15,710 results match your criteria Encephalopathy Hepatic


Prognostic performance of seven biomarkers compared to liver biopsy in early alcohol-related liver disease.

J Hepatol 2021 Jun 9. Epub 2021 Jun 9.

Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.

Background & Aims: Alcohol is the most common cause of liver-related mortality and morbidity. We therefore aimed to assess and compare the prognostic performance of elastography and blood-based markers to predict time to the first liver-related event, severe infection, and all-cause mortality in patients with a history of excess drinking.

Methods: Prospective cohort study of patients with early, compensated alcohol-related liver disease. Read More

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Prediction of post TIPS hepatic encephalopathy: are we there yet?

Hepatol Int 2021 Jun 11. Epub 2021 Jun 11.

Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 110029, India.

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[A case report of splenorenal shunt embolization for treatment of refractory hepatic encephalopathy after liver transplantation].

Zhonghua Gan Zang Bing Za Zhi 2021 May;29(5):474-476

Department of Infectious Disease, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.

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Hepatic venous-portal gradient (HVPG) measurement: pearls and pitfalls.

Br J Radiol 2021 Jun 9:20210061. Epub 2021 Jun 9.

Department of Vascular and Interventional Radiology, Division of Radiological Sciences, Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Singapore, Singapore.

Hepatic venous pressure gradient (HVPG) is the gold-standard for measurement of portal hypertension, a common cause for life-threatening conditions such as variceal bleeding and hepatic encephalopathy. HVPG also plays a crucial role in risk stratification, treatment selection and assessment of treatment response. Thus recognition of common pitfalls and unusual hepatic venous conditions is crucial. Read More

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The incidence and outcome of postoperative hepatic encephalopathy in patients with cirrhosis.

United European Gastroenterol J 2021 Jun 8. Epub 2021 Jun 8.

Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.

Background: Cirrhosis is associated with increased perioperative risks related to hepatic decompensation. However, data are lacking regarding the incidence and outcomes of postoperative hepatic encephalopathy (HE).

Objective: To determine the incidence of HE postoperatively, factors associated with its development, and its association with in-hospital mortality. Read More

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Clinical Outcomes of Children Diagnosed Dengue-Associated Acute Liver Failure with or without N-Acetylcysteine Treatment: A Retrospective Cohort Study.

J Trop Pediatr 2021 May;67(2)

Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

Objectives: N-acetylcysteine (NAC) has been shown to prevent hepatic damage and improve microcirculatory blood flow and oxygen delivery to the tissue. Previous studies have proposed the benefit of NAC in dengue-associated acute liver failure (ALF). However, most studies are descriptive and lack comparison between groups. Read More

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Use of Lactulose to Treat Hyperammonemia in ICU Patients Without Chronic Liver Disease or Significant Hepatocellular Injury.

J Intensive Care Med 2021 Jun 8:8850666211023004. Epub 2021 Jun 8.

Department of Anesthesia, Section on Critical Care Medicine, Wake Forest Baptist Medical Center, Wake Forest School of Medicine, Winston-Salem, NC, USA.

Objectives: To review ICU patients with elevated ammonia without a clear hepatic etiology, to compare outcomes between those who received lactulose and those who did not.

Design: Retrospective observational study.

Setting: Medical, surgical, and subspecialty intensive care units at Wake Forest Baptist Medical Center, Winston-Salem, North Carolina between December 2012 and August 2016. Read More

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What Is Uncommon Can Be Critical: A Case of Quinolone-Induced Acute Liver Failure.

Cureus 2021 Apr 30;13(4):e14780. Epub 2021 Apr 30.

Internal Medicine, Texas Tech University Health Sciences Center School of Medicine at the Permian Basin, Odessa, USA.

Many drugs are known to potentially cause liver injury; however, only a few reports investigate the association between levofloxacin and acute liver failure (ALF).  The case describes a 65-year-old man who was admitted with primary diagnoses of cerebrovascular accident (CVA) and acute coronary syndrome (ACS) who developed an upper respiratory tract infection for which he was started on levofloxacin. Following its administration, serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) increased more than 100-fold above the upper limit of normal. Read More

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Alkalemia and Hepatic Encephalopathy in a Chronic Dialysis Patient.

Am J Med Sci 2020 Dec 26. Epub 2020 Dec 26.

Department of Medicine, St. Elizabeth's Medical Center, Boston, MA, United States; Department of Medicine, Tufts University School of Medicine, Boston, MA, United States; Division of Nephrology, St. Elizabeth's Medical Center, Boston, MA, United States.

Hepatic encephalopathy (HE) includes cognitive, psychiatric and neuromotor abnormalities observed from brain dysfunction secondary to liver disease and/or porto-systemic shunting. HE can have a wide range of clinical manifestations ranging from trivial lack of awareness, decreased attention span, personality changes to confusion, seizures, coma, and death. The onset of HE in cirrhosis is a poor prognostic factor. Read More

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December 2020

Animal naming test for the assessment of minimal hepatic encephalopathy in Asian cirrhotic populations.

Clin Res Hepatol Gastroenterol 2021 Jun 6;45(5):101729. Epub 2021 Jun 6.

Department of Infectious Disease and Hepatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, China. Electronic address:

Background And Aim: To evaluate the diagnostic performance of simplified animal naming test (S-ANT1) for minimal hepatic encephalopathy (MHE) in patients with cirrhosis from a Chinese tertiary centre and to optimize the application strategy of S-ANT1 in clinical practice.

Methods: The Animal Naming Test 1 (ANT1) was performed in all included cirrhotic patients and healthy volunteers. S-ANT1 was calculated to adjust for age and education. Read More

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Determination of Turkish norms of psychometric tests for diagnosing minimal hepatic encephalopathy and proposal of a high sensitive screening test battery.

Hepatol Int 2021 Jun 3. Epub 2021 Jun 3.

Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey.

Background: Psychometric hepatic encephalopathy score (PHES) needs local standardization.

Aims: This study aimed at standardizing PHES for Turkish patients and compare them with German norms; to determine minimal hepatic encephalopathy (mHE) prevalence with two different methods [PHES battery and Critical Flicker Frequency (CFF)] and to assess whether sub-tests of the battery can be used for screening for mHE.

Methods: Healthy volunteers (n = 816; 400 male) and cirrhotics (n = 124; 58 male) were included. Read More

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Low yield of head CT in cirrhotic patients presenting with hepatic encephalopathy.

BMJ Open Gastroenterol 2021 Jun;8(1)

Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, Michigan, USA.

Goals And Background: The utility of routine head CT (HCT) in hepatic encephalopathy (HE) evaluation is unclear. We investigated HCT yield in detecting acute intracranial abnormalities in cirrhotic patients presenting with HE.

Study: Retrospective review of cirrhotic patient encounters with HE between 2016 and 2018 at Beaumont Health, in Michigan was performed. Read More

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Hyperammonemia in acetaminophen toxicity.

Clin Toxicol (Phila) 2021 Jun 3:1-5. Epub 2021 Jun 3.

Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Introduction: Acetaminophen-induced hepatotoxicity can result in hyperammonemia, but it is not clear if elevated ammonia concentrations predict encephalopathy.

Methods: We retrospectively studied patients with acetaminophen toxicity at a liver transplant center over 8 years (January 1, 2010-December 31, 2017), who developed hepatotoxicity (AST and/or ALT >1000 IU/L) or hyperammonemia (ammonia > 40 µmol/L). We recorded baseline characteristics, laboratory data, documented grade of encephalopathy, and treatments administered. Read More

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The utility of biomarkers in prognosis assessment of patients with acute liver failure.

Hepatol Res 2021 May 15. Epub 2021 May 15.

Department of Gastroenterology and Hepatology, Ghent University Hospital, Gent, Belgium.

Background: Acute liver failure (ALF) is a rare but potential lethal condition characterized by the sudden development of jaundice, coagulopathy and hepatic encephalopathy in patients without underlying liver disease. In selected patients, emergency liver transplantation is required. Selection of these patients is based on clinical criteria such as the Kings College Criteria (KCC) or the Clichy criteria. Read More

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METABOLIC AND NUTRITIONAL REPERCUSSIONS OF LIVER DISEASE ON CHILDREN: HOW TO MINIMIZE THEM?

Rev Paul Pediatr 2021 26;40:e2020149. Epub 2021 May 26.

Universidade de São Paulo, São Paulo, SP, Brazil.

Objective: To describe the metabolic and nutritional repercussions of chronic liver disease (CLD), proposing strategies that optimize nutritional therapy in the pre- and post-liver transplantation (LT) period, in order to promote favorable clinical outcomes and adequate growth and development, respectively.

Data Sources: Bibliographic search in the PubMed, Lilacs and SciELO databases of the last 12 years, in English and Portuguese; target population: children from early childhood to adolescence; keywords in Portuguese and their correlates in English: "Liver Transplant," "Biliary Atresia," "Nutrition Therapy," "Nutritional Status," and "Child"; in addition to Boolean logics "and" and "or," and the manual search of articles.

Data Synthesis: Malnutrition in children with CLD is a very common condition and an important risk factor for morbidity and mortality. Read More

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Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan.

J Pers Med 2021 May 27;11(6). Epub 2021 May 27.

Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan.

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Read More

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Cerebellar spongiform degeneration is accompanied by metabolic, cellular, and motor disruption in male rats with portacaval anastomosis.

J Neurosci Res 2021 Jun 1. Epub 2021 Jun 1.

Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Campus UNAM-Juriquilla, Querétaro, Mexico.

The episodes of cerebral dysfunction, known as encephalopathy, are usually coincident with liver failure. The primary metabolic marker of liver diseases is the increase in blood ammonium, which promotes neuronal damage. In the present project, we used an experimental model of hepatic encephalopathy in male rats by portacaval anastomosis (PCA) surgery. Read More

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Changing Trends in Liver Cirrhosis Etiology and Severity in Korea: the Increasing Impact of Alcohol.

J Korean Med Sci 2021 May 31;36(21):e145. Epub 2021 May 31.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

Background: Chronic hepatitis B is the most common cause of liver cirrhosis in South Korea. However, alcoholic liver disease has shown an increasing trend. Although the clinical implications surrounding liver cirrhosis have been changing over the years, few studies have recently examined cirrhosis epidemiology. Read More

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Use of lactulose in hepatic encephalopathy- Is it time to shift targets?

Clin Gastroenterol Hepatol 2021 May 28. Epub 2021 May 28.

Indira Gandhi Medical College, Shimla, India. Electronic address:

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Minimal Hepatic Encephalopathy and Biejia-Ruangan Are Associated with First Hospital Readmission in Nonalcoholic Cirrhosis Patients.

Evid Based Complement Alternat Med 2021 7;2021:6652858. Epub 2021 May 7.

Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

. Patients with cirrhosis are often hospitalized repeatedly for a variety of complications. This retrospective study aimed to assess the effects of minimal hepatic encephalopathy (MHE) and Biejia-Ruangan (BR) on first hospital readmission in nonalcoholic cirrhosis patients without previous overt hepatic encephalopathy (OHE) or hepatocellular carcinoma (HCC). Read More

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A Hepatitis C Virus-Associated Decompensated Cirrhotic Patient Who Showed the Disappearance of Hepatic Encephalopathy, Ascites, and Pleural Effusion by Antiviral Therapy with Sofosbuvir/Velpatasvir.

Case Rep Gastroenterol 2021 Jan-Apr;15(1):436-442. Epub 2021 Apr 27.

Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.

Oral direct-acting antivirals (DAAs) are the main therapy for hepatitis C virus (HCV)-associated liver disease in Japan. Moreover, many DAAs include an indication for compensated liver cirrhosis. However, patients with decompensated HCV-associated cirrhosis have hitherto not been indicated for therapy with DAAs. Read More

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Pathomechanisms in hepatic encephalopathy.

Biol Chem 2021 May 31. Epub 2021 May 31.

Clinic for Gastroenterology, Hepatology, and Infectious Diseases, Heinrich Heine University, Moorenstr. 5, D-40225Düsseldorf, Germany.

Hepatic encephalopathy (HE) is a frequent neuropsychiatric complication in patients with acute or chronic liver failure. Symptoms of HE in particular include disturbances of sensory and motor functions and cognition. HE is triggered by heterogeneous factors such as ammonia being a main toxin, benzodiazepines, proinflammatory cytokines and hyponatremia. Read More

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Kinetics of emergence of liver complications in HCV-infected patients and advanced fibrosis, with and without HIV-coinfection, after SVR.

AIDS 2021 May 27. Epub 2021 May 27.

Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme. Seville. Spain Unit of Infectious Diseases, Hospital Universitario de Puerto Real, Faculty of Medicine, Cadiz, Spain Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Córdoba, Spain Unit of Infectious Diseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain Unit of Infectious Diseases, Hospital Universitario Virgen Macarena, Sevilla, Spain Section of Infectious Medicine/Service of Internal Medicine, Hospital General Universitario Santa Lucía, Cartagena, Spain Unit of Internal Medicine, Hospital Universitario del SAS de Jerez, Cadiz, Spain Unit of Immunology, Biochemistry, Molecular Biology and Surgery, Faculty of Medicine, Universidad de Málaga, Spain Unit of Infectious Diseases and Microbiology, Hospital Virgen de la Victoria, Málaga, Spain Unit of Internal Medicine and Infectious Diseases, Hospital La Princesa, Madrid, Spain Unit of Infectious Diseases, Hospital Virgen de la Luz, Cuenca, Spain HIV and STI Unit, Department of Infectious Diseases. Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain Unit of Infectious Diseases, Hospital Juan Ramón Jiménez, Huelva, Spain Unit of Infectious Diseases. Hospital Clínico Universitario de Valencia. Spain Unit of Infectious Diseases, Hospital General Universitario de Alicante. Spain Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Granada. Spain Unit of Infectious Diseases, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia. Spain.

Objective: There is scarce available evidence on the distribution over time of liver complications emergence in hepatitis C virus (HCV)-infected patients who achieve sustained virological response (SVR) with direct-acting antiviral (DAA)-based therapy. Therefore, we aimed at describing the kinetics of liver-related events appearance in this setting.

Design: Multicentric prospective cohort study. Read More

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Meeting the challenge of antimicrobial resistance in cirrhosis: the invisible threat that lies within.

Gastroenterology 2021 May 25. Epub 2021 May 25.

Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, UK; Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK. Electronic address:

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Pathophysiology of decompensated cirrhosis: Portal hypertension, circulatory dysfunction, inflammation, metabolism and mitochondrial dysfunction.

J Hepatol 2021 Jul;75 Suppl 1:S49-S66

Department of Medical and Surgical Sciences; Alma Mater Studiorum - University of Bologna; Italy.

Patients with acutely decompensated cirrhosis have a dismal prognosis and frequently progress to acute-on-chronic liver failure, which is characterised by hepatic and extrahepatic organ failure(s). The pathomechanisms involved in decompensation and disease progression are still not well understood, and as specific disease-modifying treatments do not exist, research to identify novel therapeutic targets is of the utmost importance. This review amalgamates the latest knowledge on disease mechanisms that lead to tissue injury and extrahepatic organ failure - such as systemic inflammation, mitochondrial dysfunction, oxidative stress and metabolic changes - and marries these with the classical paradigms of acute decompensation to form a single paradigm. Read More

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Transition to decompensation and acute-on-chronic liver failure: Role of predisposing factors and precipitating events.

J Hepatol 2021 Jul;75 Suppl 1:S36-S48

Division of Digestive Diseases, Imperial College, London, UK.

The transition from compensated to decompensated cirrhosis results from a complex interplay of predisposing and precipitating factors and represents an inflection point in the probability of a patient surviving. With the progression of cirrhosis, patients accumulate multiple disorders (e.g. Read More

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New clinical and pathophysiological perspectives defining the trajectory of cirrhosis.

J Hepatol 2021 Jul;75 Suppl 1:S14-S26

European Foundation for Study of Chronic Liver Failure, EF-Clif, Barcelona, Spain.

Traditionally, the complications of cirrhosis, namely variceal bleeding, ascites and hepatic encephalopathy, were thought to result predominantly from circulatory dysfunction and altered organ perfusion arising as a result of portal hypertension. Over the past 20 years, large, international prospective studies have indicated the importance of systemic inflammation and organ immunopathology as additional determinants of organ dysfunction in cirrhosis, which not only manifests in the liver, brain, circulation and the kidneys, but also the immune system, gut, muscles, adrenal glands, reproductive organs, heart and lungs. This review provides an overview of the traditional and emerging concepts around the initiation and maintenance of organ dysfunction in cirrhosis and proposes a new paradigm based upon a better understanding of acute decompensation of cirrhosis. Read More

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Verapamil inhibits early acute liver failure through suppressing the NLRP3 inflammasome pathway.

J Cell Mol Med 2021 May 24. Epub 2021 May 24.

Emergency Department, Linyi People's Hospital, Linyi, China.

Acute liver failure (ALF) is a rare disease characterized by the sudden onset of serious hepatic injury, as manifested by a profound liver dysfunction and hepatic encephalopathy in patients without prior liver disease. In this paper, we aim to investigate whether verapamil, an antagonist of TXNIP, inhibits early ALF through suppressing the NLRP3 inflammasome pathway. Firstly, an ALF mouse model was induced by lipopolysaccharide (LPS)/D-galactosamine (GalN) treatment. Read More

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Progressive Disruption of Dynamic Functional Network Connectivity in Patients With Hepatitis B Virus-related cirrhosis.

J Magn Reson Imaging 2021 May 24. Epub 2021 May 24.

Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China.

Background: The diseased-related dynamic functional network connectivity (dFNC) disruption and its relationship with cognitive impairment in hepatitis B virus-related cirrhosis (HBV-RC) patients with minimal hepatic encephalopathy (MHE) and no MHE (NMHE) remain unknown. This knowledge would help identify MHE pathophysiology and monitor disease progression in HBV-RC patients.

Purpose: To investigate the dFNC in patients with NMHE and MHE and the relationship between dFNC indices with the psychometric hepatic encephalopathy score (PHES). Read More

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Brain-derived neurotrophic factor as a potential diagnostic marker in minimal hepatic encephalopathy.

Clin Exp Hepatol 2021 Mar 2;7(1):117-124. Epub 2021 Feb 2.

Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland.

Introduction: Minimal hepatic encephalopathy (MHE) is a common complication of liver cirrhosis not only leading to a decrease in the quality of life, but also predicting development of overt encephalopathy. The diagnosis of MHE usually relies on a combination of neuropsychological tests, while robust serum biomarkers are lacking. We aimed to assess serum concentrations of brain-derived neurotrophic factor (BDNF) in MHE patients. Read More

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