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Minimal hepatic encephalopathy

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https://www.readbyqxmd.com/read/28199774/sarcopenia-predicts-minimal-hepatic-encephalopathy-in-patients-with-liver-cirrhosis
#1
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/28193543/reduction-of-manganese-intake-improves-neuropsychological-manifestations-in-rats-with-minimal-hepatic-encephalopathy
#2
Ying Li, Lihong Mei, Jinwei Qiang, Changxue Ji, Shuai Ju
Brain manganese deposition is led by liver dysfunction and/or portal-systemic shunting in minimal hepatic encephalopathy (MHE). Manganese is toxic and can cause cognitive disorders and extrapyramidal symptoms. Thus, reduction of manganese intake might be considered as a potential treatment strategy for MHE. In this study we aimed to investigate whether low- or no-manganese feed can improve the neuropsychological manifestations in MHE rats. Rats with MHE were established by partially ligating the portal vein and fed a manganese diet (MHE-M, 10mg per kg feed; n=24), a no-manganese diet (MHE-N; n=24) and a half-manganese diet (MHE-H; n=24) for 2, 4, 6 and 8weeks, with six rats in each subgroup...
February 11, 2017: Neuroscience
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
#3
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/28125428/falls-in-patients-with-liver-cirrhosis
#4
Meric Yildirim
Health-related quality of life (HRQOL) has become an important outcome for patients with liver cirrhosis as the number of transplantation candidates increases by the progression of treatment strategies. Falls and fall-related injuries are common in patients with liver cirrhosis and negatively affect HRQOL. Many factors increase the risk for falls such as minimal hepatic encephalopathy, psychoactive drugs, muscle strength, autonomic dysfunction, hyponatremia, and sleep problems. It is important to understand the underlying mechanisms for falls in cirrhotic patients to prevent severe injuries such as fractures, decrease healthcare costs, and improve HRQOL...
January 24, 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
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
#5
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/28092641/performance-characterization-of-a-novel-electronic-number-connection-test-to-detect-minimal-hepatic-encephalopathy-in-cirrhotic-patients
#6
Tilo Wuensch, Darius Ferenc Ruether, Caroline Zöllner, Tobias Mueller, Tobias Jung, Magnus Kaffarnik, Ursula Kassner, Eckart Schott, Stephan Kiefer, Johann Pratschke, Martin Stockmann, Maximilian Jara
BACKGROUND AND AIM: Hepatic encephalopathy (HE) is a frequent complication of cirrhosis, characterized by cognitive deficits that negatively impact patients' quality of life. The mild, minimal hepatic encephalopathy (mHE) can only be detected by psychometric tests and early mHE detection can prevent more severe complications or even survival times. Here, we aimed to investigate the feasibility and validity of the novel-developed electronic number connection test (eNCT), which is designed as a fast and easy-to-perform mHE patient self-test...
January 12, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28070704/sleep-disturbances-in-patients-of-liver-cirrhosis-with-minimal-hepatic-encephalopathy-before-and-after-lactulose-therapy
#7
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
#8
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/28059938/the-effects-of-probiotics-and-symbiotics-on-risk-factors-for-hepatic-encephalopathy-a-systematic-review
#9
Daniela Viramontes Hörner, Amanda Avery, Ruth Stow
Alterations in the levels of intestinal microbiota, endotoxemia, and inflammation are novel areas of interest in the pathogenesis of hepatic encephalopathy (HE). Probiotics and symbiotics are a promising treatment option for HE due to possible beneficial effects in modulating gut microflora and might be better tolerated and more cost-effective than the traditional treatment with lactulose, rifaximin or L-ornithine-L-aspartate. A systematic search of the electronic databases PubMed, ISI Web of Science, EMBASE, and Cochrane Library was conducted for randomized controlled clinical trials in adult patients with cirrhosis, evaluating the effect of probiotics and symbiotics in changes on intestinal microflora, reduction of endotoxemia, inflammation, and ammonia, reversal of minimal hepatic encephalopathy (MHE), prevention of overt hepatic encephalopathy (OHE), and improvement of quality of life...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28051800/%C3%A2-minimal-hepatic-encephalopathy-in-cirrhosis-how-long-to-treat
#10
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
#11
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/27988985/altered-postural-control-and-stability-in-cirrhotic-patients-with-minimal-hepatic-encephalopathy-correlate-with-cognitive-deficits
#12
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/27908802/minimal-hepatic-encephalopathy-in-children-uncommon-or-unrecognised-time-to-act
#13
EDITORIAL
Eirini Kyrana, Anil Dhawan
No abstract text is available yet for this article.
November 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27895414/hepatic-encephalopathy-ever-closer-to-its-big-bang
#14
EDITORIAL
Pablo A Souto, Ariel R Marcotegui, Lisandro Orbea, Juan Skerl, Juan Carlos Perazzo
Hepatic encephalopathy (HE) is a neuropsychiatric disorder that commonly complicates the course of patients with liver disease. Despite the fact that the syndrome was probably first recognized hundreds of years ago, the exact pathogenesis still remains unclear. Minimal hepatic encephalopathy (MHE) is the earliest form of HE and is estimated to affect more that 75% of patients with liver cirrhosis. It is characterized by cognitive impairment predominantly attention, reactiveness and integrative function with very subtle clinical manifestations...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27878780/a-pilot-study-using-lactulose-in-management-of-minimal-hepatic-encephalopathy-in-children-with-extrahepatic-portal-vein-obstruction
#15
Hanaa Mostafa El-Karaksy, Omneya Afifi, Azza Bakry, Ann Abdel Kader, Noha Saber
BACKGROUND: Minimal hepatic encephalopathy (MHE) is not associated with overt neuropsychiatric symptoms but rather with subtle changes in psychometric and/or neurophysiologic tests. We aimed to diagnose MHE in children with extrahepatic portal vein obstruction (EHPVO) and to evaluate the effect of lactulose on MHE. METHODS: A prospective study was carried out on 30 patients with EHPVO (21 males; mean age 10±2.5 years). The study was carried out in the Pediatric Hepatology Unit, Cairo University Pediatric Hospital, Cairo, Egypt, between 2011 and 2013...
February 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27878554/the-involvement-of-the-decrease-of-astrocytic-wnt5a-in-the-cognitive-decline-in-minimal-hepatic-encephalopathy
#16
Saidan Ding, Zhu Xu, Jianjing Yang, Leping Liu, Xueli Huang, Xuebao Wang, Qichuan Zhuge
Wnt signaling plays a key role in neuroprotection and synaptic plasticity. We speculate that the impairment of Wnt signaling may mediate astrocytic neurotrophins (NTs) production and the impairment of Wnt signaling to astrocytic NTs production contributes to the pathogenesis of minimal hepatic encephalopathy (MHE). Here, we found that induction of astrocytic NTs synthesis was by Wnt5a via the calcium/calmodulin-sensitive protein kinase II (CaMK II)-cAMP-response element-binding protein (CREB) pathway in PCAs...
November 22, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27843538/reversibility-of-minimal-hepatic-encephalopathy-following-liver-transplantation-in-egyptian-cirrhotic-patients
#17
Mahmoud A Osman, Moataz M Sayed, Khaled A Mansour, Shereen A Saleh, Wesam A Ibrahim, Sara M Abdelhakam, Mohamed Bahaa, Wael A Yousry, Hosam S Elbaz, Reginia N Mikhail, Azza M Hassan, Ehab H Elsayed, Dalia A Mahmoud
AIM: To evaluate the reversibility of minimal hepatic encephalopathy (MHE) following liver transplantation (LT) in Egyptian cirrhotic patients. METHODS: This prospective study included twenty patients with biopsy-proven liver cirrhosis listed for LT and twenty age- and sex-matched healthy control subjects. All underwent neuro-psychiatric examination, laboratory investigations, radiological studies and psychometric tests including trail making test A (TMT A), TMT B, digit symbol test and serial dotting test...
October 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27843536/frontal-assessment-battery-a-tool-for-screening-minimal-hepatic-encephalopathy
#18
Karina Zamprogno de Souza, Maria Penha Zago-Gomes
AIM: To apply the Frontal Assessment Battery to cirrhotic patients with or without overt hepatic encephalopathy (OHE) and controls. METHODS: The frontal assessment battery (FAB) was applied to 87 patients with liver cirrhosis (16 with and 71 without OHE) and 40 control subjects without cirrhosis treated at the alcohol and liver outpatient clinics and the gastroenterology ward of the Cassiano Antônio de Moraes University Hospital (Hospital Universitário Cassiano Antônio de Moraes - HUCAM), Espírito Santo, Brazil...
October 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27815224/minimal-hepatic-encephalopathy-in-children-with-chronic-liver-disease-prevalence-pathogenesis-and-magnetic-resonance-based-diagnosis
#19
Anshu Srivastava, Saurabh Chaturvedi, Rakesh Kumar Gupta, Rohan Malik, Amrita Mathias, Naranamangalam R Jagannathan, Sunil Jain, Chandra Mani Pandey, Surender Kumar Yachha, Ram Kishor Singh Rathore
BACKGROUND & AIMS: Data on minimal hepatic encephalopathy (MHE) in children is scarce. We aimed to study MHE in children with chronic liver disease (CLD) and to validate non-invasive objective tests which can assist in its diagnosis. METHODS: We evaluated 67 children with CLD (38 boys; age 13 [7-18] years) and 37 healthy children to determine the prevalence of MHE. We also assessed the correlation of MHE with changes in brain metabolites by magnetic resonance spectroscopy ((1)HMRS), diffusion tensor imaging (DTI) derived metrics, blood ammonia and inflammatory cytokines (interleukin-6 [IL6], tumor necrosis factor alpha [TNF-α])...
March 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/27784438/-research-advances-in-diagnosis-and-treatment-of-post-transjugular-intrahepatic-portosystemic-shunt-hepatic-encephalopathy
#20
REVIEW
J F Yang, B Q Zhang
Transjugular intrahepatic portosystemic shunt (TIPS) has become an important minimally invasive interventional technique for the treatment of complications of cirrhotic portal hypertension, and currently, it is often used in cirrhotic patients with esophagogastric variceal bleeding (EVB), intractable ascites, hepatic hydrothorax, and Budd-Chiari syndrome. On one hand, TIPS can effectively reduce portal vein pressure and the risk of EVB and intractable ascites; on the other hand, it may reduce the blood flow in liver perfusion, aggravate liver impairment, and cause porto-systemic encephalopathy...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
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