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Minimal hepatic encephalopathy

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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/28518283/branched-chain-amino-acids-for-people-with-hepatic-encephalopathy
#2
REVIEW
Lise Lotte Gluud, Gitte Dam, Iñigo Les, Giulio Marchesini, Mette Borre, Niels Kristian Aagaard, Hendrik Vilstrup
BACKGROUND: Hepatic encephalopathy is a brain dysfunction with neurological and psychiatric changes associated with liver insufficiency or portal-systemic shunting. The severity ranges from minor symptoms to coma. A Cochrane systematic review including 11 randomised clinical trials on branched-chain amino acids (BCAA) versus control interventions has evaluated if BCAA may benefit people with hepatic encephalopathy. OBJECTIVES: To evaluate the beneficial and harmful effects of BCAA versus any control intervention for people with hepatic encephalopathy...
May 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28505381/insulin-resistance-disrupts-the-interaction-between-akt-and-the-nmda-receptor-and-the-inactivation-of-the-camkiv-creb-pathway-in-minimal-hepatic-encephalopathy
#3
Saidan Ding, Weishan Zhuge, Jianjing Yang, Fangfang Wen, Zhu Xu, Xuebao Wang, Qichuan Zhuge
Hepatic cirrhosis-induced Minimal hepatic encephalopathy (MHE) has been characterized for cognitive dysfunction and central nervous system (CNS) insulin resistance (IR) has been acknowledged to be closely correlated with cognitive impairment while hepatic cirrhosis has been recognized to induce IR . Thus, this study aimed to investigate whether CNS IR occurred in MHE and induced MHE, as well as the underlying mechanism. We found IR in the MHE rats, an especially decreased level of the insulin receptor (InsR), and an increased serine phosphorylation of IRS1 in CNS...
May 15, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28459409/-correlation-factor-analysis-on-constipation-in-long-term-ventilated-patients-in-intensive-care-unit-a-prospective-observational-cohort-study
#4
Mingying Dai, Huimin Wang, Kun Li, Bangxu Yu, Xinting Pan
OBJECTIVE: To explore the factors associated with delayed defecation in long-term ventilated patients in intensive care unit (ICU) and their potential effect on prognosis. METHODS: A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days)...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28408357/critical-flicker-frequency-a-stethoscope-for-minimal-hepatic-encephalopathy-evaluation
#5
EDITORIAL
Praveen Sharma
No abstract text is available yet for this article.
May 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28406121/normalization-of-the-psychometric-hepatic-encephalopathy-score-for-diagnosis-of-minimal-hepatic-encephalopathy-in-turkey
#6
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/28392702/hepatic-encephalopathy-what-the-multidisciplinary-team-can-do
#7
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/28316320/critical-flicker-frequency-test-for-diagnosing-minimal-hepatic-encephalopathy-in-patients-with-cirrhosis
#8
Banu Demet Özel Coşkun, Mustafa Özen
BACKGROUND/AIMS: The critical flicker frequency (CFF) and psychometric hepatic encephalopathy score (PHES) are commonly proposed tests for detecting minimal hepatic encephalopathy (MHE); however, no studies have examined their value for detecting MHE in Turkey. MATERIALS AND METHODS: A total of 70 patients with cirrhosis without overt HE, 205 controls for PHES, and 100 controls for the CFF test were included. All the patients underwent the PHES and CFF tests during the same session...
May 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#9
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28238775/assessing-the-brain-through-the-eye-new-ways-to-explore-hepatic-encephalopathy
#10
Natalia Arias, Marta Méndez, Ignacio Alcalde, Almudena Íñigo-Portugués, Jesús Merayo-Lloves, Jaime Arias, Jorge L Arias
BACKGROUND & AIMS: Minimal hepatic encephalopathy (mHE) has been shown to affect daily functioning, quality of life, driving and overall mortality. However, little is known about treating or diagnosing early impairments in mHE. We studied one of its precipitating factors, portal hypertension which is driving the inflammatory process behind mHE. The purpose was to describe an indirect diagnostic method able to detect the pathology at early stages based on the study of the vascularization and mast cells conjunctival hyperplasia as secondary inflammatory response associated to portal hypertension...
May 1, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28230908/probiotics-for-people-with-hepatic-encephalopathy
#11
REVIEW
Rohan Dalal, Richard G McGee, Stephen M Riordan, Angela C Webster
BACKGROUND: Hepatic encephalopathy is a disorder of brain function as a result of liver failure or portosystemic shunt or both. Both hepatic encephalopathy (clinically overt) and minimal hepatic encephalopathy (not clinically overt) significantly impair patient's quality of life and daily functioning, and represent a significant burden on healthcare resources. Probiotics are live micro-organisms, which when administered in adequate amounts, may confer a health benefit on the host. OBJECTIVES: To determine the beneficial and harmful effects of probiotics in any dosage, compared with placebo or no intervention, or with any other treatment for people with any grade of acute or chronic hepatic encephalopathy...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28199774/sarcopenia-predicts-minimal-hepatic-encephalopathy-in-patients-with-liver-cirrhosis
#12
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
#13
Ying Li, Li Hong Mei, Jin Wei Qiang, Chang Xue 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...
April 7, 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
#14
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
#15
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
#16
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
#17
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...
April 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
#18
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...
April 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
#19
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
#20
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...
April 2017: Journal of Clinical Gastroenterology
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