Abstract:
BACKGROUND:Although short-term outcome in severe alcoholic hepatitis (SAH) is well described, its long-term course remains uncharacterised. AIM:To assess determinants of long-term outcome in SAH. METHODS:Data were recorded from a cohort with SAH (admission Discriminant Function (DF) ≥32). Kaplan-Meier (KM) and Cox proportional hazards survival analyses were performed to determine predictors of outcome. RESULTS:One hundred and nine patients were included; 63.3% male, aged 49.6 ± 9.4 years with median follow-up of 40.7 months (95% CI 37.2-44.3). Median DF was 58, 86.2% had cirrhosis and 65.1% received corticosteroids and/or pentoxifylline. Overall mortality was 57.8%, 96.8% of deaths being liver-related and 65.1% occurring after the index hospitalisation. Estimated 5-year survival was 31.8%. Hepatorenal syndrome was the only baseline factor independently associated with mortality (HR 3.78, 95% CI 1.98-7.19, P < 0.0001), although it predicted short-term, rather than long-term outcome (median survival 0.52 months, 95% CI 0.43-0.61). Of the 87 patients (79.8%) who survived index hospitalisation, 65.1% experienced recidivism. Abstinence at last follow-up remained the only independent predictor of survival in multivariate analysis (HR 0.370, 95% CI 0.168-0.818, P = 0.014). Five-year survival was higher in abstainers (75.3%) compared with relapsed and continued drinkers (26.8% and 21.0%, respectively, P = 0.005). However, the survival benefit from abstinence only became statistically significant at 18 months postdischarge (HR 2.714, 95% CI 0.995-7.404, P = 0.051). CONCLUSIONS:Estimated 5-year survival after index hospitalisation with SAH is 31.8% with alcohol relapse occurring in two-thirds of patients. Abstinence remains the only independent predictor of long-term survival. Novel strategies to improve abstinence after admission with SAH are urgently needed.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Potts JR,Goubet S,Heneghan MA,Verma Sdoi
10.1111/apt.12427subject
Has Abstractpub_date
2013-09-01 00:00:00pages
584-95issue
6eissn
0269-2813issn
1365-2036journal_volume
38pub_type
杂志文章abstract:BACKGROUND:The accuracy of symptom-based diagnostic criteria for irritable bowel syndrome (IBS) is modest. AIMS:To derive and validate a new test that utilises latent class analysis. METHODS:Symptom, colonoscopy, and histology data were collected from 1981 patients and 360 patients in two cohorts referred to secondar...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13949
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:There is expanding interest in the role that diet plays in ileoanal pouch function and in the pathogenesis of pouchitis. AIMS:To present a narrative review of published literature regarding the relationship of diet with pouch function and the pathogenesis of pouchitis, and to provide potentially beneficial ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.16085
更新日期:2020-10-01 00:00:00
abstract:AIM:: To quantify through systematic review the pharmacokinetic profiles of the oral delayed release and sustained release mesalazine (5-aminosalicylate, 5ASA) formulations (Asacol, Salofalk, Mesasal, Claversal, Pentasa) and pro-drugs (sulfasalazine, olsalazine, balsalazide) used in the management of ulcerative colitis...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.2003.01408.x
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Duodenal injury persists in some coeliac disease patients despite gluten-free diet, and is associated with adverse outcomes. AIM:To determine the prevalence and clinical risk factors for persistent villus atrophy among symptomatic coeliac disease patients. METHODS:A nested cross-sectional analysis was perf...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/apt.13988
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:No definitive method for quantitative evaluation of hepatic function has as yet been established. AIM:To investigate whether the (13)C-phenylalanine breath test would be useful for the evaluation of hepatic function in patients with liver cirrhosis and acute hepatitis. METHODS:L-[1-(13)C]-phenylalanine was...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2005.02409.x
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Helicobacter pylori infection elicits persistent neutrophil infiltration in gastric mucosa. The expression of cyclooxygenase (COX)-2 and inhibition of apoptosis in the neutrophils could contribute to the pathogenesis of H. pylori infection. Rebamipide, a mucosal protective and ulcer-healing drug, has been kn...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.18.s1.1.x
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Non-cardiac chest pain is one of the most common functional gastrointestinal disorders. By recognising that gastro-oesophageal reflux disease (GERD), oesophageal dysmotility and oesophageal hypersensitivity are the main underlying mechanisms of NCCP, a more directed therapeutic approach has been developed. ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.13458
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Subtotal or total colectomy or proctocolectomy with permanent ileostomy (TC-PI) may be a treatment option for medically refractory colonic Crohn's disease (CD). AIM:To perform a systematic review and meta-analysis to evaluate the rate, risk factors and outcomes of CD recurrence after TC-PI. METHODS:In a sy...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析,评审
doi:10.1111/apt.13886
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Data on whether long-acting somatostatin analogue octreotide causes or prevents pancreatic injury following endoscopic retrograde cholangiopancreatography (ERCP) are controversial. AIM:This multicentre, prospective trial studied the effect of octreotide on pancreatic injury in a large unselected group of pa...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2036.1998.00414.x
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The widespread use of eradication therapy for Helicobacter pylori in Japan has led to an increase in antibiotic-resistant strains and the problem of re-treatment in cases of eradication failure. AIM:To perform drug sensitivity testing for metronidazole in 92 H. pylori-positive patients who had failed eradic...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2003.01401.x
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Retrospective accounts suggest that therapeutic doses of paracetamol can produce severe hepatic injury in patients with putative high-risk conditions, including alcoholism and infectious hepatitis. Metabolism of paracetamol to its hepatotoxic metabolite is enhanced in patients who abuse alcohol, who also hav...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2036.2010.04364.x
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Unable to resolve a medical problem, gastroenterologists occasionally choose an ineffectual intervention instead. The elusive path to effectual management becomes substituted with an ineffectual but readily available medical ritual. The term 'ritual' refers to the utilization of an ineffectual intervention w...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2004.02252.x
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Approximately 20% of primary sclerosing cholangitis (PSC) patients with concomitant inflammatory bowel disease (IBD) have Crohn's disease (CD). AIM:To compare PSC/CD with other PSC patients. METHODS:Retrospective study of 240 PSC patients diagnosed between 1975 and 2012 (median follow-up 12 years). Activit...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13516
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:One-week proton pump inhibitor-based triple therapies are very popular in the US despite limited US data documenting efficacy. We assessed 1-week proton pump inhibitor triple therapies for Helicobacter pylori, and compared them to dual antibiotic therapies (to assess benefit of omeprazole) and to omeprazole-...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2036.1997.00230.x
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Peptic ulcer bleeding remains a major healthcare problem despite decreasing prevalence of peptic ulcer disease. The role of chronic obstructive pulmonary disease (COPD) in the risk of peptic ulcer bleeding has not yet been established. AIM:To determine if COPD patients have a higher risk of peptic ulcer ble...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2012.05028.x
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Hepatitis C virus (HCV) genotype 6 is common among patients from Southeast Asia and the surrounding regions, where HCV prevalence is also high. HCV genotype 6 has great genetic diversity and different response to antiviral therapy compared with the more commonly known genotype 1. AIM:Our goal was to provide...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2011.04714.x
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Current guidelines recommend the cessation of clopidogrel therapy 5 days and 7-10 days prior to colonoscopic polypectomy. Recent studies have advocated for continued clopidogrel as post-polypectomy bleeding (PPB) rates have been similar to those in the general population not on antithrombotic therapy. AIM:T...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析
doi:10.1111/apt.12292
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Direct antiviral therapies for chronic hepatitis C virus (HCV) infection have expanded treatment options for neglected patient populations, including elderly patients who are ineligible/intolerant to receive interferon (IFN)-based therapy. AIM:To investigate the efficacy, tolerability and potential for drug...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13769
更新日期:2016-10-01 00:00:00
abstract::An elevated platelet count is well recognized as a marker of inflammatory bowel disease activity. There is an increased incidence of systemic thromboembolism in this disease. Recent work indicates that platelets exhibit several proinflammatory properties including release of inflammatory mediators, and recruitment, ch...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.1997.153328000.x
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:The prevalence of coeliac disease (CD) may be increased in individuals with dyspepsia, but evidence is conflicting. AIMS:To conduct a systematic review and meta-analysis of studies reporting prevalence of CD in dyspepsia. METHODS:MEDLINE, EMBASE, and CINAHL were searched up to February 2009. Case series an...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1365-2036.2009.04008.x
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:The diagnostic value of ascitic cholesterol in the differential diagnosis of ascites is controversial. AIM:To investigate the diagnostic performance of ascitic cholesterol in the differential diagnosis of ascites. METHODS:Consecutive patients with new-onset ascites were enrolled prospectively. The pertinen...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15042
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The incidence rates of gastric and oesophageal adenocarcinoma are changing significantly, but little is known about specific sub-sites. AIM:To use a population-based approach to describe the trends in the site-specific incidence of oesophageal and gastric adenocarcinoma. METHODS:Using the Rochester Epidemi...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2006.03229.x
更新日期:2007-02-15 00:00:00
abstract:BACKGROUND:In vitro studies have shown that pH is an important determinant of mucus structure and function, but the relationship in vivo is unclear. Omeprazole increases intragastric pH and also allows bacterial overgrowth. In this study we have assessed the effect of omeprazole on gastric juice viscosity and examined ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.1996.tb00183.x
更新日期:1996-02-01 00:00:00
abstract:AIM:To define the characteristics of patients consulting with active dyspeptic symptoms in urban general practice, and to consider the implications of applying the British Society of Gastroenterology Dyspepsia management guidelines. DESIGN:Prospective observational study over a period of 12 months. SETTING:Two multip...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.2000.00728.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:In the absence of prior gastrointestinal infection, the risk factors for irritable bowel syndrome (IBS) are not well established. AIM:To identify the incidence and risk factors for IBS in general population samples METHODS: Narrative review of population-based studies. Electronic databases were searched usi...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.15396
更新日期:2019-09-01 00:00:00
abstract::The treatment of non-alcoholic fatty liver disease may be worthwhile to prevent progression to advanced liver failure, but no therapy is definitely evidence-based. Weight loss or lifestyle modifications remain the primary line of intervention, particularly in overweight or obese subjects. In adult non-alcoholic fatty ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2005.02593.x
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Optimal management approach is not well defined for subjects who fail initial first- and second-line Helicobacter pylori eradication attempts and are dealt on a case-by-case basis by the specialists. AIM:To evaluate the efficacy and safety of standard and 'rescue' eradication therapies at primary and second...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2004.02210.x
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Little is known about the contribution of bile and acid reflux to night-time symptoms generation in patients who failed PPI treatment. AIM:To compare the degree of night-time oesophageal acid and bile [by the surrogate duodenogastroesophageal reflux (DGER)] exposure between gastro-oesophageal reflux disease...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2011.04583.x
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The use of non-steroidal anti-inflammatory drugs (NSAIDs) is often associated with upper gastrointestinal symptoms such as heartburn and acid regurgitation. AIM:To assess the efficacy of esomeprazole 20 and 40 mg for resolution of heartburn and acid regurgitation in continuous NSAIDs. METHODS:A post hoc an...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析
doi:10.1111/j.1365-2036.2006.03210.x
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Aim of this work was to improve standardization of the 13C-urea breath test (13C-UBT) by evaluating the effect of drug administration, feeding and colonic ureolysis on the UBT results. METHODS:Three different studies were performed. First, a 13C-UBT was performed in 41 Helicobacter pylori infected subjects ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.1995.tb00442.x
更新日期:1995-12-01 00:00:00