Fabio Attilia

PNPLA3 I148M (rs738409) genetic variant and age at onset of at-risk alcohol consumption are independent risk factors for alcoholic cirrhosis

Environmental and genetic factors contribute to alcoholic cirrhosis onset. In particular, age at exposure to liver stressors has been shown to be important in progression to fibrosis in hepatitis C individuals. However, no definite data on the role of age at onset of at‐risk alcohol consumption are available. Moreover, patatin‐like phospholipase domain‐containing protein 3 (PNPLA3) I148M (rs738409) variant has been associated with alcoholic cirrhosis, but only in cross‐sectional studies. The aim of this study was to investigate the role of age at onset of at‐risk alcohol consumption and PNPLA3 I148M variant on alcoholic cirrhosis incidence.

The multidisciplinary support in preventing alcohol relapse after liver transplantation: A single-center experience

Alcoholic liver disease (ALD) represents a frequent indication for liver transplantation (LT). Since 2004, we have adopted a program of multidisciplinary support(MS) to assist patients undergoing LT for ALD. We aimed at analyzing the relapse rate and the risk factors for relapse. The relapse rate was also compared with that of a historical group of patients who underwent transplantation. Their survival rate was also analyzed.

Drop-out, relapse and abstinence in a cohort of alcoholic people under detoxification

The Obsessive Compulsive Drinking Scale (OCDS) was developed to reflect obsessionality and compulsivity related to craving and drinking behaviour for revealing in the long-term drop-out, abstinence and relapse. This study evaluates the early OCDS predictive value in drop-out, abstinence and relapse of patients suffering from Alcohol Use Disorders (AUD) for discovering an OCDS total score cut-off capable of disclosing patients most at-risk of relapse during the beginning of the therapeutic intervention in the Day-Hospital period. The sample includes 263 AUD patients, with 192 men and 71 women. The OCDS scores were measured during the two-weeksu202fDay Hospital treatment for detoxification and after 30, 60, 90 and 180u202fdays after discharge. We also investigated the association between the all OCDS scores and abstinence and between craving, relapse and drop-out. We found that high values of OCDS during Day Hospital detoxification may predict a lower ability to maintain abstinence with elevated relapsing probabilities. Surprisingly, early dropping-out AUD people had lower OCDS total scores. However, significant differences in OCDS values in dropping-out AUD people were revealed mainly 90 and 180u202fdays after discharge compared to no dropping-out AUD subjects. Craving measured also after 30, 60, 90 and 180u202fdays from discharge in AUD relapsers, with OCDS values comprised between 6 and 10, could indicate a lower ability to continue abstinence. In conclusion, OCDS may be a useful tool to early discriminate AUD people at-risk for relapse and drop-out and for addressing the specialist to adjust both medical treatment and psychological support during crucial moments of patients treatment and follow-up.