[Follow-up study on the reduction of burnout levels through mindfulness meditation in health care professionals.] / Studio di follow-up sulla riduzione dei livelli di burnout con la meditazione mindfulness in professionisti socio-sanitari.

SUMMARY: The 8-week mindfulness meditation (MM) trainings have proven to be helpful for reducing burnout due to work-related stress. Most studies reported these positive effects with evaluations made immediately before and immediately after the therapeutic interventions. Little is known, however, about the symptoms of burnout in the months following these interventions. In our exploratory study, the effects of an 8-week MM training were assessed in a group of health care professionals (n = 19) with vulnerability to develop burnout; a 9-month follow-up was conducted on the subjects (n=8) who continued to meditate after the end of the training. Other health care professionals of the same company, who did not meditate during this research, served as control group. Burnout, mindfulness abilities and job satisfaction were evaluated through self-reports. Data showed that during the training the levels of burnout did not decrease, but significant reductions were observed during the follow-up. This indicates the possibility of obtaining results with MM even in subjects who do not have standard response time to the therapy and highlights the importance of monitoring the healing process.

Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation: an Italian position statement.

Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis, fibrosis, and cirrhosis to hepatocellular carcinoma. Forty-four per cent of all deaths from cirrhosis are attributed to alcohol. Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation (LT). The vast majority of transplant programmes (85%) require 6 mo of abstinence prior to transplantation; commonly referred to as the "6-mo rule". Both in the case of progressive end-stage liver disease (ESLD) and in the case of severe acute alcoholic hepatitis (AAH), not responding to medical therapy, there is a lack of evidence to support a 6-mo sobriety period. It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking. The "Group of Italian Regions" suggests that: in a case of ESLD with model for end-stage liver disease < 19 a 6-mo abstinence period is required; in a case of ESLD, a 3-mo sober period before LT may be more ideal than a 6-mo period, in selected patients; and in a case of severe AAH, not responding to medical therapies (up to 70% of patients die within 6 mo), LT is mandatory, even without achieving abstinence. The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist. Patients have to participate in self-help groups.