Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence.

Aim: To evaluate 5-year survival predictive factors in hospitalised patients with excessive alcohol intake and cirrhosis, including in a multivariate analysis the severity of the liver disease, gastrointestinal bleeding, concomitant viral B or C infection, smoking status, presence of alcoholic hepatitis at inclusion and abstinence from alcohol during follow-up.

Methods: In a non-concurrent cohort study, 122 patients with excessive alcohol intake and cirrhosis were followed up at least five years or till death. Two patients were lost to follow-up.

Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis (AH): individual data analysis of the last three randomized placebo controlled double blind trials of corticosteroids in severe AH.

Background/aims: Controversy surrounding the efficacy of corticosteroids in severe alcoholic hepatitis (AH) persists.

The Aims Of Our Study Were: (a) to analyze individual data of patients with severe AH discriminant function (DF)> or =32 from the last three randomized controlled trials; and (b) to identify the independent prognostic factors associated with short-term survival.

Methods: Individual data were collected from the three principal investigators.

Cigarette smoking and hepatic lesions in patients with chronic hepatitis C.

A possible hepatotoxicity of cigarette smoke has been recently suggested by epidemiological and experimental studies. Our aim was to study the possible relationships between smoking and liver fibrosis and activity in patients with chronic hepatitis C. A cross-sectional study was performed in a group of 310 patients with chronic hepatitis C consecutively hospitalized for their first liver biopsy.

[Screening of cancerous and precancerous lesions of the oral mucosa in an at-risk population].

Early diagnosis of oral carcinomas allows a limitation of functional consequences of surgical treatment. A prospective study was designed in 270 alcoholic patients. We practiced a clinical examination of the oral cavity by a stomatologist followed by a Toluidin blue test.

[Evaluation of drug treatment of primary alcoholism].

Clinical improvement (abstinence and sobriety) can be obtained in 30% of alcohol dependent (primary) patients at one year when therapy consists of meetings and talking with physicians. The association of drugs led to 40% clinical improvement in controlled studies. These drugs are acamprosate (Aotal), which is well tolerated and shown to be beneficial at one year, naltrexone (Revia), also well tolerated with a follow-up of 3 months, and lithium (Téralithe), to be used more cautiously, with a follow-up of one year.