https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367

The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.

해외산업간호정보 - 미국 산업안전보건연구원(National Institute for Occupational Safety and Health) 소개

Importance Nonalcoholic steatohepatitis (NASH) is the inflammatory subtype of nonalcoholic fatty liver disease (NAFLD) and is associated with disease progression, development of cirrhosis, and need for liver transplant. Despite its importance, NASH is underrecognized in clinical practice. Observations NASH affects an estimated 3% to 6% of the US population and the prevalence is increasing. NASH is strongly associated with obesity, dyslipidemia, type 2 diabetes, and metabolic syndrome. Although a number of noninvasive tests and scoring systems exist to characterize NAFLD and NASH, liver biopsy is the only accepted method for diagnosis of NASH. Currently, no NASH-specific therapies are approved by the US Food and Drug Administration. Lifestyle modification is the mainstay of treatment, including dietary changes and exercise, with the primary goal being weight loss. Substantial improvement in histologic outcomes, including fibrosis, is directly correlated with increasing weight loss. In some cases, bariatric surgery may be indicated to achieve and maintain the necessary degree of weight loss required for therapeutic effect. An estimated 20% of patients with NASH will develop cirrhosis, and NASH is predicted to become the leading indication for liver transplants in the US. The mortality rate among patients with NASH is substantially higher than the general population or patients without this inflammatory subtype of NAFLD, with annual all-cause mortality rate of 25.56 per 1000 person-years and a liver-specific mortality rate of 11.77 per 1000 person-years. Conclusions and Relevance Nonalcoholic steatohepatitis affects 3% to 6% of the US population, is more prevalent in patients with metabolic disease and obesity, progresses to cirrhosis in approximately 20% of cases, and is associated with increased rates of liver-specific and overall mortality. Early identification and targeted treatment of patients with nonalcoholic steatohepatitis are needed to improve patient outcomes, including directing patients toward intensive lifestyle modification to promote weight loss and referral for bariatric surgery as indicated for management of obesity and metabolic disease.

https://jamanetwork.com/journals/jama/articlepdf/2763297/jama_sheka_2020_rv_200001.pdf

Nonalcoholic Steatohepatitis: A Review.

Increasing evidence indicates that reactive oxygen species (ROS), consisting of superoxide, hydrogen peroxide, and multiple others, do not only cause oxidative stress, but rather may function as signaling molecules that promote health by preventing or delaying a number of chronic diseases, and ultimately extend lifespan. While high levels of ROS are generally accepted to cause cellular damage and to promote aging, low levels of these may rather improve systemic defense mechanisms by inducing an adaptive response. This concept has been named mitochondrial hormesis or mitohormesis. We here evaluate and summarize more than 500 publications from current literature regarding such ROS-mediated low-dose signaling events, including calorie restriction, hypoxia, temperature stress, and physical activity, as well as signaling events downstream of insulin/IGF-1 receptors, AMP-dependent kinase (AMPK), target-of-rapamycin (TOR), and lastly sirtuins to culminate in control of proteostasis, unfolded protein response (UPR), stem cell maintenance and stress resistance. Additionally, consequences of interfering with such ROS signals by pharmacological or natural compounds are being discussed, concluding that particularly antioxidants are useless or even harmful.

/pdf/mitohormesis-promoting-health-and-lifespan-by-increased-2ww3vz7l3b.pdf

Mitohormesis: Promoting Health and Lifespan by Increased Levels of Reactive Oxygen Species (ROS).

Nutraceuticals, Isoprenoids, Health and Disease, Isoflavones, Soy Protein, Soybean Isoflavones, and Bone Health, Phytoestrogens Involvement in Breast and Prostate Cancer, Anti-Cancer and Cholesterol-Lowering Activities of Citrus Flavonoids, Flavonoids as Antioxidants, Carotenoids, Metabolism and Disease, Lycopene: Source, Properties and Nutraceutical Potential, Cruciferous Vegetables and Cancer Prevention, Garlic, Antioxidant Vitamin and Phytochemical Content of Fresh and Processed Pepper Fruits, Modification of Atherogenesis and Heart Disease by Grape Wine and Tea Polyphenols, Olive Oil and Health Benefits, Anti-Cancer and Cholesterol-Lowering Activities of Tocotrienols, Dietary Fiber and Coronary Heart Disease, Omega-3 Fish Oils and Lipoprotein Metabolism, Free-Radical Oxidation in Biological Systems Enriched with EPA and DHA, Omega-3 Polyunsaturated Fatty Acids and Cardiac Arrhythmias, Omega-3Fish Oils and Insulin Resistance, Omega-3 Polyunsaturated Fatty Acids and Rheumatoid Arthritis, Sphingolipids. Mechanism-based Inhibitors of Carcinogenesis Produced by Animals, Plants and Other Organisms, Application of Herbs to Functional Foods, Probiotics and Prebiotics, Lechithin, and Choline, Stability Testing of Nutraceuticals and Functional Foods, Marketing Issues for Functional Foods and Nutraceuticals, Conjugated Linoleic Acid, Designing Functional Foods from Animals Products to reduce Human Disease, The Role of Nuts in Disease Prevention, Fiber, Tartaric Acid and Cancer

Handbook of Nutraceuticals and Functional Foods

The current analysis reexamines the relationship between supplemental vitamin E and all-cause mortality. All randomized, controlled trials testing the treatment effect of vitamin E supplementation in adults for at least one year were sought. MEDLINE, the Cochrane Library, and Biological Abstracts databases were searched using the terms “vitamin E,” “alpha-tocopherol,” “antioxidants,” “clinical trial,” and “controlled trial” for studies published through April 2010; results were limited to English, German, or Spanish language articles. Studies were also obtained through reference mining. All randomized controlled trials using vitamin E, with a supplementation period of at least one year, to prevent or treat disease in adults were identified and abstracted independently by two raters. Mortality data from trials with a supplementation period of at least one year were pooled. The selected trials (n = 57) were published between 1988 and 2009. Sample sizes ranged from 28 to 39,876 (median = 423), yielding 246,371 subjects and 29,295 all-cause deaths. Duration of supplementation for the 57 trials ranged from one to 10.1 years (median = 2.6 years). A random effects meta-analysis produced an overall risk ratio of 1.00 (95% confidence interval: 0.98, 1.02); additional analyses suggest no relationship between dose and risk of mortality. Based on the present meta-analysis, supplementation with vitamin E appears to have no effect on all-cause mortality at doses up to 5,500 IU/d.

Vitamin E and all-cause mortality: a meta-analysis.

This article reports research findings concerning 119 alleged sexual perpetrators who were reported to state authorities for abusing elderly individuals residing in care facilities. The largest group of accused was employees of the facilities, followed by facility residents. Family members of the alleged victims and visitors to the facilities also were among those reported as sexually abusive. Investigation of the allegations by Adult Protective Services and regulatory staff resulted in 32 of these individuals being confirmed as sexual perpetrators against vulnerable elders. Male and female alleged and confirmed sexual perpetrators were identified as well as both male and female elderly sexual abuse victims. Perpetrator characteristics, victim vulnerabilities, abuse acts, locations of assaults, and available case outcomes are presented. Implications of the findings are discussed.

Sexual Predators Who Target Elders: Findings from the First National Study of Sexual Abuse in Care Facilities

Oxidation of thiol-proteases in the hippocampus of Alzheimer’s disease

The average age of United States farmers has been increasing for 20 years. The objective is to examine the factors associated with hours worked among farmers age 50 and older. A cohort of Kentucky and South Carolina farmers (n = 1394) over age 50 were surveyed annually during 2002–2005. Of those that reported any farm work, males worked 24 mean hours/week and females worked 14 mean hours/week. Greater satisfaction and more experience farming, increased acreage, and presence of animals significantly increased estimated hours farmed, whereas chronic health problems, although prevalent, had a minor role in determining work hours.

Determinants of work hours among a cohort of male and female farmers 50 years and older in Kentucky and South Carolina (2002-2005).

Research of home-based health care (HBHC) has shown that care providers suffer from a high rate of injuries. Analysis of workers’ compensation records, a reliable source for injury and illness data, enables the identification of trends within a specific working population. HBHC workers’ compensation compensable claims in Washington State from 2006 to 2016 were compared to clinical health care (CHC) claims. Injury event and source attributed to HBHC claims were also analyzed, with a focus on work-related musculoskeletal disorders (WMSDs). Though CHC had 5 times the number of full-time employees during the study period, HBHC grew by 61.1%, compared to 28.7% in CHC. Claim rates for all compensable claims and WMSD claims consistently decreased year-over-year for both HBHC and CHC. WMSD claims experienced a year-over-year decline of 5.3%; for all compensable claims the decline was 4.5%. Analysis of HBHC claim rates by injury event found WMSD had the highest rates, followed by falls from the same level. However, the largest annual change was for the injury event overexertion (−10.1%, 95%CI: −13.4, −6.8). HBHC injuries attributable to the health care patient were the most common. Claims with this injury source declined annually by 6.0%. Claim rates for injuries to the back region, and specifically back WMSDs, were consistently higher year-over-year compared to other body regions and WMSD types. Claims for injuries to the back declined by an annual rate of 6.6% (95% CI: −7.9, −5.3), while back WMSD claims decreased by 6.4% (94% CI: −7.8, −4.9).

An Examination of Washington State Workers’ Compensation Claims for Home-Based Health Care Workers, 2006 to 2016: Part 2. Injury Rates and Trends

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