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hepatic encephalopathy diagnos*

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https://www.readbyqxmd.com/read/29746564/multiple-bacterial-infections-increase-the-risk-of-hepatic-encephalopathy-in-patients-with-cirrhosis
#1
Lan-Ting Yuan, Seng-Kee Chuah, Shih-Cheng Yang, Chih-Ming Liang, Cheng-Kun Wu, Wei-Chen Tai, Tsung-Hsing Hung, Seng-Howe Nguang, Jiunn-Wei Wang, Kuo-Lun Tseng, Ming-Kun Ku, Pin-I Hsu, Deng-Chyang Wu, Chien-Ning Hsu
OBJECTIVE: Patients with liver cirrhosis (LC) are at increased risk for bacterial infections. It is not fully understood how exposure to infections induces further development of hepatic encephalopathy (HE). This study estimated risks of infection associated with HE among patients with LC. METHODS: A nested case-control study of 14,428 adult patients with LC was performed using the population-based Longitudinal Health Insurance Database 2000 in Taiwan. Cases were cirrhotic patients who developed HE during follow-up...
2018: PloS One
https://www.readbyqxmd.com/read/29742811/primary-sclerosing-cholangitis-risk-estimate-tool-presto-predicts-outcomes-in-psc-a-derivation-validation-study-using-machine-learning
#2
John E Eaton, Mette Vesterhus, Bryan M McCauley, Elizabeth J Atkinson, Erik M Schlicht, Brian D Juran, Andrea A Gossard, Nicholas F LaRusso, Gregory J Gores, Tom H Karlsen, Konstantinos N Lazaridis
BACKGROUND & AIMS: Improved methods are needed to risk stratify and predict outcomes in patients with primary sclerosing cholangitis (PSC). Therefore, we sought to derive and validate a new prediction model and compare its performance to existing surrogate markers. METHODS: The model was derived using 509 subjects from a multicenter North American cohort and validated in an international multicenter cohort (n=278). Gradient boosting, a machine based learning technique, was used to create the model...
May 9, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29730740/congenital-portosystemic-shunts-diagnosis-and-treatment
#3
Stéphanie Franchi-Abella, Emmanuel Gonzales, Oanez Ackermann, Sophie Branchereau, Danièle Pariente, Florent Guérin
Congenital portosystemic shunts (CPSS) are rare vascular malformations that create an abnormal connection between portal and systemic veins resulting in complete or partial diversion of the portal flow away from the liver to the systemic venous system. Different anatomic types exist and several classifications have been proposed. They can be associated with other malformations especially cardiac and heterotaxia. The main complications include hepatic encephalopathy, liver tumors, portopulmonary hypertension, and pulmonary arteriovenous shunts...
May 5, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29705917/management-of-hepatic-encephalopathy-not-responsive-to-first-line-treatments
#4
REVIEW
Silvia Nardelli, Lorenzo Ridola, Stefania Gioia, Oliviero Riggio
PURPOSE OF REVIEW: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in up to 30% of patients with cirrhosis. HE may be a consequence of pure liver failure, as in patients with fulminant hepatitis, or of the combination of liver failure and portal-systemic shunting, as in patients with liver cirrhosis. Episodes of HE are usually related to precipitating events, such as infections or gastrointestinal bleeding; a minority of cirrhotic patients experienced a chronic HE, refractory to standard medical treatment...
April 28, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29692377/predictive-value-of-serum-creatinine-blood-urea-nitrogen-uric-acid-and-%C3%AE-2-microglobulin-in-the-evaluation-of-acute-kidney-injury-after-orthotopic-liver-transplantation
#5
Hai-Yang Lu, Xin-Yu Ning, Ying-Qi Chen, Shu-Jun Han, Ping Chi, Sai-Nan Zhu, Yun Yue
Background: As a major complication after orthotopic liver transplantation (OLT), the occurrence of acute kidney injury (AKI) is frequently defined by serum creatinine (Cr); however, the accuracy of commonly used blood urea nitrogen (BUN), uric acid (UA), and β2 -microglobulin (β2 -MG) remains to be explored. This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation. Methods: Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled...
May 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29675988/dose-dependent-impact-of-proton-pump-inhibitors-on-the-clinical-course-of-spontaneous-bacterial-peritonitis
#6
Tammo L Tergast, Anika Wranke, Hans Laser, Svetlana Gerbel, Michael P Manns, Markus Cornberg, Benjamin Maasoumy
BACKGROUND & AIMS: Spontaneous bacterial peritonitis (SBP) is a severe complication in patients with liver cirrhosis leading to acute kidney injury (AKI), hepatic encephalopathy (HE) and a high mortality. In this study we aimed to investigate the impact of proton pump inhibitors (PPI) and the potential relevance of the taken dosage on the incidence and clinical course of SBP. METHODS: Overall, 613 consecutive patients with decompensated liver cirrhosis were included...
April 19, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29650854/-a-case-of-hyperammonemia-induced-by-chemotherapy-with-5-fluorouracil-for-metastatic-colon-cancer
#7
Shinji Tokuyama, Mutsumi Fukunaga, Ken Konishi, Shoko Honda, Ryohei Yukimoto, Aoi Okamoto, Akina Saito, Kazuyuki Okada, Hideo Ota, Shigekazu Yokoyama, Hirofumi Miki, Kenji Kobayashi
Systemic chemotherapy based on 5-fluorouracil(5-FU)is a standard treatment for unresectable or recurrent colon cancers. Here, we report a case of hyperammonemia induced by chemotherapy using 5-FU for metastatic colon cancer. An 84-yearold male patient with past histories of liver cirrhosis related to hepatitis C virus and renal dysfunction underwent an operation for the rectosigmoid colon cancer 8 years ago. Three years after that operation, a local recurrence of the colon cancer was diagnosed, and chemotherapy using sLV5FU2 was initiated...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650838/-two-cases-of-hepatic-encephalopathy-after-chemotherapy-for-metastatic-colorectal-cancer
#8
Tae Matsumura, Shingo Noura, Masaki Hirota, Yuki Ozato, Daiki Marukawa, Takashi Shuto, Arisa Muratsu, Akinobu Yasuyama, Akihiro Takata, Chikato Koga, Chizu Kameda, Masahiro Murakami, Ryohei Kawabata, Junzo Shimizu, Junichi Hasegawa
We reported 2 cases of hepatic encephalopathy after chemotherapy for advanced colorectal cancer. Case 1: A 49-year-old male was diagnosed advanced sigmoid colon cancer with peritoneal dissemination, multiple liver metastasis and multiple osseous metastasis. After resection of primary lesion, we administered mFOLFOX6 plus bevacizumab combination therapy. He was in comatose(Japan coma scale 200)3 days after 2 courses of administration of this regimen. Case 2: A 57-year-old female was diagnosed advanced rectal cancer with multiple huge liver metastasis and multiple osseous metastasis...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29628453/multiple-acquired-portosystemic-shunts-secondary-to-primary-hypoplasia-of-the-portal-vein-in-a-cat
#9
Satoko Sugimoto, Shingo Maeda, Masaya Tsuboi, Kohei Saeki, James K Chambers, Tomohiro Yonezawa, Kenjiro Fukushima, Reina Fujiwara, Kazuyuki Uchida, Hajime Tsujimoto, Naoaki Matsuki, Koichi Ohno
A 6-year 5-month-old spayed female Scottish Fold cat presented with a one-month history of gait abnormalities, increased salivation, and decreased activity. A blood test showed hyperammonemia and increased serum bile acids. Imaging tests revealed multiple shunt vessels indicating acquired portosystemic shunt. Histopathologic analysis of liver biopsy showed features consistent with liver hypoperfusion, such as a barely recognizable portal vein, increased numbers of small arterioles, and diffuse vacuolar degeneration of hepatocytes...
April 9, 2018: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/29624860/hepatic-encephalopathy-diagnosis-and-management
#10
Piero Amodio
Hepatic encephalopathy (HE) is a peculiar kind of brain dysfunction caused by liver insufficiency and/or portal-systemic shunting. It is related to gut-derived substances. It is a relevant cause of morbidity and hospitalisation for patients with cirrhosis. The prognosis of HE is important in terms of survival and re-hospitalisation. It is related to impaired quality of life, falls and poor driving, presents a relevant burden for caregivers and health services, and may negatively impacts on patient's job and income...
April 6, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29624025/hepatic-encephalopathy-and-cirrhotic-cardiomyopathy-in-intensive-care-unit
#11
Giuliana Scarpati, Edoardo DE Robertis, Ciro Esposito, Ornella Piazza
Acute and chronic liver diseases may escalate to hepatic encephalopathy (HE) and multiple organ failure, requiring admission and organ support in Intensive Care Unit (ICU). Hepatic dysfunction in ICU is a broad and complex topic; unfortunately, up to now, the understanding of its underlying pathophysiology is far from complete. HE and cirrhotic cardiomyopathy (CCM) need timely diagnostic and therapeutic measures aiming at the identification and elimination of causative factors, to improve patients' prognosis...
April 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29622386/long-term-outcome-of-transjugular-intrahepatic-portosystemic-shunt-for-portal-hypertension-in-autosomal-recessive-polycystic-kidney-disease
#12
Sarah Verbeeck, Djalila Mekhali, David Cassiman, Geert Maleux, Peter Witters
BACKGROUND: Autosomal recessive polycystic kidney disease (ARPKD) with congenital hepatic fibrosis (CHF) causes portal hypertension and its complications. A transjugular intrahepatic portosystemic shunt (TIPSS) could serve as a symptomatic treatment for portal hypertension-related symptoms in these children. AIMS: To study the effect of TIPSS on portal hypertension, liver and kidney function and the long term complications. MATERIALS AND METHODS: We report on 5 children with CHF treated with a TIPSS to manage severe portal hypertension related symptoms...
March 15, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29607394/diagnostic-adequacy-and-safety-of-endoscopic-ultrasound-guided-fine-needle-aspiration-in-patients-with-lymphadenopathy-in-a-large-cohort
#13
Rinkesh K Bansal, Narendra S Choudhary, Saurabh K Patle, Mahesh K Gupta, Chitranshu Vashishtha, Gagandeep Kaur, Haimanti Sarin, Rajesh Puri
Background and study aims : The role of endoscopic-ultrasound (EUS) guided fine-needle aspiration (FNA) in patients with lymphadenopathy in terms of diagnostic adequacy and safety in large population is not well defined. The aim of this study was to evaluate diagnostic adequacy and safety of EUS-FNA in patients with lymphadenopathy. Patients and methods:  Retrospective study from October 2010 to September 2015 at tertiary care center in Delhi-NCR. We analyzed data from 1005 EUS- FNAs of lymph nodes...
April 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29606895/hepatic-encephalopathy-current-challenges-and-future-prospects
#14
REVIEW
Mirashini Swaminathan, Mark Alexander Ellul, Timothy Js Cross
Hepatic encephalopathy (HE) is a common complication of liver dysfunction, including acute liver failure and liver cirrhosis. HE presents as a spectrum of neuropsychiatric symptoms ranging from subtle fluctuating cognitive impairment to coma. It is a significant contributor of morbidity in patients with liver disease. HE is observed in acute liver failure, liver bypass procedures, for example, shunt surgry and transjugular intrahepatic portosystemic shunt, and cirrhosis. These are classified as Type A, B and C HE, respectively...
2018: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/29560652/sorafenib-induced-hepatic-encephalopathy
#15
S S Sidhu, S Agarwal, O Goyal, H Kishore, S Sidhu
A 60 year old male, known case of Hepatitis C related cirrhosis was diagnosed with exophytic Hepatocellular carcinoma (size 2.1 x 2.2 cm), Barcelona Clinic Liver Cancer Stage A, on routine surveillance. He refused liver Transplant and underwent laparoscopic segmental resection. Thereafter patient was started on Tablet Sorafenib 400mg twice daily to prevent recurrence of Hepatocellular carcinoma. On 18st post-operative day, patient presented with Hepatic encephalopathy. Routine investigations and MRI Brain were normal; Venous ammonia was high...
October 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29558045/liver-dysfunction-in-sepsis
#16
REVIEW
Ewa A Woźnica, Małgorzata Inglot, Ryszard K Woźnica, Lidia Łysenko
Despite continuous progress in medicine, sepsis remains the main cause of deaths in the intensive care unit. Liver failure complicating sepsis/septic shock has a significant impact on mortality in this group of patients. The pathophysiology of sepsis-associated liver dysfunction is very complicated and still not well understood. According to the Surviving Sepsis Campaign (SSC) Guidelines, the diagnosis of liver dysfunction during sepsis is based on the increase in bilirubin concentration >2 mg/dL and the occurrence of coagulation disorders with INR > 1...
March 20, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29551609/why-and-when-to-measure-ammonemia-in-cirrhosis
#17
Maxime Mallet, Nicolas Weiss, Dominique Thabut, Marika Rudler
Hyperammonemia plays a key role in the pathophysiology of hepatic encephalopathy (HE) and most HE treatments are ammonia-lowering drugs. However, the usefulness of measuring ammonemia in routine practice remains controversial and not recommended systematically even when neurological symptoms are present. First, ammonemia measurement should be carefully performed in order to avoid a falsely elevated result. When performed, a normal ammonemia in a cirrhotic patient with neurological symptoms should lead to reconsider the diagnosis of HE...
March 15, 2018: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29549236/living-donor-liver-transplantation-for-wilson-s-disease-associated-with-fulminant-hepatic-failure-a-case-report
#18
Yu Huang, Mitsuhisa Takatsuki, Akihiko Soyama, Masaaki Hidaka, Shinichiro Ono, Tomohiko Adachi, Takanobu Hara, Satomi Okada, Takashi Hamada, Susumu Eguchi
BACKGROUND Liver transplantation is indicated for patients with Wilson's disease (WD) who present either with acute liver failure or with end-stage liver disease and severe hepatic insufficiency as the first sign of disease. However, almost all reported cases have been treated with death donor liver transplantation. Here we report the case of a patient with WD associated with fulminant hepatic failure (WD-FHF) who underwent living donor liver transplantation (LDLT). CASE REPORT A 17-year-old female was diagnosed with WD-FHF based on high uric copper (10 603 μg/day, normal <100 μg/day), low serum ceruloplasmin (15 mg/dL, normal >20 mg/dL) and Kayser-Fleischer (K-F) corneal ring, and acute liver failure (ALF), acute renal failure (ARF) and grade 2 hepatic encephalopathy (HE)...
March 17, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29533396/diagnosis-of-minimal-hepatic-encephalopathy-a-systematic-review-of-point-of-care-diagnostic-tests
#19
REVIEW
Elliot B Tapper, Neehar D Parikh, Akbar K Waljee, Michael Volk, Noelle E Carlozzi, Anna S-F Lok
OBJECTIVES: Minimal hepatic encephalopathy (HE) is common, characterized by deficits in reaction time and executive function, and strongly associated with disability and mortality. Point-of-care diagnostics performed without specialized skills or equipment are now available, albeit with limited data regarding their generalizability. METHODS: We systematically reviewed MEDLINE, EMBASE, Cochrane Library, and Scopus for diagnostic studies of MHE using broad search terms including HE and minimal, covert, or the names of published diagnostic modalities...
March 13, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29530008/hyperglycemia-related-central-pontine-demyelinization-after-a-binge-eating-attack-in-a-patient-with-type-2-diabetes-a-case-report
#20
Rainer U Pliquett, Arno Noll, Richard Ibe, Alexandra Katz, Charlotte Ackmann, Alexandra Schreiber, Matthias Girndt
BACKGROUND: Here, we report a case of central pontine demyelinization in a type-2 diabetes patient with hyperglycemia after a binge-eating attack in the absence of a relevant hyponatremia. CASE PRESENTATION: A 55-year-old, male type-2 diabetic patient with liver cirrhosis stage Child-Pugh B was admitted due to dysmetria of his right arm, gait disturbance, dizziness, vertigo, and polyuria, polydipsia after a binge-eating attack of sweets (a whole fruit cake and 2 Liters of soft drinks)...
March 12, 2018: BMC Endocrine Disorders
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