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Severe alcoholic hepatitis is associated with high early mortality. This study aimed at identifying prognostic factors associated with in-hospital, medium-and long-term mortality of severe alcoholic hepatitis and to evaluate the different prognostic scoring systems on a cohort of patients in our hospital. To this end, we conducted a retrospective analysis of 66 episodes admitted between 2000 and 2008. Clinical and laboratory data on admission, at 7 days, 1 month, 6 months, and after one year were collected and analyzed, as were the details on the treatment and complications that occurred during hospitalization; the different prognostic indices used in the literature were calculated. Death event associated with an episode of severe alcoholic hepatitis occurs primarily during the first month, with an average mortality rate of 16.9. Infectious complications were associated with lower in-hospital survival. MELD score, urea and bilirubin values one week after admission were independently associated with both in-hospital survival (OR = 1.14, 1.012 and 1.1, respectively), and survival at 6 months (OR = 1, 15; 1.014 and 1.016, respectively). Only MELD score and urea values at 7 days were independent predictors of survival twelve months after the acute hepatitis episode. MELD score, urea, and bilirubin 7 days after admission were the only independent in-hospital survival and also long-term survival factors 6 months and one year after the episode. In our cohort, the MELD score was the best prognostic index to predict mortality associated with an episode of severe alcoholic hepatitis.

Undernutrition is asscciated to l c u scciccultural enviromemt. I t has a l s o been described a clear relation ship between undernutrition early i n l i f e , ax3 Wr grcwth and develcpwnt afterwards, t h a t can be reverted with an adeguate t r e a t m n t . Interested in t h i s prcblem we studied 283 fan& l i e s of extrene poverty v b s e M a n t s m e treated before tsm years of age i n a closed nutritional recovery center (CCNR). ?hey a l l m e severely undernourished according to W standards W/ A 63.05 2 8.4 a t admission and stayed 133.7 + 45 days in the center being discharged and rs03Vered to a relation W/ A 81.64 + 9. This grmp has been f o l l a e d up during nine years by the sam professional team. After 8 years of follcu up ue study 37 scci-nanic items lamin to be inportant to discriminate sccioeconanic level , so we could separate the sample in four qrcups. Gnce separated i n graups we correlated sccioeooMRic level with a n t h r u p e t r i c characteristic of the infants during the follcu up period a d we found t h a t imthers scholarity, envital sanitation and s t a b i l i t y i n the organization of the family correlated positively with a good nutrition emlution during the follcwup (p (0.05, (0.01, (0.02, respctively:. Instead, the presence of another mlnourished infant i n the family, father's alca!olisn were related to a bad prognosis. ?Ns study l e t us conclude t h a t an adequate nutritional treatment mst include the family. Otherwise a l l t h a t i s a gained during CNW3 t r e a t m n t is l o s t afterwards, s~e c i a l l y i f there is another mlnaurished infant a t b and i f the head of the family is an alcoholic. Family health status and its management by the mother i n families living in poverty conditions were studied. The hypothesis is that there should be more sick people in families with family conflicts than in those without these. The sample was made up of 30 slum families. Fifteen of these were stressed because health problems (A) and 15 had no problems.The f i r s t group had t o have consulted t o the health system (endogenous o r exogenous)in the 3 months prior t o selection of the sanple whereas the other 15 did not need to. The families were visited, a t home, once a week f o r a period of 6 months. Results indicate that the families of Group.A shows ~m t l y ~m r e respiratory disease (p.<.0001) o r other a s digestive,skin, etc. (p < .05) as well as i n the t o t a l amunt of illnesses (p .~1 ) than families from Group B. In both groups it is the mother who mainly take care of family health and they do not differe i n how they deal with symptom o r seek help from a general practitioner. Nevertheless, more Group A mother were of urban origin ( p < .03) had no secondary school education(p < .02), were less understood by t h e i r husbands (or mate)(p< .02) and had discussions ending i n fights (p <.02) than those of Group B. Therefore, these results agreed with the postulate. The charts of the 159 children under 2 years of age admitted i n 1985 f o r acute diarrhea and...

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