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Alcoholic Hepatitis

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1. Glucocorticosteroids for people with alcoholic hepatitis. (PubMed)

Glucocorticosteroids for people with alcoholic hepatitis. Alcoholic hepatitis is a form of alcoholic liver disease characterised by steatosis, necroinflammation, fibrosis, and complications to the liver. Typically, alcoholic hepatitis presents in people between 40 and 50 years of age. Alcoholic hepatitis can be resolved if people abstain from drinking, but the risk of death will depend on the severity of the liver damage and abstinence from alcohol. Glucocorticosteroids have been studied (...) also scanned reference lists of the studies retrieved. The last search was 18 January 2019.Randomised clinical trials assessing glucocorticosteroids versus placebo or no intervention in people with alcoholic hepatitis, irrespective of year, language of publication, or format. We considered trials with adults diagnosed with alcoholic hepatitis, which could have been established through clinical or biochemical diagnostic criteria or both. We defined alcoholic hepatitis as mild (Maddrey's score less

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2019 Cochrane

2. Glucocorticosteroids for people with alcoholic hepatitis. (PubMed)

Glucocorticosteroids for people with alcoholic hepatitis. Alcoholic hepatitis is a form of alcoholic liver disease, characterised by steatosis, necroinflammation, fibrosis, and potential complications to the liver disease. Typically, alcoholic hepatitis presents in people between 40 and 50 years of age. Alcoholic hepatitis can be resolved if people abstain from drinking, but the risk of death will depend on the severity of the liver damage and abstinence from alcohol. Glucocorticosteroids (...) are used as anti-inflammatory drugs for people with alcoholic hepatitis. Glucocorticosteroids have been studied extensively in randomised clinical trials in order to assess their benefits and harms. However, the results have been contradictory.To assess the benefits and harms of glucocorticosteroids in people with alcoholic hepatitis.We identified trials through electronic searches in Cochrane Hepato-Biliary's (CHB) Controlled Trials Register, CENTRAL, MEDLINE, Embase, LILACS, and Science Citation

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2017 Cochrane

3. Alcohol Rehabilitation Within 30 Days of Hospital Discharge is Associated With Reduced Readmission, Relapse, and Death in Patients with Alcoholic Hepatitis. (PubMed)

Alcohol Rehabilitation Within 30 Days of Hospital Discharge is Associated With Reduced Readmission, Relapse, and Death in Patients with Alcoholic Hepatitis. Patients admitted to the hospital for alcoholic hepatitis (AH) are at increased risk of readmission and death. We aimed to identify factors associated with readmission, alcohol relapse, and mortality.We performed a retrospective analysis of consecutive patients admitted with AH to a tertiary care hospital from 1999 through 2016 (test cohort (...) , n=135). We validated our findings in a prospective analysis of patients in a multi-center AH research consortium from 2013 through 2017 (validation cohort, n=159). Alcohol relapse was defined as any amount of alcohol consumption within 30 days after hospital discharge. Early alcohol rehabilitation was defined as residential or outpatient addiction treatment or mutual support group participation within 30 days after hospital discharge.Thirty-day readmission rates were 30% in both cohorts. Alcohol

2019 Clinical Gastroenterology and Hepatology

4. Characterization of intestinal microbiota in alcoholic patients with and without alcoholic hepatitis or chronic alcoholic pancreatitis (PubMed)

Characterization of intestinal microbiota in alcoholic patients with and without alcoholic hepatitis or chronic alcoholic pancreatitis Excessive alcohol consumption leads to severe alcoholic hepatitis (sAH) or chronic alcoholic pancreatitis (CAP) only in a subset of patients. We aimed to characterize the intestinal microbiota profiles of alcoholic patients according to the presence and nature of the complications observed: sAH or CAP. Eighty two alcoholic patients were included according (...) to their complications: CAP (N = 24), sAH (N = 13) or no complications (alcoholic controls, AC, N = 45). We analyzed the intestinal microbiota by high-throughput sequencing. Bacterial diversity was lower in patients with CAP, who had a global intestinal microbiota composition different from that of AC. The intestinal microbiota composition of these two groups differed for 17 genera, eight of which were more frequent in patients with CAP (e.g. Klebsiella, Enterococcus and Sphingomonas). There was no significant

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2018 Scientific reports

5. Two drug treatments for severe alcoholic hepatitis do not improve survival rates

Two drug treatments for severe alcoholic hepatitis do not improve survival rates Two drug treatments for severe alcoholic hepatitis do not improve survival rates Discover Portal Discover Portal Two drug treatments for severe alcoholic hepatitis do not improve survival rates Published on 23 April 2015 doi: This NIHR funded trial found that neither prednisolone nor pentoxifylline improved mortality for people with severe alcoholic hepatitis. No differences were found in mortality at 28 or 90 days (...) , or in the need for liver transplant at one year. Overall mortality was high. Nearly three in ten people died before 90 days and more than half (56%) at one year. This shows that other new treatments are needed and more needs to be done to encourage complete abstinence from alcohol following severe alcoholic hepatitis. Share your views on the research. Why was this study needed? UK estimates from 2009 show a quarter of adults drink in a hazardous or harmful way. People with prolonged and heavy alcohol use can

2018 NIHR Dissemination Centre

6. Two drug treatments for severe alcoholic hepatitis do not improve survival rates

Two drug treatments for severe alcoholic hepatitis do not improve survival rates Two drug treatments for severe alcoholic hepatitis do not improve survival rates Discover Portal Discover Portal Two drug treatments for severe alcoholic hepatitis do not improve survival rates Published on 23 April 2015 doi: This NIHR funded trial found that neither prednisolone nor pentoxifylline improved mortality for people with severe alcoholic hepatitis. No differences were found in mortality at 28 or 90 days (...) , or in the need for liver transplant at one year. Overall mortality was high. Nearly three in ten people died before 90 days and more than half (56%) at one year. This shows that other new treatments are needed and more needs to be done to encourage complete abstinence from alcohol following severe alcoholic hepatitis. Share your views on the research. Why was this study needed? UK estimates from 2009 show a quarter of adults drink in a hazardous or harmful way. People with prolonged and heavy alcohol use can

2018 NIHR Dissemination Centre

7. Alcohol-related changes in the intestinal microbiome influence neutrophil infiltration, inflammation and steatosis in early alcoholic hepatitis in mice. (PubMed)

Alcohol-related changes in the intestinal microbiome influence neutrophil infiltration, inflammation and steatosis in early alcoholic hepatitis in mice. Alcohol-induced intestinal dysbiosis disrupts homeostatic gut-liver axis function and is essential in the development of alcoholic liver disease. Here, we investigate changes in enteric microbiome composition in a model of early alcoholic steatohepatitis and dissect the pathogenic role of intestinal microbes in alcohol-induced liver (...) protein monocyte chemoattractant protein-1 (MCP-1) were also reduced in antibiotic-treated alcohol-fed mice. Alcohol-induced hepatic steatosis measured by Oil-Red O staining was significantly reduced in antibiotic treated mice. Genes regulating lipid production and storage were also altered by alcohol and antibiotic treatment. Interestingly, antibiotic treatment did not protect from alcohol-induced increases in serum aminotransferases (ALT/AST).Our data indicate that acute-on-chronic alcohol feeding

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2017 PLoS ONE

8. Baseline urine metabolic phenotype in patients with severe alcoholic hepatitis and its association with outcome (PubMed)

Baseline urine metabolic phenotype in patients with severe alcoholic hepatitis and its association with outcome Severe alcoholic hepatitis (SAH) has a high mortality rate, and corticosteroid therapy is effective in 60% patients. This study aimed to investigate a baseline metabolic phenotype that could help stratify patients not likely to respond to steroid therapy and to have an unfavorable outcome. Baseline urine metabolome was studied in patients with SAH using ultra-high performance liquid

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2018 Hepatology communications

9. Can we reliably predict response to corticosteroid treatment in severe alcoholic hepatitis? (PubMed)

Can we reliably predict response to corticosteroid treatment in severe alcoholic hepatitis? 29881814 2018 11 14 2471-254X 2 6 2018 Jun Hepatology communications Hepatol Commun Can we reliably predict response to corticosteroid treatment in severe alcoholic hepatitis? 625-627 10.1002/hep4.1191 Chokshi Shilpa S Chief Scientific Officer Institute of Hepatology Foundation for Liver Research London United Kingdom. eng Editorial 2018 04 27 United States Hepatol Commun 101695860 2471-254X 2018 03 29

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2018 Hepatology communications

10. NAMPT overexpression alleviates alcohol-induced hepatic steatosis in mice. (PubMed)

NAMPT overexpression alleviates alcohol-induced hepatic steatosis in mice. Nicotinamide phosphoribosyltransferase (NAMPT) is a rate-limiting enzyme in mammalian nicotinamide adenine dinucleotide (NAD)+ biosynthesis. Through its NAD+-biosynthetic activity, NAMPT influences the activity of NAD+-dependent enzymes, such as sirtuins. NAMPT is able to modulate processes involved in the pathogenesis of non-alcohol induced fatty liver disease (NAFLD), but the roles NAMPT plays in development (...) induced hepatic steatosis. Moreover, we demonstrate that SIRT1 is required to mediate the effects of NAMPT on reduction of hepatic TG accumulation and serum ALT, AST levels in ethanol-fed mice. Our results provide important insights in targeting NAMPT for treating alcoholic fatty liver disease.

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2019 PLoS ONE

11. Transient elastography for diagnosis of stages of hepatic fibrosis and cirrhosis in people with alcoholic liver disease. (PubMed)

Transient elastography for diagnosis of stages of hepatic fibrosis and cirrhosis in people with alcoholic liver disease. The presence and progression of hepatic (liver) fibrosis into cirrhosis is a prognostic variable having impact on survival in people with alcoholic liver disease. Liver biopsy, although an invasive method, is the recommended 'reference standard' for diagnosis and staging of hepatic fibrosis in people with liver diseases. Transient elastography is a non-invasive method (...) for assessing and staging hepatic fibrosis.To determine the diagnostic accuracy of transient elastography for diagnosis and staging hepatic fibrosis in people with alcoholic liver disease when compared with liver biopsy. To identify the optimal cut-off values for differentiating the five stages of hepatic fibrosis.The Cochrane Hepato-Biliary Group Controlled and Diagnostic Test Accuracy Studies Registers, The Cochrane Library, MEDLINE (OvidSP), EMBASE (OvidSP), and the Science Citation Index Expanded (last

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2015 Cochrane

12. Controlled Attenuation Parameter And Alcoholic Hepatic Steatosis: Diagnostic Accuracy and Role Of Alcohol Detoxification. (PubMed)

Controlled Attenuation Parameter And Alcoholic Hepatic Steatosis: Diagnostic Accuracy and Role Of Alcohol Detoxification. Controlled attenuation parameter (CAP) is a novel non-invasive measure of hepatic steatosis, but it has not been evaluated in alcoholic liver disease. Therefore, we aimed to validate CAP for the assessment of biopsy-verified alcoholic steatosis and to study the effect of alcohol detoxification on CAP.This was a cross-sectional biopsy-controlled diagnostic study in four (...) European liver centres. Consecutive alcohol-overusing patients underwent concomitant CAP, regular ultrasound, and liver biopsy. In addition, we measured CAP before and after admission for detoxification in a separate single-centre cohort.A total of 562 patients were included in the study: 269 patients in the diagnostic cohort with steatosis scores S0, S1, S2, and S3 = 77 (28%), 94 (35%), 64 (24%), and 34 (13%), respectively. CAP diagnosed any steatosis and moderate steatosis with fair accuracy (area

2018 Journal of Hepatology

13. Assessment of the risk of alcohol relapse following liver transplantation for alcoholic hepatitis using a meta-analysis approach.

Assessment of the risk of alcohol relapse following liver transplantation for alcoholic hepatitis using a meta-analysis approach. 29505845 2018 05 19 1600-0641 68 6 2018 Jun Journal of hepatology J. Hepatol. Assessment of the risk of alcohol relapse following liver transplantation for alcoholic hepatitis using a meta-analysis approach. 1322-1323 S0168-8278(18)30142-9 10.1016/j.jhep.2018.02.020 Deltenre Pierre P Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB

2018 Journal of Hepatology

14. Reply to: "Assessment of the risk of alcohol relapse following liver transplantation for alcoholic hepatitis using a meta-analysis approach".

Reply to: "Assessment of the risk of alcohol relapse following liver transplantation for alcoholic hepatitis using a meta-analysis approach". 29505846 2018 05 19 1600-0641 68 6 2018 Jun Journal of hepatology J. Hepatol. Reply to: "Assessment of the risk of alcohol relapse following liver transplantation for alcoholic hepatitis using a meta-analysis approach". 1323 S0168-8278(18)30141-7 10.1016/j.jhep.2018.02.019 Luther Jay J Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical

2018 Journal of Hepatology

15. Long-term prognostic value of the FibroTest in patients with non-alcoholic fatty liver disease, compared to chronic hepatitis C, B, and alcoholic liver disease. (PubMed)

Long-term prognostic value of the FibroTest in patients with non-alcoholic fatty liver disease, compared to chronic hepatitis C, B, and alcoholic liver disease. Although the FibroTest has been validated as a biomarker to determine the stage of fibrosis in non-alcoholic fatty liver disease (NAFLD) with results similar to those in chronic hepatitis C (CHC), B (CHB), and alcoholic liver disease (ALD), it has not yet been confirmed for the prediction of liver-related death.To validate the 10-year

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2018 Alimentary Pharmacology & Therapeutics

16. Predicting Low-Risk for Sustained Alcohol Use After Early Liver Transplant for Acute Alcoholic Hepatitis: The SALT Score. (PubMed)

Predicting Low-Risk for Sustained Alcohol Use After Early Liver Transplant for Acute Alcoholic Hepatitis: The SALT Score. Early liver transplant (LT) for alcohol-associated disease (i.e., without a specific sobriety period) is controversial but increasingly used. Using the multicenter American Consortium of Early Liver Transplantation for Alcoholic Hepatitis (ACCELERATE-AH) cohort, we aimed to develop a predictive tool to identify patients pretransplant with low risk for sustained alcohol use (...) posttransplant to inform selection of candidates for early LT. We included consecutive ACCELERATE-AH LT recipients between 2012 and 2017. All had clinically diagnosed severe alcoholic hepatitis (AH), no prior diagnosis of liver disease or AH, and underwent LT without a specific sobriety period. Logistic and Cox regression, classification and regression trees (CARTs), and least absolute shrinkage and selection operator (LASSO) regression were used to identify variables associated with sustained alcohol use

2018 Hepatology

17. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. (PubMed)

Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Problem alcohol use is common among people who use illicit drugs (PWID) and is associated with adverse health outcomes. It is also an important factor contributing to a poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opioid overdose in PWID.To assess the effectiveness of psychosocial interventions to reduce alcohol (...) consumption in PWID (users of opioids and stimulants).We searched the Cochrane Drugs and Alcohol Group trials register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and PsycINFO, from inception up to August 2017, and the reference lists of eligible articles. We also searched: 1) conference proceedings (online archives only) of the Society for the Study of Addiction, International Harm Reduction Association, International Conference on Alcohol Harm Reduction

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2018 Cochrane

18. Corticosteroids Reduce Risk of Death Within 28 Days for Patients With Severe Alcoholic Hepatitis, Compared With Pentoxifylline or Placebo-a Meta-analysis of Individual Data From Controlled Trials

Corticosteroids Reduce Risk of Death Within 28 Days for Patients With Severe Alcoholic Hepatitis, Compared With Pentoxifylline or Placebo-a Meta-analysis of Individual Data From Controlled Trials We performed a meta-analysis of individual patient data from 11 randomized controlled trials comparing corticosteroids, pentoxifylline, or their combination in patients with severe alcoholic hepatitis. We compared the effects of the treatments on survival for 28 days or 6 months, and response (...) to treatment based on the Lille model.We searched PubMed for randomized controlled trials of pharmacologic therapy for severe alcoholic hepatitis. Our final analysis comprised 11 studies, of 2111 patients. We performed 4 meta-analyses of the effects of corticosteroids vs placebo or control, corticosteroids vs pentoxifylline, corticosteroids and pentoxifylline vs corticosteroids and placebo or control, and pentoxifylline vs placebo. In each meta-analysis, the effect of treatment on the primary outcome

2018 EvidenceUpdates

19. Intracellular hepatitis B virus increases hepatic cholesterol deposition in alcoholic fatty liver via hepatitis B core protein (PubMed)

Intracellular hepatitis B virus increases hepatic cholesterol deposition in alcoholic fatty liver via hepatitis B core protein Hepatitis B virus (HBV) infection is a prevalent infectious disease with serious outcomes like chronic and acute hepatitis, cirrhosis, and hepatocellular carcinoma. However, the metabolic alteration by HBV is rarely taken into consideration. With the high prevalence of alcohol consumption and chronic HBV infection, their overlap is assumed to be an increasing latent (...) hazard; although the extent has not been calculated. Moreover, the impact of chronic alcohol consumption combined with HBV on cholesterol metabolism is unknown. Six-week-old male FVB/Ncrl mice were hydrodynamically injected with a pGEM-4Z-1.3HBV vector and then fed an ethanol diet for 6 weeks. Serum biomarkers and liver histology, liver cholesterol levels, and cholesterol metabolism-related molecules were measured. In vitro assays with HBx, hepatitis B surface (HBs), or hepatitis B core (HBc) protein

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2017 Journal of lipid research

20. In vivo imaging of hepatic neutrophil migration in severe alcoholic hepatitis with 111In-radiolabelled leucocytes (PubMed)

In vivo imaging of hepatic neutrophil migration in severe alcoholic hepatitis with 111In-radiolabelled leucocytes The study's aim was to image severe alcoholic hepatitis (SAH) using 111In-labelled leucocytes with two objectives in mind: firstly for non-invasive diagnosis and secondly to provide a platform for experimental therapies aiming to inhibit intrahepatic neutrophil migration. 111In-leucocyte scintigraphy was performed 30 min and 24 h post-injection in 19 patients with SAH, 14 abstinent (...) patients with alcohol-related cirrhosis and 11 normal controls. Eleven with SAH and seven with cirrhosis also had 99mTc-nanocolloid scintigraphy. Change in hepatic 111In radioactivity was expressed as decay-corrected 24 h:30 min count ratio and, in SAH, compared with histological grading of steatohepatitis and expression of granulocyte marker, CD15. Hepatic microautoradiography on biopsy specimens obtained 24 h post-injection of 111In-leucocytes was performed in one patient. Median 24 h:30 min hepatic

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2018 Bioscience reports

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