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Hepatic encephalopathy

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https://www.readbyqxmd.com/read/28107263/the-severity-of-hypoxic-ischemic-encephalopathy-correlates-with-multiple-organ-dysfunction-in-the-hypothermia-era
#1
Miguel Alsina, Ana Martín-Ancel, Ana Alarcon-Allen, Gemma Arca, Francisco Gayá, Alfredo García-Alix
OBJECTIVES: The objectives are to 1) determine whether there is a positive correlation between the severity of hypoxic-ischemic encephalopathy and multiple organ dysfunction and 2) evaluate the organ dysfunction pattern in infants with hypoxic-ischemic encephalopathy in the hypothermia era. DESIGN: Retrospective observational study of prospective data collected between April 2009 and December 2012. SETTING: The study took place in the neonatal ICU of Hospital Sant Joan de Déu-Hospital Clínic of Barcelona...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28104319/the-mexican-consensus-on-probiotics-in-gastroenterology
#2
M A Valdovinos, E Montijo, A T Abreu, S Heller, A González-Garay, D Bacarreza, M Bielsa-Fernández, M C Bojórquez-Ramos, F Bosques-Padilla, A I Burguete-García, R Carmona-Sánchez, A Consuelo-Sánchez, E Coss-Adame, J A Chávez-Barrera, M de Ariño, J Flores-Calderón, O Gómez-Escudero, M S González-Huezo, M E Icaza-Chávez, A Larrosa-Haro, M Morales-Arámbula, C Murata, J A Ramírez-Mayans, J M Remes-Troche, T Rizo-Robles, M Peláez-Luna, E M Toro-Monjaraz, A Torre, M E Urquidi-Rivera, R Vázquez, J K Yamamoto-Furusho, F Guarner
INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology...
January 16, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28102583/successful-splenorenal-shunt-occlusion-with-balloon-occluded-retrograde-transvenous-obliteration-yielded-improvement-of-residual-liver-function-enabled-administration-of-direct-acting-antivirals-and-achieved-sustained-virologic-response-to-hepatitis-c-virus
#3
Hironori Ochi, Michiko Aono, Shunji Takechi, Toshie Mashiba, Tomoyuki Yokota, Kouji Joko
We report the use of balloon-occluded retrograde transvenous obliteration (BRTO) for portosystemic shunt in one patient, resulting in marked improvements in residual liver function and enabling safe hepatitis C virus (HCV) elimination with direct-acting antiviral agents. A woman undergoing outpatient treatment at our institution for HCV-related cirrhosis with a history of hepatocellular carcinoma (HCC) treatment developed hepatic encephalopathy (HE; Child-Pugh score 8) at age 65 years. Improvement was obtained with conservative treatment; however, contrast-enhanced computed tomography revealed a splenorenal shunt with decreased portal vein blood flow...
January 19, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28099460/impact-of-radiofrequency-ablation-induced-glisson-s-capsule-associated-complications-in-patients-with-hepatocellular-carcinoma
#4
Toru Wakamatsu, Sadahisa Ogasawara, Tetsuhiro Chiba, Masayuki Yokoyama, Masanori Inoue, Naoya Kanogawa, Tomoko Saito, Eiichiro Suzuki, Yoshihiko Ooka, Akinobu Tawada, Osamu Yokosuka
BACKGROUND: Radiofrequency ablation (RFA) is commonly used to locally treat hepatocellular carcinoma (HCC). However, when tumors are close to the Glisson's capsule, RFA may induce injury in this region, complicating therapeutic efforts. We investigated the impact of RFA-induced Glisson's capsule-associated complications on liver function and prognosis of HCC patients. METHODS: We retrospectively reviewed our patient database and found 170 early-stage HCC patients treated via RFA from April 2004 to December 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28097670/acute-liver-failure-in-scotland-changes-in-aetiology-and-outcomes-over-time-the-scottish-look-back-study
#5
M C Donnelly, J S Davidson, K Martin, A Baird, P C Hayes, K J Simpson
BACKGROUND: Acute liver failure is a rare and devastating clinical condition resulting from sudden loss of hepatic parenchyma and metabolic function. The Scottish Liver Transplant Unit (SLTU) offers specialist management and emergency liver transplantation to patients with acute liver failure from across Scotland. AIM: To describe temporal changes in number of admissions, aetiology of acute liver failure, severity of disease at presentation and outcomes over a 22-year period...
January 18, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28092846/status-epilepticus-in-patients-with-cirrhosis-how-to-avoid-misdiagnosis-in-patients-with-hepatic-encephalopathy
#6
Marika Rudler, Clémence Marois, Nicolas Weiss, Dominique Thabut, Vincent Navarro
PURPOSE: Status epilepticus (SE) in patients with cirrhosis is a rare but serious situation. Diagnosis may be difficult in emergency presentation, especially when patients present with hepatic encephalopathy (HE). Misdiagnosis must be avoided since some anti-epileptic drugs aggravate HE. In this retrospective study, we therefore assessed the frequency of SE in patients with cirrhosis, evaluated the accuracy of diagnosis and determined rates of mortality. METHOD: We reviewed data from all patients hospitalized from 2005 to 2013 in the Hepatology ICU for complications of cirrhosis with an initial diagnosis of SE...
December 27, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28092641/performance-characterization-of-a-novel-electronic-number-connection-test-to-detect-minimal-hepatic-encephalopathy-in-cirrhotic-patients
#7
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...
January 12, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28091405/evaluation-of-helicobacter-pylori-infection-in-patients-with-chronic-hepatic-disease
#8
Ju Huang, Jun Cui
BACKGROUND: The 13C urea breath test (13C-UBT) is the gold standard for detecting Helicobacter pylori infection. H. pylori pathogenesis in patients with hepatitis B virus (HBV) and related diseases remains obscure. We used 13C-UBT to detect H. pylori infection in patients with chronic HBV infection, HBV-related cirrhosis, HBV-related hepatic carcinoma, and other chronic hepatic diseases. METHODS: A total of 131 patients with chronic hepatitis B (HB), 179 with HBV-related cirrhosis, 103 with HBV-related hepatic carcinoma, 45 with HBV-negative hepatic carcinoma, and 150 controls were tested for H...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28081589/preemptive-antiviral-therapy-with-entecavir-can-reduce-acute-deterioration-of-hepatic-function-following-transarterial-chemoembolization
#9
Sun Hong Yoo, Jeong Won Jang, Jung Hyun Kwon, Seung Min Jung, Bohyun Jang, Jong Young Choi
BACKGROUND/AIMS: Hepatic damage during transarterial chemoembolization (TACE) is a critical complication in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Apart from its role in preventing HBV reactivation, there is some evidence for the benefits of preemptive antiviral therapy in TACE. This study evaluated the effect of preemptive antiviral therapy on acute hepatic deterioration following TACE. METHODS: This retrospective observational study included a prospectively collected cohort of 108 patients with HBV-related HCC who underwent TACE between January 2007 and January 2013...
December 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28079146/nitrosative-stress-induced-disruption-of-baroreflex-neural-circuits-in-a-rat-model-of-hepatic-encephalopathy-a-dti-study
#10
Ching-Yi Tsai, Chia-Hao Su, Julie Y H Chan, Samuel H H Chan
The onset of hepatic encephalopathy (HE) in liver failure is associated with high mortality; the underlying mechanism is undecided. Here we report that in an acute liver failure model employing intraperitoneal administration of thioacetamide in Sprague-Dawley rats, diffusion weighted imaging revealed a progressive reduction in apparent diffusion coefficient in the brain stem. Diffusion tensor imaging further showed that the connectivity between nucleus tractus solitarii (NTS), the terminal site of baroreceptor afferents in brain stem and rostral ventrolateral medulla (RVLM), the origin of sympathetic innervation of blood vessels, was progressively disrupted until its disappearance, coincidental with the irreversible cessation of baroreflex-mediated sympathetic vasomotor tone signifying clinically the occurrence of brain death...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28078470/appropriate-timing-to-start-and-optimal-response-evaluation-of-high-dose-corticosteroid-therapy-for-patients-with-acute-liver-failure
#11
Keisuke Kakisaka, Kojiro Kataoka, Yuji Suzuki, Hidekatsu Kuroda, Yasuhiro Takikawa
BACKGROUND: Corticosteroid therapy has been commonly administered to patients with acute liver injury (ALI)/acute liver failure (ALF) in Japan to prevent the development of hepatic encephalopathy, but the appropriate timing to start corticosteroid therapy has not been determined and optimal response evaluation of the therapy has not been conducted. We prospectively investigated the optimal timing to start therapy on the established severity indication: the Japan Hepatic Encephalopathy Prediction Model (JHEPM) and prothrombin time (PT)...
January 11, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28076712/hepatic-encephalopathy
#12
LETTER
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No abstract text is available yet for this article.
12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28074668/in-vivo-evidence-of-nephrotoxicity-and-altered-hepatic-function-in-rats-following-administration-of-diglycolic-acid-a-metabolite-of-diethylene-glycol
#13
Corie N Robinson, Brian Latimer, Fleurette Abreo, Kiera Broussard, Kenneth E McMartin
CONTEXT: Diglycolic acid (DGA) is one of the two primary metabolites of diethylene glycol (DEG). DEG is an industrial solvent that has been implicated in mass poisonings resulting from product misuse in the United States and worldwide, with the hallmark toxicity being acute kidney injury, hepatotoxicity, encephalopathy and peripheral neuropathy. Our laboratory has generated in-vitro evidence suggesting that DGA is the metabolite responsible for the proximal tubule necrosis and decreased kidney function observed following DEG ingestion...
January 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28070704/sleep-disturbances-in-patients-of-liver-cirrhosis-with-minimal-hepatic-encephalopathy-before-and-after-lactulose-therapy
#14
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...
January 9, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28069286/hepatic-encephalopathy
#15
REVIEW
Adam G Gow
This article reviews hepatic encephalopathy (HE) in companion animals. Clinical signs and categories of hepatic disease likely to cause HE are discussed. Ammonia has a key role in pathogenesis and current concepts in body ammonia metabolism are reviewed. Inflammation and manganese accumulation are also thought to be important in pathogenesis. Treatment of HE in acute and chronic cases is discussed along with the rationale for current treatment recommendations. Potential avenues for new treatments and human treatments, which may be transferable to companion animals, are reviewed...
January 6, 2017: Veterinary Clinics of North America. Small Animal Practice
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
#16
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/28066916/ammonia-mediates-cortical-hemichannel-dysfunction-in-rodent-models-of-chronic-liver-disease
#17
Anna Hadjihambi, Francesco De Chiara, Patrick S Hosford, Abeba Habtetion, Anastassios Karagiannis, Nathan Davies, Alexander V Gourine, Rajiv Jalan
: The pathogenesis of hepatic encephalopathy (HE) in cirrhosis is multifactorial and ammonia is thought to play a key role. Astroglial dysfunction is known to be present in HE. Astrocytes are extensively connected by gap junctions formed of connexins, which also exist as functional hemichannels allowing exchange of molecules between the cytoplasm and the extracellular milieu. The astrocyte-neuron lactate shuttle hypothesis suggests that neuronal activity is fuelled (at least in part) by lactate provided by neighbouring astrocytes...
January 9, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28065671/glutamine-triggers-long-lasting-increase-in-striatal-network-activity-in-vitro
#18
Wiebke Fleischer, Stephan Theiss, Alfons Schnitzler, Olga Sergeeva
Accumulation of ammonium and glutamine in blood and brain is a key factor in hepatic encephalopathy (HE) - a neuropsychiatric syndrome characterized by various cognitive and motor deficits. MRI imaging identified abnormalities notably in the basal ganglia of HE patients, including its major input station, the striatum. While neurotoxic effects of ammonia have been extensively studied, glutamine is primarily perceived as "detoxified" form of ammonia. We applied ammonium and glutamine to striatal and cortical cells from newborn rats cultured on microelectrode arrays...
January 6, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28059938/the-effects-of-probiotics-and-symbiotics-on-risk-factors-for-hepatic-encephalopathy-a-systematic-review
#19
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...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28059612/fecal-microbial-transplantation-as-a-therapeutic-option-in-patients-colonized-with-antibiotic-resistant-organisms
#20
Michael Laffin, Braden Millan, Karen L Madsen
Despite increasing interest in fecal microbiota transplantation (FMT), its full therapeutic potential has yet to be determined. Since its increase in popularity, FMT has been shown to be highly effective in the treatment of both Clostridium difficile infection (CDI) and its recurrent form. Interest in FMT now expands well beyond the treatment of CDI to other processes with known associations to the microbiota such as antibiotic resistant infections, inflammatory bowel disease (IBD), hepatic encephalopathy, neuropsychiatric disorders, and metabolic disease...
January 6, 2017: Gut Microbes
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