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Study Objective: To determine the distribution of coronary artery disease (CAD) and its risk factors across the various etiologies of end-stage liver disease, and to elucidate the relationship between severe alcohol consumption and CAD. Design: Retrospective multicenter study analysis. Setting: National Standard Transplant Analysis and Research file data. Measurements: Data from all primary adult orthotopic liver transplant recipients during the period from 2004 through 2006 were studied. Data were divided into 5 groups according to each patient's etiology of end-stage liver disease. The prevalence of CAD and the distribution of its risk factors were compared among groups. Main results: 17,482 cases were studied. The incidence of CAD was highest in nonalcoholic hepatic steatosis (7.4%) and lowest in biliary cirrhosis (1.7%). No difference in prevalence of CAD and its risk factors was noted between the viral and alcoholic etiologies (Hepatitis C 2.7%, Hepatitis B 2.3%, and alcoholic cirrhosis 2.9%). Conclusions: Prevalence of CAD and the distribution of CAD risk factors in patients with severe alcohol consumption were similar to patients with viral hepatitis. CAD was most prevalent in patients with hepatic steatosis. This study argues against the notion of decreased expression and progression of CAD in patients with alcoholic cirrhosis presenting for liver transplantation. [ABSTRACT FROM AUTHOR]

The article discusses the principles and practice of disaster medicine and the role of anesthesiologists in disaster response. The topics discussed include an overview of the science of disaster medicine including the three phases of disaster management, the U.S. National Response Framework, and the knowledge, skills, and the varied roles of anesthesiologists in mass casualty and disaster management such as in an attack with weapons for mass destruction (WMD). A definition of terms is provided.