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Minimal hepatic encephalopathy

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https://www.readbyqxmd.com/read/27908802/minimal-hepatic-encephalopathy-in-children-uncommon-or-unrecognised-time-to-act
#1
EDITORIAL
Eirini Kyrana, Anil Dhawan
No abstract text is available yet for this article.
November 28, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27895414/hepatic-encephalopathy-ever-closer-to-its-big-bang
#2
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
#3
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...
November 23, 2016: 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
#4
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
#5
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
#6
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
#7
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 AND AIMS: Data on minimal hepatic encephalopathy (MHE) in children is scanty. We evaluated children with chronic liver disease (CLD) to determine prevalence of MHE, its correlation with changes in brain metabolites by magnetic resonance spectroscopy ((1)HMRS), diffusion tensor imaging (DTI) derived metrics, blood ammonia (BA) and inflammatory cytokines and the accuracy of MR based investigations for diagnosis METHODS: 67(38 boys; age 13[7-18] years) CLD and 37 healthy children were evaluated with neuropsychological tests (NPT), BA, interleukin-6 [IL6], tumor necrosis factor alpha [TNFα], magnetic resonance imaging (MRI),(1)HMRS and DTI...
November 1, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27784438/-research-advances-in-diagnosis-and-treatment-of-post-transjugular-intrahepatic-portosystemic-shunt-hepatic-encephalopathy
#8
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
https://www.readbyqxmd.com/read/27756208/effect-of-the-severity-of-liver-dysfunction-on-the-minimum-alveolar-concentration-of-sevoflurane-responding-to-an-electronic-stimulation-in-cirrhotic-patients
#9
Yan Yin, Hong Xiao, Jirimutuya Han, Weiyi Zhang, Jianguo Cheng, Tao Zhu
BACKGROUND: It has been observed that patients with liver dysfunction need lower dose anesthetic compared patients with normal liver function. The minimum amount of volatile anesthetic to achieve an optimal depth of anesthesia for these patients is still unclear. In this study, Minimum alveolar concentration (MAC) of the sevoflurane was determined using an electric stimulation and the effect of severity of liver dysfunction on the MAC was observed in cirrhotic patients. METHODS: Thirty patients undergoing upper abdominal surgery were divided into the following groups: group N (normal liver function), group A (Child-Pugh grade A) and group B (Child-Pugh grade B-C)...
October 18, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27727713/detection-of-minimal-hepatic-encephalopathy-by-comparison-of-psychometric-tests-and-critical-flicker-frequency
#10
Kishore Kv, Ravi K
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27717156/combining-arterial-spin-labeling-with-functional-magnetic-resonance-imaging-measurement-for-characterizing-patients-with-minimal-hepatic-encephalopathy
#11
Ying Li, Huaijun Liu, Jiping Yang, Xin Tian, Haiqing Yang, Zuojun Geng
AIM: Our objective is to explore key changes in brain functions in relation to minimal hepatic encephalopathy (MHE). We incorporated both resting-state functional magnetic resonance imaging (fMRI) and arterial spin labeling (ASL) to enhance the detection of MHE. METHODS: We undertook fMRI scanning for 56 MHE patients and 66 healthy controls. Region functional connectivity was carried out to assess the connectivity status between pairs of regions among 90 brain regions...
October 7, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/27711069/rifaximin-microbiota-biology-and-hepatic-encephalopathy
#12
Cedric Peleman, Michael Camilleri
Rifaximin is beneficial in the treatment of minimal hepatic encephalopathy (MHE). Kang et al. (Clin Transl Gastroenterol 7: e187; doi:10.1038/ctg.2016.44) investigated the effects of rifaximin in a mouse model of MHE-associated microbiota without concomitant liver disease. In addition to some impact on the composition of microbiota, rifaximin altered bacterial functions, ameliorated local and systemic inflammation, and reduced enterocyte glutaminase activity. We discuss these effects as well as the interpretation of the permeability studies, given the potential interaction of dysbiosis with dysfunctional intestinal barrier, leading to systemic inflammation and increased uptake of bacterial metabolites that contribute to MHE in the presence of hepatic dysfunction...
October 6, 2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27651930/combination-therapy-using-pse-and-tio-ameliorates-hepatic-encephalopathy-due-to-intrahepatic-portosystemic-venous-shunt-in-idiopathic-portal-hypertension
#13
Seiichiro Kojima, Hiroyuki Ito, Shinji Takashimizu, Hitoshi Ichikawa, Tomohiro Matsumoto, Terumitsu Hasebe, Norihito Watanabe
A 64-year-old woman treated for anemia and ascites exhibited hepatic encephalopathy. Abdominal ultrasonography and computed tomography (CT) showed communication between the portal vein and the middle hepatic vein, indicating an intrahepatic portosystemic venous shunt (PSS). Since hepatic encephalopathy of the patient was resistant to medical treatment, interventional radiology was performed for the treatment of shunt obliteration. Hepatic venography showed anastomosis between the hepatic vein branches, supporting the diagnosis of idiopathic portal hypertension (IPH)...
September 2016: Acta Radiologica Open
https://www.readbyqxmd.com/read/27651376/current-state-of-knowledge-of-hepatic-encephalopathy-part-ii-changes-in-brain-white-matter-tracts-integrity-are-associated-with-cognitive-deficits-in-minimal-hepatic-encephalopathy
#14
Carmina Montoliu, Vicente Felipo
No abstract text is available yet for this article.
September 20, 2016: Metabolic Brain Disease
https://www.readbyqxmd.com/read/27582881/the-role-of-antioxidants-and-zinc-in-minimal-hepatic-encephalopathy-a-randomized-trial
#15
Nasser Mousa, Ahmed Abdel-Razik, Ashraf Zaher, Magdy Hamed, Gamal Shiha, Narmin Effat, Sherif Elbaz, Rania Elhelaly, Mohamed Hafez, Niveen El-Wakeel, Waleed Eldars
BACKGROUND: Minimal hepatic encephalopathy (MHE) has a far-reaching impact on quality and function ability in daily life and may progress to overt hepatic encephalopathy. There is a synergistic effect between systemic oxidative stress and ammonia that is implicated in the pathogenesis of hepatic encephalopathy. The aim of this study is to investigate the effectiveness of oral supplementation of antioxidants and zinc gluconate on MHE versus lactulose. METHODS: Our study included 58 patients with cirrhosis diagnosed as having MHE by neuropsychometric tests, including number connection test part A (NCT-A), digit symbol test (DST) and block design tests (BDTs)...
September 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27571468/-hepatic-encephalopathy
#16
Davide Festi, Giovanni Marasco, Federico Ravaioli, Antonio Colecchia
Hepatic encephalopathy (HE) is a common complication of liver cirrhosis and it can manifest with a broad spectrum of neuropsychiatric abnormalities of varying severity, acuity and time course with important clinical implications. According to recent guidelines, HE has been classified into different types, depending on the severity of hepatic dysfunction, the presence of porto-systemic shunts and the number of previous episodes or persistent manifestations. From a clinical point of view, HE can be recognized as unimpaired, covert (that deals with minimal and grade 1 according to the grading of mental state), and overt (that is categorized from grade 2 to grade 4)...
July 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27560928/rifaximin-exerts-beneficial-effects-independent-of-its-ability-to-alter-microbiota-composition
#17
Dae J Kang, Genta Kakiyama, Naga S Betrapally, Jeremy Herzog, Hiroshi Nittono, Phillip B Hylemon, Huiping Zhou, Ian Carroll, Jing Yang, Patrick M Gillevet, Chunhua Jiao, Hajime Takei, William M Pandak, Takashi Iida, Douglas M Heuman, Sili Fan, Oliver Fiehn, Takao Kurosawa, Masoumeh Sikaroodi, R B Sartor, Jasmohan S Bajaj
OBJECTIVES: Rifaximin has clinical benefits in minimal hepatic encephalopathy (MHE) but the mechanism of action is unclear. The antibiotic-dependent and -independent effects of rifaximin need to be elucidated in the setting of MHE-associated microbiota. To assess the action of rifaximin on intestinal barrier, inflammatory milieu and ammonia generation independent of microbiota using rifaximin. METHODS: Four germ-free (GF) mice groups were used (1) GF, (2) GF+rifaximin, (3) Humanized with stools from an MHE patient, and (4) Humanized+rifaximin...
2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27547007/use-of-rifaximin-in-gastrointestinal-and-liver-diseases
#18
REVIEW
Rani H Shayto, Rachel Abou Mrad, Ala I Sharara
Rifaximin is a broad spectrum oral antibiotic with antimicrobial activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria. It is poorly absorbed and thus has a highly favorable safety profile. Rifaximin has been shown to be effective in the treatment of traveler's diarrhea, functional bloating and irritable bowel syndrome, small bowel bacterial overgrowth and in the prevention of recurrent overt hepatic encephalopathy. In addition, there is emerging evidence for a possible beneficial effect of rifaximin in the treatment of uncomplicated diverticular disease and in the prevention of recurrent diverticulitis...
August 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27520878/cerebrospinal-fluid-metabolomics-highlights-dysregulation-of-energy-metabolism-in-overt-hepatic-encephalopathy
#19
Nicolas Weiss, Pierre Barbier Saint Hilaire, Benoit Colsch, Foucauld Isnard, Suleiman Attala, Augustin Schaefer, Maria Del Mar Amador, Marika Rudler, Foudil Lamari, Frédéric Sedel, Dominique Thabut, Christophe Junot
BACKGROUND & AIMS: Hepatic encephalopathy (HE) is a neurological complication observed in patients with liver disease and/or porto-systemic shunt. The proportion of cirrhotic patients developing overt HE is about 20%, and 60-80% of cirrhotic patients exhibit mild cognitive impairment potentially related to minimal HE. However, the pathophysiological mechanisms of HE remain poorly understood. In this context, metabolomics was used to highlight dysfunction of metabolic pathways in cerebrospinal fluid (CSF) samples of patients suffering from HE...
August 9, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27518472/increased-serum-interleukin-6-not-minimal-hepatic-encephalopathy-predicts-poor-sleep-quality-in-nonalcoholic-cirrhotic-patients
#20
C-F Tsai, C-J Chu, Y-P Wang, P-Y Liu, Y-H Huang, H-C Lin, F-Y Lee, C-L Lu
BACKGROUND: Sleep-wake disturbances are common in patients with cirrhosis and have a considerable effect on health-related quality of life; however, the underlying mechanism behind the phenomenon is unclear. Cytokines are involved in the mediation of signalling pathways regulating fibrogenesis, leading to cirrhosis. In addition, increased cytokines could contribute to sleep disturbances. AIM: To determine the relationship between pro-inflammatory cytokines and sleep disturbance in cirrhotic patients...
October 2016: Alimentary Pharmacology & Therapeutics
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