geoffrey modest medical blogs

  A recent analysis found that wealth redistribution to decrease inequities in the United States would be predicted to lead to both substantial reductions in social inequities together with population longevity, similar to other high income countries in the world (see  income inequality dec life expectancy JAMAIntMed2024  in dropbox or d oi:10.1001/jamainternmed.2023.7975)   Details : -- 35,164 participants were evaluated with data on wealth and longevity from the Health and Retirement Study (1992-2018), a study of community-dwelling individuals >50yo, assessing the difference between personal wealth and their death rates. Death rates were adjudicated through the National Death Index     -- the HRS involved interviews in 14 biennial waves     -- the researchers chose to assess deciles of wealth given the nonlinear pattern of wealth differences in the US (see below for details of the dramatic inequities within the US)   ...

  A recent study assessed the outcomes of adults with Nonalcoholic Fatty Liver Disease (NAFLD) across the histologic spectrum (see   nafld prospective outcome study nejm2021  in dropbox, or DOI: 10.1056/NEJMoa2029349 )    Details:   -- 1773 adults with NAFLD in a perspective cohort study, from the NAFLD Database Study Phase 2 non-interventional registry of the NASH Clinical Research Network (NASH = Non-Alcoholic Steatohepatitis) -- all had liver biopsies that found NAFLD and had at least one follow-up visit after 48 weeks  -- to differentiate NAFLD from Alcoholic Fatty Liver Disease, a questionnaire was used to establish consumption of less than 20 g of alcohol daily for women and less than 30 g for men [biopsy analysis of NAFLD vs alcoholic fatty liver disease can be indistinguishable] -- median age 52,  36% male, 85% white, 12% Latinx, BMI 33, mean time since NAFLD diagnosis 2.7 years --75% of those with NAFLD had NASH --mean ALT 51 , ...