This paper reports novel and interesting data on the causes of liver cirrhosis in Mexico. The authors collected in a prospective, cross-sectional way more that 1,500 cases of cirrhosis admitted to 4 major hospitals in the country over a period of 30 months. Cirrhosis was defined by the golden standard (liver biopsy) in more that ¾ of the cases while the remaining 25% was assessed clinically since invasive procedures were not applicable. Alcohol abuse accounted for about 40% of the cases, a figure almost identical for what found for HCV (37%). Cirrhosis from unknown origin (cryptogenic), PBC or related to HBV infection were by far less frequent. From these data, two main messages to be taken home may be derived: 1) in Mexico, as well as in other regions of the world, liver cirrhosis is a leading cause of dearth and of hospitalization. The high prevalence of HCV and the still high consumption of “improper” doses of alcohol seem to be the main reservoir for this heavy social and medical burden; and 2) liver disease are for sure of great social impact and some action should be taken to reduce its high and possibly increasing number. Since both HCV infection and alcohol abuse can be prevented, a strong social campaign of advertisement seems more that necessary worldwide.
Changes of coagulation inhibitors and
fibrinolysis system in newborn infants
with transitory neonatal cholestasis
Héctor Alfredo Baptista González, et al
The coagulation system in newborns functions differently than in the adult life and, in general, the newborn tends to face greater coagulatory risk. This study reports on the plasma concentration of a vast number of protein involved in fibrinolysis in 24 newborns with cholestasis either with or liver damage assessed by the activity of ALT. This is even more clinically evident in sick newborns. Thus, this study may provide important practical guidelines on how to deal in this not infrequent neonatal condition. A greater thrombotic state was observed and this was somehow related to liver damage. Unfortunately neither strong clinical evidence nor experimental insights were provided in explaining these alterations preventing the definition of a strategy for the treatment of these defects. Clearly additional studies are needed to shed further light on this serious condition.
