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Hepatic encephalopathy

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https://www.readbyqxmd.com/read/29678162/tacrolimus-induced-parkinsonism-in-a-patient-after-liver-transplantation-case-report
#1
Karin Gmitterová, Michal Minár, Miroslav Žigrai, Zuzana Košutzká, Alice Kušnírová, Peter Valkovič
BACKGROUND: Hepatic encephalopathy may manifest by a wide spectrum of neuropsychiatric symptoms, including cognitive impairment, seizures or extrapyramidal symptoms. The liver transplant can lead to improvement of the signs of encephalopathy but subsequent immunosuppressive treatment might possess pronounced neurotoxicity. CASE PRESENTATION: We present a case report of a patient with chronic liver disease who developed signs of Parkinsonism after an orthotopic liver transplant, with consecutive immunosuppressant treatment with tacrolimus...
April 20, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29675988/dose-dependent-impact-of-proton-pump-inhibitors-on-the-clinical-course-of-spontaneous-bacterial-peritonitis
#2
Tammo L Tergast, Anika Wranke, Hans Laser, Svetlana Gerbel, Michael P Manns, Markus Cornberg, Benjamin Maasoumy
BACKGROUND & AIMS: Spontaneous bacterial peritonitis (SBP) is a severe complication in patients with liver cirrhosis leading to acute kidney injury (AKI), hepatic encephalopathy (HE) and a high mortality. In this study we aimed to investigate the impact of proton pump inhibitors (PPI) and the potential relevance of the taken dosage on the incidence and clinical course of SBP. METHODS: Overall, 613 consecutive patients with decompensated liver cirrhosis were included...
April 19, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29674011/endovascular-transjugular-occlusion-of-congenital-intrahepatic-portosystemic-venous-shunt-using-simultaneous-fluoroscopy-and-transabdominal-ultrasound-guidance-report-of-2-cases
#3
Ujjwal Gorsi, Naveen Kalra, Pankaj Gupta, Karthik Rayasam, Babu Ram Thapa, Hemant Bhagat, Niranjan Khandelwal
Congenital intrahepatic portosystemic venous shunts (CIPVS) are rare anomalies that can be detected before birth or in early infancy or later in life. Symptomatic shunts are treated as they carry high risk of complications like hepatic encephalopathy. Various treatment options include surgery, endovascular embolization, and percutaneous closure devices. We treated 2 infants with CIPVS successfully by endovascular embolization of the shunt using vascular plug through transjugular route. Transabdominal ultrasound guidance in addition to fluoroscopy was used at the time of vascular plug placement...
March 20, 2018: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29668568/transjugular-intrahepatic-portosystemic-shunt-insertion-for-the-management-of-portal-hypertension-in-children
#4
Lauren Johansen, Patrick McKiernan, Khalid Sharif, Simon McGuirk
OBJECTIVES: To describe our 20-year experience with transjugular intrahepatic portosystemic shunt (TIPSS) procedures for children with resistant portal hypertension (PHTN). METHODS: Retrospective review of all children that had a TIPSS performed at Birmingham Children's Hospital from 1 January 1995 - 1 January 2015. RESULTS: 40 children underwent 42 attempted TIPSS for resistant PHTN with recurrent variceal bleeding (n = 35), refractory ascites (n = 4), and hypersplenism (n = 1)...
April 17, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29668561/a-randomized-controlled-trial-comparing-nitazoxanide-plus-lactulose-with-lactulose-alone-in-treatment-of-overt-hepatic-encephalopathy
#5
Sherief Abd-Elsalam, Ferial El-Kalla, Nadia Elwan, Rehab Badawi, Nehad Hawash, Shaimaa Soliman, Samah Soliman, Walaa Elkhalawany, Mennat-Allah ElSawaf, Asem Elfert
BACKGROUND AND AIMS: Hepatic encephalopathy (HE) is a reversible spectrum of neuropsychiatric abnormalities associated with liver dysfunction. Lactulose is a nonabsorbable disaccharide presently used to treat HE. Nitazoxanide (NTZ) has a broad-spectrum activity against urease-producing bacteria, so it decreases ammonia production and is therefore expected to reverse the symptoms of HE. A previous pilot study on HE patients given NTZ and lactulose had encouraging results with regard to amelioration of the clinical picture...
April 17, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29664461/bilateral-thalamic-lesions-in-hepatic-encephalopathy
#6
Abdulelah N Al Jasser, Nawal I Al Adwani
No abstract text is available yet for this article.
April 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29657612/deal-a-death-blow-hcc-in-cirrhotics-thrombotic-complications-their-frequency-characteristics-and-risk-factors
#7
Khalid Mahmood, Iftikhar Haider Naqvi, Aamer Mahmood, Syed Muhammad, Noor Muhammad
Introduction: The hepatocellular carcinoma (HCC), being the commonest primary cancer, holds the sixth slot in the list of common cancers worldwide. Thrombotic complications in the form of portal vein tumour thrombosis (PVTT) and bland portal vein thrombosis with HCC are common with a bad prognosis. Aim: The study aims to determine the demographic, clinical, and biochemical parameters of HCC patients. The study also compares the clinical and biochemical parameters among patients having HCC with and without thrombotic complication...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#8
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29651764/can-functional-parameters-from-hepatobiliary-phase-of-gadoxetate-mri-predict-clinical-outcomes-in-patients-with-cirrhosis
#9
Kumar Sandrasegaran, Enming Cui, Reem Elkady, Pauley Gasparis, Gitasree Borthakur, Mark Tann, Suthat Liangpunsakul
OBJECTIVES: To determine the value of quantitative parameters of gadoxetate-enhanced magnetic resonance imaging (MRI) in predicting prognosis in patients with cirrhosis. METHODS: A cohort of 63 cirrhotic patients who had gadoxetate MRI and 2-year clinical follow-up was enrolled. Enhancement ratio (ER), contrast enhancement index (CEI) and contrast enhancement spleen index (CES) were calculated. The usefulness of these parameters and clinical scores, such as Child-Pugh score (CPS) and model for end stage liver disease (MELD), in predicting adverse outcomes, such as variceal bleeding (VB), hepatic encephalopathy (HE) and mortality at 2 years were evaluated...
April 12, 2018: European Radiology
https://www.readbyqxmd.com/read/29651749/medium-chain-triglycerides-supplement-therapy-with-a-low-carbohydrate-formula-can-supply-energy-and-enhance-ammonia-detoxification-in-the-hepatocytes-of-patients-with-adult-onset-type-ii-citrullinemia
#10
Kiyoshi Hayasaka, Chikahiko Numakura, Mitsunori Yamakawa, Tetsuo Mitsui, Hisayoshi Watanabe, Hiroaki Haga, Masahide Yazaki, Hiromasa Ohira, Yasuo Ochiai, Toshiyuki Tahara, Tamio Nakahara, Noriyo Yamashiki, Takahiro Nakayama, Takashi Kon, Hiroshi Mitsubuchi, Hiroshi Yoshida
Citrin, encoded by SLC25A13, constitutes the malate-aspartate shuttle, the main NADH-shuttle in the liver. Citrin deficiency causes neonatal intrahepatic cholestasis (NICCD) and adult-onset type II citrullinemia (CTLN2). Citrin deficiency is predicted to impair hepatic glycolysis and de novo lipogenesis, resulting in hepatic energy deficit. Secondary decrease in hepatic argininosuccinate synthetase (ASS1) expression has been considered a cause of hyperammonemia in CTLN2. We previously reported that medium-chain triglyceride (MCT) supplement therapy with a low-carbohydrate formula was effective in CTLN2 to prevent a relapse of hyperammonemic encephalopathy...
April 12, 2018: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/29651649/systematic-review-of-the-economic-burden-of-overt-hepatic-encephalopathy-and-pharmacoeconomic-impact-of-rifaximin
#11
REVIEW
Guy Neff, Woodie Zachry Iii
BACKGROUND: Hepatic encephalopathy (HE), a common neurologic complication in cirrhosis, is associated with substantial disease and economic burden. Rifaximin is a non-systemic antibiotic that reduces the risk of overt HE recurrence and overt HE-related hospitalizations. OBJECTIVE: Our objective was to provide an overview of the direct HE-related costs and cost benefits of rifaximin, lactulose, and rifaximin plus lactulose. METHODS: A systematic review of PubMed and relevant meeting abstracts was conducted to identify publications since 1 January 2007 reporting economic data related to HE and rifaximin and/or lactulose...
April 12, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29650854/-a-case-of-hyperammonemia-induced-by-chemotherapy-with-5-fluorouracil-for-metastatic-colon-cancer
#12
Shinji Tokuyama, Mutsumi Fukunaga, Ken Konishi, Shoko Honda, Ryohei Yukimoto, Aoi Okamoto, Akina Saito, Kazuyuki Okada, Hideo Ota, Shigekazu Yokoyama, Hirofumi Miki, Kenji Kobayashi
Systemic chemotherapy based on 5-fluorouracil(5-FU)is a standard treatment for unresectable or recurrent colon cancers. Here, we report a case of hyperammonemia induced by chemotherapy using 5-FU for metastatic colon cancer. An 84-yearold male patient with past histories of liver cirrhosis related to hepatitis C virus and renal dysfunction underwent an operation for the rectosigmoid colon cancer 8 years ago. Three years after that operation, a local recurrence of the colon cancer was diagnosed, and chemotherapy using sLV5FU2 was initiated...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650838/-two-cases-of-hepatic-encephalopathy-after-chemotherapy-for-metastatic-colorectal-cancer
#13
Tae Matsumura, Shingo Noura, Masaki Hirota, Yuki Ozato, Daiki Marukawa, Takashi Shuto, Arisa Muratsu, Akinobu Yasuyama, Akihiro Takata, Chikato Koga, Chizu Kameda, Masahiro Murakami, Ryohei Kawabata, Junzo Shimizu, Junichi Hasegawa
We reported 2 cases of hepatic encephalopathy after chemotherapy for advanced colorectal cancer. Case 1: A 49-year-old male was diagnosed advanced sigmoid colon cancer with peritoneal dissemination, multiple liver metastasis and multiple osseous metastasis. After resection of primary lesion, we administered mFOLFOX6 plus bevacizumab combination therapy. He was in comatose(Japan coma scale 200)3 days after 2 courses of administration of this regimen. Case 2: A 57-year-old female was diagnosed advanced rectal cancer with multiple huge liver metastasis and multiple osseous metastasis...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29644492/update-on-the-therapeutic-management-of-hepatic-encephalopathy
#14
REVIEW
Linda Skibsted Kornerup, Lise Lotte Gluud, Hendrik Vilstrup, Gitte Dam
PURPOSE OF REVIEW: Hepatic encephalopathy (HE) is a common and devastating complication to chronic liver disease. In this paper, we summarize the latest research and evidence of both conventional and up-coming treatments. RECENT FINDINGS: Meta-analyses report beneficial effects of lactulose, branched-chain amino acids, rifaximin, and to some degree L-ornithine L-aspartate on the manifestations of HE in patients with cirrhosis, and generally the numbers needed to treat are low...
April 11, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29629490/long-term-follow-up-study-of-liver-related-outcome-after-bilio-pancreatic-diversion-in-patients-with-initial-significant-liver-damage
#15
Edoardo G Giannini, Claudia Coppo, Chiara Romana, Giovanni B Camerini, Franco De Cian, Nicola Scopinaro, Francesco S Papadia
BACKGROUND: Obesity is associated with NAFLD, and bariatric surgery has significant impact on this liver disease, with reported improvement in hepatic fibrosis. AIMS: To investigate the effects of bariatric surgery on long-term liver disease-related outcome in obese patients with nonalcoholic fatty liver disease (NAFLD) and significant liver damage. METHODS: This study included 56 NAFLD patients who underwent bilio-pancreatic diversion for morbid obesity and who had significant fibrosis at intraoperative liver biopsy...
April 9, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29628453/multiple-acquired-portosystemic-shunts-secondary-to-primary-hypoplasia-of-the-portal-vein-in-a-cat
#16
Satoko Sugimoto, Shingo Maeda, Masaya Tsuboi, Kohei Saeki, James K Chambers, Tomohiro Yonezawa, Kenjiro Fukushima, Reina Fujiwara, Kazuyuki Uchida, Hajime Tsujimoto, Naoaki Matsuki, Koichi Ohno
A 6-year 5-month-old spayed female Scottish Fold cat presented with a one-month history of gait abnormalities, increased salivation, and decreased activity. A blood test showed hyperammonemia and increased serum bile acids. Imaging tests revealed multiple shunt vessels indicating acquired portosystemic shunt. Histopathologic analysis of liver biopsy showed features consistent with liver hypoperfusion, such as a barely recognizable portal vein, increased numbers of small arterioles, and diffuse vacuolar degeneration of hepatocytes...
April 9, 2018: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/29624860/hepatic-encephalopathy-diagnosis-and-management
#17
Piero Amodio
Hepatic encephalopathy (HE) is a peculiar kind of brain dysfunction caused by liver insufficiency and/or portal-systemic shunting. It is related to gut-derived substances. It is a relevant cause of morbidity and hospitalisation for patients with cirrhosis. The prognosis of HE is important in terms of survival and re-hospitalisation. It is related to impaired quality of life, falls and poor driving, presents a relevant burden for caregivers and health services, and may negatively impacts on patient's job and income...
April 6, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29624025/hepatic-encephalopathy-and-cirrhotic-cardiomyopathy-in-intensive-care-unit
#18
Giuliana Scarpati, Edoardo DE Robertis, Ciro Esposito, Ornella Piazza
Acute and chronic liver diseases may escalate to hepatic encephalopathy (HE) and multiple organ failure, requiring admission and organ support in Intensive Care Unit (ICU). Hepatic dysfunction in ICU is a broad and complex topic; unfortunately, up to now, the understanding of its underlying pathophysiology is far from complete. HE and cirrhotic cardiomyopathy (CCM) need timely diagnostic and therapeutic measures aiming at the identification and elimination of causative factors, to improve patients' prognosis...
April 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29622386/long-term-outcome-of-transjugular-intrahepatic-portosystemic-shunt-for-portal-hypertension-in-autosomal-recessive-polycystic-kidney-disease
#19
Sarah Verbeeck, Djalila Mekhali, David Cassiman, Geert Maleux, Peter Witters
BACKGROUND: Autosomal recessive polycystic kidney disease (ARPKD) with congenital hepatic fibrosis (CHF) causes portal hypertension and its complications. A transjugular intrahepatic portosystemic shunt (TIPSS) could serve as a symptomatic treatment for portal hypertension-related symptoms in these children. AIMS: To study the effect of TIPSS on portal hypertension, liver and kidney function and the long term complications. MATERIALS AND METHODS: We report on 5 children with CHF treated with a TIPSS to manage severe portal hypertension related symptoms...
March 15, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29615062/kars-related-diseases-progressive-leukoencephalopathy-with-brainstem-and-spinal-cord-calcifications-as-new-phenotype-and-a-review-of-literature
#20
Anna Ardissone, Davide Tonduti, Andrea Legati, Eleonora Lamantea, Rita Barone, Imen Dorboz, Odile Boespflug-Tanguy, Gabriella Nebbia, Marco Maggioni, Barbara Garavaglia, Isabella Moroni, Laura Farina, Anna Pichiecchio, Simona Orcesi, Luisa Chiapparini, Daniele Ghezzi
BACKGROUND: KARS encodes lysyl- transfer ribonucleic acid (tRNA) synthetase, which catalyzes the aminoacylation of tRNA-Lys in the cytoplasm and mitochondria. Eleven families/sporadic patients and 16 different mutations in KARS have been reported to date. The associated clinical phenotype is heterogeneous ranging from early onset encephalopathy to isolated peripheral neuropathy or nonsyndromic hearing impairment. Recently additional presentations including leukoencephalopathy as predominant cerebral involvement or cardiomyopathy, isolated or associated with muscular and cerebral involvement, have been reported...
April 4, 2018: Orphanet Journal of Rare Diseases
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