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chronic bilirubin encephalopathy

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
Kalpana Bhardwaj, Tiffany Locke, Anne Biringer, Allyson Booth, Elizabeth Kathleen Darling, Shelley Dougan, Jane Harrison, Stephen Hill, Ana Johnson, Susan Makin, Beth Potter, Thierry Lacaze-Masmonteil, Julian Little
: hyperbilirubinemia [2], every newborn should be assessed for the risk of developing severe hyperbilirubinemia with the help of predischarge total serum bilirubin or transcutaneous bilirubin measurements and/or assessments of clinical risk factors. The aim of this rapid review is 1) to review the evidence for 1) predicting and preventing severe hyperbilirubinemia and bilirubin encephalopathy, 2) determining the efficacy of home/community treatments (home phototherapy) in the prevention of severe hyperbilirubinemia, and 3) non-invasive/transcutaneous methods for estimating serum bilirubin level...
January 10, 2017: Current Pediatric Reviews
Jonel Trebicka
Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of cirrhosis such as variceal bleeding and refractory ascites, but it also bears the risk of liver failure, overt hepatic encephalopathy (HE) and cardiac decompensation. Variceal bleeding may be controlled using endoscopic and medical treatment in patients with compensated cirrhosis; in decompensated patients, however, TIPS improves survival. Therefore, an early TIPS (within 72h or if later, still early after bleeding) might improve the survival of patients by preventing an inflammatory response and bacterial translocation...
October 29, 2016: Journal of Hepatology
Q R Gan, X Y Jiang, X Zhang, M S Chen, C Pan
Objective: To investigate the association between serum keratin 18 (K18) level and prognosis in patients with HBV-related acute-on-chronic liver failure (ACLF). Methods: A total of 120 patients who visited Department of Hepatology in Fuzhou Infectious Disease Hospital and were diagnosed with HBV-related ACLF from December 2012 to March 2014 were enrolled and followed up for 3 months. The patients were divided into death group and survival group. The serum levels of K18 fragments (M30 and M65) were measured and related laboratory data were collected to analyze the differences in M30, M65, M30/M65, and other laboratory markers...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Asmaa N Mohammad, Khairy H Morsy, Moustafa A Ali
BACKGROUND/AIMS: To find the most accurate, suitable, and applicable scoring system for the prediction of outcome in cirrhotic patients with bleeding varices. MATERIALS AND METHODS: A prospective study was conducted comprising 120 cirrhotic patients with acute variceal bleeding who were admitted to Tropical Medicine and Gastroenterology Department in Sohag University Hospital, over a 1-year period (1/2015 to 1/2016). The clinical, laboratory, and endoscopic parameters were studied...
September 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Sean M Riordan, Douglas C Bittel, Jean-Baptiste Le Pichon, Silvia Gazzin, Claudio Tiribelli, Jon F Watchko, Richard P Wennberg, Steven M Shapiro
Genetic-based susceptibility to bilirubin neurotoxicity and chronic bilirubin encephalopathy (kernicterus) is still poorly understood. Neonatal jaundice affects 60-80% of newborns, and considerable effort goes into preventing this relatively benign condition from escalating into the development of kernicterus making the incidence of this potentially devastating condition very rare in more developed countries. The current understanding of the genetic background of kernicterus is largely comprised of mutations related to alterations of bilirubin production, elimination, or both...
2016: Frontiers in Neuroscience
Hsin-Ling Ho, Shao-Jung Hsu, Fa-Yauh Lee, Hui-Chun Huang, I-Fang Hsin, Ming-Chih Hou, Shou-Dong Lee
BACKGROUND: Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome secondary to acute or chronic liver failure. However, its pathophysiology remains obscure. Recently, we found that the inhibition of cyclooxygenase by indomethacin aggravated HE in rats with thioacetamide-induced acute hepatic failure, suggesting a pivotal role of cyclooxygenase in HE. This study was aimed at surveying the roles of cyclooxygenase isoforms responsible for prostaglandins synthesis, cyclooxygenase-1 (COX1) and COX2, in cirrhotic rats with HE...
August 28, 2016: Journal of the Chinese Medical Association: JCMA
S H Ou, Y P Chen, R L Jiang, J Peng
OBJECTIVE: To investigate the prognostic factors for acute-on-chronic liver failure (ACLF) after the withdrawal of nucleos(t)ide analogues (NAs) for the antiviral treatment of chronic hepatitis B (CHB). METHODS: The clinical data of 67 hospitalized patients with ACLF after withdrawal of NAs for the antiviral treatment of CHB were analyzed retrospectively. RESULTS: The HBeAg status before initial treatment and after recurrence, course of the antiviral treatment, duration from the withdrawal of NAs to recurrence, and type of NAs before and after withdrawal were not associated with the prognosis of ACLF...
April 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Lisa Baumann, Susanne Haen, Christoph Berg, Ferruh Artunc, Reimer Riessen, Werner Spengler, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: We report on a 48-year-old man presenting with progressive hepatopathy and encephalopathy for two weeks based on a chronic hepatitis C. He takes ledipasvir and sofosbuvir (Harvoni) and ribavirin for almost 24 weeks. After admission to hospital his state deteriorated rapidly. He is directly transferred to the medical intensive care unit, where he died on day 3. INVESTIGATIONS: During the physical examination, a pronounced jaundice and significant peripheral edema were found...
July 2016: Deutsche Medizinische Wochenschrift
Jin Hee Jeong, In Sung Park, Dong Hoon Kim, Seong Chun Kim, Changwoo Kang, Soo Hoon Lee, Tae Yun Kim, Sang Bong Lee
Hepatic encephalopathy (HE) is a complication associated with worst prognosis in decompensated liver cirrhosis (LC) patients. Previous studies have identified prognostic factors for HE, and recent studies reported an association between systemic inflammatory response syndrome (SIRS) and liver disease. This study aimed to identify prognostic factors for 30-day mortality in alcoholic LC patients with HE who visited the emergency department (ED).This was a retrospective study of alcoholic LC patients with HE from January 1, 2010, to April 30, 2015...
June 2016: Medicine (Baltimore)
Cecilia A Mabogunje, Sarah M Olaifa, Bolajoko O Olusanya
Several clinical guidelines for the management of infants with severe neonatal hyperbilirubinemia recommend immediate exchange transfusion (ET) when the risk or presence of acute bilirubin encephalopathy is established in order to prevent chronic bilirubin encephalopathy or kernicterus. However, the literature is sparse concerning the interval between the time the decision for ET is made and the actual initiation of ET, especially in low- and middle-income countries (LMICs) with significant resource constraints but high rates of ET...
May 8, 2016: World Journal of Clinical Pediatrics
C Li, S Lyu, B Zhu, Z H Wan, W S Liu, L Guo, S L You, S J Xin
OBJECTIVE: To investigate the risk factors for the short-term outcome of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), and to establish a risk model for predicting the short-term outcome of these patients. METHODS: A total of 338 patients with HBV-related ACLF who were admitted to 30 Lod hospital of PLA hospital from January 2010 to January 2014 were enrolled, and a prospective clinical follow-up was performed for them. Multivariate logistic regression was used to determine the risk factors for short-term (12 weeks) outcome, the predictive model with logistic regression equation was established, and the predictive value of this model was evaluated...
March 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Qianqian Zhang, Xiaolin Guo, Shixing Zhao, Xiaoli Pang, Yang Wang, Yujiao Zhang, Baorong Chi
The present study aimed to analyze the prognostic factors of acute-on-chronic liver failure (ACLF), with the perspective of an improved selection of optimal therapeutic schemes. A retrospective analysis was used to study 164 patients with ACLF hospitalized between 2010 and 2014 in a single center. Patients were divided into favorable and unfavorable groups, according to the treatment outcomes. General characteristics and clinical manifestations were analyzed to determine whether they would affect the prognosis of the patients with ACLF, with a particular focus on the scoring systems Child-Pugh, model for end-stage liver disease (MELD), MELD with incorporation of sodium (MELD-Na), MELD and serum sodium ratio (MESO) and integrated MELD (iMELD)...
April 2016: Experimental and Therapeutic Medicine
Muhammad Khurram, Wajeeha Qayyum, Muhammad Umar, Zain ul Abedin, Hamama Tul Bushra
BACKGROUND: Model for End Stage Liver Disease (MELD) is scoring system used for prioritization of patients waiting liver transplantation. Patients with decompensated chronic liver disease (DCLD) with higher MELD score and hepatic encephalopathy (HE) have poor outcome. We planned to note association between short-term mortality and various cut-off values of at admission MELD score in HCV related DCLD patients presenting with HE. METHODS: In this descriptive case series, 208 Hepatitis C (HCV) related chronic liver disease (CLD) patients with HE were included...
October 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Seema Alam, Bikrant B Lal, Vikrant Sood, Dinesh Rawat
OBJECTIVES: The aim of the study was to assess the prevalence, profile, outcome, and predictive factors of pediatric acute-on-chronic liver failure (ACLF). METHODS: All children 3 months to 18 years satisfying the Asia Pacific Association for the Study of Liver Diseases definition of ACLF were included. Data were both extracted from records (January 2011 to December 2014) and prospectively collected (January to October 2015). Successful outcome was defined as survival with native liver at 90 days, whereas poor outcome included those who died or received liver transplantation...
October 2016: Journal of Pediatric Gastroenterology and Nutrition
Aisling Barry, Jennifer J Knox, Alice C Wei, Laura A Dawson
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
February 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Wan Yue-Meng, Li-Hong Yang, Jin-Hui Yang, Ying Xu, Jing Yang, Gui-Bo Song
BACKGROUND AND AIMS: Various studies showed that entecavir (ETV) failed to improve the short-term survival in chronic hepatitis B (CHB) patients with severe acute exacerbation (SAE) and hepatic de-compensation or acute-on-chronic liver failure (ACLF). One study concluded that plasma exchange (PE) significantly decreased the short-term mortality of CHB patients with ACLF who were treated with lamivudine (LAM). Our study was designed to examine the effect of PE on CHB patients with ACLF who were treated with ETV...
May 2016: Hepatology International
Gaeun Kim, Young Woo Eom, Soon Koo Baik, Yeonghee Shin, Yoo Li Lim, Moon Young Kim, Sang Ok Kwon, Sei Jin Chang
Based on their ability to differentiate into multiple cell types including hepatocytes, the transplantation of mesenchymal stem cells (MSCs) has been suggested as an effective therapy for chronic liver diseases. The aim of this study was to evaluate the safety, efficacy and therapeutic effects of MSCs in patients with chronic liver disease through a literature-based examination. We performed a systematic review (SR) and meta-analysis (MA) of the literature using the Ovid-MEDLINE, EMBASE and Cochrane Library databases (up to November 2014) to identify clinical studies in which patients with liver diseases were treated with MSC therapy...
October 2015: Journal of Korean Medical Science
E T Contreras, U Giger, J L Malmberg, J M Quimby, P A Schaffer
A 7-month-old female domestic shorthair cat was diagnosed with chronic regenerative hemolytic anemia characterized by increased osmotic fragility of unknown etiology. At 13 months of age, the cat was evaluated for acute collapse. The cat was icteric with severe hyperbilirubinemia but no hematocrit changes. Severe obtundation and lateral recumbency progressed to tetraparesis and loss of proprioception in all 4 limbs, and a cerebellar or brainstem lesion was suspected. Postmortem examination revealed suppurative cholangiohepatitis and acute neuronal necrosis in the nuclei of the brainstem and cerebellum, consistent with bilirubin encephalopathy...
May 2016: Veterinary Pathology
Yu-Bao Zheng, Shi-Bin Xie, Dong-Ying Xie, Liang Peng, Zi-Ying Lei, Hong Deng, Bin-Liang Lin, Chao-Shuang Lin, Zhi-Xin Zhao, Wei-Min Ke, Zhi-Liang Gao
PURPOSE: The present study was done to establish an objective, sensitive prognostic scoring system and to determine the applicability of this model in predicting the 3-month mortality of patients with acute-on-chronic liver failure in hepatitis B (ACLFB). METHODS: We developed a novel prognostic scoring system, calculated from six clinical indices including serum total bilirubin, prothrombin activity, serum creatinine, hepatic encephalopathy, infections, and the depth of ascites from 499 patients with ACLFB...
October 2012: Hepatology International
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