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Minimal encephalopathy

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https://www.readbyqxmd.com/read/29237520/-patterns-of-brain-injury-in-neonatal-hypoxic-ischemic-encephalopathy-on-magnetic-resonance-imaging-recommendations-on-classification
#1
Jian Mao
Although there are unified criteria for the clinical diagnosis and grading of neonatal hypoxic-ischemic encephalopathy (HIE), clinical features and neuropathological patterns vary considerably among the neonates with HIE due to birth asphyxia in the same classification. The patterns and progression of brain injury in HIE, which is closely associated with long-term neurodevelopment outcomes, can be well shown on magnetic resonance imaging (MRI), but different sequences may lead to different MRI findings at the same time...
December 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29216388/insulin-resistance-disrupts-the-interaction-between-akt-and-the-nmda-receptor-and-the-inactivation-of-the-camkiv-creb-pathway-in-minimal-hepatic-encephalopathy
#2
Saidan Ding, Weishan Zhuge, Jianjing Yang, Fangfang Wen, Zhu Xu, Xuebao Wang, Qichuan Zhuge
No abstract text is available yet for this article.
December 5, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29201772/managing-encephalopathy-in-the-outpatient-setting
#3
REVIEW
Tarana Gupta, Sahaj Rathi, Radha K Dhiman
In cirrhosis of liver, hepatic encephalopathy (HE) has an important impact on health-related quality of life. It is important to define whether HE is episodic, recurrent, or persistent; types A, B, or C; overt HE or covert HE; and spontaneous or precipitated. The overt HE is clinically evident and needs hospitalization. Nonabsorbable disaccharides, rifaximin, and probiotics are proven to be useful in the treatment of overt HE. Covert HE includes both minimal HE and grade I HE. It is not apparent on routine clinical examination...
January 2017: Euroasian journal of hepato-gastroenterology
https://www.readbyqxmd.com/read/29201193/effect-of-different-treatments-and-alcohol-addiction-on-gut-microbiota-in-minimal-hepatic-encephalopathy-patients
#4
Zan Zuo, Hong Fan, Xiao-Dan Tang, Yan-Min Chen, Lin-Ting Xun, Yan Li, Zheng-Ji Song, Hui-Qiong Zhai
Minimal hepatic encephalopathy (MHE) is caused by dysbiosis of gut microbiota, particularly the ammonia-producing bacteria. Given the efficacy of certain treatments on MHE and the connection between alcoholism and MHE, a thorough understanding of how these strategies affect the gut microbiota in patients (alcoholic or non-alcoholic) will facilitate the assessment of their efficacy in the reshaping of gut microbiota. In the present study, a metagenomics approach was adopted to reveal alterations in gut microbiota of 14 MHE patients following treatment with rifaximin alone or rifaximin plus probiotics...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29199027/10-patients-10-years-long-term-follow-up-of-cardiovascular-risk-factors-in-glut1-deficiency-treated-with-ketogenic-diet-therapies-a%C3%A2-prospective-multicenter-case-series
#5
Nicole Heussinger, Adela Della Marina, Andreas Beyerlein, Baerbel Leiendecker, Sofia Hermann-Alves, Robert Dalla Pozza, Joerg Klepper
BACKGROUND AND AIMS: Glut1 Deficiency (Glut1D) is caused by impaired glucose transport into brain. The resulting epileptic encephalopathy and movement disorders can be treated effectively by high-fat carbohydrate-restricted ketogenic diet therapies (KDT) mimicking fasting and providing ketones as an alternative cerebral fuel. Recently 6-24 months follow-ups of epileptic patients reported elevated blood lipids and intima thickening of the carotid artery raising concerns about potential cardiovascular risks by KDT...
November 11, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29171503/-prevention-and-treatment-of-hepatic-encephalopathy
#6
Yu P Sivolap
Hepatic encephalopathy is a common neuropsychiatric complication of serious liver diseases and serves as a marker for worsening of their course and increasing the risk of death. The principal pathogenesis factors of hepatic encephalopathy is the excessive formation of ammonia and its accumulation by astrocytes. A key role in the prevention and treatment of hepatic encephalopathy is played by drugs that prevent hyperammonemia and promote the removal of ammonia from the body, namely lactulose, rifaximin and L-ornithine-L-aspartate...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29115938/carbon-ion-radiotherapy-for-80%C3%A2-years-or-older-patients-with-hepatocellular-carcinoma
#7
Shintaro Shiba, Takanori Abe, Kei Shibuya, Hiroyuki Katoh, Yoshinori Koyama, Hirohumi Shimada, Satoru Kakizaki, Ken Shirabe, Hiroyuki Kuwano, Tatsuya Ohno, Takashi Nakano
BACKGROUND: To evaluate the safety and efficacy of carbon ion radiotherapy (C-ion RT) for 80 years or older patients with hepatocellular carcinoma (HCC). METHODS: Eligibility criteria of this retrospective study were: 1) HCC confirmed by histology or typical hallmarks of HCC by imaging techniques of four-phase multidetector-row computed tomography or dynamic contrast-enhanced magnetic resonance imaging; 2) no intrahepatic metastasis or distant metastasis; 3) no findings suggesting direct infiltration of the gastrointestinal tract; 4) performance status ≤2 by Eastern Cooperative Oncology Group classification; and 5) Child-Pugh classification A or B...
November 7, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29097814/multi-sensory-integration-impairment-in-patients-with-minimal-hepatic-encephalopathy
#8
Kyoungwon Seo, Dae Won Jun, Jae-Kwan Kim, Hokyoung Ryu
Paper-and-pencil-based psychometric tests are the gold standard for diagnosis of cognitive dysfunction in liver disease. However, they take time, can be affected by demographic factors, and lack ecological validity. This study explored multi-sensory integration ability to discriminate cognitive dysfunction in cirrhosis. Thirty-two healthy controls and 30 cirrhotic patients were recruited. The sensory integration test presents stimuli from two different modalities (e.g., image/sound) with a short time lag, and subjects judge which stimuli appeared first...
November 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29077582/neuroimaging-in-the-diagnosis-of-chronic-traumatic-encephalopathy-a-systematic-review
#9
Philip Sparks, Tim Lawrence, Stephan Hinze
OBJECTIVE: Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repeated subconcussive and concussive head injury. Clinical features include cognitive, behavioral, mood, and motor impairments. Definitive diagnosis is only possible at postmortem. Here, the utility of neuroimaging in the diagnosis of CTE is evaluated by systematically reviewing recent evidence for changes in neuroimaging biomarkers in suspected cases of CTE compared with controls. DATA SOURCES: Providing an update on a previous systematic review of articles published until December 2014, we searched for articles published between December 2014 and July 2016...
October 25, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29049389/endemic-chronic-wasting-disease-causes-mule-deer-population-decline-in-wyoming
#10
Melia T DeVivo, David R Edmunds, Matthew J Kauffman, Brant A Schumaker, Justin Binfet, Terry J Kreeger, Bryan J Richards, Hermann M Schätzl, Todd E Cornish
Chronic wasting disease (CWD) is a fatal transmissible spongiform encephalopathy affecting white-tailed deer (Odocoileus virginianus), mule deer (Odocoileus hemionus), Rocky Mountain elk (Cervus elaphus nelsoni), and moose (Alces alces shirasi) in North America. In southeastern Wyoming average annual CWD prevalence in mule deer exceeds 20% and appears to contribute to regional population declines. We determined the effect of CWD on mule deer demography using age-specific, female-only, CWD transition matrix models to estimate the population growth rate (λ)...
2017: PloS One
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#11
Lori Kennedy Madden, Michelle Hill, Teresa L May, Theresa Human, Mary McKenna Guanci, Judith Jacobi, Melissa V Moreda, Neeraj Badjatia
BACKGROUND: Targeted temperature management (TTM) is often used in neurocritical care to minimize secondary neurologic injury and improve outcomes. TTM encompasses therapeutic hypothermia, controlled normothermia, and treatment of fever. TTM is best supported by evidence from neonatal hypoxic-ischemic encephalopathy and out-of-hospital cardiac arrest, although it has also been explored in ischemic stroke, traumatic brain injury, and intracranial hemorrhage patients. Critical care clinicians using TTM must select appropriate cooling techniques, provide a reasonable rate of cooling, manage shivering, and ensure adequate patient monitoring among other challenges...
October 16, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29023586/reduced-resting-state-connectivity-and-gray-matter-volume-correlate-with-cognitive-impairment-in-minimal-hepatic-encephalopathy
#12
Raquel García-García, Álvaro Javier Cruz-Gómez, Alba Mangas-Losada, Amparo Urios, Cristina Forn, Desamparados Escudero-García, Elena Kosenko, Juan Fermín Ordoño, Joan Tosca, Remedios Giner-Durán, Miguel Angel Serra, César Avila, Vicente Belloch, Vicente Felipo, Carmina Montoliu
BACKGROUND AND AIMS: Minimal hepatic encephalopathy (MHE) is associated with cognitive alterations and changes in connectivity. We assessed the relationship of the abnormalities of resting-state functional connectivity (rs-FC) and gray matter (GM) volume with different cognitive alterations and biochemical parameters associated to MHE. METHODS: Thirty-nine cirrhotic patients (26 without and 13 with MHE) and 24 controls were widely cognitive assessed with a battery of psychometric tests...
2017: PloS One
https://www.readbyqxmd.com/read/29020023/the-continuous-reaction-time-test-for-minimal-hepatic-encephalopathy-validated-by-a-randomized-controlled-multi-modal-intervention-a-pilot-study
#13
RANDOMIZED CONTROLLED TRIAL
M M Lauridsen, S Mikkelsen, T Svensson, J Holm, C Klüver, J Gram, H Vilstrup, O B Schaffalitzky de Muckadell
BACKGROUND: Minimal hepatic encephalopathy (MHE) is clinically undetectable and the diagnosis requires psychometric tests. However, a lack of clarity exists as to whether the tests are in fact able to detect changes in cognition. AIM: To examine if the continuous reaction time test (CRT) can detect changes in cognition with anti-HE intervention in patients with cirrhosis and without clinically manifest hepatic encephalopathy (HE). METHODS: Firstly, we conducted a reproducibility analysis and secondly measured change in CRT induced by anti-HE treatment in a randomized controlled pilot study: We stratified 44 patients with liver cirrhosis and without clinically manifest HE according to a normal (n = 22) or abnormal (n = 22) CRT...
2017: PloS One
https://www.readbyqxmd.com/read/28974999/malignant-posterior-reversible-encephalopathy-syndrome-an-exacting-challenge-for-neurocritical-care-physicians
#14
Shahvaiz Magsi, Atif Zafar
We report a case of malignant posterior reversible encephalopathy syndrome (PRES) in a 62-year-old Caucasian female with a complex medical history and comorbidities admitted for bowel resection and lysis of iatrogenic bowel adhesions and enterocutaneous fistulas. Postoperatively, the patient developed sudden bilateral visual loss with no other neurologic deficits. Computed tomography scan showed very severe PRES-like changes, confirmed on magnetic resonance imaging (MRI). Systolic blood pressure remained around 170 mm HG...
October 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28965835/dopamine-induces-glutamate-accumulation-in-astrocytes-to-disrupt-neuronal-function-leading-to-pathogenesis-of-minimal-hepatic-encephalopathy
#15
Saidan Ding, Xuebao Wang, Weishan Zhuge, Jianjing Yang, Qichuan Zhuge
Minimal hepatic encephalopathy (MHE) is induced by elevated intracranial dopamine (DA). Glutamate (Glu) toxicity is known to be involved in many neurological disorders. In this study, we investigated whether DA increased Glu levels and collaborated with Glu to impair memory. We found that DA upregulated TAAR1, leading to reduced EAAT2 expression and Glu clearance in primary cortical astrocytes (PCAs). High DA increased TAAR1 expression, and high Glu increased AMPAR expression, inducing the activation of CaN/NFAT signaling and a decrease in the production of BDNF (Brain Derived Nerve Growth Factor)/NT3 (neurotrophin-3) in primary cortical neurons (PCNs)...
December 4, 2017: Neuroscience
https://www.readbyqxmd.com/read/28953991/candesartan-rather-than-losartan-improves-motor-dysfunction-in-thioacetamide-induced-chronic-liver-failure-in-rats
#16
H A Murad, Z J Gazzaz, S S Ali, M S Ibraheem
Minimal hepatic encephalopathy is more common than the acute syndrome. Losartan, the first angiotensin-II receptor blocker (ARB), and candesartan, another widely-used ARB, have protected against developing fibrogenesis, but there is no clear data about their curative antifibrotic effects. The current study was designed to examine their effects in an already-established model of hepatic fibrosis and also their effects on the associated motor dysfunction. Low-grade chronic liver failure (CLF) was induced in 3-month old Sprague-Dawley male rats using thioacetamide (TAA, 50 mg·kg-1·day-1) intraperitoneally for 2 weeks...
September 21, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28932186/da-negatively-regulates-igf-i-actions-implicated-in-cognitive-function-via-interaction-of-psd95-and-nnos-in-minimal-hepatic-encephalopathy
#17
Saidan Ding, Weishan Zhuge, Xuebao Wang, Jianjing Yang, Yuanshao Lin, Chengde Wang, Jiangnan Hu, Qichuan Zhuge
Insulin-like growth factor I (IGF-I) has been positively correlated with cognitive ability. Cognitive decline in minimal hepatic encephalopathy (MHE) was shown to be induced by elevated intracranial dopamine (DA). The beneficial effect of IGF-I signaling in MHE remains unknown. In this study, we found that IGF-I content was reduced in MHE rats and that IGF-I administration mitigated cognitive decline of MHE rats. A protective effect of IGF-I on the DA-induced interaction between postsynaptic density protein 95 (PSD95) and neuronal nitric oxide synthase (nNOS) was found in neurons...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28926420/seronegative-paraneoplastic-limbic-encephalitis-associated-with-thymoma
#18
Jaime Toro, David Cuellar-Giraldo, Alejandra Duque, Karla Minota, Jorge Patiño, Manuel García
Paraneoplastic limbic encephalitis is an autoimmune syndrome characterized by the acute or subacute onset of encephalopathy, memory loss, confusion, temporal lobe seizures, and behavioral and mood changes. Although most patients with paraneoplastic limbic encephalitis have antineuronal antibodies, advances in the field now permit the diagnosis without autoantibody test results. In this case illustrating the new diagnostic criteria, we report a 70-year-old woman who was brought to the emergency room after the acute onset of cognitive impairment, altered mental status, and choreoathetoid movements...
September 2017: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/28925994/chimeric-antigen-receptor-t-cell-therapy-assessment-and-management-of-toxicities
#19
REVIEW
Sattva S Neelapu, Sudhakar Tummala, Partow Kebriaei, William Wierda, Cristina Gutierrez, Frederick L Locke, Krishna V Komanduri, Yi Lin, Nitin Jain, Naval Daver, Jason Westin, Alison M Gulbis, Monica E Loghin, John F de Groot, Sherry Adkins, Suzanne E Davis, Katayoun Rezvani, Patrick Hwu, Elizabeth J Shpall
Immunotherapy using T cells genetically engineered to express a chimeric antigen receptor (CAR) is rapidly emerging as a promising new treatment for haematological and non-haematological malignancies. CAR-T-cell therapy can induce rapid and durable clinical responses, but is associated with unique acute toxicities, which can be severe or even fatal. Cytokine-release syndrome (CRS), the most commonly observed toxicity, can range in severity from low-grade constitutional symptoms to a high-grade syndrome associated with life-threatening multiorgan dysfunction; rarely, severe CRS can evolve into fulminant haemophagocytic lymphohistiocytosis (HLH)...
September 19, 2017: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/28919805/a-pilot-evaluation-of-a-computer-based-psychometric-test-battery-designed-to-detect-impairment-in-patients-with-cirrhosis
#20
Nicola A Cook, Jin Un Kim, Yasmin Pasha, Mary Me Crossey, Adrian J Schembri, Brian T Harel, Torben Kimhofer, Simon D Taylor-Robinson
BACKGROUND: Psychometric testing is used to identify patients with cirrhosis who have developed hepatic encephalopathy (HE). Most batteries consist of a series of paper-and-pencil tests, which are cumbersome for most clinicians. A modern, easy-to-use, computer-based battery would be a helpful clinical tool, given that in its minimal form, HE has an impact on both patients' quality of life and the ability to drive and operate machinery (with societal consequences). AIM: We compared the Cogstate™ computer battery testing with the Psychometric Hepatic Encephalopathy Score (PHES) tests, with a view to simplify the diagnosis...
2017: International Journal of General Medicine
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