A cooperative study was conducted to determine the efficacy of 30 days of treatment with either a glucocorticosteroid (prednisolone) or an anabolic steroid (oxandrolone) in moderate or severe alcoholic hepatitis. One hundred thirty-two patients with moderate disease and 131 with severe disease were randomly assigned to one of three treatments: prednisolone, oxandrolone, or placebo. During the 30 days, mortality in the groups receiving steroid therapy was not significantly different from mortality in the placebo group. Thirteen per cent of the moderately ill patients and 29 per cent of the severely ill patients died. Although neither steroid improved short-term survival, oxandrolone therapy was associated with a beneficial effect on long-term survival. This was especially true in patients with moderate disease: among those who survived for one or two months after the start of treatment the conditional six-month death rate was 3.5 per cent after oxandrolone and 19 to 20 per cent after placebo (P = 0.02). No consistent long-term effect was associated with prednisolone therapy.

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The purpose of this research was to examine the role of gender in hemodynamic response patterns to stress. Sixty-four male and 55 female young adults were administered a protocol of rest, mental arithmetic, video game, and anger recall interview while blood pressure, heart rate, and cardiac impedance measures were obtained. Men had higher levels of systolic blood pressure and cardiac output and greater reactivity to tasks, indexed by increases in cardiac output and diastolic blood pressure. Extreme groups of myocardial and vascular reactors were formed from cardiac output and total peripheral resistance change scores during mental arithmetic. The myocardial reactors exhibited greater sensitivity to task demands, whereas vascular reactors exhibited comparable total peripheral resistance increases to all tasks. Vascular reactors exhibited greater diastolic blood pressure reactivity than myocardial reactors. Future studies should address the predictive validity of these reactor patterns for the subsequent development of coronary heart disease.

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