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Hepatic encephalopathy

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https://www.readbyqxmd.com/read/29235218/efficacy-and-safety-of-rifaximin-in-japanese-patients-with-hepatic-encephalopathy-a-phase-2-3-multicenter-randomized-evaluator-blinded-active-controlled-trial-and-a-phase-3-multicenter-open-trial
#1
Kazuyuki Suzuki, Ryujin Endo, Yasuhiro Takikawa, Fuminori Moriyasu, Yutaka Aoyagi, Hisataka Moriwaki, Shuji Terai, Isao Sakaida, Yoshiyuki Sakai, Shuhei Nishiguchi, Toru Ishikawa, Hitoshi Takagi, Atsushi Naganuma, Takuya Genda, Takafumi Ichida, Koichi Takaguchi, Katsuhiko Miyazawa, Kiwamu Okita
AIM: The efficacy and safety of rifaximin in the treatment of hepatic encephalopathy (HE) are widely known, but they have not been confirmed in Japanese patients with HE. Thus, two prospective, randomized studies (phase 2/3 study and phase 3 study) were conducted. METHODS: Subjects with grade I or II HE and hyperammonemia were enrolled. The phase 2/3 study, which was a randomized, evaluator-blinded, active-comparator, parallel-group study, was conducted at 37 institutions in Japan...
December 13, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29234200/nutrition-and-muscle-in-cirrhosis
#2
REVIEW
Anil C Anand
As the cirrhosis progresses, development of complication like ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma signify increasing risk of short term mortality. Malnutrition and muscle wasting (sarcopenia) is yet other complications that negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Conventionally, these are not routinely looked for, because nutritional assessment can be a difficult especially if there is associated fluid retention and/or obesity...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234193/results-of-portosystemic-shunt-embolization-in-selected-patients-with-cirrhosis-and-recurrent-hepatic-encephalopathy
#3
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29231188/major-hepatic-complications-in-ursodeoxycholic-acid-treated-patients-with-primary-biliary-cholangitis-risk-factors-and-time-trends-in-incidence-and-outcome
#4
Maren H Harms, Willem J Lammers, Douglas Thorburn, Christophe Corpechot, Pietro Invernizzi, Harry L A Janssen, Pier M Battezzati, Frederik Nevens, Keith D Lindor, Annarosa Floreani, Cyriel Y Ponsioen, Marlyn J Mayo, George N Dalekos, Tony Bruns, Albert Parés, Andrew L Mason, Xavier Verhelst, Kris V Kowdley, Jorn C Goet, Gideon M Hirschfield, Bettina E Hansen, Henk R van Buuren
OBJECTIVES: In this era of near universal ursodeoxycholic acid (UDCA) treatment for primary biliary cholangitis (PBC), progression to cirrhosis still occurs in an important proportion of patients. The aim of this study was to describe the incidence of cirrhosis-associated complications in patients with PBC and assess risk factors and impact on survival. METHODS: Cohorts of UDCA-treated patients from 16 European and North-American liver centers were included. We used Cox proportional hazards assumptions and Kaplan-Meier estimates...
December 12, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29230145/practical-issues-in-the-management-of-overt-hepatic-encephalopathy
#5
Ganesh Pantham, Kevin D Mullen
Hepatic encephalopathy (HE) is a condition that encompasses a range of neuropsychiatric abnormalities in patients with significant liver disease. Overt HE occurs in approximately 30% to 45% of patients with cirrhosis. This article discusses practical issues in the management of patients with overt HE and cirrhosis, including a recently developed 4-pronged approach that consists of identifying and correcting precipitating factors, recognizing and treating concomitant medical conditions, commencing empiric treatment, and caring for the unconscious patient...
November 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29230112/clinical-images-transjugular-intrahepatic-portosystemic-shunt-reduction-for-management-of-recurrent-hepatic-encephalopathy
#6
Hafez Khalili, Daryl Goldman, Sarah Frischhertz, David Kirsch
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29227269/reye-ray-s-syndrome-a-problem-everyone-should-remember
#7
I Chornomydz, O Boyarchuk, A Chornomydz
Reye syndrome is a rare but a very dangerous emergency that children and teenagers suffer. This threatening condition occurs during the treatment of fever in the clinical course of viral diseases with drugs containing acetylsalicylic acid and other salicylates. The high mortality rate from this disease is associated with the development of a rapidly progressing toxic encephalopathy and hepatic insufficiency. The etiology and pathogenesis of the Reye syndrome, despite the large number of investigations, is not clear enough...
November 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29226766/a-case-report-of-living-donor-liver-transplantation-for-fulminant-hepatitis-related-to-hepatitis-e-virus-infection
#8
Keita Shimata, Yasuhiko Sugawara, Hidekazu Yamamoto, Hiroaki Okamoto, Koushi Uchida, Seiichi Kawabata, Kaori Isono, Shintaro Hayashida, Yukihiro Inomata
Hepatitis E virus (HEV) infection which may become fulminant, especially in elderly people is more common than previously recognized in develop countries. Here we report successful living-donor liver transplantation (LDLT) in a case of acute liver failure due to HEV. A 63-year-old Japanese man with no previous history of liver disease was admitted for severe acute hepatitis. Detection of anti-HEV immunoglobulin A established a diagnosis of this virus-related liver failure. The patient suffered from hepatic encephalopathy 10 days after symptom onset and underwent LDLT...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29225269/late-relapse-after-a-sustained-virologic-response-at-24-weeks-after-treatment-with-daclatasvir-and-asunaprevir-combination-therapy-for-chronic-hepatitis-c-virus-genotype-1b-infection-with-liver-cirrhosis
#9
Haruki Uojima, Shuko Murakami, Seigo Nakatani, Hisashi Hidaka, Atsuko Takeuchi, Yoshiaki Tanaka, Tomoyoshi Inoue, Keiko Yamane, Kousuke Kubota, Takahide Nakazawa, Akitaka Shibuya, Yasuhito Tanaka, Wasaburo Koizumi
There have been few studies on relapse after a sustained virological response in hepatitis C virus (HCV) patients treated with interferon-free regimens. Thus, the risk of late relapse in patients treated with interferon-free therapy remains unclear. A 67-year-old woman with HCV genotype 1b and liver cirrhosis received oral daclatasvir and asunaprevir. Combination therapy was stopped after 4 weeks because of an episode of encephalopathy. Nonetheless, an HCV polymerase chain reaction at 24 weeks posttreatment was negative...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29221886/a-model-including-sarcopenia-surpasses-the-meld-score-in-predicting-waiting-list-mortality-in-cirrhotic-liver-transplant-candidates
#10
Jeroen Laurens Ad van Vugt, Louise Johanna Maria Alferink, Stefan Buettner, Marcia Patricia Gaspersz, Daphne Bot, Sarwa Darwish Murad, Shirin Feshtali, Peter Martinus Adranius van Ooijen, Wojciech Grzegorz Polak, Robert Jan Porte, Bart van Hoek, Aad Pieter van den Berg, Herold Johnny Metselaar, Jan Nicolaas Maria IJzermans
BACKGROUND AND AIMS: Frail patients with low MELD scores may be underprioritised. Low skeletal muscle mass (i.e. sarcopenia) has been identified as risk factor for waiting list mortality and a recent study proposed to incorporate sarcopenia in the MELD score (i.e. MELD-Sarcopenia score). We aimed to investigate the association between sarcopenia and waiting list mortality, and to validate the MELD-Sarcopenia score (i.e. MELD+10.35∗Sarcopenia). METHODS: We identified consecutive patients with cirrhosis listed for liver transplantation in the Eurotransplant registry between 2007-2014 and measured skeletal muscle mass on computed tomography (CT)...
December 5, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29216388/insulin-resistance-disrupts-the-interaction-between-akt-and-the-nmda-receptor-and-the-inactivation-of-the-camkiv-creb-pathway-in-minimal-hepatic-encephalopathy
#11
Saidan Ding, Weishan Zhuge, Jianjing Yang, Fangfang Wen, Zhu Xu, Xuebao Wang, Qichuan Zhuge
No abstract text is available yet for this article.
December 5, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29216295/alpha-1-antichymotrypsin-is-involved-in-astrocyte-injury-in-concert-with-arginine-vasopressin-during-the-development-of-acute-hepatic-encephalopathy
#12
Jonghyuk Park, Takahiro Masaki, Yoshihiro Mezaki, Hiroshi Yokoyama, Mariko Nakamura, Haruka Maehashi, Takahiko J Fujimi, Sabine S Gouraud, Keisuke Nagatsuma, Madoka Nakagomi, Naofumi Kimura, Tomokazu Matsuura
BACKGROUND AND AIMS: We developed a bio-artificial liver (BAL) using a radial-flow bioreactor and rescued mini-pig models with lethal acute liver failure (ALF). The point of the rescue is the recovery from hepatic encephalopathy (HE). HE on ALF has sometimes resulted in brain death following brain edema with astrocyte swelling. Several factors, including ammonia and glutamine, have been reported to induce astrocyte swelling and injury. However, many clinicians believe that there are any other factors involved in the development of HE...
2017: PloS One
https://www.readbyqxmd.com/read/29201804/aneurysm-of-portosystemic-fistula-a-case-report-and-review-of-literature
#13
Sila Ulus, Gulhan Ertan Akan, Cengiz Erol
Aim: A case of asymptomatic aneurysm of spontaneous portosystemic venous fistula (SPVF) with the radiologic findings is described. Background: Although advances and more widespread use of ultrasound (US) and computed tomog -raphy angiography (CTA) have enabled more detection of SPVF in the liver, it is a rare entity. Case report: A 49-year-old male was referred to our hospital's nephrology outpatient clinic due to hypertension. Abdominal sonography examination detected a well-defined cystic lesion adjacent to the middle hepatic vein in the liver...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29201772/managing-encephalopathy-in-the-outpatient-setting
#14
REVIEW
Tarana Gupta, Sahaj Rathi, Radha K Dhiman
In cirrhosis of liver, hepatic encephalopathy (HE) has an important impact on health-related quality of life. It is important to define whether HE is episodic, recurrent, or persistent; types A, B, or C; overt HE or covert HE; and spontaneous or precipitated. The overt HE is clinically evident and needs hospitalization. Nonabsorbable disaccharides, rifaximin, and probiotics are proven to be useful in the treatment of overt HE. Covert HE includes both minimal HE and grade I HE. It is not apparent on routine clinical examination...
January 2017: Euroasian journal of hepato-gastroenterology
https://www.readbyqxmd.com/read/29201764/predictive-value-of-mean-platelet-volume-in-variceal-bleeding-due-to-cirrhotic-portal-hypertension
#15
Mehmet A Erdogan, Ali R Benli, Serap B Acmali, Mustafa Koroglu, Yahya Atayan, Ahmet Danalioglu, Burcak Kayhan
Aim: To investigate whether mean platelet volume (MPV) is a predictor of variceal bleeding in patients with cirrhotic portal hypertension. Materials and methods: This prospective cohort was performed in the internal medicine department of our tertiary care center. Cirrhotic patients were allocated into two groups: Group I consisted of 31 cases without a history of variceal bleeding, whereas group II was made up of 31 patients with a history of variceal bleeding...
January 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29201193/effect-of-different-treatments-and-alcohol-addiction-on-gut-microbiota-in-minimal-hepatic-encephalopathy-patients
#16
Zan Zuo, Hong Fan, Xiao-Dan Tang, Yan-Min Chen, Lin-Ting Xun, Yan Li, Zheng-Ji Song, Hui-Qiong Zhai
Minimal hepatic encephalopathy (MHE) is caused by dysbiosis of gut microbiota, particularly the ammonia-producing bacteria. Given the efficacy of certain treatments on MHE and the connection between alcoholism and MHE, a thorough understanding of how these strategies affect the gut microbiota in patients (alcoholic or non-alcoholic) will facilitate the assessment of their efficacy in the reshaping of gut microbiota. In the present study, a metagenomics approach was adopted to reveal alterations in gut microbiota of 14 MHE patients following treatment with rifaximin alone or rifaximin plus probiotics...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29199145/acetaminophen-induced-acute-liver-failure-is-more-common-and-more-severe-in-women
#17
Jessica B Rubin, Bilal Hameed, Michelle Gottfried, William M Lee, Monika Sarkar
BACKGROUND & AIMS: Acetaminophen overdose is the leading cause of acute liver injury (ALI) and acute liver failure (ALF) in the developed world. Sex differences in acetaminophen-induced hepatotoxicity have not been described. METHODS: We collected data from the Acute Liver Failure Study Group cohort, a national registry of 32 academic medical centers in North America of adults with ALI or ALF, including 1162 patients with acetaminophen-induced ALI (n=250) or acetaminophen-induced ALF (n=912) from January 2000 through September 2016...
November 30, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29196972/proximal-total-splenic-artery-embolization-for-refractory-hepatic-encephalopathy
#18
Harufumi Maki, Junichi Kaneko, Junichi Arita, Nobuhisa Akamatsu, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Sumihito Tamura, Hidemasa Takao, Eisuke Shibata, Norihiro Kokudo
A Japanese woman with a history of Kasai operation for biliary atresia had living-donor liver transplantation at the age of 22. The first episode of refractory HE and late cellular rejection was treated by a high dose of methylprednisolone. The second episode of refractory HE was treated by balloon-occluded retrograde transvenous obliteration for a spleno-renal shunt. However, the third episode of refractory HE occurred 11 years after liver transplantation. The liver cirrhosis and hypersplenism were present with a Child-Pugh score of C-10...
December 1, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29187686/-portal-systemic-encephalopathy-with-bilateral-thalamic-and-internal-capsule-lesions-using-diffusion-weighted-mri-in-a-super-aged-patient
#19
Michiaki Matsuda, Shinpei Takesako, Mitsuhiro Nakazaki, Toru Nandate, Fujio Umehara
We describe the case of a 90-year-old woman who was hospitalized in July 2016 and subsequently experienced a sudden decline in consciousness level resulting in a state of deep coma. Involuntary movements were not observed, and bilateral Babinski signs were inconclusive. Diffusion-weighted MRI (DWI) of the brain showed bilateral hyperintensity in the thalamus and internal capsule, laboratory testing detected high levels of plasma ammonia, and an electroencephalogram showed delta waves and triphasic waves predominantly in the frontal lobe...
November 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29179682/faecal-bacterial-microbiota-in-patients-with-cirrhosis-and-the-effect-of-lactulose-administration
#20
Aditya Narayan Sarangi, Amit Goel, Ankur Singh, Avani Sasi, Rakesh Aggarwal
BACKGROUND: Gut microbiota may be altered in patients with cirrhosis, and may further change after administration of lactulose. We studied the composition of gut microbiota in patients with cirrhosis and assessed the effect on it of lactulose administration. METHODS: Stool specimens were collected from 35 patients with cirrhosis (male 26; median [range] age: 42 [29-65] years) and 18 healthy controls (male 14; 44.5 [24-67] years); 21 patients provided another specimen after lactulose administration for 55 [42-77] days...
November 28, 2017: BMC Gastroenterology
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