Access to Comprehensive Services for Advanced Liver Disease in the Veterans Health Administration

AbstractBackgroundThe Veterans Health Administration (VHA) provides care to the one of the largest cohorts of patients with advanced liver disease (ALD) in the USA.AimsWe performed a national survey to assess system-wide strengths and barriers to care for Veterans with ALD in this national integrated healthcare setting.MethodsA 52-item survey was developed to assess access and barriers to care in Veterans with ALD. The survey was distributed to all VHA medical centers in 2015. Results were analyzed using descriptive statistics.ResultsOne hundred and fifty-three sites responded to this survey. Multidisciplinary services were available on-site at>  80% of sites. Ninety-five percent of sites had mental health and addictions treatment available, with 14% co-locating these services within the liver clinic. Few sites (
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research

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Conclusion: Natural recovery after TBI may include delayed onset of functional decline or early recovery, followed by progressive deterioration, and is negatively affected by medical comorbidities. Results contribute to the growing evidence that TBI is most appropriately treated as a chronic medical condition complicated by a variety of comorbid conditions.
Source: The Journal of Head Trauma Rehabilitation - Category: Neurology Tags: Original Articles Source Type: research
Conclusions: LT candidates without known alcohol or drug use may have a clinically significant consumption of alcohol and previous illicit drug use. Efforts should be put on identification of these patients during LT evaluation. The use of structured questionnaires such as the ASI and the LDH could facilitate detection of alcohol and drug problems. PMID: 31453745 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Authors: Arab JP, Roblero JP, Altamirano J, Bessone F, Chaves Araujo R, Higuera-De la Tijera F, Restrepo JC, Torre A, Urzua A, Simonetto DA, Abraldes JG, Méndez-Sánchez N, Contreras F, Lucey MR, Shah VH, Cortez-Pinto H, Bataller R Abstract Alcohol-related liver disease (ALD) is a major cause of advanced chronic liver disease in Latin-America, although data on prevalence is limited. Public health policies aimed at reducing the alarming prevalence of alcohol use disorder in Latin-America should be implemented. ALD comprises a clinical-pathological spectrum that ranges from steatosis, steatohepatitis to ...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
CONCLUSIONS: The prevalence of moderate/heavy alcohol use is high among HCV antibody positive PWID and occurs frequently in combination with other drug use. This may contribute to progressive liver fibrosis thus limiting the gains achieved from HCV cure. Public health interventions need to address the overlapping epidemics of HCV, alcohol use, and other substance use in this population. PMID: 31035079 [PubMed - as supplied by publisher]
Source: Addictive Behaviors - Category: Addiction Authors: Tags: Addict Behav Source Type: research
We describe one such approach, albumin binding, and explain how it was applied in the development of the human GLP-1 analog liraglutide once daily and, subsequently, semaglutide once weekly. The pharmacology of these two long-acting GLP-1 analogs, in terms of improving glycemic control, reducing body weight and decreasing cardiovascular (CV) risk, is also reviewed, together with some novel biology. In addition, we describe the importance of accurate target (GLP-1 receptor) tissue expression analysis. Now an established class of agents, GLP-1-based therapies represent a significant advance in the treatment of T2D. All curr...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Conclusion: This method can assist radiologists in their routine alcoholism screening of brain magnetic resonance images. Introduction Alcoholism (1) was previously composed of two types: alcohol abuse and alcohol dependence. According to current terminology, alcoholism differs from “harmful drinking” (2), which is an occasional pattern of drinking that contributes to increasing levels of alcohol-related ill-health. Today, it is defined depending on more than one of the following conditions: alcohol is strongly desired, usage results in social problems, drinking large amounts over a long time period, di...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
AbstractPurpose of ReviewThis review provides a brief overview of key concepts in addiction medicine and provides tips and tricks as it pertains to treating patients with alcohol addiction in the setting of advanced alcohol-related liver disease (ALD).Recent FindingsUnderstanding the brain disease model of addiction by both providers and patients is a vital springboard for establishing a therapeutic relationship. Despite a paucity of high-quality evidence, psychosocial treatments have withstood the test of time and still form the foundation of alcohol use disorder (AUD) treatment in advanced ALD. Despite the inescapable li...
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research
Authors: Lindenger C, Castedal M, Schult A, Åberg F Abstract OBJECTIVE: Studies of predictive factors of alcohol recidivism and survival post-LT are not up-to-date. With evolving LT activity and with longer-term outcomes becoming increasingly available, re-evaluating post-LT outcomes is imperative. We analyzed recent data on survival, alcohol recurrence and predictive factors. METHODS: We compared long-term survival among 159 consecutive ALD patients transplanted 2003-2016 with 159 propensity-score matched controls transplanted for non-ALD. Alcohol 'slips' (occasional lapse) and relapse to moderate or har...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
ConclusionsInpatient charges for cirrhosis care are high and increasing. Alcohol-related liver disease accounts for more than half of these charges and is driven by sheer volume of admissions and readmissions of the same patients. Effective alcohol addictions therapy may be the most cost-effective way to substantially reduce inpatient cirrhosis care expenditures.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
There is a commonly held belief that winter conditions — that are characterized by extreme cold and low sunlight — are connected to heavy drinking. Whenever we think of countries in Northern Europe we instantly think of sub-zero temperatures, dark clouds and polar landscapes. We also imagine its inhabitants tucked in a bar drinking their sorrows away. What creates this image is the perception that strong spirits and binge drinking are a staple of many Northern countries. However, scientific and factual evidence shows a more nuanced picture. Statistical Verdict The argument that countries with a colder climate e...
Source: Psych Central - Category: Psychiatry Authors: Tags: Addictions Substance Abuse alcohol use Alcoholism heavy drinking Holiday Blues Holiday Season Public Health Winter Source Type: news
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