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cirrhosis brain

G Oriolo, E Egmond, Z Mariño, M Cavero, R Navines, L Zamarrenho, R Solà, J Pujol, N Bargallo, X Forns, R Martin-Santos
BACKGROUND: Chronic hepatitis C is considered a systemic disease because of extra-hepatic manifestations. Neuroimaging has been employed in hepatitis C virus-infected patients to find in vivo evidence of central nervous system alterations. AIMS: Systematic review and meta-analysis of neuroimaging research in chronic hepatitis C treatment naive patients, or patients previously treated without sustained viral response, to study structural and functional brain impact of hepatitis C...
March 14, 2018: Alimentary Pharmacology & Therapeutics
Steven L Flamm
Hepatic encephalopathy (HE) is a neuropsychiatric complication commonly associated with liver disease, namely cirrhosis. The inability of the liver to metabolize ammonia results in a buildup of ammonia, which can cross the blood-brain barrier and cause significant neurocognitive impairment. Up to 80% of patients with cirrhosis will experience HE and a large proportion of these patients are at high risk of recurrent HE. There are several factors to consider when developing a cost-effective approach to managing HE, such as patient compliance, the adverse event (AE) profile of drug therapy, efficacy of drug therapy, and relative cost-benefits of drug therapy...
March 2018: American Journal of Managed Care
Kai G Kahl, Tillmann Krüger, Gabriel Eckermann, Heiner Wedemeyer
Depression and liver disease are closely associated. Every third patient with liver cirrhosis or hepatitis shows depressive symptoms. On the other hand, every third patient with depressive disorder develops an alcohol disorder at some point during his / her life. A crucial link between depression and hepatic disease seems to be inflammatory processes in which the microbiome and increased intestinal permeability of the intestine play a pivotal role. Depression as well as liver disease, alcohol consumption, stress, and aging processes disturb the delicate balance of intestinal microbiota resulting in increased intestinal permeability...
February 28, 2018: Fortschritte der Neurologie-Psychiatrie
Andrea Mancini, Francesca Campagna, Piero Amodio, Kieran M Tuohy
Hepatic encephalopathy (HE) is a debilitating neuropsychiatric condition often associated with acute liver failure or cirrhosis. Advanced liver diseases are characterized by a leaky gut and systemic inflammation. There is strong evidence that the pathogenesis of HE is linked to a dysbiotic gut microbiota and to harmful microbial by-products, such as ammonia, indoles, oxindoles and endotoxins. Increased concentrations of these toxic metabolites together with the inability of the diseased liver to clear such products is thought to play an important patho-ethiological role...
February 27, 2018: Food & Function
Yu-Ju Chen, Chao-Liang Chou, Kuan-Ju Lai, Ya-Ju Lin Lin
PURPOSE: Invasive mycosis caused by the Aspergillus, Fusarium, and Mucor can be fetal, especially in the immunocompromised patients with central nervous system (CNS) involvement. Here we present a case of CNS Fusarium infection, and this is the first reported case of Fusarium brain abscess in Taiwan. CASE REPORT: A 65-year-old woman presented with fever and conscious disturbance for 3 days. Neurological examination showed stupor consciousness, neck stiffness, multiple cranial nerves palsy, and bilateral Babinski signs...
September 15, 2017: Acta Neurologica Taiwanica
Zhe-Ting Yang, Hua-Jun Chen, Qiu-Feng Chen, Hailong Lin
Objective: Patients with cirrhosis often exhibit cognitive deficits, particularly executive dysfunction, which is considered a predictor of overt hepatic encephalopathy (OHE). We examined brain intrinsic networks associated with executive function to investigate the neural basis of this cognitive deficiency in cirrhosis. Methods: Resting-state functional MRI data were acquired from 20 cirrhotic patients and 18 healthy controls. Seed-based correlation analysis was used to identify the three well-known networks associated with executive function, including executive control (ECN), default mode (DMN), and salience (SN) networks...
2018: Frontiers in Neurology
Brian C Davis, Jasmohan S Bajaj
Recent advances have led to a greater understanding of how alcohol alters the brain, both in acute stages (intoxication and alcohol withdrawal) and in chronic misuse. This review focuses on the current understanding of how alcohol affects the brain in cirrhosis patients with and without hepatic encephalopathy. Chronic alcohol use is associated with nutritional deficiencies, dementia, cirrhosis, and decompensating events such as hepatic encephalopathy. Direct toxicity on brain tissue, induction of neuro-inflammation, and alcohol's alterations of the gut microbiome are possible mechanisms for the clinical features of hepatic encephalopathy associated with alcohol use...
February 8, 2018: Alcoholism, Clinical and Experimental Research
Michelle Clayton
Patients with cirrhosis are at risk of hepatic encephalopathy (HE). While its pathogenesis is not fully understood, the circulation of increased levels of ammonia through the bloodstream to the brain is thought to be a key causative factor. The ammonia penetrates the blood-brain barrier, ultimately leading to cerebral oedema. This can result in cognitive impairments, which can exhibit in multiple ways, adversely affecting quality of life for both patients and their families. The need for hospitalisation and longer hospital stays associated with HE has cost implications for the health service...
February 7, 2018: British Journal of Nursing: BJN
Khalil Hajiasgharzadeh, Behzad Baradaran
The hepatic vagus branches innervate the liver and serve an important role in liver-brain connection. It appears that brain modulates inflammatory responses by activation of vagal efferent fibers. This activation and subsequent acetylcholine releases from vagus nerve terminals leads to inhibition of inflammatory cytokines through α7 nicotinic acetylcholine receptors (α7nAChRs) which located on the surface of different cell types such as liver Kupffer cells. This protective role of vagus-α7nAChR axis in liver diseases has been shown in several experimental studies...
December 2017: Advanced Pharmaceutical Bulletin
Roxana Cristina Rimbaş, Sorina Mihăilă Baldea, Ruxandra Drăgoi Galrinho Antunes Guerra, Simona Ionela Visoiu, Mihai Rimbaş, Corina Silvia Pop, Dragoş Vinereanu
There are no clear recommendations regarding cirrhotic cardiomyopathy (CC) evaluation in patients with pre-transplant liver cirrhosis. The roles of new methods, tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) in the diagnosis and prognosis of cirrhotic cardiomyopathy remain controversial. We investigated the utility of TDI/STE parameters in cirrhotic cardiomyopathy diagnosis and also in predicting mortality in patients with liver cirrhosis. Left/right ventricular function was studied using conventional TDI (velocities) and STE (strain/strain rate)...
March 2018: Ultrasound in Medicine & Biology
J S Lee, S-H Kim, J H Kwon, Y C Yoon
BACKGROUND: Invasive aspergillosis (IA) is a rare condition that generally affects immunosuppressed patients. The mortality of IA is known to be >90% in liver transplantation (LT) recipients; the lung is the most commonly affected organ, followed by the brain. There have been reports in the literature of cerebral aspergillosis (CA) in LT recipients. In all previous reports, CA developed after LT. We present the first case (to the best of our knowledge) of preexisting CA diagnosed and successfully treated after LT...
December 2017: Transplantation Proceedings
Kashif Asghar, John Brain, Jeremy M Palmer, Stephen Douglass, Fatmah M A Naemi, Graeme O'Boyle, John Kirby, Simi Ali
Indoleamine 2,3-dioxygenase (IDO)-induced immunosuppression can be clinically beneficial for autoimmune diseases. Primary biliary cirrhosis (PBC) is characterized by autoimmune lesions of intrahepatic bile duct epithelial cells that may lead to irreversible cirrhosis or hepatocellular carcinoma. The present study assessed the expression and function of IDO in a cell culture model and in PBC patients. IDO expression was monitored in a human immortalized but non-malignant biliary epithelial cell (iBEC) line. Increased expression of IDO1/2 was observed in the iBECs following stimulation with interferon-γ (IFN-γ)...
November 2017: Oncology Letters
Bhavna N Desai, Garima Singhal, Mikiko Watanabe, Darko Stevanovic, Thomas Lundasen, Ffolliott M Fisher, Marie L Mather, Hilde G Vardeh, Nicholas Douris, Andrew C Adams, Imad A Nasser, Garret A FitzGerald, Jeffrey S Flier, Carsten Skarke, Eleftheria Maratos-Flier
OBJECTIVE: Excess ethanol consumption has serious pathologic consequences. In humans, repeated episodes of binge drinking can lead to liver damage and have adverse effects on other organs such as pancreas and brain. Long term chronic consumption of ethanol can also result in progressive alcoholic liver disease and cirrhosis. Fibroblast growth factor 21 (FGF21) is a metabolic regulator with multiple physiologic functions. FGF21 is a novel biomarker for non-alcoholic fatty liver disease (NAFLD) in humans and limits hepatotoxicity in mice...
November 2017: Molecular Metabolism
Rafael Sartori Balbinot, Ana Laura Facco Muscope, Mateus Dal Castel, Silvana Sartori Balbinot, Raul Angelo Balbinot, Jonathan Soldera
Although extrahepatic metastases from hepatocellular carcinoma (HCC) are present in only 5-15% of cases, they are certainly factors associated with poor prognosis. The main sites include lung, lymph nodes, bones, and adrenal glands, in descending order. Metastasis in the central nervous system is extremely rare, and the incidences vary from 0.6 to 1.7%. We report a case of a 54-year-old man previously diagnosed with alcohol-induced cirrhosis of the liver and HCC. The patient was admitted presenting progressive left hemiparesis and headache which started 2 days earlier, with no history of cranioencephalic trauma...
September 2017: Case Reports in Gastroenterology
Tarana Gupta, Radha K Dhiman, Chirag K Ahuja, Swastik Agrawal, Madhu Chopra, Naveen Kalra, Ajay Duseja, Sunil Taneja, Niranjan Khandelwal, Yogesh Chawla
BACKGROUND AND AIMS: The nature of cerebral edema in acute-on-chronic liver failure (ACLF) is not well studied. We aimed to characterize cerebral edema in ACLF using magnetization transfer ratio (MTR) and diffusion tensor imaging (DTI). METHODS: Forty-six patients with cirrhosis and acute decompensation were included. Patients were divided into groups A (no cerebral failure, n = 39) and B (cerebral failure, n = 7). Group A was subdivided into no-ACLF (n = 11), grade 1 (n = 10), grade 2 (n = 9) and grade 3 (n = 9) ACLF as per CANONIC study...
September 2017: Journal of Clinical and Experimental Hepatology
Syeda Zainab Ilyas, Rabia Tabassum, Haroon Hamed, Shafiq Ur Rehman, Ishtiaq Qadri
Besides liver cirrhosis and hepatocellular carcinoma, chronic hepatitis C virus (HCV) infection is associated with many extrahepatic manifestations (EHMs). HCV exhibits lymphotropism that is responsible for various EHM. An important characteristic of HCV is escape from the immune system, which enables it to produce chronic infections and autoimmune disorders along with accumulation of circulating immune complexes. These EHMs have large spectrum, because they affect many organs such as heart, lungs, kidney, brain, thyroid, and skin...
November 2017: Viral Immunology
Liu-Xian Wang, Li Guo, Fan Guo, Shu-Yao Ren, Ning-Bo Fei, Kang Liu, Lin Liu, Tian-Lei Yu, Chuang-Ye He, Yi-Bin Xi, Ping Tian, Long-Biao Cui, Zhan-Xin Yin, Zheng-Yu Wang, Wei Qin, Guo-Hong Han, Hong Yin
We aimed to detect alterations in diffusion characteristics of brain white matter in hepatic myelopathy (HM) patients. Liver cirrhosis patients with (n=25) and without (n=18) HM after transjugular intrahepatic portosystemic shunt and 26 healthy controls were enrolled in this study. All participants were scanned with diffusion tensor imaging on a 3T Siemens scanner. Tract-based spatial statistics analysis was used to detect abnormalities of intracranial white matter tracts. Correlations between clinical characteristics and diffusion metrics were also calculated...
December 6, 2017: Neuroreport
Donald J Grandis, Gregory Nah, Isaac R Whitman, Eric Vittinghoff, Thomas A Dewland, Jeffrey E Olgin, Gregory M Marcus
Wilson's disease is a well-characterized disorder known to cause liver and brain disease due to abnormal copper deposition. Data regarding copper infiltration of the heart is conflicting, and the risk of heart disease has not been well described. We aimed to determine whether Wilson's disease is associated with cardiac myopathy, clinically evident in the atria as atrial fibrillation (AF) and in the ventricles as heart failure (HF). We longitudinally assessed 14.3 million patients in the California Healthcare Cost and Utilization Project database from 2005 through 2009 for diagnoses of Wilson's disease, AF, HF, and covariates using International Classification of Diseases-9th Edition codes...
December 1, 2017: American Journal of Cardiology
Tomomi Kogiso, Mutsuki Kobayashi, Kuniko Yamamoto, Yuichi Ikarashi, Kazuhisa Kodama, Makiko Taniai, Nobuyuki Torii, Etsuko Hashimoto, Katsutoshi Tokushige
Objective Hyponatremia is frequently observed in patients with decompensated liver cirrhosis and it is also related to a poor prognosis. The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites and increases the serum sodium (Na) level. In this study, we investigated (i) whether or not correction of the Na level improves the prognosis of cirrhotic patients with ascites and (ii) predictors of normalization of the serum Na level after tolvaptan therapy. Methods This was a single-center retrospective study...
November 15, 2017: Internal Medicine
Hideaki Takada, Takashi Kobayashi, Kohei Ogawa, Hitomi Miyata, Atsuro Sawada, Shusuke Akamatsu, Hiromitsu Negoro, Ryoichi Saito, Naoki Terada, Toshinari Yamasaki, Takahiro Inoue, Yuki Teramoto, Shinsuke Shibuya, Hironori Haga, Toshimi Kaido, Shinji Uemoto, Osamu Ogawa
We report a case of lethal hepatorenal insufficiency in a 52-year-old man who received successful simultaneous hepatorenal transplantation from a deceased donor. The patient had undergone live-donor liver transplantation for type-C hepatitis and liver cirrhosis 11 years before he developed graft liver dysfunction due to recurrent viral hepatitis and cirrhosis. At that instance, he also developed end-stage renal dysfunction due to calcineurin inhibitor nephropathy and hepatorenal syndrome. Although he needed three open hemostases and abundant blood transfusion, he was withdrawn from continuous hemodiafiltration on the 55th day and discharged from the hospital on the 272nd day postoperatively...
August 2017: Hinyokika Kiyo. Acta Urologica Japonica
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