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https://www.readbyqxmd.com/read/28533911/hepatic-encephalopathy
#1
Peter Ferenci
Hepatic encephalopathy (HE) is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases. The precise pathophysiology of HE is still under discussion; the leading hypothesis focus on the role of neurotoxins, impaired neurotransmission due to metabolic changes in liver failure, changes in brain energy metabolism, systemic inflammatory response and alterations of the blood brain barrier. HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28511674/predictors-of-fifty-days-in-hospital-mortality-in-patients-with-culture-negative-neutrocytic-ascites
#2
Chinmaya Kumar Bal, Vikram Bhatia, Ripu Daman
BACKGROUND: Culture negative neutrocytic ascites is a variant of spontaneous bacterial peritonitis. But there are conflicting reports regarding the mortality associated with culture negativeneutrocytic ascites. Therefore we aim to determine the predictors of mortality associated with culture negativeneutrocytic ascites in a larger sample population. METHODS: We analysed 170 patients consecutively admitted to intensive care unit with diagnosis of culture negative neutrocytic ascites...
May 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28510807/incidence-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-tips-according-to-its-severity-and-temporal-grading-classification
#3
Paolo Fonio, Andrea Discalzi, Marco Calandri, Andrea Doriguzzi Breatta, Laura Bergamasco, Silvia Martini, Antonio Ottobrelli, Dorico Righi, Giovanni Gandini
OBJECTIVES: To evaluate hepatic encephalopathy (HE) incidence after transjugular intrahepatic portosystemic shunt (TIPS) and classify by gravity and frequency. METHODS: This is a retrospective study of 75 patients with no previous episodes of HE who underwent TIPS between 2008 and 2014 with clinical follow-up after 6 and 12 months. Patient risk factors evaluated include age, INR (international normalized ratio), creatinine, bilirubin, and MELD score (Model for End-of-stage Liver Disease)...
May 16, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28508963/hemodiafiltration-for-hepatic-encephalopathy-induced-by-budd-chiari-syndrome-in-a-patient-with-end-stage-kidney-disease
#4
Takuya Wakamatsu, Suguru Yamamoto, Kenya Kamimura, Takeshi Nakatsue, Noriaki Iino, Seitaro Iguchi, Yoshikatsu Kaneko, Shin Goto, Junichiro James Kazama, Ichiei Narita
A 36-year-old woman who was undergoing dialysis for end-stage kidney disease (ESKD) was admitted to our hospital with consciousness disorder. She was diagnosed with Budd-Chiari syndrome due to antiphospholipid syndrome at the age of 28 years. Her kidney function and leg edema gradually deteriorated. After initiation of hemodialysis (HD), transient loss of consciousness due to hepatic encephalopathy during HD treatment occurred frequently. Her kidney replacement therapy was changed to online hemodiafiltration (HDF), which dramatically improved her hepatic coma...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28507634/multi-system-complications-after-intravenous-cocaine-abuse
#5
Lidija Petkovska, Andon Chibishev, Aleksandra Stevcevska, Ivica Smokovski, Dusan Petkovski, Emilija Antova
BACKGROUND: Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration. AIM: We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome. CASE PRESENTATION: Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28503286/fulminant-hepatic-failure-due-to-metastatic-choroidal-melanoma
#6
Emmanuel Escobar-Valdivia, Roberto Monreal-Robles, Guillermo Delgado-García, Badir Hernández-Velazquez
BACKGROUND: Acute liver failure (ALF) as a consequence of metastatic disease is extremely uncommon. The liver is the most commonly affected organ by metastatic disease, but only a few cases of ALF in the setting of metastatic choroidal melanoma have been reported. CASE PRESENTATION: We describe the case of a 47-year-old man with right upper quadrant pain, progressive jaundice, and unintentional weight loss. He also reported that he had experienced reduced left visual acuity which progressed to blindness over 2 months...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28501971/electrolyte-and-acid-base-disturbances-in-end-stage-liver-disease-a-physiopathological-approach
#7
REVIEW
José Víctor Jiménez, Diego Luis Carrillo-Pérez, Rodrigo Rosado-Canto, Ignacio García-Juárez, Aldo Torre, David Kershenobich, Eduardo Carrillo-Maravilla
Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination...
May 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28499323/-cmv-associated-acute-liver-failure-in-a-patient-receiving-tocilizumab-for-systemic-lupus-erythematosus
#8
Sophie Fromhold-Treu, Andreas Erbersdobler, Manuela Turan, Gunther Neeck, Georg Lamprecht
A 41-year-old female patient was admitted because of febrile jaundice and acute liver failure. The quick and the bilirubin were 21 % and 258 µmol/l, and there was hepatic encephalopathy I°. AST and AP had a maximum of 612 and 215 U/l. Despite a strong left shift in the differential, the CRP had a maximum of 15 mg/l. Because of an atypically presenting systemic lupus erythematosus, she had been treated with Azathioprine, steroids and Tocilizumab until 12 days before admission. The diagnostic workup revealed CMV hepatitis and necrotizing hepatopathy, which was interpreted as toxic hepatitis...
May 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28494539/-current-status-and-perspectives-of-diagnosis-and-treatment-of-complications-related-to-liver-cirrhosis
#9
Y M Nan
Liver cirrhosis is the severe period of chronic liver diseases, especially decompensated liver cirrhosis and its complications, such as ascites, esophagogastric variceal bleeding, hepatic encephalopathy, acute kidney injury, and hepatocellular carcinoma, which greatly affect patients' quality of life and even threaten their lives. Early prevention and treatment of the causes of development and progression and pathogenic mechanism may slow down or reverse liver cirrhosis and its severe complications. Once the disease progresses to portal hypertension and related complications, it is very important to select preventive measures for acute exacerbation of different complications, as well as the methods and timing for treatment in acute stage, which may help to save patients' lives and improve their prognosis...
April 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28467096/clif-c-aclf-score-is-a-better-mortality-predictor-than-meld-meld-na-and-ctp-in-patients-with-acute-on-chronic-liver-failure-admitted-to-the-ward
#10
Rita Barosa, Lídia Roque Ramos, Marta Patita, Gonçalo Nunes, Jorge Fonseca
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is a frequent syndrome associated with high mortality. The aims of the present study are: a) comparing the Chronic Liver Failure Consortium (CLIF-C) ACLF Model for End-Stage Liver Disease (MELD), MELD Sodium (MELD-Na) and Child-Turcotte-Pugh (CTP) scores for prediction of short/medium term mortality; b) identifying ACLF prevalence in patients admitted to the ward; and c) comparing mortality between non-ACLF/ACLF. METHODS: Retrospective cohort study of 177 patients admitted to the Gastroenterology ward for acute decompensation of cirrhosis...
May 3, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28464883/late-presentation-of-chronic-viral-hepatitis-for-medical-care-a-consensus-definition
#11
Stefan Mauss, Stanislas Pol, Maria Buti, Erika Duffell, Charles Gore, Jeffrey V Lazarus, Hilje Logtenberg-van der Grient, Jens Lundgren, Antons Mozalevskis, Dorthe Raben, Eberhard Schatz, Stefan Wiktor, Jürgen K Rockstroh
INTRODUCTION: We present two consensus definitions of advanced and late stage liver disease being used as epidemiological tools. These definitions can be applied to assess the morbidity caused by liver diseases in different health care systems. We focus is on hepatitis B and C virus infections, because effective and well tolerated treatments for both of these infections have greatly improved our ability to successfully treat and prevent advanced and late stage disease, especially if diagnosed early...
May 3, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28444411/-acute-liver-failure
#12
A Koch, C Trautwein, F Tacke
Acute liver failure (ALF) is a rare, but life-threatening disease that is characterized by the acute onset of jaundice, coagulopathy, and hepatic encephalopathy (HE) in patients without pre-existing liver disease. Main causes in Germany are drug toxicity, acetaminophen overdose, and viral hepatitis (A, B, E). For the initial assessment of patients with ALF and the diagnostic algorithm, the early detection of HE, exclusion of liver cirrhosis, immediate diagnosis of the underlying etiology, and evaluation for the necessity of liver transplantation (LT) are critical...
May 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28443156/serum-25-hydroxyvitamin-d-deficiency-and-hepatic-encephalopathy-in-chronic-liver-disease
#13
Helen Vidot, Alison Potter, Robert Cheng, Margaret Allman-Farinelli, Nicholas Shackel
AIM: To investigate the relationship between 25-hydroxyvitamin D (25-OHD) deficiency and hepatic encephalopathy (HE) in patients with chronic liver disease (CLD). METHODS: A retrospective analysis of the results of 392 adult patients with chronic liver disease who were assessed for liver transplantation between 2006 and 2010 was undertaken. HE, severity of CLD, nutritional status and 25-OHD were analysed in patients assessed for liver transplantation between 2006 and 2010...
April 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28433104/wilson-disease-symptomatic-liver-therapy
#14
Jan Pfeiffenberger, Karl-Heinz Weiss, Wolfgang Stremmel
Wilson disease leads to symptomatic impairment of liver function or liver cirrhosis. Strict adherence to decoppering agents is essential in these patients. Secondary prevention of additional hepatic damage by avoidance of other toxic substances (e.g., alcohol, drugs) and sufficient calorie intake is recommended. Routine examinations in cirrhotic patients include screening for signs of portal hypertension (esophagus varices), development of ascites, and hepatic encephalopathy. Where varices are present, primary or secondary preventive interventions may include treatment with nonselective beta-blockers or variceal ligation, similar to the approach in patients with liver cirrhosis due to other etiologies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28406121/normalization-of-the-psychometric-hepatic-encephalopathy-score-for-diagnosis-of-minimal-hepatic-encephalopathy-in-turkey
#15
Bdo Coskun, M Ozen, S Gursoy, O Ozbakir, O K Poyrazoglu, M Baskol, G C Sezgin, M Yucesoy
AIM: To construct normal values for the tests of the psychometric hepatic encephalopathy score (PHES) and evaluate the prevalence of minimal hepatic encephalopathy (MHE) among Turkish patients with liver cirrhosis. MATERIALS AND METHODS: One hundred and eighty-five healthy subjects and sixty patients with liver cirrhosis without overt hepatic encephalopathy were included in the study. All subjects underwent psychometric tests, which include number connection test-A and B (NCT-A/B), serial dotting test (DST), line drawing test (LDT), and digit symbol test (DST) in the same day...
April 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28403980/characteristics-management-and-outcomes-of-patients-with-hepatocellular-carcinoma-in-africa-a-multicountry-observational-study-from-the-africa-liver-cancer-consortium
#16
Ju Dong Yang, Essa A Mohamed, Ashraf O Abdel Aziz, Hend I Shousha, Mohamed B Hashem, Mohamed M Nabeel, Ahmed H Abdelmaksoud, Tamer M Elbaz, Mary Y Afihene, Babatunde M Duduyemi, Joshua P Ayawin, Adam Gyedu, Marie-Jeanne Lohouès-Kouacou, Antonin W Ndjitoyap Ndam, Ehab F Moustafa, Sahar M Hassany, Abdelmajeed M Moussa, Rose A Ugiagbe, Casimir E Omuemu, Richard Anthony, Dennis Palmer, Albert F Nyanga, Abraham O Malu, Solomon Obekpa, Abdelmounem E Abdo, Awatif I Siddig, Hatim M Y Mudawi, Uchenna Okonkwo, Mbang Kooffreh-Ada, Yaw A Awuku, Yvonne A Nartey, Elizabeth T Abbew, Nana A Awuku, Jesse A Otegbayo, Kolawole O Akande, Hailemichael M Desalegn, Abidemi E Omonisi, Akande O Ajayi, Edith N Okeke, Mary J Duguru, Pantong M Davwar, Michael C Okorie, Shettima Mustapha, Jose D Debes, Ponsiano Ocama, Olufunmilayo A Lesi, Emuobor Odeghe, Ruth Bello, Charles Onyekwere, Francis Ekere, Rufina Igetei, Mitchell A Mah'moud, Benyam Addissie, Hawa M Ali, Gregory J Gores, Mark D Topazian, Lewis R Roberts
BACKGROUND: Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa. METHODS: We did a multicentre, multicountry, retrospective observational cohort study, inviting investigators from the African Network for Gastrointestinal and Liver Diseases to participate in the consortium to develop hepatocellular carcinoma research databases and biospecimen repositories...
February 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403092/hyperammonemic-coma-after-craniotomy-hepatic-encephalopathy-from-upper-gastrointestinal-hemorrhage-or-valproate-side-effect-case-report-and-literature-review
#17
REVIEW
Xiaopeng Guo, Junji Wei, Lu Gao, Bing Xing, Zhiqin Xu
RATIONALE: Postoperative coma is not uncommon in patients after craniotomy. It generally presents as mental state changes and is usually caused by intracranial hematoma, brain edema, or swelling. Hyperammonemia can also result in postoperative coma; however, it is rarely recognized as a potential cause in coma patients. Hyperammonemic coma is determined through a complicated differential diagnosis, and although it can also be induced as a side effect of valproate (VPA), this cause is frequently unrecognized or confused with upper gastrointestinal hemorrhage (UGH)-induced hepatic encephalopathy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28392702/hepatic-encephalopathy-what-the-multidisciplinary-team-can-do
#18
REVIEW
Andy Liu, Eric R Yoo, Osama Siddique, Ryan B Perumpail, George Cholankeril, Aijaz Ahmed
Hepatic encephalopathy (HE) is a complex disease requiring a multidisciplinary approach among specialists, primary care team, family, and caregivers. HE is currently a diagnosis of exclusion, requiring an extensive workup to exclude other possible etiologies, including mental status changes, metabolic, infectious, traumatic, and iatrogenic causes. The categorization of HE encompasses a continuum, varying from the clinically silent minimal HE (MHE), which is only detectable using psychometric tests, to overt HE, which is further divided into four grades of severity...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28383566/adventures-in-developing-an-app-for-covert-hepatic-encephalopathy
#19
Jasmohan S Bajaj
Patient-reported outcomes (PRO) are critical to understand the spectrum of disease in chronic conditions but are often ignored in clinical practice. Cirrhosis, one of the leading causes of morbidity, is associated with severely impaired PROs likely due to covert hepatic encephalopathy (CHE). The clinical relevance and logistic barriers to routine CHE testing led us to develop the "EncephalApp Stroop App", which is now being used to diagnose CHE. The Primer discusses this example which can potentially be applied to other diseases...
April 6, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28375406/hot-topics-in-primary-care-diagnosis-of-cirrhosis-and-evaluation-of-hepatic-encephalopathy-common-errors-and-their-significance-for-the-pcp
#20
REVIEW
Steven L Flamm
Cirrhosis has become the focus of greater attention in recent years largely because of the increasing prevalence of 2 of its most common causes: chronic viral hepatitis and steatohepatitis (a subset of nonalcoholic fatty liver disease [NAFLD]). Cirrhosis is the result of progressive destruction and regeneration of the liver parenchyma due to chronic liver disease (CLD).
April 2017: Journal of Family Practice
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