PATIENTS AND METHODSThough the hepatotoxicity of ethanol has been established, only 8% to 20% of chronic alcoholics develop cirBetween January of 1982 and May of 1995, a total of 2,848 patients rhosis. The aim of this study was to assess whether being were admitted to the Hepatogastroenterology Unit of the Antoine overweight is a risk factor for alcoholic liver disease. Béclère Hospital in Clamart, France, for alcoholism or alcoholic liver One thousand six hundred four alcoholic patients were disease. To be included in the study, patients must have drunk at studied. According to the liver biopsies, 194 patients had least 50 g of alcohol per day over the previous year. We used only a normal liver; 402 had steatosis without fibrosis; 281 the data that were recorded during the first admissions in our unit. presented with fibrosis, with or without steatosis; 119 From these 2,848 patients, 1,244 patients were excluded, including 596 on whom no liver biopsy was performed and for whom cirrhosis presented with acute alcoholic hepatitis (AAH) without was not clinically obvious, and 313 because of missing data. Fortycirrhosis; 232 indicated cirrhosis without AAH; and 179 one patients were excluded because of the presence of hepatitis B presented with cirrhosis with AAH. One hundred ninetysurface antigen; 289 were excluded because of the presence of antiseven patients had clinically obvious cirrhosis. In the bodies to hepatitis C virus; and 5 patients were excluded because of study, five variables were studied as risk factors: age, the presence of hepatitis B surface antigen and antibodies to hepatisex, daily consumption of alcohol during the previous 5 tis C virus. In fact, hepatitis B virus markers were prospectively and years, the total duration of alcohol abuse, and tendency systematically recorded in all patients. Serum antibodies against to be overweight (body mass index [BMI] ¢ 25 in women hepatitis C virus were also assessed in all patients when serum and ¢ 27 in men). The BMI was calculated according to markers for hepatitis C virus infection became available. 5 Hepatitis C virus antibodies were tested retrospectively with a first-generathe minimum weight over the 10 previous years. In the tion, enzyme-linked immunosorbent assay system (Ortho Diagnostic first stepwise logistic regression analysis, age, being System, Raritan, NJ) from January 1982 to May 1991, afterward, overweight for at least 10 years, being of the female sex, they were tested prospectively with second-and third-generation and the total duration of alcohol abuse were indepenenzyme-linked immunosorbent assay systems. dently correlated with the presence of cirrhosis. In the One thousand six hundred and four patients were included in the second analysis, female sex being overweight were the study of which 608 had cirrhosis. This was histologically proven in 411 two independent risk factors of AAH. In the third analy-patients and was clinically obvious in the other 197 patients, who had sis, being overweight for at least 10 years was the only a posi...

Recent studies have shown that hepatitis C virus antibodies are present in a large proportion of patients with autoimmune hepatitis type 2. We have studied 83 patients with liver/kidney microsome antibody-positive type 1 hepatitis. Hepatitis C virus antibodies were sought in every case by second-generation tests (hepatitis C virus enzyme-linked immunosorbent assay and recombinant immunoblot assay). Hepatitis C virus RNA sequences were sought in 22 patients (12 with recombinant immunoblot assay-positive results and 10 with recombinant immunoblot assay-negative results) by means of polymerase chain reaction and by use of primers located in the 5' noncoding region. Sixty-four patients (77%) had positive results for hepatitis C virus antibodies in the enzyme-linked immunosorbent assay test, and 41 (49.3%) were confirmed by recombinant immunoblot assay. Hepatitis C virus RNA sequences were found in all the recombinant immunoblot assay-positive patients but in none of the 10 who were recombinant immunoblot assay-negative. The recombinant immunoblot assay-negative patients were younger than those who were positive (13 +/- 11 vs. 50 +/- 11 years) and had higher gamma-globulin levels and liver/kidney microsome antibody-positive type 1 titers (61% had a titer of 1:1,000 or more, vs. only 17% of the recombinant immunoblot assay-positive patients).(ABSTRACT TRUNCATED AT 250 WORDS)

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This study shows the feasibility and the usefulness of CCE in the situation of colonoscopy failure or contraindication. The colon capsule modality should be tested against other available approaches, such as virtual colonoscopy or repeat colonoscopy by an expert.

Background and aims: Excessive alcohol consumption is a risk factor for developing colorectal adenomas. This study aimed to investigate the influence of excessive alcohol consumption on the occurrence of high risk polyps (adenoma >10 mm, villous component, high grade dysplasia) or colorectal cancer among patients with at least one colonic adenoma. Patients and methods: Three groups of patients with at least one colorectal adenoma were included in a case control study: 401 heavy drinkers (group HD, mean daily alcohol intake 117 (SD 4) g/day for a mean duration of 22 (SD 0.6) years), aged 57 (0.5) years (78% men); 152 patients suffering from irritable bowel syndrome (IBS), aged 61 (0.9) years (57% male); and 108 patients with a family history (FH) of colorectal adenoma or cancer, aged 55 (1) years (64% male). Exclusion criteria were: anaemia, haematochezia, personal history of colorectal adenoma or cancer, and for groups HD and IBS a family history of colorectal adenoma and/or cancer. Relative risks were estimated by the odds ratio (OR) using a logistic regression model and were expressed with 95% confidence interval (CI). Results: After age and sex adjustment, the likelihood of having an adenoma >10 mm was higher in group HD than in the IBS group (OR 1.8, 95% CI (1.2-2.7)) and the likelihood of having high risk adenomas or cancer was higher in group HD compared with the IBS group (OR 1.6, 95% CI (1.2-2.1)) and the FH group although this was not significant (OR 1.6, 95% CI (0.97-2.6) (p=0.081); 90% CI (1.03-2.4)). After age and sex adjustment, the likelihood of having an adenoma with high grade dysplasia or cancer was higher in group HD than in the IBS group (OR 1.7, 95% CI (1.02-2.8)) or group FH, although this was not significant (OR 3.7, 95% CI (0.98-15) (p=0.076); 90% CI (1.10-12.47)). Conclusion:In patients with at least one colorectal adenoma, excessive alcohol consumption increases the likelihood of developing high risk adenomas or colorectal cancer.