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hepatic encephalopathy diagnos*

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https://www.readbyqxmd.com/read/28231412/impact-of-family-history-of-metabolic-traits-on-severity-of-nash-related-cirrhosis-a-cross-sectional-study
#1
Ajeet Singh Bhadoria, Chandan Kumar Kedarisetty, Chhagan Bihari, Guresh Kumar, Ankur Jindal, Ankit Bhardwaj, Varsha Shasthry, Tanmay Vyas, Jaya Benjamin, Shvetank Sharma, Manoj Kumar Sharma, Shiv Kumar Sarin
BACKGROUND AND AIMS: Familial aggregation of metabolic traits with fatty liver disease is well documented. However, there is scarcity of data regarding such association with non-alcoholic steato-hepatitis (NASH) related cirrhosis. This study was aimed to explore the association of family history of metabolic traits with severity of cirrhosis. METHODS: In a cross-sectional study, all consecutive patients with NASH related cirrhosis presenting to our tertiary care centre were included...
February 23, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28207633/acute-liver-failure-injury-related-to-drug-reaction-with-eosinophilia-and-systemic-symptoms-outcomes-and-prognostic-factors
#2
Philippe Ichai, Astrid Laurent-Bellue, Faouzi Saliba, David Moreau, Camille Besch, Claire Francoz, Laurence Valeyrie-Allanore, Sylvie Roussin Bretagne, Marc Boudon, Teresa Maria Antonini, Florent Artru, Gabriella Pittau, Olivier Roux, Daniel Azoulay, Eric Levesque, François Durand, Catherine Guettier, Didier Samuel
BACKGROUND: Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) is a rare severe adverse drug induced reaction with multiorgan involvement. The outcome and prediction of those patients who develop severe acute liver injury (sALI) or acute liver failure (ALF) remain little known. METHODS: A multicenter retrospective study of patients admitted with a diagnosis of DRESS-related sALI or ALF. Histological review was performed on liver core biopsies from native livers...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28199774/sarcopenia-predicts-minimal-hepatic-encephalopathy-in-patients-with-liver-cirrhosis
#3
Tatsunori Hanai, Makoto Shiraki, Satoshi Watanabe, Takahiro Kochi, Kenji Imai, Atsushi Suetsugu, Koji Takai, Hisataka Moriwaki, Masahito Shimizu
AIM: Minimal hepatic encephalopathy (MHE) and sarcopenia impair the health-related quality of life and prognosis in patients with liver cirrhosis; however, the relationship between MHE and sarcopenia remains unclear. The aim of this study was to investigate their relationship and to identify the predictors of MHE in cirrhotic patients. METHODS: This retrospective study evaluated 120 cirrhotic patients who were tested for MHE and sarcopenia. MHE was diagnosed by using the computer-aided neuropsychiatric test...
February 15, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28195876/development-and-validation-of-a-prognostic-model-for-acute-on-chronic-hepatitis-b-liver-failure
#4
Fangyuan Gao, Le Sun, Xieqiong Ye, Yao Liu, Huimin Liu, Mingfan Geng, Xiaoshu Li, Xue Yang, Yuxin Li, Rui Wang, Jialiang Chen, Gang Wan, Yuyong Jiang, Xianbo Wang
AIM: The CANONIC study proposed the Chronic Liver Failure Consortium acute-on-chronic liver failure (CLIF-C ACLF) prognostic model at the European Association for the Study of the Liver-CLIF diagnosis. This study aimed to develop and validate a prognostic model for predicting the short-term mortality of hepatitis B virus (HBV) ACLF as defined by the Asia-Pacific Association for the Study of the Liver. PATIENTS AND METHODS: A retrospective cohort of 381 HBV ACLF patients and a prospective cohort of 192 patients were included in this study...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28146589/the-phes-battery-does-not-detect-all-cirrhotic-patients-with-early-neurological-deficits-which-are-different-in-different-patients
#5
Carla Giménez-Garzó, Juan José Garcés, Amparo Urios, Alba Mangas-Losada, Raquel García-García, Olga González-López, Remedios Giner-Durán, Desamparados Escudero-García, Miguel Angel Serra, Emilio Soria, Vicente Felipo, Carmina Montoliu
BACKGROUND AND AIMS: The psychometric hepatic encephalopathy score (PHES) is the "gold standard" for minimal hepatic encephalopathy (MHE) diagnosis. Some reports suggest that some cirrhotic patients "without" MHE according to PHES show neurological deficits and other reports that neurological alterations are not homogeneous in all cirrhotic patients. This work aimed to assess whether: 1) a relevant proportion of cirrhotic patients show neurological deficits not detected by PHES; 2) cirrhotic patients with mild neurological deficits are a homogeneous population or may be classified in sub-groups according to specific deficits...
2017: PloS One
https://www.readbyqxmd.com/read/28138203/reversible-encephalopathy-due-to-valproic-acid-induced-hyperammonemia-in-a-patient-with-bipolar-i-disorder-a-cautionary-report
#6
Neel Patel, Katherine B Landry, Rachel E Fargason, Badari Birur
Valproic acid (VPA) is an FDA-approved medication widely prescribed for seizures, migraines, and mixed or manic episodes in bipolar disorder. Hyperammonemia is a rare complication of VPA use, which can result in high morbidity and occasionally fatal encephalopathy. The scant literature on Valproate Induced Hyperammonemic Encephalopathy (VIHE) is characterized by acute onset of decreasing level of consciousness, drowsiness, lethargy which in rare instances can lead to seizures, stupor, coma, and persistent morbidity and cortical damage...
January 26, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28127211/posterior-reversible-encephalopathy-syndrome-in-alcoholic-hepatitis-hepatic-encephalopathy-a-common-theme
#7
Elizabeth S John, Ramy Sedhom, Ishita Dalal, Ranita Sharma
Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiologic diagnosis that has become more widely recognized and reported over the past few decades. As such, there are a number of known risk factors that contribute to the development of this syndrome, including volatile blood pressures, renal failure, cytotoxic drugs, autoimmune disorders, pre-eclampsia, and eclampsia. This report documents the first reported case of PRES in a patient with severe alcoholic hepatitis with hepatic encephalopathy and delves into a molecular pathophysiology of the syndrome...
January 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28119160/evaluation-of-prepulse-inhibition-and-memory-impairments-at-early-stage-of-cirrhosis-may-be-considered-as-a-diagnostic-index-for-minimal-hepatic-encephalopathy
#8
Iraj Aghaei, Seyed Soheil Saeedi Saravi, Samaneh Ghotbi Ravandi, Masoumeh Nozari, Ali Roudbari, Afshin Dalili, Mohammad Shabani, Ahmad Reza Dehpour
Minimal hepatic encephalopathy (MHE), which represents the early stage of this condition, is not clinically apparent and is prevalent in up to 80% of patients. The poor outcomes of MHE encouraged us to identify more simple methods for early diagnosis of MHE. To this purpose, we evaluated the contemporary manifestations of motor, cognitive and sensorimotor gaiting deficits following bile duct-ligation (BDL). Male Wistar rats were undergone BDL to induce cirrhosis and locomotor, spatial learning and memory and sensorimotor gating were assessed 2, 3, and 4weeks after the operation by rotarod, Morris water-maze and prepulse inhibition (PPI) tests...
January 21, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28107263/the-severity-of-hypoxic-ischemic-encephalopathy-correlates-with-multiple-organ-dysfunction-in-the-hypothermia-era
#9
Miguel Alsina, Ana Martín-Ancel, Ana Alarcon-Allen, Gemma Arca, Francisco Gayá, Alfredo García-Alix
OBJECTIVES: The objectives are to 1) determine whether there is a positive correlation between the severity of hypoxic-ischemic encephalopathy and multiple organ dysfunction and 2) evaluate the organ dysfunction pattern in infants with hypoxic-ischemic encephalopathy in the hypothermia era. DESIGN: Retrospective observational study of prospective data collected between April 2009 and December 2012. SETTING: The study took place in the neonatal ICU of Hospital Sant Joan de Déu-Hospital Clínic of Barcelona...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28092846/status-epilepticus-in-patients-with-cirrhosis-how-to-avoid-misdiagnosis-in-patients-with-hepatic-encephalopathy
#10
Marika Rudler, Clémence Marois, Nicolas Weiss, Dominique Thabut, Vincent Navarro
PURPOSE: Status epilepticus (SE) in patients with cirrhosis is a rare but serious situation. Diagnosis may be difficult in emergency presentation, especially when patients present with hepatic encephalopathy (HE). Misdiagnosis must be avoided since some anti-epileptic drugs aggravate HE. In this retrospective study, we therefore assessed the frequency of SE in patients with cirrhosis, evaluated the accuracy of diagnosis and determined rates of mortality. METHOD: We reviewed data from all patients hospitalized from 2005 to 2013 in the Hepatology ICU for complications of cirrhosis with an initial diagnosis of SE...
December 27, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28081589/preemptive-antiviral-therapy-with-entecavir-can-reduce-acute-deterioration-of-hepatic-function-following-transarterial-chemoembolization
#11
Sun Hong Yoo, Jeong Won Jang, Jung Hyun Kwon, Seung Min Jung, Bohyun Jang, Jong Young Choi
BACKGROUND/AIMS: Hepatic damage during transarterial chemoembolization (TACE) is a critical complication in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Apart from its role in preventing HBV reactivation, there is some evidence for the benefits of preemptive antiviral therapy in TACE. This study evaluated the effect of preemptive antiviral therapy on acute hepatic deterioration following TACE. METHODS: This retrospective observational study included a prospectively collected cohort of 108 patients with HBV-related HCC who underwent TACE between January 2007 and January 2013...
December 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28070704/sleep-disturbances-in-patients-of-liver-cirrhosis-with-minimal-hepatic-encephalopathy-before-and-after-lactulose-therapy
#12
Jatinderpal Singh, Barjesh Chander Sharma, Vinod Puri, Sanjeev Sachdeva, Siddharth Srivastava
Sleep disturbances are common in patients of cirrhosis with minimal hepatic encephalopathy (MHE) and affect health related quality of life (HRQOL). No study has evaluated effect of lactulose on sleep disturbances and correlation with HRQOL in patients with MHE. We assessed sleep disturbances in cirrhosis with MHE and effect of lactulose on sleep disturbances and HRQOL. One hundred patients of cirrhosis [MHE; (n = 50, age 45.3 ± 11.2 years, 45 males) no-MHE (n = 50, age 46.3 ± 10.4 years, 44 males)] were included...
January 9, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28066966/updating-neuropsychological-test-system-for-the-elderly-and-modern-touch-screen-tablet-society-by-resetting-of-the-cut-off-values
#13
Takumi Kawaguchi, Mika Konishi, Akinobu Kato, Motoichiro Kato, Yohei Kooka, Kei Sawara, Ryujin Endo, Takuji Torimura, Kazuyuki Suzuki, Yasuhiro Takikawa
BACKGROUND & AIMS: Covert hepatic encephalopathy (CHE) is frequently seen in cirrhotic patients. CHE can be diagnosed by a computerized neuropsychological test system (NPT); however, NPT has not been updated about two decades in Japan. The aim of this study is to update the NPT for fitting the elderly and modern society by resetting of the cut-off values. METHODS: We enrolled 367 healthy subjects with 40 to 79 years old between 2003 and 2010. NPT consist of following 8 tests: number connection tests A and B, a figure position test, a digit symbol test, a block design test, and reaction time test A, B, and C...
January 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28055330/hepatic-lipodystrophy-in-galloway-calves
#14
M Wieland, S Mann, A Hafner-Marx, A Ignatius, M Metzner
Hepatic lipodystrophy in Galloway calves is a fatal liver disease affecting a small proportion of the Galloway breed described in different parts of Europe and North America during the past decades. The clinical findings include a diversity of neurological signs. Clinical pathology findings frequently indicate hepatobiliary disease. Postmortem examination reveals an enlarged, pale yellow, and firm liver. Histologic lesions include hepatic fibrosis, hepatic lipidosis, and bile duct hyperplasia. To date, the etiopathogenesis remains obscure...
January 1, 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/28051800/%C3%A2-minimal-hepatic-encephalopathy-in-cirrhosis-how-long-to-treat
#15
Omesh Goyal, Sandeep S Sidhu, Harsh Kishore
INTRODUCTION: Minimal hepatic encephalopathy (MHE) can reverse after short-term treatment. However, relapse rate of MHE after stopping treatment has not been studied so far. We aimed to evaluate long-term (9 months) efficacy of a short-term (3 months) treatment of MHE with lactulose/rifaximin, for maintenance of remission from MHE. MATERIAL AND METHODS: In this prospective study, consecutive patients with cirrhosis and MHE were treated with lactulose/rifaximin for 3 months...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28027071/covert-hepatic-encephalopathy-can-my-patient-drive
#16
Jawaid Shaw, Jasmohan S Bajaj
Liver cirrhosis is a public health problem and hepatic encephalopathy is one of its main complications, which can be either overt meaning thereby evident and readily diagnosed, or covert/minimal (covert hepatic encephalopathy-CHE) needing psychometric testing for diagnosis. Patients with CHE hepatic encephalopathy have deficits in multiple domains including visuospatial assessment, attention, response inhibition, working memory, along with psychomotor speed to name a few areas. These patients have poor navigational skills, get fatigued easily, and demonstrate poor insight into their driving deficits...
February 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28003725/neonatal-cholestasis-as-initial-presentation-of-portosystemic-shunt-a-case-report
#17
Güzide Doğan, Fatih Düzgün, Serdar Tarhan, Yeliz Çağan Appak, Erhun Kasırga
Congenital intrahepatic portosystemic shunts are rare in children. Portosystemic venous malformations are characterized by extreme clinical variability. We report a full-term 33-day-old male infant presenting with neonatal jaundice. On physical examination, he had generalized icterus and the liver was palpable 3.5 cm below the right costal margin. He had no other symptoms. Laboratory tests showed AST 632 U/L, ALT 198 U/L, total bilirubin 12.1 mg/dL, conjugated bilirubin 10.2 mg/dL, alkaline phosphatase 753 U/L, GGT 47 U/L and glucose 67 U/L...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28003716/pharmacologic-treatment-of-alcoholic-hepatitis-examining-outcomes-based-on-disease-severity-stratification
#18
Ryan E Owens, Heather S Snyder, Jennifer D Twilla, Sanjaya K Satapathy
OBJECTIVES: Maddrey discriminant function (MDF) score is a measure of disease prognosis in alcoholic hepatitis (AH) used to identify patients at highest risk of mortality and determine the need for initiation of pharmacologic treatment. The purpose of this study was to evaluate the effects of pharmacologic therapy for hospitalized AH patients as stratified by MDF score. METHODS: A retrospective review of patients with an AH diagnosis admitted to a Methodist LeBonheur Healthcare adult hospital between 06/2009 and 06/2014 was conducted...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/27988985/altered-postural-control-and-stability-in-cirrhotic-patients-with-minimal-hepatic-encephalopathy-correlate-with-cognitive-deficits
#19
Amparo Urios, Alba Mangas-Losada, Carla Gimenez-Garzó, Olga González-López, Remedios Giner-Durán, Miguel A Serra, Enrique Noe, Vicente Felipo, Carmina Montoliu
BACKGROUND & AIMS: Cognitive dysfunction in cirrhotic patients with minimal hepatic encephalopathy (MHE) is associated with falls. Alterations in postural control and stability could contribute to increase falls risk in these patients. We aimed to assess whether postural control and direction-specific limits of stability are altered in cirrhotic patients with MHE compared to patients without MHE and controls. We also assessed if alterations in postural control correlate with neurological impairment and/or blood biomarkers...
December 18, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27988236/predicting-mortality-of-patients-with-cirrhosis-admitted-to-medical-intensive-care-unit-an-experience-of-a-single-tertiary-center
#20
Abdel-Naser Elzouki, Shireen Suliman, Rania Alhasan, Ali Abdullah, Muftah Othman, Ahmad Badi
BACKGROUND AND STUDY AIMS: Prognosis for patients with cirrhosis admitted to a medical intensive care unit (MICU) is poor and no previous studies have been published from Qatar or other countries in the region to investigate this issue. The objective of this study was to assess the predictors for in-hospital mortality and admission of cirrhotic patients to MICU in a single tertiary hospital in Qatar. PATIENTS AND METHODS: All adult cirrhotic MICU patients hospitalized from 2007 through 2012 to Hamad General Hospital-Qatar were included...
December 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
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