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Hepatic encephalopathy

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https://www.readbyqxmd.com/read/28445288/association-between-proton-pump-inhibitors-and-hepatic-encephalopathy-a-meta-analysis
#1
Jin Bian, Anqiang Wang, Jianzhen Lin, Liangcai Wu, Hanchun Huang, Shanshan Wang, Xiaobo Yang, Xin Lu, Yiyao Xu, Haitao Zhao
BACKGROUND & AIMS: Several studies have shown that proton pump inhibitors (PPIs) use can increase the risk of developing hepatic encephalopathy (HE) in patients with liver dysfunction. However, no definite conclusion is drawn because of study design limitations. Therefore, we conducted a meta-analysis to explore the association between PPIs and HE. METHODS: We searched PubMed, EMBASE, and the Cochrane Library from inception until November 2016. Data from the identified studies were combined using a random effects model, and odds ratios (ORs) were calculated...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444411/-acute-liver-failure
#2
A Koch, C Trautwein, F Tacke
Acute liver failure (ALF) is a rare, but life-threatening disease that is characterized by the acute onset of jaundice, coagulopathy, and hepatic encephalopathy (HE) in patients without pre-existing liver disease. Main causes in Germany are drug toxicity, acetaminophen overdose, and viral hepatitis (A, B, E). For the initial assessment of patients with ALF and the diagnostic algorithm, the early detection of HE, exclusion of liver cirrhosis, immediate diagnosis of the underlying etiology, and evaluation for the necessity of liver transplantation (LT) are critical...
April 25, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28443157/hepatic-encephalopathy-before-and-neurological-complications-after-liver-transplantation-have-no-impact-on-the-employment-status-1-year-after-transplantation
#3
Henning Pflugrad, Anita B Tryc, Annemarie Goldbecker, Christian P Strassburg, Hannelore Barg-Hock, Jürgen Klempnauer, Karin Weissenborn
AIM: To investigate the impact of hepatic encephalopathy before orthotopic liver transplantation (OLT) and neurological complications after OLT on employment after OLT. METHODS: One hundred and fourteen patients with chronic liver disease aged 18-60 years underwent neurological examination to identify neurological complications, neuropsychological tests comprising the PSE-Syndrome-Test yielding the psychometric hepatic encephalopathy score, the critical flicker frequency and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), completed a questionnaire concerning their occupation and filled in the short form 36 (SF-36) to assess health-related quality of life before OLT and 12 mo after OLT, if possible...
April 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28443156/serum-25-hydroxyvitamin-d-deficiency-and-hepatic-encephalopathy-in-chronic-liver-disease
#4
Helen Vidot, Alison Potter, Robert Cheng, Margaret Allman-Farinelli, Nicholas Shackel
AIM: To investigate the relationship between 25-hydroxyvitamin D (25-OHD) deficiency and hepatic encephalopathy (HE) in patients with chronic liver disease (CLD). METHODS: A retrospective analysis of the results of 392 adult patients with chronic liver disease who were assessed for liver transplantation between 2006 and 2010 was undertaken. HE, severity of CLD, nutritional status and 25-OHD were analysed in patients assessed for liver transplantation between 2006 and 2010...
April 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28440304/the-natural-history-of-severe-acute-liver-injury
#5
David G Koch, J L Speiser, V Durkalski, R J Fontana, T Davern, B McGuire, R T Stravitz, A M Larson, I Liou, O Fix, M L Schilsky, T McCashland, J E Hay, N Murray, O S Shaikh, D Ganger, A Zaman, S B Han, R T Chung, R S Brown, S Munoz, K R Reddy, L Rossaro, R Satyanarayana, A J Hanje, J Olson, R M Subramanian, C Karvellas, B Hameed, A H Sherker, W M Lee, A Reuben
OBJECTIVES: Acute liver failure (ALF) is classically defined by coagulopathy and hepatic encephalopathy (HE); however, acute liver injury (ALI), i.e., severe acute hepatocyte necrosis without HE, has not been carefully defined nor studied. Our aim is to describe the clinical course of specifically defined ALI, including the risk and clinical predictors of poor outcomes, namely progression to ALF, the need for liver transplantation (LT) and death. METHODS: 386 subjects prospectively enrolled in the Acute Liver Failure Study Group registry between 1 September 2008 through 25 October 2013, met criteria for ALI: International Normalized Ratio (INR)≥2...
April 25, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28439409/serial-deletion-reveals-structural-basis-and-stability-for-the-core-enzyme-activity-of-human-glutaminase-1-isoforms-relevance-to-excitotoxic-neurodegeneration
#6
Yuju Li, Justin Peer, Runze Zhao, Yinghua Xu, Beiqing Wu, Yi Wang, Changhai Tian, Yunlong Huang, Jialin Zheng
BACKGROUND: Glutaminase 1 is a phosphate-activated metabolic enzyme that catalyzes the first step of glutaminolysis, which converts glutamine into glutamate. Glutamate is the major neurotransmitter of excitatory synapses, executing important physiological functions in the central nervous system. There are two isoforms of glutaminase 1, KGA and GAC, both of which are generated through alternative splicing from the same gene. KGA and GAC both transcribe 1-14 exons in the N-terminal, but each has its unique C-terminal in the coding sequence...
2017: Translational Neurodegeneration
https://www.readbyqxmd.com/read/28438044/hepatic-encephalopathy
#7
Giles Aldworth
No abstract text is available yet for this article.
May 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28433104/wilson-disease-symptomatic-liver-therapy
#8
Jan Pfeiffenberger, Karl-Heinz Weiss, Wolfgang Stremmel
Wilson disease leads to symptomatic impairment of liver function or liver cirrhosis. Strict adherence to decoppering agents is essential in these patients. Secondary prevention of additional hepatic damage by avoidance of other toxic substances (e.g., alcohol, drugs) and sufficient calorie intake is recommended. Routine examinations in cirrhotic patients include screening for signs of portal hypertension (esophagus varices), development of ascites, and hepatic encephalopathy. Where varices are present, primary or secondary preventive interventions may include treatment with nonselective beta-blockers or variceal ligation, similar to the approach in patients with liver cirrhosis due to other etiologies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28422839/unexpected-side-effect-in-mcrc-a-care-compliant-case-report-of-regorafenib-induced-hyperammonemic-encephalopathy
#9
Michela Quirino, Sabrina Rossi, Giovanni Schinzari, Michele Basso, Antonia Strippoli, Alessandra Cassano, Carlo Barone
RATIONALE: Regorafenib represents a treatment option in heavily pretreated patients affected by metastatic colorectal cancer (mCRC). Its safety profile is typical of small-molecule tyrosine-kinase inhibitors (TKIs) and most adverse events are manageable. PATIENT CONCERNS: A 56 years-old Caucasian man affected by mCRC with normal hepatic reserve was treated with regorafenib as second-line treatment. After only 2 days of therapy, the patient presented to the emergency department due to impairment of both spatial and temporal orientation and motor function with bradylalia...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28417882/easl-clinical-practical-guidelines-on-the-management-of-acute-fulminant-liver-failure
#10
(no author information available yet)
The term acute liver failure (ALF) is frequently applied as a generic expression to describe patients presenting with or developing an acute episode of liver dysfunction. In the context of hepatological practice, however, ALF refers to a highly specific and rare syndrome, characterised by an acute abnormality of liver blood tests in an individual without underlying chronic liver disease. The disease process is associated with development of a coagulopathy of liver aetiology, and clinically apparent altered level of consciousness due to hepatic encephalopathy...
May 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28408357/critical-flicker-frequency-a-stethoscope-for-minimal-hepatic-encephalopathy-evaluation
#11
EDITORIAL
Praveen Sharma
No abstract text is available yet for this article.
April 14, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28408059/effect-of-a-high-protein-high-fiber-diet-plus-supplementation-with-branched-chain-amino-acids-on-the-nutritional-status-of-patients-with-cirrhosis
#12
A Ruiz-Margáin, R U Macías-Rodríguez, S L Ríos-Torres, B M Román-Calleja, O Méndez-Guerrero, P Rodríguez-Córdova, A Torre
INTRODUCTION AND OBJECTIVES: The potential benefits of branched-chain amino acids (BCAAs) in cirrhosis extend beyond just the improvement of nutritional status. Their effects include improvement of glucose tolerance, oxidative stress, and inflammatory markers, as has been shown in several studies. A dual nutritional approach of a high-protein, high-fiber diet plus BCAAs in cirrhosis could have additional benefits, compared with BCAAs alone. Such an approach has not been explored and therefore the aim of the present study was to evaluate the effect of a combination of a high-protein, high-fiber diet plus BCAA supplementation over a 6-month period of time on the nutritional status of patients with cirrhosis, as well as its safety and tolerability for those same patients...
April 10, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28407303/rifampicin-reverses-nicardipine-effect-inducing-uncontrolled-essential-hypertension
#13
Elena-Mihaela Cordeanu, Sébastien Gaertner, Alix Faller, Corina Mirea, Jean-Marc Lessinger, Veronique Kemmel, Dominique Stephan
Dihydropyridine calcium-channel blockers are a known substrate for the cytochrome P450 isoform 3A4. Rifampicin, an antitubercular agent, is one of the most potent inducers of hepatic and intestinal CYP3A4 thus increasing dihydropyridine metabolism. We report a case of a 67-year-old hypertensive female treated with a 4-drug antihypertensive regimen including a dihydropyridine (nicardipine 50mg bid), who was admitted for septic arthritis of the knee requiring antibiotic treatment with teicoplanin 400mg od and rifampicin 600mg bid...
April 13, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28407280/coil-assisted-retrograde-transvenous-obliteration-and-partial-splenic-artery-embolization-for-hepatic-encephalopathy
#14
Frank Kuo, Jonathan Park, Alice Chen
No abstract text is available yet for this article.
April 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28406121/normalization-of-the-psychometric-hepatic-encephalopathy-score-for-diagnosis-of-minimal-hepatic-encephalopathy-in-turkey
#15
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/28404069/patient-reported-outcomes-with-sofosbuvir-and-velpatasvir-with-or-without-ribavirin-for-hepatitis-c-virus-related-decompensated-cirrhosis-an-exploratory-analysis-from-the-randomised-open-label-astral-4-phase-3-trial
#16
Zobair M Younossi, Maria Stepanova, Michael Charlton, Michael P Curry, Jacqueline G O'Leary, Robert S Brown, Sharon Hunt
BACKGROUND: Hepatitis C virus (HCV) treatment regimens with direct-acting antivirals have not been extensively studied in patients with decompensated cirrhosis. We assessed patient-reported outcomes (PROs) in patients with decompensated cirrhosis given a fixed-dose combination of sofosbuvir and velpatasvir with and without ribavirin. METHODS: This study was an exploratory analysis of data collected in a randomised, open-label phase 3 trial (ASTRAL-4) in which patients with HCV-related decompensated cirrhosis were randomly assigned to an all-oral fixed-dose combination of sofosbuvir (400 mg) and velpatasvir (100 mg) once daily for 12 weeks, sofosbuvir and velpatasvir plus oral ribavirin (weight-based 1000 mg or 1200 mg) for 12 weeks, or sofosbuvir and velpatasvir for 24 weeks...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403980/characteristics-management-and-outcomes-of-patients-with-hepatocellular-carcinoma-in-africa-a-multicountry-observational-study-from-the-africa-liver-cancer-consortium
#17
Ju Dong Yang, Essa A Mohamed, Ashraf O Abdel Aziz, Hend I Shousha, Mohamed B Hashem, Mohamed M Nabeel, Ahmed H Abdelmaksoud, Tamer M Elbaz, Mary Y Afihene, Babatunde M Duduyemi, Joshua P Ayawin, Adam Gyedu, Marie-Jeanne Lohouès-Kouacou, Antonin W Ndjitoyap Ndam, Ehab F Moustafa, Sahar M Hassany, Abdelmajeed M Moussa, Rose A Ugiagbe, Casimir E Omuemu, Richard Anthony, Dennis Palmer, Albert F Nyanga, Abraham O Malu, Solomon Obekpa, Abdelmounem E Abdo, Awatif I Siddig, Hatim M Y Mudawi, Uchenna Okonkwo, Mbang Kooffreh-Ada, Yaw A Awuku, Yvonne A Nartey, Elizabeth T Abbew, Nana A Awuku, Jesse A Otegbayo, Kolawole O Akande, Hailemichael M Desalegn, Abidemi E Omonisi, Akande O Ajayi, Edith N Okeke, Mary J Duguru, Pantong M Davwar, Michael C Okorie, Shettima Mustapha, Jose D Debes, Ponsiano Ocama, Olufunmilayo A Lesi, Emuobor Odeghe, Ruth Bello, Charles Onyekwere, Francis Ekere, Rufina Igetei, Mitchell A Mah'moud, Benyam Addissie, Hawa M Ali, Gregory J Gores, Mark D Topazian, Lewis R Roberts
BACKGROUND: Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa. METHODS: We did a multicentre, multicountry, retrospective observational cohort study, inviting investigators from the African Network for Gastrointestinal and Liver Diseases to participate in the consortium to develop hepatocellular carcinoma research databases and biospecimen repositories...
February 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403210/molecular-adsorbent-recirculating-system-mars-in-acute-liver-injury-and-graft-dysfunction-results-from-a-case-control-study
#18
Hans U Gerth, Michele Pohlen, Gerold Thölking, Hermann Pavenstädt, Marcus Brand, Christian Wilms, Anna Hüsing-Kabar, Dennis Görlich, Iyad Kabar, Hartmut H J Schmidt
BACKGROUND: The primary therapeutic goals in the treatment of liver injury are to support liver regeneration or bridge the gap to liver transplantation (LT). Molecular adsorbent recirculating system (MARS) therapy has shown beneficial effects for specific symptoms of liver failure; however, general survival advantages have not yet been demonstrated. AIM: We studied the effects of MARS therapy compared to standard medical treatment (SMT) in two patient cohorts: in patients with an acute liver injury and in those with graft dysfunction (GD)...
2017: PloS One
https://www.readbyqxmd.com/read/28403092/hyperammonemic-coma-after-craniotomy-hepatic-encephalopathy-from-upper-gastrointestinal-hemorrhage-or-valproate-side-effect-case-report-and-literature-review
#19
REVIEW
Xiaopeng Guo, Junji Wei, Lu Gao, Bing Xing, Zhiqin Xu
RATIONALE: Postoperative coma is not uncommon in patients after craniotomy. It generally presents as mental state changes and is usually caused by intracranial hematoma, brain edema, or swelling. Hyperammonemia can also result in postoperative coma; however, it is rarely recognized as a potential cause in coma patients. Hyperammonemic coma is determined through a complicated differential diagnosis, and although it can also be induced as a side effect of valproate (VPA), this cause is frequently unrecognized or confused with upper gastrointestinal hemorrhage (UGH)-induced hepatic encephalopathy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28392702/hepatic-encephalopathy-what-the-multidisciplinary-team-can-do
#20
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
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