Journal ArticleDOI
Protein Energy Malnutrition in Severe Alcoholic Hepatitis: Diagnosis and Response to Treatment
Charles L. Mendenhall,Thomas E. Moritz,Gary A. Roselle,Timothy R. Morgan,Bernard A. Nemchausky,Carlo H. Tamburro,Eugene R. Schiff,Craig J. McClain,Luis Marsano,John I. Allen,Arun Samanta,Robert E. Weesner,William G. Henderson,Thomas S. Chen,Samuel W. French,Antonio Chedid +15 more
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TLDR
Most of the parameters improved significantly from baseline on standard care; the largest improvement seen in visceral proteins, the smallest in fat stores (skinfold thickness).Abstract:
Background: Active nutrition therapy and the anabolic steroid oxandrolone (OX), in selected patients with severe alcoholic hepatitis, significantly improved liver status and survival. We report here on the changes in their nutritional parameters. Methods: Protein energy malnutrition (PEM) was evaluated and expressed as percent of low normal in 271 patients initially, at 1 month and at 3 months. Active therapy consisted of OX plus a high caloric food supplement vs a matching placebo and a low calorie supplement. Results: PEM was present in every patient; mean PEM score 60% of low normal. Most of the parameters improved significantly from baseline on standard care; the largest improvement seen in visceral proteins, the smallest in fat stores (skinfold thickness). Total PEM score significantly correlated with 6 month mortality (p=.0012). Using logistic regression analysis, creatinine height index, hand grip strength and total peripheral blood lymphocytes were the best risk factors for survival. When CD lymph...read more
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Journal ArticleDOI
ESPEN Guidelines on Enteral Nutrition: Liver disease ☆
Mathias Plauth,Eduard Cabré,Oliviero Riggio,M. Assis-Camilo,Matthias Pirlich,Jens Kondrup,P. Ferenci,E. Holm,S. vom Dahl,Manfred J. Müller,W. Nolte +10 more
TL;DR: EN by means of ONS is recommended for patients with chronic LD in whom undernutrition is very common and TF commenced early after liver transplantation can reduce complication rate and cost and is preferable to parenteral nutrition.
Journal ArticleDOI
Nutrition and survival in patients with liver cirrhosis.
F. Alberino,Angelo Gatta,Piero Amodio,Carlo Merkel,Lorenza Di Pascoli,G. Boffo,Lorenza Caregaro +6 more
TL;DR: It is demonstrated that malnutrition is an independent predictor of survival in patients with liver cirrhosis, and the inclusion of anthropometric measures in the assessment of these patients might provide better prognostic information.
Journal ArticleDOI
EASL Clinical Practice Guidelines: Management of alcohol-related liver disease
Mark Thursz,Antoni Gual,C. Lackner,Philippe Mathurin,Christophe Moreno,Laurent Spahr,Martina Sterneck,Helena Cortez-Pinto +7 more
TL;DR: The latest data on the treatment and management of alcohol-related liver disease will be reviewed and up to date recommendations for clinical management will be provided.
Journal ArticleDOI
ESPEN guidelines for nutrition in liver disease and transplantation
TL;DR: The presence of muscle wasting indicates an advanced stage of chronic liver disease, and the higher prevalence of malnutrition in patients with alcoholic liver disease is generally restricted to skid row alcoholics and patients from low socioeconomic classes.
Journal ArticleDOI
A Review of the Chemistry, Biological Action, and Clinical Applications of Anabolic-Androgenic Steroids
TL;DR: Given the biological effects and potential adverse effects of AAS, administration of these agents should be avoided in pregnant women, women with breast cancer or hypercalcemia, men with cancers of the prostate or breast, and patients with nephrotic syndromes or significant liver dysfunction.
References
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Journal ArticleDOI
Nutritional and metabolic assessment of the hospitalized patient
Journal ArticleDOI
Corticosteroid therapy of alcoholic hepatitis
Willis C. Maddrey,John K. Boitnott,Marshall Bedine,Fredrick L. Weber,Esteban Mezey,Robert I. White +5 more
TL;DR: It is suggested that corticosteroid therapy does decrease early mortality in patients with severe alcoholic hepatitis, but has no short term effect on the development of portal hypertension.
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Protein-calorie malnutrition associated with alcoholic hepatitis: Veterans administration cooperative study group on alcoholic hepatitis
TL;DR: The nearly constant association of either complete or partial kwashiorkor or marasmus suggests that the separation of these two entities is artificial in alcoholic patients with liver disease.
Journal ArticleDOI
Effect of total enteral nutrition on the short-term outcome of severely malnourished cirrhotics. A randomized controlled trial.
E. Cabre,Ferrán González-Huix,A Abad-Lacruz,M. Esteve,D. Acero,Fernando Fernández-Bañares,Xavier Xiol,M.A. Gassull +7 more
TL;DR: Results show that total enteral nutrition is safe and effective in improving the short-term clinical outcome in severely malnourished cirrhotics.
Journal ArticleDOI
A study of oral nutritional support with oxandrolone in malnourished patients with alcoholic hepatitis: Results of a department of veterans affairs cooperative study
Charles L. Mendenhall,Thomas E. Moritz,Gary A. Roselle,Timothy R. Morgan,Bernard A. Nemchausky,Carlo H. Tamburro,Eugene R. Schiff,Craig J. McClain,Luis S. Marsano,John I. Allen,Arun Samanta,Robert E. Weesner,William G. Henderson,Peter S. Gartside,Thomas S. Chen,Samuel W. French,Antonio Chedid +16 more
TL;DR: The results indicate that nutritional status should be evaluated in patients with alcoholic hepatitis, and when malnutrition is present, vigorous nutrition therapy should be provided, and in Patients with moderate malnutrition oxandrolone should be added to the regimen.