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https://www.readbyqxmd.com/read/28642818/nivolumab-as-salvage-treatment-in-a-patient-with-hiv-related-relapsed-refractory-hodgkin-lymphoma-and-liver-failure-with-encephalopathy
#1
Jose D Sandoval-Sus, Francis Mogollon-Duffo, Ankita Patel, Nathan Visweshwar, Damian A Laber, Richard Kim, Michael V Jagal
BACKGROUND: We report the first case to our knowledge of a patient with relapsed/refractory classical hodgkin lymphoma and liver failure with encephalopathy along with human immunodeficiency virus/acquired immunodeficiency syndrome infection, successfully treated with nivolumab without major side effects and encouraging prolonged disease control. CASE PRESENTATION: In December 2015, at the time of the patient's progression from his Hodgkin lymphoma after fourth line treatment, he developed persistent fevers, abdominal distension, jaundice and worsening of his liver function tests...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28618192/the-patient-buddy-app-can-potentially-prevent-hepatic-encephalopathy-related-readmissions
#2
Dinesh Ganapathy, Chathur Acharya, Jatinder Lachar, Kavish Patidar, Richard K Sterling, Melanie B White, Catherine Ignudo, Swamy Bommidi, John DeSoto, Leroy R Thacker, Scott Matherly, Jawaid Shaw, Mohammad S Siddiqui, Puneet Puri, Arun J Sanyal, Velimir Luketic, Hannah Lee, R Todd Stravitz, Jasmohan S Bajaj
BACKGROUND AND AIM: Readmissions are a major burden in cirrhosis. A proportion of readmissions in cirrhosis, especially due to hepatic encephalopathy (HE) could be avoided through patient and caregiver engagement. We aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. METHODS: Cirrhotic inpatients with caregivers were enrolled and followed for 30 days post-discharge...
June 15, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28614215/effects-of-branched-chain-amino-acids-bcaas-on-the-progression-of-advanced-liver-disease-a-korean-nationwide-multicenter-retrospective-observational-cohort-study
#3
Jung Gil Park, Won Young Tak, Soo Young Park, Young Oh Kweon, Se Young Jang, Yu Rim Lee, Si Hyun Bae, Jae Young Jang, Do Young Kim, June Sung Lee, Ki Tae Suk, In Hee Kim, Heon Ju Lee, Woo Jin Chung, Byoung Kuk Jang, Jeong Ill Suh, Jeong Heo, Won Kee Lee
Evidence of the potential benefits of long-term oral branched-chain amino acid (BCAA) supplementation in reducing the severity of liver disease is limited.Patients who were diagnosed with liver cirrhosis with a Child-Pugh (CP) score of 8-10 were included. The BCAA group consumed BCAAs daily for at least 6 months, and the control group consumed a diet without BCAA. We analyzed the improvements based on the model for end-stage liver disease (MELD) score, CP score, incidence of cirrhosis-related complications, and event-free survival over 2 years...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28611340/role-of-n-acetylcysteine-treatment-in-non-acetaminophen-induced-acute-liver-failure-a-prospective-study
#4
Tauseef Nabi, Sumaiya Nabi, Nadeema Rafiq, Altaf Shah
BACKGROUND/AIMS: Acute liver failure (ALF) is a rare but severe medical emergency. To date, there is no established treatment for non-acetaminophen-induced acute liver failure (NAI-ALF) other than liver transplantation, and little is known about the use of N-acetylcysteine (NAC) in NAI-ALF. A randomized case control study was conducted with the aim to determine the effect of NAC on the mortality of NAI-ALF patients, as well as to evaluate the safety and efficacy of NAC use. PATIENTS AND METHODS: A total of 80 patients diagnosed with NAI-ALF were included in the study...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28611264/symptoms-of-daytime-sleepiness-and-sleep-apnea-in-liver-cirrhosis-patients
#5
Abdullah Enezi, Fares Al-Jahdali, Anwar Ahmed, Nahid Shirbini, Abdullah Harbi, Baharoon Salim, Yosra Ali, Aljumah Abdulrahman, Mohd Khan, Abdullah Khaleid, Al-Jahdali Hamdan
Background/propose. Sleep disturbance and excessive daytime sleepiness (EDS) have been reported in patients with hepatic cirrhosis with no hepatic encephalopathy (HE). The objective of this study was to evaluate daytime sleepiness and risk of obstructive sleep apnea (OSA) among liver cirrhosis patients. MATERIAL AND METHODS: A cross-sectional study was conducted at King Abdulaziz Medical City (KAMC)-Riyadh over a period of six months, using a structured questionnaire that investigated: 1) Sleep patterns and daytime sleepiness using the Epworth Sleeping Scale (ESS), and 2) The risk for sleep apnea using the Berlin Questionnaire (BQ)...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28606043/a-study-of-extrapyramidal-manifestations-accompanying-decompensated-viral-hepatic-cirrhosis-patients
#6
Samia Ashour, Ahmed Gaber, Osama Aboelfotoh Aly, Saeed Hashem, Mohamed Salama, Ali Shalash
Despite the high prevalence of viral hepatic cirrhosis all over the world, the characteristic motor features of related Parkinsonism (extrapyramidal manifestations) are not well described. The current study aimed to characterize such disorder in a sample of Egyptian patients with chronic viral liver disease (CLD), and their clinical correlates. METHODS: Ninety-six (96) patients with CLD were examined for presence of extrapyramidal signs. Parkinsonism was assessed using the UPDRS-III scale and its sub scores...
June 12, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28592738/a-case-of-hereditary-hemorrhagic-telangiectasia-with-hepatic-encephalopathy-due-to-portal-hepatic-venous-shunt
#7
Kazumasa Ono, Toshimasa Obara, Miki Takeshita, Shinichiro Inoue, Shinjirou Mizukawa, Hiroshi Hasegawa, Koichi Kozaki
An 86-year-old male who was able to perform all activities of daily living (ADL) was diagnosed with hereditary hemorrhagic telangiectasia (HHT) at 70 years of age. Following his diagnosis, he had been receiving treatment at our hospital. After the sudden onset of a consciousness disorder, he was admitted to our hospital's emergency department with asterixis, a high serum ammonia level, and hepatic encephalopathy. After angiography, he was diagnosed with hepatic encephalopathy due to portal hepatic venous shunts...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28589058/metoprolol-induced-severe-liver-injury-and-successful-management-with-therapeutic-plasma-exchange
#8
Cyriac Philips, Rajaguru Paramaguru, Pushpa Mahadevan, Jayasurya Ravindranath, Philip Augustine
Liver injury caused by metoprolol is very rare with current reports limited to an isolated elevation in transaminases. We report the first case of severe icteric liver injury leading to hepatic encephalopathy secondary to metoprolol use in a patient diagnosed with coronary heart disease. We also describe the histopathology of metoprolol-related liver injury, discuss mechanisms of injury with new insights on the immunological phenomenon, and shed light on the successful utility of early plasmapheresis as a salvage therapy in metoprolol-induced severe liver damage...
May 2, 2017: Curēus
https://www.readbyqxmd.com/read/28588751/protein-tolerance-to-standard-and-high-protein-meals-in-patients-with-liver-cirrhosis
#9
Octavio Campollo, Dirk Sprengers, Gitte Dam, Hendrik Vilstrup, Neil McIntyre
AIM: To investigate the plasma amino acid response and tolerance to normal or high protein meals in patients with cirrhosis. METHODS: The plasma amino acid response to a 20 g mixed protein meal was compared in 8 biopsy-proven compensated cirrhotic patients and 6 healthy subjects. In addition the response to a high protein meal (1 g/kg body weight) was studied in 6 decompensated biopsy-proven cirrhotics in order to evaluate their protein tolerance and the likelihood of developing hepatic encephalopathy (HE) following a porto-caval shunt procedure...
May 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28586116/fecal-microbiota-transplant-from-a-rational-stool-donor-improves-hepatic-encephalopathy-a-randomized-clinical-trial
#10
Jasmohan S Bajaj, Zain Kassam, Andrew Fagan, Edith A Gavis, Eric Liu, I Jane Cox, Raffi Kheradman, Douglas Heuman, Jessica Wang, Thomas Gurry, Roger Williams, Masoumeh Sikaroodi, Michael Fuchs, Eric Alm, Binu John, Leroy R Thacker, Antonio Riva, Mark Smith, Simon D Taylor-Robinson, Patrick M Gillevet
Recurrent hepatic encephalopathy (HE) is a leading cause of readmission despite standard of care (SOC) associated with microbial dysbiosis. Fecal microbiota transplantation (FMT) may improve dysbiosis; however, it has not been studied in HE. We aimed to define whether FMT using a rationally-derived stool donor is safe in recurrent HE compared to SOC alone. An open-label, randomized clinical trial with a 5 month follow-up in outpatient cirrhotic men with recurrent HE on SOC was conducted with 1:1 randomization...
June 6, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28585310/direct-acting-antivirals-for-chronic-hepatitis-c
#11
REVIEW
Janus C Jakobsen, Emil Eik Nielsen, Joshua Feinberg, Kiran Kumar Katakam, Kristina Fobian, Goran Hauser, Goran Poropat, Snezana Djurisic, Karl Heinz Weiss, Milica Bjelakovic, Goran Bjelakovic, Sarah Louise Klingenberg, Jian Ping Liu, Dimitrinka Nikolova, Ronald L Koretz, Christian Gluud
BACKGROUND: Millions of people worldwide suffer from hepatitis C, which can lead to severe liver disease, liver cancer, and death. Direct-acting antivirals (DAAs) are relatively new and expensive interventions for chronic hepatitis C, and preliminary results suggest that DAAs may eradicate hepatitis C virus (HCV) from the blood (sustained virological response). However, it is still questionable if eradication of hepatitis C virus in the blood eliminates hepatitis C in the body, and improves survival and leads to fewer complications...
June 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28584525/gastrointestinal-motility-disorders-and-their-clinical-implications-in-cirrhosis
#12
REVIEW
Eleni Theocharidou, Ameet Dhar, David Patch
Gastrointestinal motility is impaired in a substantial proportion of patients with cirrhosis. Cirrhosis-related autonomic neuropathy, increased nitric oxide production, and gut hormonal changes have been implicated. Oesophageal dysmotility has been associated with increased frequency of abnormal gastro-oesophageal reflux. Impaired gastric emptying and accommodation may result in early satiety and may have an impact on the nutritional status of these patients. Small intestinal dysmotility might be implicated in small intestinal bacterial overgrowth and increased bacterial translocation...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28583539/prognostic-factors-predicting-poor-outcome-in-living-donor-liver-transplantation-for-fulminant-hepatic-failure
#13
T-S Kim, J M Kim, C H D Kwon, S J Kim, J-W Joh, S-K Lee
BACKGROUND: Living-donor liver transplantation (LDLT) has been accepted as feasible treatment for fulminant hepatic failure (FHF), although it has generated several debatable issues. In this study, we investigated the prognostic factors predicting fatal outcome after LDLT for FHF. METHODS: From April 1999 to April 2011, 60 patients underwent LT for acute liver failure, including 42 patients for FHF at Samsung Medical Center, Seoul, Korea. Among 42 patients, 30 patients underwent LDLT for FHF, and the database of these patients was analyzed retrospectively to investigate the prognostic factors after LDLT for FHF...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28576312/hepatocellular-carcinoma-in-a-patient-with-congenital-porto-systemic-shunt
#14
B Malgras, F Guerin, S Dokmak
Congenital porto-caval shunt is a rare anomaly that can result in direct shunt-related complications (encephalopathy, pulmonary hypertension) or indirect complications such as the development of benign or malignant hepatic neoplasms. Treatment consists of management of the complications and occlusion of the porto-caval shunt in one or two stages by either a surgical or an interventional radiology approach.
May 30, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28573602/cognitive-reserve-is-a-resilience-factor-for-cognitive-dysfunction-in-hepatic-encephalopathy
#15
Piero Amodio, Sara Montagnese, Giuseppe Spinelli, Sami Schiff, Daniela Mapelli
Cognitive Reserve (CR) modulates symptoms of brain disease. The aim of this study was: to evaluate the effect of CR on cognition in cirrhosis and on the mismatch between cognitive and neurophysiologic assessment of hepatic encephalopathy (HE). Eighty-two outpatient patients with cirrhosis without overt HE were studied [73% males; age: 62 (54-68) (median, interq. range) yrs.; education: 8 (6-13) yrs.]. The Psychometric Hepatic Encephalopathy Score (PHES) was used as cognitive measure of HE. The spectral analysis of the electroencephalogram (EEG) was used as neurophysiologic measure of HE...
June 2, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28571184/the-importance-of-liver-fatty-acid-binding-protein-in-diagnosis-of-liver-damage-in-patients-with-acute-hepatitis
#16
Ozlem Ozer Cakir, Aysun Toker, Huseyin Ataseven, Ali Demir, Hakki Polat
INTRODUCTION: Acute hepatitis is acute inflammation of liver elicited by a large number of causes. It sometimes spontaneously recovers, sometimes may progress to chronic hepatitis. Liver- Fatty Acid Binding Protein (L-FABP) is a small protein that is abundant in hepatocytes, and which binds most of the long-chain fatty acids present in the cytosol. AIM: The present study was aimed to investigate the levels of serum and urine L-FABP in acute hepatitis and diagnostic value of serum and urine L-FABP levels in patients with acute hepatitis...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28570328/liver-disease-and-neurology
#17
Robert N Schwendimann, Alireza Minagar
PURPOSE OF REVIEW: Neurologists often encounter patients with acute and chronic liver disease and must be aware of how these diseases can affect the nervous system. This is particularly true when evaluating patients with alterations in cognition and level of consciousness. Wilson disease, while uncommon, is a treatable condition with many neurologic and psychiatric symptoms. Neurologic disorders associated with liver disease may affect not only the brain, but also the spinal cord and peripheral nervous system...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28560484/a-new-look-at-precipitants-of-overt-hepatic-encephalopathy-in-cirrhosis
#18
Ganesh Pantham, Anthony Post, Deepak Venkat, Douglas Einstadter, Kevin D Mullen
BACKGROUND AND AIMS: Overt hepatic encephalopathy (HE) is a major cause of significant morbidity and mortality in patients with liver cirrhosis. We examined the frequency and profile of the precipitating factors resulting in hospitalizations for overt HE. METHODS: We conducted both retrospective and prospective studies to identify clinical precipitants of overt HE in patients with cirrhosis. The retrospective study patients were hospitalized at a large urban safety-net hospital, and the prospective study included the patients admitted at a liver transplant center...
May 30, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28559637/reversible-encephalopathy-due-to-valproic-acid-induced-hyperammonemia-in-a-patient-with-bipolar-i-disorder-a-cautionary-report
#19
Neel Patel, Katherine B Landry, Rachel E Fargason, Badari Birur
Valproic acid (VPA) is an FDA-approved medication widely prescribed for seizures, migraines, and mixed or manic episodes in bipolar disorder. Hyperammonemia is a rare complication of VPA use, which can result in high morbidity and occasionally fatal encephalopathy. The scant literature on Valproate Induced Hyperammonemic Encephalopathy (VIHE) is characterized by acute onset of decreasing level of consciousness, drowsiness, lethargy which in rare instances can lead to seizures, stupor, coma, and persistent morbidity and cortical damage...
January 26, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28559523/the-first-report-of-two-cases-of-fatal-liver-injury-due-to-anti-tuberculosis-drugs-in-the-presence-of-alpha-1-antitrypsin-deficiency
#20
Shahram Habibzadeh, Jafar Mohammad Shahi, Hassan Ghobadi, Nasrollah Maleki
Tuberculosis (TB) is a major global health problem. Awareness of liver injury due to anti-TB therapy is vital because fulminant hepatic failure is a devastating and often fatal condition without liver transplantation. Here, we report for the first time, two patients of fatal liver injury due to anti-TB drugs in the presence of alpha-1 antitrypsin deficiency. Based on the triad of rapid loss in hepatocyte function, the onset of hepatic encephalopathy, and absence of a prior history of liver disease, the diagnosis of acute liver failure was established...
April 2017: International Journal of Mycobacteriology
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