as well as diseases like diabetes and cancer.

Let’s give credit where it’s due: Transplant surgery, in popular lore, has become one of modern medicine’s most miraculous practices, not only saving individual lives but also blazing new frontiers about the functions of organs in the body and providing insights of large significance into the workings of the human immune system. This progress hasn’t come without considerable cost to health care as a whole — and recent developments should prompt some deep thinking on how transplants work now.

First, let’s look at the disturbing study that suggests that wealth gives patients needing a transplant an edge when it comes to getting an organ. As the Associated Press notes in describing the research just presented to the American Heart Association, “You can’t buy hearts, kidneys or other organs but money can still help you get one. Wealthy people are more likely to get on multiple waiting lists and score a transplant, and less likely to die while waiting for one …[This work] confirms what many have long suspected — the rich have advantages even in a system designed to steer organs to the sickest patients and those who have waited longest. Wealthier people can better afford the tests and travel to get on more than one transplant center’s waiting list, and the new study shows how much this pays off.”

Who is to blame for this seeming inequity or gaming of the system? The United Network for Organ Sharing, or UNOS, has a government contract to run the system that decides who among 100,000 Americans waiting for various organs will get one suitable for transplant. The independent body “considers medical urgency, tissue type, distance from the donor, time spent on the waiting list and other factors.” Despite criticism of its practices, such as occurred when Apple tycoon and California resident Steve Jobs got on the liver transplant list in Tennessee, UNOS allows patients to traverse the country seeking the optimal situation for themselves and possible procedures. To even get on the lists, however, the patients–each time–must fork over, depending on the organ the need, anywhere from $23,000 to $51,000 for various suitability tests. Ouch.

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