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https://www.readbyqxmd.com/read/28812008/evaluation-of-adrenal-function-in-nonhospitalized-patients-with-cirrhosis
#1
Maryam Moini, Mitra Yazdani Sarvestani, Mesbah Shams, Masood Nomovi
BACKGROUND: Patients with cirrhosis and advancing hepatic insufficiency may show various degrees of other organ malfunction, including brain, kidney, and lung. Several studies have also shown a high prevalence of adrenal insufficiency in cirrhotic patients that may cause hemodynamic instability. MATERIALS AND METHODS: In this study we prospectively evaluated adrenal function in a population of nonhospitalized cirrhotic patients. Categorization of liver disease severity was done according to model for end-stage liver disease (MELD) score...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28800720/jc-virus-related-progressive-multifocal-leukoencephalopathy-after-living-donor-liver-transplant-a-rare-case
#2
Archana Rastogi, Natasha Gulati, Chhagan Bihari, Ashok Chaudhary, Kalpana Bansal, Shridhar Sasturkar, Shalini Thapar, Viniyendra Pamecha
Progressive multifocal leukoencephalopathy caused by polyoma JC virus is a rare and severe demyelinating disease of the central nervous system. It occurs in immunocompromised patients and is scarcely reported in liver transplant recipients. Brain biopsy demonstrating demyelination with presence of foamy macrophages, relative preservation of axons, astrogliosis, and typical polyomavirus inclusions in the enlarged oligodendroglial nuclei is essential for diagnosis. Here, we report a case of JC virus-associated progressive multifocal leukoencephalopathy in a living-donor liver transplant recipient who was transplanted for hepatitis C virus-related decompensated cirrhosis...
August 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28798943/a-fatal-case-of-erdheim-chester-disease-with-hepatic-involvement
#3
Gokulakrishnan Balasubramanian, Alexandra Modiri, Marina Affi, Catherine E Hagen, Bjorn Batdorf, Kiyoko Oshima, Laura Michaelis, Kia Saeian
Erdheim-Chester disease (ECD) is a rare form of systemic histiocytosis, typically presenting with striking osseous involvement characterized by bilateral osteosclerosis and involvement of organs such as the lung, pituitary gland, heart, and brain. Liver involvement with ECD is extremely uncommon. We report a 56-year-old woman presenting with newly diagnosed cirrhosis and signs concerning for intra-abdominal malignancy, including omental caking and peritoneal thickening. Liver biopsy demonstrated xanthogranulomatous infiltration from ECD...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28798299/diabetes-mellitus-is-associated-with-more-severe-brain-spontaneous-activity-impairment-and-gray-matter-loss-in-patients-with-cirrhosis
#4
Yun Fei Wang, Xiang Kong, Guang Ming Lu, Long Jiang Zhang
Recent studies showed many cirrhosis patients may have diabetes mellitus (DM), however, the effect of DM on brain in cirrhotic patients is unclear. This study included 34 cirrhosis patients (17 with DM, 17 without DM) and 17 age-, sex-matched healthy controls. MRI examination and neuropsychological tests were performed. Fractional amplitude of low-frequency fluctuation (fALFF) and voxel-based morphometry algorithms were used to obtain fALFF values and gray matter volume, which were compared and correlated with clinical variables...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28797986/increased-occurrence-of-brain-abscesses-in-cirrhotic-patients-a-population-based-3-year-follow-up-study
#5
Yen Chun Chen, Tsung Hsing Hung, Kuo Chih Tseng, Chih Wei Tseng, Yu Hsi Hsieh, Chih Chun Tsai, Chen Chi Tsai
BACKGROUND/AIMS: Cirrhotic patients are prone to various infectious diseases. However, it is still unknown if the occurrence of a brain abscess is associated with cirrhosis. The purpose of this study was to identify the relationship between the occurrence of a brain abscess and cirrhosis. MATERIALS AND METHODS: The National Health Insurance Database, which is derived from the Taiwan National Health Insurance program, was used to collect data from 40,878 patients with cirrhosis and from 40,896 randomly selected age- and sex-matched patients...
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28796283/flumazenil-versus-placebo-or-no-intervention-for-people-with-cirrhosis-and-hepatic-encephalopathy
#6
REVIEW
Ee Teng Goh, Mette L Andersen, Marsha Y Morgan, Lise Lotte Gluud
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis which results in poor brain functioning. The spectrum of changes associated with hepatic encephalopathy ranges from the clinically 'indiscernible' or minimal hepatic encephalopathy to the clinically 'obvious' or overt hepatic encephalopathy. Flumazenil is a synthetic benzodiazepine antagonist with high affinity for the central benzodiazepine recognition site. Flumazenil may benefit people with hepatic encephalopathy through an indirect negative allosteric modulatory effect on gamma-aminobutyric acid receptor function...
August 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28790516/the-molecular-basis-of-portal-hypertension
#7
Don C Rockey
Cirrhosis leads to portal hypertension and vascular abnormalities in multiple vascular beds. There is intense vasoconstriction in the liver and the kidneys, but also vasodilation in the other vascular beds, including the periphery, lungs, brain, and mesentery. The derangement in each of these beds leads to specific clinical disease. The vasoconstrictive phenotype in the liver ultimately leads to clinical portal hypertension, and is caused by an imbalance of vasoconstrictive and vasorelaxing molecules, which will be the focus of this review...
2017: Transactions of the American Clinical and Climatological Association
https://www.readbyqxmd.com/read/28765023/a-multicenter-retrospective-cohort-study-of-talk-and-die-after-traumatic-brain-injury
#8
Keita Shibahashi, Kazuhiro Sugiyama, Yoshihiro Okura, Hidenori Hoda, Yuichi Hamabe
BACKGROUND: Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting, and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. METHODS: We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28760433/branched-chain-amino-acid-supplementation-in-treatment-of-liver-cirrhosis-updated-views-on-how-to-attenuate-their-harmful-effects-on-cataplerosis-and-ammonia-formation
#9
REVIEW
Milan Holeček
Branched-chain amino acid (BCAA; valine, leucine, and isoleucine) supplementation is common for patients with liver cirrhosis due to decreased levels of BCAA in the blood plasma of these patients, which plays a role in pathogenesis of hepatic encephalopathy and cachexia. The unique pharmacologic properties of BCAA also are a factor for use as supplementation in this population. In the present article, BCAA is shown to provide nitrogen to alpha-ketoglutarate (α-KG) for synthesis of glutamate, which is a substrate for ammonia detoxification to glutamine (GLN) in the brain and muscles...
September 2017: Nutrition
https://www.readbyqxmd.com/read/28745801/flumazenil-versus-placebo-or-no-intervention-for-people-with-cirrhosis-and-hepatic-encephalopathy
#10
REVIEW
Ee Teng Goh, Mette L Andersen, Marsha Y Morgan, Lise Lotte Gluud
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis which results in poor brain functioning. The spectrum of changes associated with hepatic encephalopathy ranges from the clinically 'indiscernible' or minimal hepatic encephalopathy to the clinically 'obvious' or overt hepatic encephalopathy. Flumazenil is a synthetic benzodiazepine antagonist with high affinity for the central benzodiazepine recognition site. Flumazenil may benefit people with hepatic encephalopathy through an indirect negative allosteric modulatory effect on gamma-aminobutyric acid receptor function...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28717971/subnetwork-mining-on-functional-connectivity-network-for-classification-of-minimal-hepatic-encephalopathy
#11
Daoqiang Zhang, Liyang Tu, Long-Jiang Zhang, Biao Jie, Guang-Ming Lu
Hepatic encephalopathy (HE), as a complication of cirrhosis, is a serious brain disease, which may lead to death. Accurate diagnosis of HE and its intermediate stage, i.e., minimal HE (MHE), is very important for possibly early diagnosis and treatment. Brain connectivity network, as a simple representation of brain interaction, has been widely used for the brain disease (e.g., HE and MHE) analysis. However, those studies mainly focus on finding disease-related abnormal connectivity between brain regions, although a large number of studies have indicated that some brain diseases are usually related to local structure of brain connectivity network (i...
July 17, 2017: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/28715721/pushing-the-boundaries-in-liver-graft-utilisation-in-transplantation-case-report-of-a-donor-with-previous-bile-duct-injury-repair
#12
Asma Sultana, James J Powell, Gabriel C Oniscu
INTRODUCTION: Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. PRESENTATION OF CASE: Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28710238/is-fch-pet-able-to-identify-foci-of-infection-superiorly-to-fdg-pet
#13
Liesel Elisabeth Hardy, Hannah Hessamodini, Michael Wallace, Roslyn Francis
We report a case of a brain abscess identified on fluorine-18 choline (FCH) positron emission tomography (PET) scan, which was not identified on fluorodeoxyglucose (FDG) PET scan. To our knowledge, there are no previous case reports of incidental brain abscess identified by FCH PET imaging. A 51-year-old man, with liver cirrhosis complicated by hepatocellular carcinoma (HCC) was enrolled in a research trial comparing HCC detection in FCH PET versus FDG PET. During the course of the trial, he underwent radiofrequency ablation (RFA) for HCC...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28707166/altered-dynamic-functional-connectivity-in-the-default-mode-network-in-patients-with-cirrhosis-and-minimal-hepatic-encephalopathy
#14
Hua-Jun Chen, Hai-Long Lin, Qiu-Feng Chen, Peng-Fei Liu
PURPOSE: Abnormal brain intrinsic functional connectivity (FC) has been documented in minimal hepatic encephalopathy (MHE) by static connectivity analysis. However, changes in dynamic FC (dFC) remain unknown. We aimed to identify altered dFC within the default mode network (DMN) associated with MHE. METHODS: Resting-state functional MRI data were acquired from 20 cirrhotic patients with MHE and 24 healthy controls. DMN seed regions were defined using seed-based FC analysis (centered on the posterior cingulate cortex (PCC))...
July 13, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28704077/the-assessment-and-care-of-patients-with-hepatic-encephalopathy
#15
Palle Bager
This article provides an overview of the metabolic brain dysfunction hepatic encephalopathy (HE). HE is caused by severe liver cirrhosis and patients will often be treated in a liver unit, but patients with symptoms of HE may require nursing care anywhere in the healthcare system. Therefore it is beneficial for all nurses to have a basic knowledge of HE and this article explains the symptoms and treatment. Possible differential diagnoses are presented, as well as factors that can trigger episodes of HE. Both patients' and relatives' experiences are examined...
July 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28700067/acquired-hepatocerebral-degeneration-in-a-patient-with-hepatitis-b-and-hepatitis-delta-virus-coinfection
#16
Viviane de Carvalho, Dessana Francis Chehuan, Marcia Melo Damian
Acquired hepatocerebral degeneration is a neurological syndrome with typical clinical (extrapyramidal and neuropsychiatric) symptoms and brain magnetic resonance imaging findings (high T1 signal in the globus pallidus). It occurs mainly in patients with advanced liver disease, such as in patients co-infected with hepatitis B virus (HBV) and hepatitis delta virus (HDV). However, there are no reports relating HBV/HDV coinfection and acquired hepatocerebral degeneration. This report presents the case of a 49-year-old woman with characteristics of acquired hepatocerebral degeneration and liver cirrhosis due to HBV/HDV coinfection, and presents the main theories of the physiopathology of this condition...
May 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/28692648/zebrafish-slc30a10-deficiency-revealed-a-novel-compensatory-mechanism-of-atp2c1-in-maintaining-manganese-homeostasis
#17
Zhidan Xia, Jiayu Wei, Yingniang Li, Jia Wang, Wenwen Li, Kai Wang, Xiaoli Hong, Lu Zhao, Caiyong Chen, Junxia Min, Fudi Wang
Recent studies found that mutations in the human SLC30A10 gene, which encodes a manganese (Mn) efflux transporter, are associated with hypermanganesemia with dystonia, polycythemia, and cirrhosis (HMDPC). However, the relationship between Mn metabolism and HMDPC is poorly understood, and no specific treatments are available for this disorder. Here, we generated two zebrafish slc30a10 mutant lines using the CRISPR/Cas9 system. Compared to wild-type animals, mutant adult animals developed significantly higher systemic Mn levels, and Mn accumulated in the brain and liver of mutant embryos in response to exogenous Mn...
July 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28680841/hepatic-encephalopathy-in-liver-cirrhosis
#18
Herbert Djiambou-Nganjeu
Liver cirrhosis is a worldwide gastroenterological condition, characterized by a slow, progressive and irreversible replacement of liver cells by fibrous tissue (scar) that prevents liver function. This condition often leads to the development of other syndromes. Cardiac complications can be indicated through abnormal QTc interval and arrhythmias, thereby their analysis aids in the prevention of cardiovascular events. Most cirrhotic cases have abnormal laboratory values (bilirubin, albumin, AST, ALT, AST/ALT, INR) indicating the presence of concomitant infection, inflammation and coagulopathy...
March 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28675360/four-years-of-hepatic-transplantation-in-the-republic-of-moldova
#19
Vladimir Hotineanu, Adrian Hotineanu, Serghei Burgoci, Grigore Ivancov, Natalia Taran, Angela Peltec, Dumitru Cazacu, Vitalie Sîrghi
Ever since the first liver transplant in the Republic of Moldova in 2013 we have performed 30 liver transplantations, the first having been performed in collaboration with the surgical team from Romania, led by Professor Irinel Popescu. The serious deficit of available cadaveric organs has forced us to begin with right hemi-liver transplantation from a living donor. In one third of liver transplantations we used right hemi-liver graft from a living donor, and in 2/3 of cases whole liver graft was harvested from brain-dead donors...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28663680/hepatocellular-carcinoma-an-unusual-complication-of-longstanding-wilson-disease
#20
Deepak Gunjan, Shalimar, Neeti Nadda, Saurabh Kedia, Baibaswata Nayak, Shashi B Paul, Shivanand Ramachandra Gamanagatti, Subrat K Acharya
Wilson disease is caused by the accumulation of copper in the liver, brain or other organs, due to the mutation in ATP7B gene, which encodes protein that helps in excretion of copper in the bile canaliculus. Clinical presentation varies from asymptomatic elevation of transaminases to cirrhosis with decompensation. Hepatocellular carcinoma is a known complication of cirrhosis, but a rare occurrence in Wilson disease. We present a case of neurological Wilson disease, who later developed decompensated cirrhosis and hepatocellular carcinoma...
June 2017: Journal of Clinical and Experimental Hepatology
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