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Hepatic encephalopathy

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https://www.readbyqxmd.com/read/29050854/pretransplantation-portal-vein-recanalization-and-transjugular-intrahepatic-portosystemic-shunt-creation-for-chronic-portal-vein-thrombosis-final-analysis-of-a-61-patient-cohort
#1
Bartley Thornburg, Kush Desai, Ryan Hickey, Elias Hohlastos, Laura Kulik, Daniel Ganger, Talia Baker, Michael Abecassis, Juan C Caicedo, Daniela Ladner, Jonathan Fryer, Ahsun Riaz, Robert J Lewandowski, Riad Salem
PURPOSE: To report the final analysis of the safety and efficacy of portal vein (PV) recanalization (PVR) and transjugular intrahepatic portosystemic shunt (TIPS) creation (PVR-TIPS) in patients with PV thrombosis (PVT) in need of liver transplantation. MATERIALS AND METHODS: Sixty-one patients with cirrhosis and PVT underwent PVR-TIPS to improve transplantation candidacy. Median patient age was 58 years (range, 22-75 y), and median pre-TIPS Model for End-Stage Liver Disease score was 14 (range, 7-42)...
October 17, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29049129/transjugular-intrahepatic-portosystemic-shunt-placement-before-abdominal-intervention-in-cirrhotic-patients-with-portal-hypertension-lessons-from-a-pilot-study
#2
Nadim Fares, Marie-Angèle Robic, Jean-Marie Péron, Fabrice Muscari, Philippe Otal, Bertrand Suc, Jean-Pierre Vinel, Christophe Bureau
BACKGROUND: Abdominal interventions are usually contraindicated in patients with cirrhosis and portal hypertension because of increased morbidity and mortality. Decreasing portal pressure with transjugular intrahepatic portosystemic shunt (TIPS) may improve patient outcomes. We report our experience with patients treated by neoadjuvant TIPS to identify those who would most benefit from this two-step procedure. PATIENTS AND METHODS: All patients treated by dedicated neoadjuvant TIPS between 2005 and March 2013 in two tertiary referral hospitals were included...
October 18, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29044307/immune-reconstitution-inflammatory-syndrome-as-a-cause-of-autoimmune-hepatitis-and-acute-liver-failure
#3
Edison Moraes Rodrigues, Rogério Fernandes, Ruth Susin, Bárbara Fior
Acute liver failure is a rare syndrome with high mortality and is often diagnosed late. Intensivist physicians play fundamental roles in the diagnostic suspicion and the management of the multiple-organic dysfunctions characteristic of this entity. Immune reconstitution inflammatory syndrome is an entity that is characterized by the paradoxical worsening of the patient's previous condition, after the initiation of antiretrovirals, triggered against either pathogens present in the host or autoantigens. Autoimmune hepatitis has recently been described as one of these autoimmune manifestations...
July 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29038875/sclerotherapy-for-rectal-varices-by-a-small-bore-needle-puncture-through-the-greater-sciatic-foramen
#4
Shuji Kariya, Miyuki Nakatani, Takuji Maruyama, Yasuyuki Ono, Yutaka Ueno, Hiroshi Shimizu, Atsushi Komemushi, Noboru Tanigawa
PURPOSE: To report a sclerotherapy technique for rectal varices consisting of direct puncture of the superior rectal vein with a small-bore sheathed needle via the greater sciatic foramen without insertion of a sheath or catheter. MATERIALS AND METHODS: The subjects of this retrospective study were three consecutive patients who underwent embolization of rectal varices, two for rupture of rectal varices and one for hepatic encephalopathy and hyperammonemia. A 5% solution of ethanolamine oleate with iodinated contrast agent (5% EOI) was injected through puncture of the superior rectal vein and carried in the blood flow, after which n-butyl cyanoacrylate mixed with lipiodol (NBCA-Lip) was immediately injected to stop the blood flow...
October 16, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29026534/recent-advances-in-hepatic-encephalopathy
#5
REVIEW
Victoria Liere, Gurkarminder Sandhu, Sharon DeMorrow
Hepatic encephalopathy describes the array of neurological alterations that occur during acute liver failure or chronic liver injury. While key players in the pathogenesis of hepatic encephalopathy, such as increases in brain ammonia, alterations in neurosteroid levels, and neuroinflammation, have been identified, there is still a paucity in our knowledge of the precise pathogenic mechanism. This review gives a brief overview of our understanding of the pathogenesis of hepatic encephalopathy and then summarizes the significant recent advances made in clinical and basic research contributing to our understanding, diagnosis, and possible treatment of hepatic encephalopathy...
2017: F1000Research
https://www.readbyqxmd.com/read/29026340/economic-impact-of-the-use-of-rifaximin-550-mg-twice-daily-for-the-treatment-of-overt-hepatic-encephalopathy-in-italy
#6
Daniela Paola Roggeri, Alessandro Roggeri
PURPOSE: Hepatic encephalopathy (HE) is associated with a reduced survival, an increased risk of hospitalization for recurrences, and a reduced health-related quality of life. The purpose of the present economic analysis was to evaluate the impact on the Italian National Health Service (INHS) expenditure of the treatment with rifaximin 550 mg twice daily (Tixteller(®)/Tixtar(®)) for the reduction of the recurrences of overt HE, with respect to the current treatment approach. PATIENTS AND METHODS: Costs associated with patients treated with rifaximin 550 mg twice daily were estimated considering the reduction in hospitalizations for HE recurrences revealed by registrative clinical trial (-50%) applied to the hospitalization rate (42...
2017: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/29023586/reduced-resting-state-connectivity-and-gray-matter-volume-correlate-with-cognitive-impairment-in-minimal-hepatic-encephalopathy
#7
Raquel García-García, Álvaro Javier Cruz-Gómez, Alba Mangas-Losada, Amparo Urios, Cristina Forn, Desamparados Escudero-García, Elena Kosenko, Juan Fermín Ordoño, Joan Tosca, Remedios Giner-Durán, Miguel Angel Serra, César Avila, Vicente Belloch, Vicente Felipo, Carmina Montoliu
BACKGROUND AND AIMS: Minimal hepatic encephalopathy (MHE) is associated with cognitive alterations and changes in connectivity. We assessed the relationship of the abnormalities of resting-state functional connectivity (rs-FC) and gray matter (GM) volume with different cognitive alterations and biochemical parameters associated to MHE. METHODS: Thirty-nine cirrhotic patients (26 without and 13 with MHE) and 24 controls were widely cognitive assessed with a battery of psychometric tests...
2017: PloS One
https://www.readbyqxmd.com/read/29020023/the-continuous-reaction-time-test-for-minimal-hepatic-encephalopathy-validated-by-a-randomized-controlled-multi-modal-intervention-a-pilot-study
#8
M M Lauridsen, S Mikkelsen, T Svensson, J Holm, C Klüver, J Gram, H Vilstrup, O B Schaffalitzky de Muckadell
BACKGROUND: Minimal hepatic encephalopathy (MHE) is clinically undetectable and the diagnosis requires psychometric tests. However, a lack of clarity exists as to whether the tests are in fact able to detect changes in cognition. AIM: To examine if the continuous reaction time test (CRT) can detect changes in cognition with anti-HE intervention in patients with cirrhosis and without clinically manifest hepatic encephalopathy (HE). METHODS: Firstly, we conducted a reproducibility analysis and secondly measured change in CRT induced by anti-HE treatment in a randomized controlled pilot study: We stratified 44 patients with liver cirrhosis and without clinically manifest HE according to a normal (n = 22) or abnormal (n = 22) CRT...
2017: PloS One
https://www.readbyqxmd.com/read/28990812/transjugular-intrahepatic-portosystemic-shunt-treatment-of-variceal-bleeding-in-an-unselected-patient-population
#9
K Rosenqvist, R Sheikhi, R Nyman, F Rorsman, P Sangfelt, C Ebeling Barbier
OBJECTIVE: To evaluate transjugular intrahepatic portosystemic shunt (TIPS) in variceal bleeding in a clinical setting. MATERIALS AND METHODS: Retrospective review of 131 patients (116 with liver cirrhosis) treated with TIPS with covered stent grafts in a single centre from 2002 to 2016. RESULTS: Survival at 1 and 2 years was 70% and 57% in patents with, and 100% at 2 years in patients without liver cirrhosis, respectively. A high Child-Pugh score and severe hepatic encephalopathy (HE) within 12 months post-TIPS were related to increased mortality...
October 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28988573/alcohol-s-effects-on-the-brain-neuroimaging-results-in-humans-and-animal-models
#10
Natalie M Zahr, Adolf Pfefferbaum
Brain imaging technology has allowed researchers to conduct rigorous studies of the dynamic course of alcoholism through periods of drinking, sobriety, and relapse and to gain insights into the effects of chronic alcoholism on the human brain. Magnetic resonance imaging (MRI) studies have distinguished alcohol-related brain effects that are permanent from those that are reversible with abstinence. In support of postmortem neuropathological studies showing degeneration of white matter, MRI studies have shown a specific vulnerability of white matter to chronic alcohol exposure...
2017: Alcohol Research: Current Reviews
https://www.readbyqxmd.com/read/28987167/nutritional-and-systemic-metabolic-disorders
#11
Serge Weis, Andreas Büttner
Vitamin deficiency disorders display a wide variety of neurologic signs and symptoms, the pathogenesis of which is not clearly understood. Metabolic encephalopathies (hepatic, hypoglycemic, and uremic) have to be considered in the differential diagnosis of patients with cognitive impairment, motor disturbances, psychiatric symptoms, seizures, and neuropathies. Calcifications (vascular wall and parenchymal) occur in the normal aging brain and in neurodegeneration; some associated genes are already described.
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28984618/reduced-th-expression-and-%C3%AE-synuclein-accumulation-contribute-towards-nigrostriatal-dysfunction-in-experimental-hepatic-encephalopathy
#12
Isabel Suárez, Guillermo Bodega, Miguel Rubio, Benjamín Fernández
PURPOSE: The present work examines α-synuclein expression in the nigrostriatal system of a rat chronic hepatic encephalopathy model induced by portacaval anastomosis (PCA). There is evidence that dopaminergic dysfunction in disease conditions is strongly associated with such expression. Possible relationships among dopaminergic neurons, astroglial cells and α-synuclein expression were sought. METHODS: Brain tissue samples from rats at 1 and 6 months post-PCA, and controls, were analysed immunohistochemically using antibodies against tyrosine hydroxylase (TH), α-synuclein, glial fibrillary acidic protein (GFAP) and ubiquitin (Ub)...
2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28984101/possible-explanations-for-the-odd-phenomenon-of-hepatic-encephalopathy-plateau-stepwise-electroencephalography-recovery
#13
Ashraf A Dahaba
No abstract text is available yet for this article.
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28982166/emergence-of-rifampin-resistant-staphylococci-after-rifaximin-administration-in-cirrhotic-patients
#14
Ji Young Chang, Seong-Eun Kim, Tae Hun Kim, So-Youn Woo, Min Sun Ryu, Yang-Hee Joo, Ko Eun Lee, Jihyun Lee, Kang Hoon Lee, Chang Mo Moon, Hye-Kyung Jung, Ki-Nam Shim, Sung-Ae Jung
OBJECTIVES: Rifaximin, a poorly absorbed antibiotics, has gut-specific therapeutic effects. Although frequently prescribed to manipulate intestinal luminal bacterial population in various diseases, the possible induction of antibacterial cross-resistance to a target pathogen is a major concern in long-term rifaximin administration. We aimed to evaluate whether rifampin-resistant staphylococci could evolve after rifaximin treatment in cirrhotic patients. METHOD: A total of 25 cirrhotic patients who were administered rifaximin for the prevention of hepatic encephalopathy were enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28978075/the-abnormality-of-thyroid-hormones-in-patients-with-type-a-hepatic-encephalopathy
#15
Lin Wang, Wanyou Yu, Wukui Cao, Wei Lu
Abnormality of thyroid hormones in liver diseases is common, but data is lacking in patients with type A hepatic encephalopathy (HE). The present study was aimed to determine whether there was an abnormality in thyroid hormones among patients with type A HE. We measured the levels of thyroid hormones in 36 acute liver failure (ALF) patients with type A HE and in 29 acute liver injury patients (international normalized ratio, INR ≥ 1.5) without encephalopathy as control. The clinical parameters associated with abnormality of thyroid hormones were evaluated...
September 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28974899/natural-history-of-covert-hepatic-encephalopathy-an-observational-study-of-366-cirrhotic-patients
#16
An-Jiang Wang, A-Ping Peng, Bi-Min Li, Na Gan, Li Pei, Xue-Lian Zheng, Jun-Bo Hong, Hai-Ying Xiao, Jia-Wei Zhong, Xuan Zhu
AIM: To explore the natural history of covert hepatic encephalopathy (CHE) in absence of medication intervention. METHODS: Consecutive outpatient cirrhotic patients in a Chinese tertiary care hospital were enrolled and evaluated for CHE diagnosis. They were followed up for a mean of 11.2 ± 1.3 mo. Time to the first cirrhosis-related complications requiring hospitalization, including overt HE (OHE), resolution of CHE and death/transplantation, were compared between CHE and no-CHE patients...
September 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28970291/covered-tips-versus-endoscopic-band-ligation-plus-propranolol-for-the-prevention-of-variceal-rebleeding-in-cirrhotic-patients-with-portal-vein-thrombosis-a-randomised-controlled-trial
#17
Yong Lv, Xingshun Qi, Chuangye He, Zhengyu Wang, Zhanxin Yin, Jing Niu, Wengang Guo, Wei Bai, Hongbo Zhang, Huahong Xie, Liping Yao, Jianhong Wang, Tao Li, Qiuhe Wang, Hui Chen, Haibo Liu, Enxing Wang, Dongdong Xia, Bohan Luo, Xiaomei Li, Jie Yuan, Na Han, Ying Zhu, Jielai Xia, Hongwei Cai, Zhiping Yang, Kaichun Wu, Daiming Fan, Guohong Han
OBJECTIVE: Limited data are available on the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). This study aimed to compare transjugular intrahepatic portosystemic shunt (TIPS) with covered stents versus endoscopic band ligation (EBL) plus propranolol for the prevention of variceal rebleeding among patients with cirrhosis and PVT. DESIGN: Consecutive cirrhotic patients (94% Child-Pugh class A or B) with PVT who had variceal bleeding in the past 6 weeks were randomly assigned to TIPS group (n=24) or EBL plus propranolol group (EBL+drug, n=25), respectively...
September 28, 2017: Gut
https://www.readbyqxmd.com/read/28968053/improving-the-identification-and-monitoring-of-cirrhosis
#18
Margaret G Keane, Charles Hensher, Stephen P Pereira
Morbidity and mortality associated with cirrhosis are on the increase. In a recent UK cohort study the incidence of cirrhosis increased by 50.6% between 1998 and 2009. Although all causes of liver disease increased during this period, this trend was primarily attributed to rising levels of alcohol misuse and obesity. Cirrhosis generally results from chronic liver damage over many years. It is characterised by fibrosis and nodularity of the parenchyma, which interferes with the synthetic, metabolic and excretory functions of the liver...
November 2016: Practitioner
https://www.readbyqxmd.com/read/28965835/dopamine-induces-glutamate-accumulation-in-astrocytes-to-disrupt-neuronal-function-leading-to-pathogenesis-of-minimal-hepatic-encephalopathy
#19
Saidan Ding, Xuebao Wang, Weishan Zhuge, Jianjing Yang, Qichuan Zhuge
Minimal hepatic encephalopathy (MHE) is induced by elevated intracranial dopamine (DA). Glutamate (Glu) toxicity is known to be involved in many neurological disorders. In this study, we investigated whether DA increased Glu levels and collaborated with Glu to impair memory. We found that DA upregulated TAAR1, leading to reduced EAAT2 expression and Glu clearance in primary cortical astrocytes (PCAs). High DA increased TAAR1 expression, and high Glu increased AMPAR expression, inducing the activation of CaN/NFAT signaling and a decrease in the production of BDNF (Brain Derived Nerve Growth Factor)/NT3 (neurotrophin-3) in primary cortical neurons (PCNs)...
September 29, 2017: Neuroscience
https://www.readbyqxmd.com/read/28965313/significant-liver-related-morbidity-after-bariatric-surgery-and-its-reversal-a-case-series
#20
Magdalena Eilenberg, Felix B Langer, Andrea Beer, Michael Trauner, Gerhard Prager, Katharina Staufer
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) occurs in up to 80% of patients with obesity. Current data suggest an improvement of NAFLD after established bariatric procedures. OBJECTIVES: This study investigated liver function impairment after Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB). SETTING: University Hospital, Bariatric Surgery Unit METHODS: In this single-center case series, consecutive in- and outpatients after bariatric surgery who presented with severe liver dysfunction from March 2014 to February 2017 were included and followed until March 2017...
September 30, 2017: Obesity Surgery
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