16,366 results match your criteria Encephalopathy Hepatic

Dosing of Rifaximin Soluble Solid Dispersion Tablets in Adults With Cirrhosis: 2 Randomized, Placebo-Controlled Trials.

Clin Gastroenterol Hepatol 2022 Jun 21. Epub 2022 Jun 21.

Medical University of South Carolina, Charleston, South Carolina.

Background & Aims: Cirrhosis-related complications are a major burden. Rifaximin soluble solid dispersion (SSD) tablets (immediate-release [IR]; sustained extended-release [SER]) were designed to increase rifaximin water solubility. These analyses evaluate dosing for prevention of cirrhosis complication-related hospitalizations/mortality and overt hepatic encephalopathy (OHE) treatment. Read More

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Outcomes of transjugular intrahepatic portosystemic shunt using 12 mm diameter polytetrafluoroethylene covered stents in cirrhotic patients with portal hypertension.

Diagn Interv Radiol 2022 May;28(3):239-243

Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

PURPOSE We aimed to evaluate the safety and efficacy of 12 mm diameter polytetrafluoroethylene (PTFE)- covered stents for the creation of transjugular intrahepatic portosystemic shunt (TIPS) in cir- rhotic patients with portal hypertension complicated by variceal bleeding and volume-overload. METHODS This retrospective study included 360 patients who had TIPS created between January 2004 and December 2017 using 12 mm diameter PTFE-covered stents. Demographic data, model for end- stage liver disease (MELD) score, etiology of cirrhosis, and Charlson comorbidity index were recorded. Read More

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Transplantation for EASL-CLIF and APASL acute-on-chronic liver failure (ACLF) patients: The to evaluate long-term post-Transplant outcomes.

EClinicalMedicine 2022 Jul 4;49:101476. Epub 2022 Jun 4.

Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.

Background: The forecast accuracy of the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) and Asian Pacific Association for the Study of the Liver (APASL) acute-on-chronic liver failure (ACLF) criteria in assessing long-term outcomes after liver transplantation (LT) is still unclear, especially when the staging of the two standards is inconsistent.

Methods: A retrospective cohort () including 565 patients from January 2015 to June 2021 was conducted. The 28 and 90 days, 1- and 3-years overall survival (OS) after LT were compared between different grades. Read More

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The Usefulness of the Athens Insomnia Scale for Evaluating Sleep Disturbance in Patients with Chronic Liver Disease Comparing with Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale.

Medicina (Kaunas) 2022 May 30;58(6). Epub 2022 May 30.

Kanto Central Hospital, Tokyo 158-8531, Japan.

: Sleep disturbance due to muscle cramps or hepatic encephalopathy in patients with chronic liver disease (CLD) can lead to a reduced quality of life. The Pittsburgh sleep quality index (PSQI) is commonly used for evaluating sleep disturbance; however, this questionnaire is time-consuming owing to the large number of questions. As the usefulness of the Athens insomnia scale (AIS) in patients with CLD is not sufficiently known, the present study aimed to determine whether the AIS and Epworth sleepiness scale (ESS) could be used as simple alternative questionnaires for evaluating sleep disturbances in patients with CLD. Read More

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Role of Seipin in Human Diseases and Experimental Animal Models.

Biomolecules 2022 Jun 17;12(6). Epub 2022 Jun 17.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Department of Paediatrics, West China Second University Hospital, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu 610041, China.

Seipin, a protein encoded by the Berardinelli-Seip congenital lipodystrophy type 2 () gene, is famous for its key role in the biogenesis of lipid droplets and type 2 congenital generalised lipodystrophy (CGL2). gene mutations result in genetic diseases including CGL2, progressive encephalopathy with or without lipodystrophy (also called Celia's encephalopathy), and -associated motor neuron diseases. Abnormal expression of seipin has also been found in hepatic steatosis, neurodegenerative diseases, glioblastoma stroke, cardiac hypertrophy, and other diseases. Read More

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Rifaximin Improves Spatial Learning and Memory Impairment in Rats with Liver Damage-Associated Neuroinflammation.

Biomedicines 2022 May 28;10(6). Epub 2022 May 28.

Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, 46012 Valencia, Spain.

Patients with non-alcoholic fatty liver disease (NAFLD) may show mild cognitive impairment. Neuroinflammation in the hippocampus mediates cognitive impairment in rat models of minimal hepatic encephalopathy (MHE). Treatment with rifaximin reverses cognitive impairment in a large proportion of cirrhotic patients with MHE. Read More

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Hepatic encephalopathy.


Nat Rev Dis Primers 2022 Jun 23;8(1):44. Epub 2022 Jun 23.

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Hepatic encephalopathy.

Nat Rev Dis Primers 2022 Jun 23;8(1):43. Epub 2022 Jun 23.

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Hepatic encephalopathy (HE) is a prognostically relevant neuropsychiatric syndrome that occurs in the course of acute or chronic liver disease. Besides ascites and variceal bleeding, it is the most serious complication of decompensated liver cirrhosis. Ammonia and inflammation are major triggers for the appearance of HE, which in patients with liver cirrhosis involves pathophysiologically low-grade cerebral oedema with oxidative/nitrosative stress, inflammation and disturbances of oscillatory networks in the brain. Read More

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Aberrant stability of brain functional architecture in cirrhotic patients with minimal hepatic encephalopathy.

Brain Imaging Behav 2022 Jun 21. Epub 2022 Jun 21.

Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, China.

To investigate the stability changes of brain functional architecture and the relationship between stability change and cognitive impairment in cirrhotic patients. Fifty-one cirrhotic patients (21 with minimal hepatic encephalopathy (MHE) and 30 without MHE (NHE)) and 29 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging and neurocognitive assessment using the Psychometric Hepatic Encephalopathy Score (PHES). Voxel-wise functional connectivity density (FCD) was calculated as the sum of connectivity strength between one voxel and others within the entire brain. Read More

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Evolution of hepatic encephalopathy over time: ecological data from a tertiary referral centre for hepatology.

Dig Liver Dis 2022 Jun 17. Epub 2022 Jun 17.

Department of Medicine, University of Padova, Via Giustiniani 2, Padova 35128, Italy. Electronic address:

Objectives: Few data on hepatic encephalopathy (HE) over time are available, thus our aim was to study its evolution in patients with varying degree of HE on first assessment.

Methods: Eighty-six patients with cirrhosis (age = 58 ± 11 years; males = 72) were evaluated 2-10 times for liver transplantation selection purposes, differential diagnosis or treatment optimization. The presence/severity of HE was assessed by clinical and neuropsychiatric indices [ Psychometric Hepatic Encephalopathy Score (PHES) and electroencephalography (EEG)] and the severity of liver disease by the Model for End-Stage Liver Disease (MELD) score. Read More

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Testing for ammonia: do as I say, not as we do.

Frontline Gastroenterol 2022 21;13(4):273-274. Epub 2021 Oct 21.

Center for Liver Disease and Transplantation, NewYork-Presbyterian Hospital, New York, New York, USA.

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October 2021

Serum ammonia use: unnecessary, frequent and costly.

Frontline Gastroenterol 2022 18;13(4):275-279. Epub 2021 Aug 18.

Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.

Background/objective: While ammonia plays a role in the complex pathophysiology of hepatic encephalopathy (HE), serum ammonia is unreliable for both diagnosis of, and correlation with, neurological symptoms in patients with cirrhosis. We aimed to quantify ordering, cost and appropriate use of serum ammonia in a major Midwestern healthcare system.

Design/method: Serum ammonia ordering in adult patients presenting to a large Midwestern health system was evaluated from 1 January 2015 to 31 December 2019. Read More

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Nationwide analysis of incidence and predictors of 30-day readmissions in patients with decompensated cirrhosis.

Frontline Gastroenterol 2022 2;13(4):295-302. Epub 2021 Jul 2.

Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA.

Background And Objective: Cirrhosis is the number one cause of non-cancer deaths among gastrointestinal diseases and is responsible for significant morbidity and healthcare utilisation. The objectives were to measure the 30-day readmissions rate following index hospitalisation, to determine the predictors of readmission, and to estimate the cost of 30-day readmission in patients with decompensated cirrhosis.

Methods: We performed a retrospective cohort study of patients with decompensated cirrhosis using 2014 Nationwide Readmission Database from January to November. Read More

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Computed Tomography Images of Spontaneous Portosystemic Shunt in Liver Cirrhosis.

Can J Gastroenterol Hepatol 2022 8;2022:3231144. Epub 2022 Jun 8.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang 110840, China.

Spontaneous portosystemic shunt (SPSS) refers to collateral vessels that communicate between the portal vein system and systemic circulation. SPSS mainly includes esophageal varices, gastric varices, left gastric vein, recanalized paraumbilical vein, abdominal wall varices, and spontaneous splenorenal shunt. SPSS contributes to the development of hepatic encephalopathy caused by portal vein inflow bypassing and carries a higher risk of death in liver cirrhosis. Read More

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Hepatic Encephalopathy by Manganese Deposition: A Case Report and a Review of Literature.

Rev Recent Clin Trials 2022 Jun 17. Epub 2022 Jun 17.

Department of Health Sciences, University "Magna Graecia", Catanzaro Italy.

Background: Hepatic encephalopathy is defined as a spectrum of neuropsychiatric disorders in patients with liver dysfunction, usually cirrhosis, after exclusion of brain disease. This study reports the role of manganese in brain alterations and therefore in clinical manifestations of hepatic encephalopathy.

Case Presentation: Male patient, 67 years old, suffering from alcoholic liver cirrhosis and two previous episodes of hepatic encephalopathy, developed drowsiness, asterixis, amnesia, disorientation in time and space, and psychomotor retardation. Read More

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The Role of Vti1a in Biological Functions and Its Possible Role in Nervous System Disorders.

Front Mol Neurosci 2022 27;15:918664. Epub 2022 May 27.

Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China.

Vesicle transport through interaction with t-SNAREs 1A (Vti1a), a member of the N-ethylmaleimide-sensitive factor attachment protein receptor protein family, is involved in cell signaling as a vesicular protein and mediates vesicle trafficking. Vti1a appears to have specific roles in neurons, primarily by regulating upstream neurosecretory events that mediate exocytotic proteins and the availability of secretory organelles, as well as regulating spontaneous synaptic transmission and postsynaptic efficacy to control neurosecretion. Vti1a also has essential roles in neural development, autophagy, and unconventional extracellular transport of neurons. Read More

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Spleen bed laparoscopic splenectomy plus pericardial devascularization for elderly patients with portal hypertension.

Wideochir Inne Tech Maloinwazyjne 2022 Jun 16;17(2):338-343. Epub 2022 Mar 16.

Department of Hepatobiliary Surgery, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.

Introduction: Laparoscopy splenectomy has been a preferred choice over open surgery, but limited studies dealing with laparoscopy splenectomy plus pericardial devascularization (LSPD) for elderly patients are available.

Aim: To assess the safety and long-term efficacy of spleen bed LSPD for elderly patients with portal hypertension.

Material And Methods: A total of 132 elderly patients (age > 60 years) suffering from portal hypertension were operated on in the department. Read More

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Gamma-Glutamyltransferase Activity (GGT) Is a Long-Sought Biomarker of Redox Status in Blood Circulation: A Retrospective Clinical Study of 44 Types of Human Diseases.

Oxid Med Cell Longev 2022 6;2022:8494076. Epub 2022 Jun 6.

Systems Biology & Medicine Center for Complex Diseases, Center for Clinical Research, Affiliated Hospital of Qingdao University, Qingdao 266003, China.

Methods: The clinical GGT data from 168,858 patients with 44 diseases and 132,357 healthy control in the clinical laboratory of our hospital over the past five years were retrieved. All data were analyzed with SPSS, RStudio V.1. Read More

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Pediatric Acute Liver Failure in Sickle Cell Disease.

GE Port J Gastroenterol 2022 May 28;29(3):192-196. Epub 2021 Apr 28.

Gastroenterology Unit, Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.

Introduction: Sickle cell intrahepatic cholestasis (SCIC) is one of the rarest and the most severe acute hepatic manifestations of sickle cell disease (SCD) and it can rapidly progress to acute liver failure. It is associated with a high mortality rate, demanding prompt recognition and management.

Case Presentation: We report a case of a 7-year-old boy with a history of homozygous HbS SCD who presented to the emergency department with fever, increasing abdominal pain, and jaundice. Read More

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Comparable outcomes of decompensated chronic hepatitis B patients treated with entecavir or tenofovir: an 8-year cohort study.

Hepatol Int 2022 Jun 14. Epub 2022 Jun 14.

Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5, Fu Hsing Street, Kuei Shan, Taoyuan, Taiwan.

Background/aims: Whether the efficacies of entecavir (ETV) and tenofovir disoproxil fumarate (TDF) in treating liver-related outcomes of decompensated chronic hepatitis B (CHB) patients are comparable remained inconclusive.

Methods: An 8-year cohort study of 736 decompensated CHB patients was conducted, and 65 TDF-treated patients were sex, age and model for end-stage liver disease (MELD) scores-1:4 matched with 260 ETV-treated patients through propensity score-matching method.

Results: Of 736 patients, 574 (78%) were male, with a mean age of 54. Read More

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The infection risk after transjugular intrahepatic portosystemic shunt: A multiple competing risk analysis from a tertiary care center.

Dig Liver Dis 2022 Jun 10. Epub 2022 Jun 10.

Infectious Diseases I Unit, IRCCS San Matteo, Pavia, Italy and Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, V.le Golgi, 19, PV, 27100, Padiglione n. 42, Pavia, Italy; Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, Italy.

Background: Infections following transjugular intrahepatic portosystemic shunt (TIPS) placement have been poorly described. We aim to investigate the rate and the potential predictors of infections occurring after TIPS placement.

Methods: Single center, retrospective, observational study. Read More

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Effect of HCV eradication on critical flicker frequency in HIV/HCV coinfected patients with advanced cirrhosis.

Rev Clin Esp (Barc) 2022 Jun 7. Epub 2022 Jun 7.

Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.

Background: Critical flicker frequency (CFF), defined as the frequency at which a subject perceives a flickering light as continuous, is directly associated with central nervous system alertness.

Methods: We studied CFF using the Hepatonorm analyzer (Medi-Business Freiburg GmGH, Germany) at baseline and after hepatitis C virus (HCV) eradication in 47 patients with human immunodeficiency virus (HIV)/HCV coinfection and cirrhosis. Patients had a mean age of 52 years, 81% were male, and 80% had a history of drug use. Read More

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Randomized Clinical Trial: Effects of β-Hydroxy-β-Methylbutyrate (HMB)-Enriched vs. HMB-Free Oral Nutritional Supplementation in Malnourished Cirrhotic Patients.

Nutrients 2022 Jun 3;14(11). Epub 2022 Jun 3.

Instituto de Investigación Sanitaria (IIS) Aragon, 50009 Zaragoza, Spain.

β-Hydroxy-β-methylbutyrate (HMB) supplementation increases muscle and strength mass in some muscle-wasting disorders. Malnutrition and sarcopenia are often present in liver cirrhosis. We aimed to investigate the effects of oral HMB supplementation on changes in body composition and liver status in patients with cirrhosis and malnutrition. Read More

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Imaging-guided interventions modulating portal venous flow: Evidence and controversies.

JHEP Rep 2022 Jul 4;4(7):100484. Epub 2022 Apr 4.

Université Paris Cité; AP-HP, Hôpital Beaujon, Service de Radiologie, Clichy; Centre de Recherche sur l'inflammation Inserm, UMR 1149, Paris, France.

Portal hypertension is defined by an increase in the portosystemic venous gradient. In most cases, increased resistance to portal blood flow is the initial cause of elevated portal pressure. More than 90% of cases of portal hypertension are estimated to be due to advanced chronic liver disease or cirrhosis. Read More

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Impact of Hyponatremia on Morbidity, Mortality, and Resource Utilization in Portal Hypertensive Ascites: A Nationwide Analysis.

J Clin Exp Hepatol 2022 May-Jun;12(3):871-875. Epub 2021 Oct 28.

Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore MD, USA.

Background And Aims: Ascites and hyponatremia are important milestones of worsening portal hypertension in those with cirrhosis. The objective of our study was to evaluate the differences in clinical characteristics, resource utilization, and disposition of hospitalized cirrhotic patients with ascites with and without hyponatremia.

Methods: The National Inpatient Sample (NIS) database was used to identify all adult hospitalized patients with a diagnosis of cirrhosis and ascites with or without hyponatremia from 2016 to 2017 using ICD-10 codes. Read More

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October 2021

Encephalopathy in Cirrhosis: Prevention and Management.

J Clin Exp Hepatol 2022 May-Jun;12(3):927-936. Epub 2021 Dec 22.

Institute of Digestive & Liver Diseases, BLK Superspeciality Hospital, Delhi, India.

Hepatic encephalopathy (HE) is a major neuropsychiatric complication of cirrhosis. The clinical manifestations of HE ranges from mild confusion, disorientation to altered behaviour and coma in advanced stages. HE is an important cause of recurrent admissions in liver cirrhosis patients. Read More

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December 2021

Application of Noninvasive Tools to Decide the Need for Beta-Blockers for Variceal Bleeding Prophylaxis in Compensated Advanced Liver Disease: A Decision Curve Analysis.

J Clin Exp Hepatol 2022 May-Jun;12(3):917-926. Epub 2021 Sep 25.

Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110026, India.

Background And Aims: Noninvasive tools (NITs) reliably categorise patients with compensated advanced chronic liver disease (cACLD) into high-risk and low-risk group for harbouring varices needing treatment. Here, we assess the ability of these NITs to predict the need for nonselective beta-blockers at baseline based on risk of variceal bleeding (VB) on follow-up.

Methods: This was a retrospective multicentre analysis of patients with cACLD categorised at baseline into different risk groups by NITs (Baveno-VI, expanded Baveno-VI, platelet-albumin, platelet-model for end-stage liver disease (MELD) and anticipate study platelet criteria) and by endoscopy (high risk vs low risk/no varices). Read More

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September 2021

High Prevalence of Hormonal Changes and Hepatic Osteodystrophy in Frail Patients with Cirrhosis-An Observational Study.

J Clin Exp Hepatol 2022 May-Jun;12(3):800-807. Epub 2021 Nov 26.

Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

Background/aim: Hormonal changes and hepatic osteodystrophy are less often studied complications of cirrhosis. This study describes the variance in hormones and osteodystrophy between Frail and Not frail patients with cirrhosis.

Methods: 116 outpatients with cirrhosis were prospectively enrolled in this study. Read More

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November 2021

Correlation between dynamic changes in free triiodothyronine levels and 90-day prognosis in patients with HBV-related acute-on-chronic liver failure.

Eur J Med Res 2022 Jun 7;27(1):88. Epub 2022 Jun 7.

Difficult Liver Disease and Artificial Liver Center, Beijing You'an Hospital, Capital Medical University, No. 8, You An Men Outer Street, Fengtai, Beijing, 100069, China.

Background: Patients with HBV-related acute-on-chronic liver failure (HBV-ACLF) have a high 90-day mortality rate, so early prognostic evaluation is important.

Aim: We aimed to explore the correlation between dynamic changes in free triiodothyronine (FT3) levels and 90-day prognosis of patients with HBV-ACLF.

Methods: A prospective cohort study investigated 122 inpatients with HBV-ACLF. Read More

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