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Alcoholic Hepatitis

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121. Alcoholic liver disease confers a worse prognosis than HCV infection and non-alcoholic fatty liver disease among patients with cirrhosis: An observational study. Full Text available with Trip Pro

and death were collected during a 21-year period among patients with cirrhosis related to alcoholic liver disease (ALD) (n = 529), chronic hepatitis C virus (HCV) infection (n = 145) or non-alcoholic fatty liver disease (NAFLD) (n = 78).At inclusion, ALD patients were younger than HCV and NAFLD patients (56 vs. 67 vs. 63 years; p<0.001) and had worse liver function (percent of patients with Child-Pugh stages B or C: 48% vs. 8% vs. 17%; p<0.001). During follow-up, 85 patients developed HCC and 379 died (...) Alcoholic liver disease confers a worse prognosis than HCV infection and non-alcoholic fatty liver disease among patients with cirrhosis: An observational study. Cirrhosis is a heterogeneous clinical condition that includes patients at wide-ranging stages of severity. The role of the underlying liver disease on patient prognosis remains unclear.To assess the impact of the underlying liver disease on the occurrence of hepatocellular carcinoma (HCC) and death.Data related to the occurrence of HCC

2017 PLoS ONE

122. Acute alcoholic hepatitis and cellular Th1 immune responses to alcohol dehydrogenase. (Abstract)

Acute alcoholic hepatitis and cellular Th1 immune responses to alcohol dehydrogenase. Alcoholic hepatitis is characterised by florid hepatic inflammation, liver failure, and death within 28 days in 35% of patients. We recently showed proliferative peripheral blood mononuclear cell (PBMC) responses to alcohol dehydrogenase (ADH) in patients with alcohol-related cirrhosis, associated with T-helper-type 1 (Th1) immunity and disease severity. We aimed to define whether ADH-specific cellular (...) immunity is present in alcoholic hepatitis.PBMCs were collected from 15 patients with alcoholic hepatitis (modified Maddrey's discriminant function >32), nine with alcohol-related cirrhosis (long-term alcohol abstinence), and three healthy controls. 25 overlapping peptides, spanning the human ADH β1 subunit, were constructed. Proliferation to ADH peptides (1 × 10(5) cells per well, cultured with 10 mM peptides for 7 days) was assessed by (3)H-thymidine incorporation. A stimulation index (SI) of 2·5

2015 Lancet

123. Finding Quality Addiction Care in Canada: Drug and Alcohol Treatment Guide

and other harms by providing a safe, supervised environment for drug use. Managed alcohol programs provide shelter and carefully dosed amounts of alcohol to people who are homeless and have chronic alcohol use problems. Through close monitoring in a safe environment, these shelters allow their residents to avoid the withdrawal symptoms associated with alcohol dependence. Overdose prevention and response provides training and naloxone kits for people who are at risk of overdosing on opioids and those who (...) and treatment settings. The best fit for you will depend on many things, including how severe your problem is and your physical and mental health. These details are determined through a comprehensive assessment by a qualified addiction or healthcare provider. Outpatient (community): Delivered in a variety of places in the community, such as an addiction or healthcare provider’s office, a mental health clinic or an addiction clinic. Most often used by people whose alcohol or other drug use does not put them

2017 Canadian Centre on Substance Abuse

124. Pharmacological Treatment of Patients with Alcohol Use Disorder

for indications other than AUD. It also does not address the manage- ment of individuals who are intoxicated with alcohol, who require pharmacotherapy for the acute treatment of alcohol withdrawal, or who are experiencing other acute medical problems related to alcohol use. Evidence-based psychotherapeutic treatments for AUD, including cognitive-behavioral therapy (CBT), twelve-step facilitation (TSF), and motivational enhancement therapy (MET) (Anton et al. 2006; Martin and Rehm 2012; Project MATCH Research (...) Pharmacological Treatment of Patients with Alcohol Use Disorder THE AMERICAN PSYCHIATRIC ASSOCIATION PRACTICE GUIDELINE FOR THE Pharmacological Treatment of Patients With Alcohol Use Disorder THE AMERICAN PSYCHIATRIC ASSOCIATION PRACTICE GUIDELINE FOR THE PHARMACOLOGICAL TREATMENT OF PATIENTS WITH ALCOHOL USE DISORDER WWW.APPI.ORG A lcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1

2017 American Psychiatric Association

125. Frequent Emergency Department Visits are More Prevalent in Psychiatric, Alcohol Abuse, and Dual Diagnosis Conditions than in Chronic Viral Illnesses Such as Hepatitis and Human Immunodeficiency Virus. (Abstract)

Frequent Emergency Department Visits are More Prevalent in Psychiatric, Alcohol Abuse, and Dual Diagnosis Conditions than in Chronic Viral Illnesses Such as Hepatitis and Human Immunodeficiency Virus. Repeat users of Emergency Departments (ED), so-called "frequent visitors," place a substantial burden on limited ED resources. The illness features of frequent visitors have not been well defined, though chronic medical and psychiatric illness and substance abuse are implicated.This study assessed (...) whether chronic conditions such as hepatitis C (HCV) and human immunodeficiency virus (HIV) are more prevalent in frequent ED users compared to a viral condition with relatively less disability, hepatitis B (HBV). As a comparison, psychiatric complaints and alcohol abuse were also compared in frequent and non-frequent visitors.All visits to a university ED in a particular calendar year were retrospectively reviewed. Frequent visitors were defined as those who made four or more visits. Presenting

2013 Journal of Emergency Medicine

126. The Hepatitis C-Alcohol Reduction Treatment (Hep ART) intervention: Study protocol of a multi-center randomized controlled trial. Full Text available with Trip Pro

to compare clinical effectiveness and cost-effectiveness of integrated alcohol treatment compared to enhanced treatment as usual (TAU) on alcohol consumption and economic outcomes among patients ever infected with HCV.Patients recruited from three liver centers who had current or prior chronic HCV and qualifying alcohol screener scores were randomly assigned to enhanced TAU or the Hepatitis C-Alcohol Reduction Treatment (Hep ART) intervention. All patients received enhanced TAU, consisting of a patient (...) The Hepatitis C-Alcohol Reduction Treatment (Hep ART) intervention: Study protocol of a multi-center randomized controlled trial. Among patients with hepatitis C virus (HCV) infection, alcohol synergistically increases the risk of cirrhosis, hepatocellular carcinoma, and death. Randomized controlled trials of integrated models of HCV-alcohol treatment have been recommended but only performed in patients with severe alcohol use disorders.This pragmatic randomized controlled trial seeks

2018 Contemporary clinical trials Controlled trial quality: uncertain

127. Evidence for a role of genetics in alcoholic hepatitis: Data from the STOPAH randomized controlled trial. (Abstract)

Evidence for a role of genetics in alcoholic hepatitis: Data from the STOPAH randomized controlled trial. 28412295 2018 12 14 2018 12 14 1600-0641 67 1 2017 07 Journal of hepatology J. Hepatol. Evidence for a role of genetics in alcoholic hepatitis: Data from the STOPAH randomized controlled trial. 12-14 S0168-8278(17)30210-6 10.1016/j.jhep.2017.04.001 Louvet Alexandre A Service des maladies de l'appareil digestif, Hôpital Huriez, Lille, France. Electronic address: alexandre.louvet@chru (...) -lille.fr. Peck-Radosavljevic Markus M Abteilung Gastroenterologie & Hepatologie, Endokrinologie und Nephrologie, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria. Electronic address: markus@peck.at. eng Editorial Comment 2017 04 13 Netherlands J Hepatol 8503886 0168-8278 IM J Hepatol. 2017 Jul;67(1):120-127 28161471 Hepatitis, Alcoholic Homozygote Humans 2017 03 14 2017 03 27 2017 04 04 2017 4 17 6 0 2018 12 15 6 0 2017 4 17 6 0 ppublish 28412295 S0168-8278(17)30210-6 10.1016/j.jhep.2017.04.001

2018 Journal of Hepatology Controlled trial quality: uncertain

128. Extracorporeal cellular therapy (ELAD) in severe alcoholic hepatitis: A multinational, prospective, controlled, randomized trial. Full Text available with Trip Pro

Extracorporeal cellular therapy (ELAD) in severe alcoholic hepatitis: A multinational, prospective, controlled, randomized trial. 29385313 2018 05 01 2018 12 02 1527-6473 24 5 2018 05 Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Liver Transpl. Extracorporeal cellular therapy (ELAD) in severe alcoholic hepatitis: A multinational, prospective, controlled, randomized trial. 711 10.1002 (...) /lt.25026 Sussman Norman L NL Abdominal Transplant and Liver Disease Clinic, Baylor College of Medicine, Houston, TX. Kelly James H JH Cell Machines, Inc., Houston, TX. eng Letter Comment 2018 04 06 United States Liver Transpl 100909185 1527-6465 IM Liver Transpl. 2018 Mar;24(3):380-393 29171941 Hepatitis, Alcoholic Humans Liver Transplantation Prospective Studies 2017 12 25 2018 01 29 2018 2 1 6 0 2018 5 2 6 0 2018 2 1 6 0 ppublish 29385313 10.1002/lt.25026

2018 Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Controlled trial quality: uncertain

129. Noncholesterol Sterols as Surrogate Markers in Patients with Severe Alcoholic Hepatitis. (Abstract)

Noncholesterol Sterols as Surrogate Markers in Patients with Severe Alcoholic Hepatitis. Severe alcoholic hepatitis (AH) is a life-threatening condition lacking good serologic markers to tailor treatment and predict recovery. We examined the cholesterol metabolism in severe AH to explore prognostic markers and evaluate the profile of cholesterol precursors, cholestanol and phytosterols, in this context. We assessed serum cholesterol, cholesterol precursors, cholestanol, phytosterols

2018 Lipids Controlled trial quality: uncertain

130. Efficacy of granulocyte colony stimulating factor in patients with severe alcoholic hepatitis with partial or null response to steroid (GRACIAH trial): study protocol for a randomized controlled trial. Full Text available with Trip Pro

Efficacy of granulocyte colony stimulating factor in patients with severe alcoholic hepatitis with partial or null response to steroid (GRACIAH trial): study protocol for a randomized controlled trial. Alcoholic hepatitis (AH) has the most severe presentation among alcohol-related liver diseases. Corticosteroids are the most widely recommended treatment for severe AH. However, more innovative, refined treatment measures are required because of its high mortality despite corticosteroid treatment

2018 Trials Controlled trial quality: uncertain

131. Transplantation for Alcoholic Hepatitis: Are We Achieving Justice and Utility? (Abstract)

Transplantation for Alcoholic Hepatitis: Are We Achieving Justice and Utility? Early liver transplantation for alcoholic hepatitis is a potentially life-saving treatment. As this practice becomes increasingly common, however, the liver transplant community is taking a fresh look at a familiar challenge: best stewardship of donor organs. Herein, we examine a few basic, necessary ethical and practical concerns relevant to this indication.© 2018 by the American Association for the Study of Liver

2018 Hepatology

132. Arid1a loss drives non-alcoholic steatohepatitis in mice via epigenetic dysregulation of hepatic lipogenesis and fatty acid oxidation. (Abstract)

Arid1a loss drives non-alcoholic steatohepatitis in mice via epigenetic dysregulation of hepatic lipogenesis and fatty acid oxidation. Nonalcoholic steatohepatitis (NASH) is a rapidly growing cause of chronic liver damage, cirrhosis, and hepatocellular carcinoma (HCC). How fatty liver pathogenesis is subject to epigenetic regulation is unknown. We hypothesized that chromatin remodeling is important for the pathogenesis of fatty liver disease. ARID1A, a DNA-binding component of the SWI/SNF ATP (...) -dependent chromatin-remodeling complex, contributes to nucleosome repositioning and access by transcriptional regulators. Liver-specific deletion of Arid1a (Arid1a LKO) caused the development of age-dependent fatty liver disease in mice. Transcriptome analysis revealed upregulation of lipogenesis and down-regulation of fatty acid oxidation genes. As evidence of direct regulation, ARID1A demonstrated direct binding to the promoters of many of these differentially regulated genes. Additionally, Arid1a LKO

2018 Hepatology

133. IL-1 Signal Inhibition in Alcoholic Hepatitis (ISAIAH)

mDF* ≥ 32 and MELD ≤ 25 at baseline visit Informed consent Women of child-bearing potential have to use an effective contraception method (as specified in section 9.6). Exclusion Criteria: Alcohol abstinence of >6 weeks prior to randomization/baseline visit Duration of clinically apparent jaundice > 3 months before baseline visit Other causes of liver disease including: Evidence of chronic viral hepatitis (Hepatitis B or C) Biliary obstruction Hepatocellular carcinoma Evidence of current (...) malignancy (except non-melanotic skin cancer) Previous entry into the study, or use of either prednisolone or PTX within 6 weeks of hospital admission AST >500 U/L or ALT >300 U/L (not compatible with alcoholic hepatitis) Patients with a serum creatinine >220 μmol/L (2.5 mg / dL) or requiring renal support (see below) Patients dependent upon inotropic support (adrenaline or noradrenaline). Terlipressin is allowed Variceal haemorrhage on this admission Untreated sepsis (see below) Patients with known

2018 Clinical Trials

134. Evaluation of the effects of dapagliflozin, an SGLT2 inhibitor, on hepatic steatosis and fibrosis by transient elastography in patients with type 2 diabetes and non-alcoholic fatty liver disease. (Abstract)

Evaluation of the effects of dapagliflozin, an SGLT2 inhibitor, on hepatic steatosis and fibrosis by transient elastography in patients with type 2 diabetes and non-alcoholic fatty liver disease. To investigate the effects of dapagliflozin on liver steatosis and fibrosis evaluated in patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD).In a randomized, active-controlled, open-label trial, 57 patients with type 2 diabetes and NAFLD were randomized to a dapagliflozin group (...) (5 mg/d; n = 33) or a control group (n = 24) and were treated for 24 weeks. Hepatic steatosis and fibrosis were assessed using transient elastography to measure controlled attenuation parameter (CAP) and liver stiffness, respectively.Baseline liver stiffness measurement (LSM) was positively correlated with several markers and scoring systems for liver fibrosis. In week 24, there was a significant decrease in CAP from 314 ± 61 to 290 ± 73 dB/m (P = 0.0424) in the dapagliflozin group, while

2018 obesity & metabolism Controlled trial quality: uncertain

135. A Validated Score Predicts Acute Kidney Injury and Survival in Patients with Alcoholic Hepatitis: A Multicentric International Prospective Cohort Study. Full Text available with Trip Pro

A Validated Score Predicts Acute Kidney Injury and Survival in Patients with Alcoholic Hepatitis: A Multicentric International Prospective Cohort Study. Identifying patients at high risk for acute kidney injury (AKI) during hospitalization among patients admitted with severe alcoholic hepatitis (AH) is an unmet clinical need. We performed a multicentric prospective cohort study using data from 4 different cohorts on well-characterized patients hospitalized with severe AH. Data collected on 773 (...) AH patients from 4 cohorts across the globe were randomly split into test (n = 390) and validation (n = 383) cohorts. We found that 32% of the patients developed inpatient AKI in the test cohort. Approximately 60% of patients met criteria for systemic inflammatory response syndrome (SIRS) at admission. Hepatic encephalopathy, SIRS, and Model for End-Stage Liver Disease score at admission predicted inpatient AKI with odds ratios of 3.86, 2.24, and 1.14, respectively. The AKI risk score developed

2018 Liver Transplantation

136. Efficacy and Safety of Orally Administered DS102 in Patients With Acute Alcoholic Hepatitis

in DS102 capsules or placebo capsules. Duration of clinically apparent jaundice >3 months prior to baseline Other causes of liver disease including: Evidence of chronic viral hepatitis (Hepatitis B DNA positive or Hepatitis C (HCV) RNA positive) Biliary obstruction Hepatocellular carcinoma Wilsons disease Budd Chiari Syndrome Non-alcoholic fatty liver disease History of or active non-liver malignancies other than curatively treated skin cancer (basal cell or squamous cell carcinomas). Treatment (...) Efficacy and Safety of Orally Administered DS102 in Patients With Acute Alcoholic Hepatitis Efficacy and Safety of Orally Administered DS102 in Patients With Acute Alcoholic Hepatitis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more

2018 Clinical Trials

137. Effect of Omega 5 Fatty Acid as an Adyuvant Treatment to Prednisone in Patients With Severe Alcoholic Hepatitis

(Total bilirubin greater than 5 mg/dl in absence of biliary tract obstruction evidenced by ultrasound, history of chronic alcohol intake (greater than 50 g / day for at least 3 months), leukocytosis, neutrophilia, elevation of transaminases with an aspartate aminotransferase / alanine aminotransferase ratio equal or greater than 2), discriminant function greater than 32. Exclusion Criteria: Hepatorenal syndrome, Hepatocellular carcinoma. Hepatitis C virus, hepatitis B virus or human immunodeficiency (...) of 3 blood tubes (2 purple and 1 yellow) for the measurement of cytokines, markers of oxidative stress, lipid peroxidation and protein carbonyls. The initial evaluation will include liver ultrasound, heart rate, blood pressure, temperature, anthropometric evaluation (weight, height, BMI), evaluation of ascites (abdominal circumference), hepatic encephalopathy (West Haven Scale). Alcohol abuse will be assessed using the AUDIT and CAGE score. Start-up laboratories will be carried out: TP, INR

2018 Clinical Trials

138. Hepatic expression of Yin Yang 1 (YY1) is associated with the non-alcoholic fatty liver disease (NAFLD) progression in patients undergoing bariatric surgery. Full Text available with Trip Pro

Hepatic expression of Yin Yang 1 (YY1) is associated with the non-alcoholic fatty liver disease (NAFLD) progression in patients undergoing bariatric surgery. This study is to investigate the association between the hepatic expression of Yin Yang 1 (YY1) and the progression of non-alcoholic fatty liver disease (NAFLD) in patients undergoing bariatric surgery.Obese patients undergoing bariatric surgery were included. Liver tissues were subjected to the quantitative real-time PCR, Western blot (...) analysis, and immunohistochemical assay, to determine the expression levels of YY1.Totally 88 patients were included. According to the NAFLD activity score (NAS), these patients were divided into the control (n = 12), steatosis (n = 20), non-defining NASH (n = 38), and NASH (n = 18) groups. Significant differences in the serum glucose, insulin, ALT, AST, and HOMA-IR levels were observed among these different NAFLD groups. Hepatic YY1 expression had correlation with serum glucose, insulin, HOMA-IR, ALT

2018 BMC Gastroenterology

139. Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. Full Text available with Trip Pro

 contingency tables can be calculated via the reported number of cases; sensitivity and specificity were excluded according to the following criteria: history of other hepatic damage, such as chronic hepatitis C, concurrent active hepatitis B infection, autoimmune hepatitis, suspicious drug usage and alcohol abuse.Nine pSWE studies comprising a total of 982 patients and 11 TE studies comprising a total of 1753 patients were included. For detection of significant fibrosis, advanced fibrosis and cirrhosis (...) Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. This study aimed to assess the accuracy of staging liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) usingpoint shear wave elastography (pSWE) and transient elastography (TE).Relevant records on NAFLD were retrieved from PubMed, Embase, Web of Science and the China National Knowledge

2018 BMJ open

140. Survey of Liver Transplantation Practices for Severe Acute Alcoholic Hepatitis. Full Text available with Trip Pro

Survey of Liver Transplantation Practices for Severe Acute Alcoholic Hepatitis. Liver transplantation (LT) has a demonstrated survival benefit in select patients with severe acute alcoholic hepatitis (SAH) who do not respond to steroids, but prior studies suggest low adoption among US LT centers. Our study explored current perceptions and practice patterns of LT for SAH in the United States. We administered a Web-based survey to medical directors of US LT centers between May and October of 2017 (...) psychiatric disorder (91.3%), and official psychosocial evaluation (87.0%). Reported posttransplant survival of SAH patients was excellent, with 17 (73.9%) centers reporting 1-year posttransplant survival exceeding 90%. Among centers that had not performed LT for SAH, the most commonly cited reason was perceived high risk of alcohol relapse. In conclusion, our data demonstrate that LT is increasingly adopted as a therapeutic intervention for patients with SAH and that careful selection allows

2018 Liver Transplantation

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