{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,8]],"date-time":"2025-02-08T05:24:51Z","timestamp":1738992291751,"version":"3.37.0"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":9131,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1990,9]]},"abstract":"\n Study Objective:<\/jats:title>\n To determine the efficacy of a corticosteroid in reducing the short-term mortality of patients with 8evere alcoholic hepatitis.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Randomized, double-blind, placebo-controlled multicenter trial.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Four university teaching hospitals.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n We enrolled 66 patients with alcoholic hepatitis and either spontaneous hepatic encephalopathy or a discriminant function value greater than 32, calculated using the formula: 4.6(prothrombin time -control time) + serum bilirubin [in pmoUL]\/17.1. Fifty-nine patients (89%)completed the study. Two patients withdrew from the trial. The other 64 patients were hospitalized for the duration of the trial: however, treatment was discontinued in 5 patients because of potential drug toxicity.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n Patients were randomly assigned to receive either methylprednisolone (32 mg) or placebo within 7 days of admission. Treatment was given for 28 days. The doses were then tapered over 2 weeks and discontinued.<\/jats:p>\n <\/jats:sec>\n \n Measurements and Main Results:<\/jats:title>\n The endpoint of the study was death. Of the 31 recipients of placebo, 11 (35%)died within 28 days of randomization compared with 2 (6%)of the 36 patients given methylprednisolone (p<\/jats:italic> = 0.006). The 95% CI for the difference in mortality was 12% to 70%. In the patients with spontaneous hepatic encephalopathy at entry, 9 of 19 recipients of placebo died (47%)compared with 1 (7%)of the 14 patients given methylprednisolone (p<\/jats:italic> = 0.02). The 95% CI for the difference in mortality was 14% to 66%. The Cox proportional hazards regression model showed the advantage of methylprednisolone over placebo after adjustment for other potentidy important prognostic variables (p<\/jats:italic> = 0.004).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Methylprednisolone therapy decreases short-term mortality in patients with severe alcoholic hepatitis manifested either by spontaneous hepatic encephalopathy or a markedly elevated discriminant function value.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/hep.1840120331","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T23:35:23Z","timestamp":1172964923000},"page":"619-621","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Corticosteroid therapy of alcoholic hepatitis: How many studies will it take?"],"prefix":"10.1097","volume":"12","author":[{"given":"Telfer B.","family":"Reynolds","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"10.1002\/hep.1840120331-BIB1","doi-asserted-by":"crossref","first-page":"311","DOI":"10.7326\/0003-4819-74-3-311","volume":"74","author":"Helman","year":"1971","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.1840120331-BIB2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/0016-5085(78)90790-4","volume":"74","author":"Lesesne","year":"1978","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840120331-BIB3","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/0016-5085(80)90867-7","volume":"78","author":"Depew","year":"1980","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840120331-BIB4","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0016-5085(78)90401-8","volume":"75","author":"Maddrey","year":"1978","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840120331-BIB5","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1056\/NEJM198412063112302","volume":"311","author":"Mendenhall","year":"1984","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.1840120331-BIB6","first-page":"208","volume":"2","author":"Reynolds","year":"1989","journal-title":"Gastroenterology Int"},{"key":"10.1002\/hep.1840120331-BIB7","first-page":"580","volume":"10","author":"Imperiale","year":"1989","journal-title":"Hepatology"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.1840120331","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-199009000-00030","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T15:31:25Z","timestamp":1738942285000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-199009000-00030"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,9]]},"references-count":7,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1990]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.1840120331","relation":{},"ISSN":["0270-9139"],"issn-type":[{"type":"print","value":"0270-9139"}],"subject":[],"published":{"date-parts":[[1990,9]]}}}