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Alcoholic Hepatitis

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28341. A randomized placebo controlled trial of vitamin E for alcoholic hepatitis. (PubMed)

A randomized placebo controlled trial of vitamin E for alcoholic hepatitis. The effect of vitamin E administration on clinical and laboratory parameters of liver function and on markers of fibrogenesis was assessed in patients with mild to moderate alcoholic hepatitis in a double blind placebo controlled randomized trial.Twenty-five patients received 1000 I.U. of vitamin E per day, while 26 patients received placebo for 3 months. The patients were followed for 1 year after entry (...) <0.05) while serum aminoterminal peptide of type III procollagen did not change in either group. Four patients in the treatment group and five in the placebo group died during the 1-year study.Vitamin E treatment improves serum hyaluronic acid but has no beneficial effects on tests of liver function in patients with mild to moderate alcoholic hepatitis.

2004 Journal of hepatology Controlled trial quality: uncertain

28342. A double-blind randomized controlled trial of infliximab associated with prednisolone in acute alcoholic hepatitis. (Full text)

A double-blind randomized controlled trial of infliximab associated with prednisolone in acute alcoholic hepatitis. Tumor necrosis factor-alpha (TNF-alpha) may contribute to the progression of acute alcoholic hepatitis (AAH). The aim of this study was to evaluate the efficacy of an association of infliximab and prednisolone at reducing the 2-month mortality rate among patients with severe AAH. Patients with severe AAH (Maddrey score >/=32) were randomly assigned to group A receiving intravenous

2004 Hepatology Controlled trial quality: predicted high

28343. Antioxidants versus corticosteroids in the treatment of severe alcoholic hepatitis--a randomised clinical trial. (PubMed)

Antioxidants versus corticosteroids in the treatment of severe alcoholic hepatitis--a randomised clinical trial. Severe alcoholic hepatitis is associated with high morbidity and short-term mortality. Corticosteroids are the only widely used therapy but established contraindications to treatment or the risk of serious side-effects limit their use. The perceived need for alternative treatments together with the theoretical benefits of anti-oxidant therapy triggered the design of a randomised (...) frequently in the AO group (P=0.05), although microbiologically proven episodes of infection occurred more often in the CS group (P<0.01). The survival advantage for corticosteroid treated patients was lost at 1 year of follow-up (P=0.43).This study has shown that corticosteroids in the form of prednisolone 30 mg daily are superior to a broad antioxidant cocktail in the treatment of severe alcoholic hepatitis.

2006 Journal of hepatology Controlled trial quality: uncertain

28344. High prevalence of alcohol use among hepatitis C virus antibody positive injection drug users in three US cities. (Full text)

High prevalence of alcohol use among hepatitis C virus antibody positive injection drug users in three US cities. Injection drug users (IDUs) acquire the majority of new hepatitis C virus (HCV) infections and frequently use alcohol. Alcohol abuse accelerates liver disease among HCV-infected persons, can reduce the effectiveness of treatment for HCV infection and may be a contraindication for HCV treatment. HCV seropositive, HIV-negative IDUs aged 18-35 years in Baltimore, New York City (...) and Seattle who were enrolled in a behavioral risk-reduction intervention trial underwent computerized self-interviews to assess baseline alcohol use and dependence and medical history. We measured problem alcohol use using the 10-item Alcohol Use Disorders Identification Test (AUDIT) scale. Of 598 participants, 84% responded "false" to: "it is safe for a person with HCV to drink alcohol". Problem drinking, defined as score > or =8 on AUDIT, was identified in 37%. Correlates of scoring > or =8 on AUDIT

2006 Drug and alcohol dependence Controlled trial quality: uncertain

28345. Management of Alcoholic Hepatitis (Full text)

Management of Alcoholic Hepatitis 21960817 2011 11 10 2018 11 13 1554-7914 3 2 2007 Feb Gastroenterology & hepatology Gastroenterol Hepatol (N Y) Management of alcoholic hepatitis. 97-9 Morgan Timothy R TR Chief of Hepatology VA Long Beach Healthcare System. eng Journal Article United States Gastroenterol Hepatol (N Y) 101262648 1554-7914 2011 10 1 6 0 2007 2 1 0 0 2007 2 1 0 1 ppublish 21960817 PMC3099359 Gastroenterology. 2000 Dec;119(6):1787-91 11113103 Hepatology. 2007 Jun;45(6):1348-54

2007 Gastroenterology & hepatology

28346. Monounsaturated fat decreases hepatic lipid content in non-alcoholic fatty liver disease in rats (Full text)

Monounsaturated fat decreases hepatic lipid content in non-alcoholic fatty liver disease in rats To evaluate the effects of different types of dietary fats on the hepatic lipid content and oxidative stress parameters in rat liver with experimental non-alcoholic fatty liver disease (NAFLD).A total of 32 Sprague-Dawley rats were randomly divided into five groups. The rats in the control group (n = 8) were on chow diet (Group 1), rats (n = 6) on methionine choline-deficient diet (MCDD) (Group 2 (...) in hepatic triglycerides (TG) levels was blunted by 30% in MCDD + olive oil group (0.59 +/- 0.09) compared with MCDD group (0.85 +/- 0.04, P < 0.004), by 37% compared with MCDD + fish oil group (0.95 +/- 0.07, P < 0.001), and by 33% compared with MCDD + butter group (0.09 +/- 0.1, P < 0.01). The increase in serum TG was lowered by 10% in MCDD + olive oil group (0.9 +/- 0.07) compared with MCDD group (1.05 +/- 0.06). Hepatic cholesterol increased by 15-fold in MCDD group [(0.08 +/- 0.02, this increment

2007 World journal of gastroenterology : WJG

28347. Genome-wide differences in hepatitis C- vs alcoholism-associated hepatocellular carcinoma (Full text)

Genome-wide differences in hepatitis C- vs alcoholism-associated hepatocellular carcinoma To look at a comprehensive picture of etiology-dependent gene abnormalities in hepatocellular carcinoma in Western Europe.With a liver-oriented microarray, transcript levels were compared in nodules and cirrhosis from a training set of patients with hepatocellular carcinoma (alcoholism, 12; hepatitis C, 10) and 5 controls. Loose or tight selection of informative transcripts with an abnormal abundance (...) was statistically valid and the tightly selected transcripts were next quantified by qRTPCR in the nodules from our training set (12 + 10) and a test set (6 + 7).A selection of 475 transcripts pointed to significant gene over-representation on chromosome 8 (alcoholism) or -2 (hepatitis C) and ontology indicated a predominant inflammatory response (alcoholism) or changes in cell cycle regulation, transcription factors and interferon responsiveness (hepatitis C). A stringent selection of 23 transcripts whose

2008 World journal of gastroenterology : WJG

28348. Short-term and long-term survival in patients with alcoholic hepatitis treated with oxandrolone and prednisolone. (PubMed)

Short-term and long-term survival in patients with alcoholic hepatitis treated with oxandrolone and prednisolone. A cooperative study was conducted to determine the efficacy of 30 days of treatment with either a glucocorticosteroid (prednisolone) or an anabolic steroid (oxandrolone) in moderate or severe alcoholic hepatitis. One hundred thirty-two patients with moderate disease and 131 with severe disease were randomly assigned to one of three treatments: prednisolone, oxandrolone, or placebo

1984 NEJM Controlled trial quality: uncertain

28349. Aminoacid therapy of alcoholic hepatitis. (PubMed)

Aminoacid therapy of alcoholic hepatitis. 35 consecutive patients with alcoholic hepatitis were randomly allocated to control (18 patients) and study (17 patients) groups. All patients were offered a 3000 kcal 100 g protein diet and were studied for 28 days. The study group received 70-85 g of intravenous aminoacids daily in the form of 'Aminosyn' or 'Travasol'. Both groups had similar clinical and biochemical features at the time of randomisation. Ascites and encephalopathy tended to improve (...) more in the study group. Serum concentrations of bilirubin (p < 0.01) and albumin (p < 0.025) improved in the study but not in the control group. 4 patients died in the control group, but none died in the study group. Intravenous therapy with aminoacid for 4 weeks seemed to be associated with lower mortality rate (p < 0.02) and improved serum bilirubin and albumin concentrations in patients with alcoholic hepatitis.

1980 Lancet Controlled trial quality: uncertain

28350. Safety of alcohol after viral hepatitis. (PubMed)

Safety of alcohol after viral hepatitis. To test the validity of the generally held belief that moderate consumption of alcohol during convalescence from acute viral hepatitis adversely affects outcome, 87 adults recovering from acute viral hepatitis (hepatitis A in 36, hepatitis B in 34, hepatitis non-A, non-B in 17) were studied. Criteria for entry to the study attempted to ensure that no patient was a chronic hepatitis B carrier. Patients were randomised either to a moderate alcohol intake (...) , or to continued complete abstention. Drinkers consumed 26 g alcohol daily (mean) and none remained abstinent. At 3 months all patients were well, with normal liver function tests. There were no significant differences between the two groups at anytime. The findings suggest that moderate alcohol intake during convalescence from acute viral hepatitis does not seem to be harmful.

1991 Lancet Controlled trial quality: uncertain

28351. A randomized trial of prednisolone in patients with severe alcoholic hepatitis. (PubMed)

A randomized trial of prednisolone in patients with severe alcoholic hepatitis. Controlled trials have yielded inconsistent results with regard to the efficacy of corticosteroids in the treatment of alcoholic hepatitis. Three meta-analyses suggest that they may be effective in patients with encephalopathy who have severe liver disease.We conducted a randomized, double-blind trial comparing 28 days of prednisolone treatment (40 mg per day) with placebo in 61 patients with biopsy-proved alcoholic (...) biopsy-proved alcoholic hepatitis.

1992 NEJM Controlled trial quality: predicted high

28352. A single alcohol ingestion does not affect serum hepatitis C virus RNA in patients with chronic hepatitis C. (PubMed)

A single alcohol ingestion does not affect serum hepatitis C virus RNA in patients with chronic hepatitis C. The safe level of alcohol ingestion in sporadic drinkers with hepatitis C is unknown. Our aim was to evaluate the effect of a single moderate alcohol intake on serum HCV RNA concentrations and hepatic function in patients with chronic HCV infection.Twenty-one patients with chronic hepatitis C were randomly assigned to consume 50 g alcohol (group 1) or a non-alcoholic beverage (group 2 (...) in transaminase and gamma-GT levels at different time points in each group or among the groups [(ALT (P = 0.082), AST (P = 0.33), gamma-GT (P = 0.538)].In patients with chronic hepatitis C, a single intake of 50 g alcohol does not affect liver biochemistry and HCV RNA concentrations. Therefore, it is a matter of further research whether sporadic drinking of light or moderate amounts of alcohol should be avoided in patients with chronic hepatitis C.

2006 Liver international : official journal of the International Association for the Study of the Liver Controlled trial quality: uncertain

28353. Prognostic value of hepatic venous pressure gradient for in-hospital mortality of patients with severe acute alcoholic hepatitis. (Full text)

Prognostic value of hepatic venous pressure gradient for in-hospital mortality of patients with severe acute alcoholic hepatitis. Hepatic venous pressure gradient (HVPG) has prognostic value in complications and survival of patients with liver cirrhosis. However, the relationship between HVPG and the outcome of acute alcoholic hepatitis (AAH), as well as the specific features of portal hypertension syndrome in this setting, have not been defined.To evaluate the prognostic value of HVPG (...) and to analyse the degree of portal hypertension and hyperdynamic circulation in patients with severe AAH.Early measurements of HVPG were performed in 60 patients with severe AAH, and compared with the haemodynamic findings of 37 and 29 liver transplantation candidates with alcoholic or viral end-stage cirrhosis respectively.Twenty-three patients (38%) died during hospitalization. Portal hypertension and hyperdynamic circulation were more severe in AAH patients. HVPG was greater in non-survivors [26.9 (7.4

2007 Alimentary Pharmacology & Therapeutics

28354. Alcohol and hepatitis C virus core protein additively increase lipid peroxidation and synergistically trigger hepatic cytokine expression in a transgenic mouse model. (PubMed)

Alcohol and hepatitis C virus core protein additively increase lipid peroxidation and synergistically trigger hepatic cytokine expression in a transgenic mouse model. Alcohol consumption accelerates the appearance of liver fibrosis and hepatocellular carcinoma in patients with chronic hepatitis C virus (HCV) infection, but the mechanisms of these interactions are unknown. We therefore investigated the effects of chronic ethanol consumption in HCV core protein-expressing transgenic mice.Ethanol (...) expression of transforming growth factor-beta (TGF-beta) and, to a less extent, tumor necrosis factor-alpha (TNF-alpha).HCV core protein expression and chronic alcohol consumption have no effects on in vivo fatty acid oxidation and do not additively impair hepatic lipoprotein secretion, but additively increase hepatic lipid peroxidation and synergistically increase hepatic TNF-alpha and TGF-beta expression. These effects may be involved in the activation of fibrogenesis and the development

2003 Journal of Hepatology

28355. "Pseudotumoral" hepatic areas in acute alcoholic hepatitis: a computed tomography and histological study. (PubMed)

"Pseudotumoral" hepatic areas in acute alcoholic hepatitis: a computed tomography and histological study. Computed tomography (CT) findings in acute alcoholic hepatitis (AAH) have not been investigated and a "pseudotumoral aspect" of the liver parenchyma has rarely been reported as an exceedingly unusual finding. We observed 11 patients with AAH over a 1-yr period, five of whom underwent CT for concomitant clinical reasons. Arterial enhancement indicated areas of hypervascularized tissue in all

2005 American Journal of Gastroenterology

28356. Post-load insulin resistance is an independent predictor of hepatic fibrosis in virus C chronic hepatitis and in non-alcoholic fatty liver disease. (Full text)

Post-load insulin resistance is an independent predictor of hepatic fibrosis in virus C chronic hepatitis and in non-alcoholic fatty liver disease. Insulin resistance is a significant risk factor for hepatic fibrosis in patients with both non-alcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC), either directly or by favouring hepatic steatosis. Several methods are available to assess insulin resistance, but their impact on this issue has never been evaluated.To determine (...) the relative contribution of steatosis, metabolic abnormalities and insulin resistance, measured by different basal and post-load parameters, to hepatic fibrosis in CHC and in NAFLD patients.In 90 patients with CHC and 90 pair-matched patients with NAFLD, the degree of basal insulin resistance (by the homeostasis model assessment, (HOMA)) and post-load insulin sensitivity (by the oral glucose insulin sensitivity (OGIS) index) was assessed, together with the features of the metabolic syndrome according

2007 Gut

28357. Tumour necrosis factor related apoptosis inducing ligand (TRAIL) induces hepatic steatosis in viral hepatitis and after alcohol intake. (Full text)

Tumour necrosis factor related apoptosis inducing ligand (TRAIL) induces hepatic steatosis in viral hepatitis and after alcohol intake. Tumour necrosis factor related apoptosis inducing ligand (TRAIL) induces apoptosis in transformed cells and is considered as an agent for cancer therapy. As there is evidence that TRAIL is also essential for apoptosis in animal models of liver injury, we investigated the role of TRAIL in viral hepatitis and after alcohol consumption.Expression of TRAIL (...) was determined by western blot analysis in the liver of patients with chronic hepatitis C virus (HCV) infection as well as in experimental acute adenoviral hepatitis and after alcohol intake in the liver of mice. To investigate the effect of FasL and TRAIL expression, we used low dose adenoviral gene transfer. Apoptosis and steatosis were assessed by TUNEL and fat red staining, and by caspase assays.TRAIL was overexpressed in the liver of patients with HCV associated steatosis while acute adenoviral

2005 Gut

28358. Mortality related to chronic hepatitis B and chronic hepatitis C in France: Evidence for the role of HIV coinfection and alcohol consumption. (PubMed)

Mortality related to chronic hepatitis B and chronic hepatitis C in France: Evidence for the role of HIV coinfection and alcohol consumption. Mortality related to HCV and HBV infections was estimated in France.A random sample (n=999) of death certificates was obtained from all death certificates listing HBV, HCV, hepatitis, liver disease, possible complication of cirrhosis, bacterial infection, HIV, or transplantation (n=65,000) in France in 2001. Physicians who reported the deaths were sent (...) 100,000 inhabitants, respectively). In the HCV infection group, 95 percent had cirrhosis; 33 percent had hepatocellular carcinoma (HCC). In the HBV infection group, 93 percent had cirrhosis; 35 percent had HCC. Eleven percent of deaths occurred in patients with HIV coinfection. Deaths related to HBV or HCV infection occurred at an earlier age in patients with a history of excessive alcohol consumption.In France, 4000-5000 deaths related to HCV and HBV infection occurred in 2001. Alcohol consumption

2007 Journal of Hepatology

28359. The diagnostic value of biomarkers (AshTest) for the prediction of alcoholic steato-hepatitis in patients with chronic alcoholic liver disease. (PubMed)

The diagnostic value of biomarkers (AshTest) for the prediction of alcoholic steato-hepatitis in patients with chronic alcoholic liver disease. The aim was to identify a panel of biomarkers (AshTest) for the diagnosis of alcoholic steato-hepatitis (ASH), in patients with chronic alcoholic liver disease.Biomarkers were assessed in patients with an alcohol intake>50 g/d, in a training group, and in two validation groups. Diagnosis of ASH (polymorphonuclear infiltrate and hepatocellular necrosis (...) was 0.005 in controls, 0.05 in patients without or with mild ASH, 0.64 in moderate, and 0.84 in severe ASH grade 3, (P<0.05 between all groups). At a 0.50 cut-off, the sensitivity of AshTest was 0.80 and the specificity was 0.84.In heavy drinkers, AshTest is a simple and non-invasive quantitative estimate of alcoholic hepatitis. The use of AshTest may reduce the need for liver biopsy, and therefore allow an earlier treatment of alcoholic hepatitis.

2006 Journal of Hepatology

28360. Hepatitis B and A virus antibodies in alcoholic steatosis and cirrhosis. (Full text)

Hepatitis B and A virus antibodies in alcoholic steatosis and cirrhosis. Sera from 74 alcoholics with cirrhosis and 63 alcoholics with steatosis were tested for antibody to hepatitis B surface antigen, to hepatitis B core antigen, and to hepatitis A virus by radioimmunoassay or enzyme-linked immunosorbent assay. No significant difference between the two groups of alcoholics could be found concerning the prevalence of these antibodies. The total group of patients had antibody to hepatitis B (...) virus does not play a major role in the progression of alcoholic liver disease, but longitudinal studies are needed to solve this problem. The reason for the increased prevalence of antibodies to hepatitis B virus in these patients is unknown.

1982 Journal of Clinical Pathology

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