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Titolo:
Short- and long-term outcome of severe alcohol-induced hepatitis treated with steroids or enteral nutrition: A multicenter randomized trial
Autore:
Cabre, E; Rodriguez-Iglesias, P; Caballeria, J; Quer, JC; Sanchez-Lombrana, JL; Pares, A; Papo, M; Planas, R; Gassull, MA;
Indirizzi:
Hosp Univ Germans Trias & Pujol, Dept Gastroenterol, Badalona 08916, Catalonia, Spain Hosp Univ Germans Trias & Pujol Badalona Catalonia Spain 08916nia, Spain Hosp Clin & Prov, Liver Unit, Barcelona, Spain Hosp Clin & Prov Barcelona Spain n & Prov, Liver Unit, Barcelona, Spain Hosp Univ Joan XXIII, Dept Internal Med, Tarragona, Spain Hosp Univ Joan XXIII Tarragona Spain ept Internal Med, Tarragona, Spain Univ Oviedo, Hosp Cent Asturias, Dept Gastroenterol, E-33080 Oviedo, SpainUniv Oviedo Oviedo Spain E-33080 pt Gastroenterol, E-33080 Oviedo, Spain Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Barcelona, Spain Hosp Santa Creu & Sant Pau Barcelona Spain troenterol, Barcelona, Spain Hosp Reina Sofia, Dept Gastroenterol, Cordoba, Spain Hosp Reina Sofia Cordoba Spain ofia, Dept Gastroenterol, Cordoba, Spain Hosp Dr Josep Trueta, Gastroenterol Unit, Girona, Spain Hosp Dr Josep Trueta Girona Spain ta, Gastroenterol Unit, Girona, Spain Hosp Univ Mar, Dept Gastroenterol, Barcelona, Spain Hosp Univ Mar Barcelona Spain Mar, Dept Gastroenterol, Barcelona, Spain
Titolo Testata:
HEPATOLOGY
fascicolo: 1, volume: 32, anno: 2000,
pagine: 36 - 42
SICI:
0270-9139(200007)32:1<36:SALOOS>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
SPONTANEOUS BACTERIAL PERITONITIS; AMINO-ACID SUPPLEMENTATION; LIVER-DISEASE; TRANSCRIPTION FACTOR; PROGNOSTIC FACTORS; CIRRHOTIC RATS; KAPPA-B; THERAPY; TRANSLOCATION; METAANALYSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
47
Recensione:
Indirizzi per estratti:
Indirizzo: Gassull, MA Hosp Univ Germans Trias & Pujol, Dept Gastroenterol, CarreteraCanyet S-N,Badalona 08916, Catalonia, Spain Hosp Univ Germans Trias & Pujol Carretera Canyet S-N Badalona Catalonia Spain 08916
Citazione:
E. Cabre et al., "Short- and long-term outcome of severe alcohol-induced hepatitis treated with steroids or enteral nutrition: A multicenter randomized trial", HEPATOLOGY, 32(1), 2000, pp. 36-42

Abstract

Steroids are recommended in severe alcohol-induced hepatitis, but some data suggest that artificial nutrition could also be effective. We conducted arandomized trial comparing the short- and long-term effects of total enteral nutrition or steroids in these patients. A total of 71 patients (80% cirrhotic) were randomized to receive 40 mg/d prednisolone (n = 36) or enteraltube feeding (2,000 kcal/d) for 28 days (n = 35), and were followed for 1 year or until death. Side effects of treatment occurred in 5 patients on steroids and 10 on enteral nutrition (not significant). Eight enterally fed patients were prematurely withdrawn from the trial, Mortality during treatment was similar in both groups (9 of 36 vs. 11 of 35, intention-to-treat) but occurred earlier with enteral feeding (median 7 vs. 23 days; P = .025). Mortality during follow-up was higher with steroids (10 of 27 vs, 2 of 24 intention-to-treat; P = .04). Seven steroid patients died within the first 1.5 months of follow-up. In contrast to total enteral nutrition (TEN), infections accounted for 9 of 10 follow-up deaths in the steroid group. In conclusion, enteral feeding does not seem to be worse than steroids in the short-term treatment of severe alcohol-induced hepatitis, although death occurs earlier with enteral nutrition. However, steroid therapy is associated with a higher mortality rate in the immediate weeks after treatment, mainly because of infections. A possible synergistic effect of both treatments should be investigated.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/10/20 alle ore 00:34:54