14,637 results match your criteria Portal-Systemic Encephalopathy


Inhibition of inflammation is not enough for recovery of cognitive impairment in hepatic encephalopathy: effects of minocycline and ibuprofen.

Brain Res Bull 2019 Apr 18. Epub 2019 Apr 18.

Neuroscience Research Centre, neuropharmacology institute, Kerman University of Medical Sciences, Kerman, Iran. Electronic address:

There is evidence that hyperammonia and inflammation play crucial roles in hepatic encephalopathy. This study intends to determine neuroprotective effects of minocycline (MINO) and ibuprofen (IBU), and also set out to assess whether inhibition of inflammation is enough to achieve optimal improvement of hepatic encephalopathy symptoms. The hepatic encephalopathy was induced by bile-duct ligation (BDL), and the animals received first dose of MINO and/or IBU 15 days later and then every day until the 28 day. Read More

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http://dx.doi.org/10.1016/j.brainresbull.2019.04.015DOI Listing

Predicting clinical outcomes of cirrhosis patients with hepatic encephalopathy from the fecal microbiome.

Cell Mol Gastroenterol Hepatol 2019 Apr 17. Epub 2019 Apr 17.

Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address:

Background & Aims: Gut dysbiosis plays a role in hepatic encephalopathy (HE), while its relationship at the acute episode of overt HE (AHE), the disease progression and clinical outcomes remains unclear. We aimed to identify AHE-specific microbiome and its association to patients' outcomes.

Methods: We profiled fecal microbiome changes for a cohort of 62 patients with cirrhosis and AHE i) before treatment, ii) 2-3 days after medication and iii) 2-3 months after recovery, and three control cohorts i) healthy individuals, patients with ii) compensated or iii) decompensated cirrhosis. Read More

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http://dx.doi.org/10.1016/j.jcmgh.2019.04.008DOI Listing
April 2019
1 Read

Application of tabu search-based Bayesian networks in exploring related factors of liver cirrhosis complicated with hepatic encephalopathy and disease identification.

Sci Rep 2019 Apr 18;9(1):6251. Epub 2019 Apr 18.

Department of Health Statistics, School of Public Health, Shanxi Medical University, No.56 XinJian South Road, Taiyuan, Shanxi, 030001, China.

This study aimed to explore the related factors and strengths of hepatic cirrhosis complicated with hepatic encephalopathy (HE) by multivariate logistic regression analysis and tabu search-based Bayesian networks (BNs), and to deduce the probability of HE in patients with cirrhosis under different conditions through BN reasoning. Multivariate logistic regression analysis indicated that electrolyte disorders, infections, poor spirits, hepatorenal syndrome, hepatic diabetes, prothrombin time, and total bilirubin are associated with HE. Inferences by BNs found that infection, electrolyte disorder and hepatorenal syndrome are closely related to HE. Read More

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http://dx.doi.org/10.1038/s41598-019-42791-wDOI Listing

gene predicts clinical recovery after sustained virological response in decompensated hepatitis C cirrhosis.

BMJ Open Gastroenterol 2019 12;6(1):e000241. Epub 2019 Mar 12.

Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Missouri, USA.

Background: Patients with decompensated hepatitis C virus (HCV) cirrhosis experience various outcomes after sustained virological response (SVR), ranging from clinical recovery to further deterioration. We hypothesised that the genetic risk for steatosis, namely the polymorphisms rs738409 of Patatin-like Phospholipase Domain-Containing 3 (), rs58542926 of Transmembrane-6-Superfamily-2 (), and rs641738 of Membrane-bound O-acyltransferase Domain-Containing 7 (), is predictive of recovery.

Methods: We prospectively enrolled 56 patients with Child-Pugh (CPT) B/C cirrhosis who underwent antiviral therapy. Read More

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http://dx.doi.org/10.1136/bmjgast-2018-000241DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441264PMC
March 2019
1 Read

[Hepatic cirrhosis: early diagnosis and prevention of complications].

Authors:
Manfred Gross

MMW Fortschr Med 2019 Apr;161(7):48-52

Internistisches Klinikum München Süd, Am Isarkanal 36, D-81379, München, Deutschland.

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https://www.springermedizin.de/doi/10.1007/s15006-019-0408-9
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http://dx.doi.org/10.1007/s15006-019-0408-9DOI Listing
April 2019
1 Read

Donor age predicts calcineurin inhibitor induced neurotoxicity after liver transplantation.

Transplantation 2019 Apr 8. Epub 2019 Apr 8.

Fundación Instituto Investigacion Sanitaria (IIS) Aragón, Zaragoza, Spain.

Background: Calcineurin inhibitor-induced neurotoxicity (CIIN) is a common and debilitating side effect after liver transplantation (LT). Risk factors and impact on patient outcomes are not well defined. Our aim was to assess the incidence, risk factors and clinical outcomes of CIIN. Read More

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http://dx.doi.org/10.1097/TP.0000000000002750DOI Listing
April 2019
2 Reads

GABA-ergic tone hypothesis in hepatic encephalopathy - Revisited.

Clin Neurophysiol 2019 Mar 30;130(6):911-916. Epub 2019 Mar 30.

Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Department of Neurology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.

Objective: The GABA hypothesis of hepatic encephalopathy (HE) proposes an increased cerebral GABA-ergic tone in HE but has not been investigated in vivo in HE-patients yet. Cortical GABA-ergic and glutamatergic neurotransmission in HE-patients were evaluated using transcranial magnetic stimulation.

Methods: Twenty-one patients with HE grade 1 and 2 and age matched controls participated in the study. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S13882457193010
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http://dx.doi.org/10.1016/j.clinph.2019.03.011DOI Listing
March 2019
1 Read

Cerebellar inhibition in hepatic encephalopathy.

Clin Neurophysiol 2019 Mar 30;130(6):886-892. Epub 2019 Mar 30.

Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Germany. Electronic address:

Objective: Previous animal work reported that hyperammonemia leads to opposing changes of GABAergic neurotransmission in terms of increase in the cerebellum and decrease in the cerebral cortex. In this study, we investigate GABAergic tone in the cerebellum in patients with hepatic encephalopathy (HE) at different stages of the disease and its relation to critical flicker frequency (CFF) and ataxia.

Methods: Cerebellar inhibition using transcranial magnetic stimulation was investigated in 15 patients with different stages of HE and 15 healthy controls. Read More

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http://dx.doi.org/10.1016/j.clinph.2019.02.020DOI Listing
March 2019
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Predictive value of hepatic venous pressure gradient for graft hemodynamics in living donor liver transplantation.

Liver Transpl 2019 Apr 13. Epub 2019 Apr 13.

Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH.

Hepatic venous pressure gradient (HVPG) is known to correlate with severity of portal hypertension in patients with liver cirrhosis. This retrospective study investigated the clinical value of preoperative measurement of HVPG in patients who underwent adult-to-adult LDLT and its predictive value for hepatic hemodynamics after graft reperfusion. For this study, seventy-five patients who underwent adult-to-adult LDLT were divided into two groups (HVPG < 16 mmHg or HVPG > 16 mmHg) to investigate the correlation between preoperative HVPG and characteristics and surgical outcomes of the patients, including portal vein flow (PVF) and hepatic artery flow (HAF) after graft reperfusion. Read More

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http://dx.doi.org/10.1002/lt.25471DOI Listing
April 2019
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Relationship Between Intraoperative Bispectral Index and Consciousness Recovery in Patients With Hepatic Encephalopathy Undergoing Liver Transplant: A Retrospective Analysis.

Transplant Proc 2019 Apr 9;51(3):798-804. Epub 2019 Jan 9.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address:

Background: Although liver transplant (LT) improves liver function and restores symptoms of hepatic encephalopathy (HE), there is no index to predict the recovery of consciousness in patients with HE during LT. In this study, we evaluated the relationship between intraoperative bispectral index (BIS) values and the recovery of consciousness in patients with HE who were undergoing LT.

Methods: Patients with HE who underwent LT from June 2011 to December 2017 at our institution were enrolled. Read More

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http://dx.doi.org/10.1016/j.transproceed.2018.10.031DOI Listing

Serum keratin-18 fragments as cell death biomarker in association with disease progression and prognosis in HBV-related cirrhosis.

J Viral Hepat 2019 Apr 11. Epub 2019 Apr 11.

Department of Infectious Diseases, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.

Extensive hepatocyte death leads to hepatic inflammation and contributes to systemic inflammation in decompensated cirrhosis. We aimed to investigate the prognostic value of serum cell death markers in patients with Hepatitis B virus (HBV)-related acute decompensation (AD) of cirrhosis with and without acute-on-chronic liver failure (ACLF). We studied two cohorts - cohort 1: 201 outpatients with stable chronic hepatitis B (49 cirrhosis); cohort 2: 232 inpatients with HBV-related cirrhosis admitted for AD. Read More

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http://dx.doi.org/10.1111/jvh.13100DOI Listing
April 2019
3 Reads

Improvement of hyponatremia in cirrhosis is associated with improved complex information processing.

J Gastroenterol Hepatol 2019 Apr 9. Epub 2019 Apr 9.

Liver Unit, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), and Centro de Investigaciones en Red Hepatologia y Digestivas (CIBEReHD), Barcelona, Spain.

Background And Aim: Hyponatremia, a cause of brain dysfunction and risk factor for hepatic encephalopathy, is frequent in patients with advanced cirrhosis and ascites. The interdependence of liver failure and hyponatremia makes it difficult to separate the effects of each on cognitive function. The objective was to assess whether an increase in plasma sodium in patients with cirrhosis and ascites leads to an improvement in cognitive function. Read More

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http://dx.doi.org/10.1111/jgh.14683DOI Listing
April 2019
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Molecular docking of natural phenolic compounds for screening of urease inhibitors.

Curr Pharm Biotechnol 2019 Apr 9. Epub 2019 Apr 9.

International Institute of Pharmaceutical Sciences, Sonepat, Haryana. India.

Bacterial ureases have been the cause of various human and animal pathogenicity including hepatic encephalopathy, hepatic coma urolithiasis, gastric and peptic ulcers, pyelonephritis, and urinary catheter encrustation by production of ammonia. Hence in view of the side effects of existing drugs, there is a strong need to discover, more safe, effective and potent compounds for treatment of infections caused by urease. For this purpose, several natural phenolic compounds have been screened by molecular modelling techniques. Read More

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http://dx.doi.org/10.2174/1389201020666190409110948DOI Listing
April 2019
5 Reads
2.511 Impact Factor

[Esophageal variceal bleeding: management and tips on transjugular intrahepatic portosystemic shunt].

Chirurg 2019 Apr 8. Epub 2019 Apr 8.

Klinik und Poliklinik für Allgemein‑, Viszeral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum der Rheinischen Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Deutschland.

Background: Esophageal variceal bleeding is a life-threatening complication in patients with liver cirrhosis, which is pathophysiologically explained by the presence of portal hypertension. The incidence of such bleeding greatly depends on the severity of the underlying liver disease.

Objective: The aim of this article is to present the current treatment concepts for acute esophageal variceal bleeding, the management in acute situations and the indications for treatment of the causal portal hypertension with a transjugular intrahepatic portosystemic shunt (TIPS). Read More

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http://dx.doi.org/10.1007/s00104-019-0949-6DOI Listing
April 2019
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To the editor: Proton pump inhibitors are associated to minimal and overt hepatic encephalopathy and increase mortality in cirrhotics.

Hepatology 2019 Apr 8. Epub 2019 Apr 8.

Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital.

We read the paper by Nardelli et al with great interest. The study tried to establish the correlation between using of proton pump inhibitors (PPIs) and the occurrence of minimal/overt hepatic encephalopathy (HE) among cirrhotics. In accordance with our previous retrospective population study, Nardelli et al. Read More

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http://dx.doi.org/10.1002/hep.30641DOI Listing
April 2019
5 Reads

Clinical course and mortality by etiology of liver cirrhosis in Sweden: a population based, long-term follow-up study of 1317 patients.

Aliment Pharmacol Ther 2019 Apr 8. Epub 2019 Apr 8.

Department of Clinical Sciences, Lund University, Lund, Sweden.

Background: Liver cirrhosis is characterized by a silent phase until decompensation, which is defined by ascites, bleeding from esophageal varices or hepatic encephalopathy.

Aim: We compare the clinical course, patterns of survival and causes of death by etiology during long-term follow-up in a large population-based cohort of patients with incident cirrhosis.

Material And Methods: We used population-based medical registries for a cohort study of patients with liver cirrhosis diagnosed January 2001 to December 2010, in the Scania region of Sweden. Read More

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http://doi.wiley.com/10.1111/apt.15255
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http://dx.doi.org/10.1111/apt.15255DOI Listing
April 2019
8 Reads

Deteriorated Outcome of Recent Patients with Acute Liver Failure and Late-Onset Hepatic Failure Caused by Infection with Hepatitis A Virus: A Subanalysis of Patients Seen Between 1998 and 2015 and Enrolled in Nationwide Surveys in Japan.

Hepatol Res 2019 Apr 7. Epub 2019 Apr 7.

Department of Gastroenterology & Hepatology, Saitama Medical University.

Aim: A nationwide survey of acute liver failure (ALF) and late-onset hepatic failure (LOHF) has revealed that the outcomes of recent patients whose diseases were caused by infection with hepatitis A virus (HAV) have worsened, compared with those of previously reported patients. Here, the factors associated with this deterioration were evaluated.

Methods: A total of 83 patients with HAV infection seen between 1998 and 2015 were enrolled. Read More

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http://dx.doi.org/10.1111/hepr.13345DOI Listing
April 2019
2 Reads

Incidence and Risk Factors Associated With 30-Day Readmission for Alcoholic Hepatitis.

J Clin Gastroenterol 2019 Apr 3. Epub 2019 Apr 3.

Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester.

Background: Alcohol abuse and liver disease are associated with high rates of 30-day hospital readmission, but factors linking alcoholic hepatitis (AH) to readmission are not well understood. We aimed to determine the incidence rate of 30-day readmission for patients with AH and to evaluate potential predictors of readmission.

Methods: We used the Nationwide Readmissions Database to determine the 30-day readmission rate for recurrent AH between 2010 and 2014 and examined trends in readmissions during the study period. Read More

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http://dx.doi.org/10.1097/MCG.0000000000001202DOI Listing
April 2019
2 Reads
3.498 Impact Factor

Contemporary Epidemiology of Cirrhosis.

Curr Treat Options Gastroenterol 2019 Apr 4. Epub 2019 Apr 4.

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

Purpose Of Review: We sought to review the contemporary epidemiology of cirrhosis, focusing on the relative burden of the most common chronic liver diseases.

Recent Findings: The key findings in the review highlight the increasing prevalence and impact of alcohol-related liver disease, particularly among young people, and the epidemic of nonalcoholic fatty liver commensurate with rising rates of obesity. We also contrast recent advances in the care of persons with hepatitis C with the lamentable rise in new infections associated with intravenous drug use. Read More

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http://dx.doi.org/10.1007/s11938-019-00228-3DOI Listing

Structural and functional abnormalities of vision-related brain regions in cirrhotic patients: a MRI study.

Neuroradiology 2019 Apr 4. Epub 2019 Apr 4.

Department of Radiology, The First Affiliated Hospital of AnHui Medical University, Hefei, 230022, Anhui, China.

Purpose: Previous studies have focused on global cerebral alterations observed in cirrhosis. However, little was known about the specific abnormalities of vision-related brain regions in cirrhotic patients. In this study, we sought to explore neurological alterations of vision-related regions by measuring brain resting-state network connectivity, based on the structural investigation in cirrhotic patients without clinical sign of hepatic encephalopathy (HE). Read More

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http://dx.doi.org/10.1007/s00234-019-02199-9DOI Listing
April 2019
1 Read

Portal Hypertension and Related Complications: Diagnosis and Management.

Mayo Clin Proc 2019 Apr;94(4):714-726

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

Portal hypertension is a major complication of cirrhosis, and its consequences, including ascites, esophageal varices, hepatic encephalopathy, and hepatorenal syndrome, lead to substantial morbidity and mortality. The past several decades have seen major improvements in the clinical management of complications of portal hypertension, resulting in substantial gains in patient outcomes. However, important challenges remain. Read More

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http://dx.doi.org/10.1016/j.mayocp.2018.12.020DOI Listing
April 2019
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Bilirubin encephalopathy (kernicterus) in an adult cat.

JFMS Open Rep 2019 Jan-Jun;5(1):2055116919838874. Epub 2019 Mar 27.

Pathology Sector, Clinic and Surgery Department, Veterinary School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Case Summary: An adult cat presented with neurological signs and marked icterus. Clinical pathology tests detected increased serum alkaline phosphatase levels, as well as alanine aminotransferase, total bilirubin, unconjugated bilirubin and conjugated bilirubin above the normal reference intervals. Ultrasonography showed hepatomegaly and a dilated gall bladder. Read More

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http://dx.doi.org/10.1177/2055116919838874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437325PMC
March 2019
4 Reads

Smaller Diameter Covered Transjugular Intrahepatic Portosystemic Shunt Stents are Associated With Increased Survival.

Clin Gastroenterol Hepatol 2019 Mar 30. Epub 2019 Mar 30.

Department of Gastroenterology, University Hospital Freiburg, Freiburg, Germany.

Background & Aims: We studied effects of diameter of covered, self-expandable nitinol stents on survival times of patients with a transjugular intrahepatic portosystemic shunt (TIPS).

Methods: We collected data from 185 patients (median age, 55 years; 30% female) who received a covered nitinol stent, from February 2006 through September 2010, using the online, multicenter, German TIPS registry. TIPS were given to 107 patients for refractory ascites and to 78 patients for variceal bleeding. Read More

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http://dx.doi.org/10.1016/j.cgh.2019.03.042DOI Listing
March 2019
3 Reads

Complications of Stem Cell Transplantation that Affect Infections in Stem Cell Transplant Recipients, with Analogies to Patients with Hematologic Malignancies.

Infect Dis Clin North Am 2019 Jun 30;33(2):331-359. Epub 2019 Mar 30.

Section of Bone Marrow Transplant and Cellular Therapy, Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, 1725 West Harrison Street, Suite 809, Chicago, IL 60612, USA. Electronic address:

This article discusses the complications of hematopoietic stem cell transplantion (HSCT) that affect infections in HSCT recipients, with analogies to patients with hematologic malignancies. Mucositis, with mucosal barrier disruption, is common and increases the risk of gram-positive and anaerobic bacterial, and fungal infections, and can evolve to typhlitis. Engraftment syndrome; graft-versus-host disease, hepatic sinusoidal obstruction syndrome; and posterior reversible encephalopathy syndrome can affect the infectious potential either directly from organ dysfunction or indirectly from specific treatment. Read More

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http://dx.doi.org/10.1016/j.idc.2019.01.002DOI Listing
June 2019
3 Reads

Elevated circulating TGFβ1 during acute liver failure activates TGFβR2 on cortical neurons and exacerbates neuroinflammation and hepatic encephalopathy in mice.

J Neuroinflammation 2019 Apr 2;16(1):69. Epub 2019 Apr 2.

Central Texas Veterans Health Care System, Temple, TX, USA.

Background: Acute liver failure resulting from drug-induced liver injury can lead to the development of neurological complications called hepatic encephalopathy (HE). Hepatic transforming growth factor beta 1 (TGFβ1) is upregulated due to liver failure in mice and inhibiting circulating TGFβ reduced HE progression. However, the specific contributions of TGFβ1 on brain cell populations and neuroinflammation during HE are not known. Read More

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http://dx.doi.org/10.1186/s12974-019-1455-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446280PMC
April 2019
2 Reads

Sarcopenia Is Associated With Development of Acute-on-Chronic Liver Failure in Decompensated Liver Cirrhosis Receiving Transjugular Intrahepatic Portosystemic Shunt.

Clin Transl Gastroenterol 2019 Mar 29. Epub 2019 Mar 29.

Department of Internal Medicine I, University of Bonn, Bonn, Germany.

Introduction: Muscle mass has been shown to be a prognostic marker in patients with liver cirrhosis. Transversal psoas muscle thickness normalized by height (TPMT/height) obtained by routine computed tomography is a simple surrogate parameter for sarcopenia. TPMT/height, however, is not sex specific, which might play a role in risk stratification. Read More

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http://dx.doi.org/10.14309/ctg.0000000000000025DOI Listing
March 2019
1 Read

Upper gastrointestinal bleeding in Egyptian patients with cirrhosis: Post-therapeutic outcome and prognostic indicators.

J Gastroenterol Hepatol 2019 Mar 14. Epub 2019 Mar 14.

Hepatology Department, National Liver Institute, University of Menoufia, Shebeen El-Kom, Egypt.

Background And Aim: Upper gastrointestinal bleeding (UGIB) is a serious complication of portal hypertension in cirrhotic patients. The objective of this study is to identify the risk factors for morbidity and mortality occurring after an UGIB attack.

Methods: A total of 1097 UGIB attacks in 690 patients with liver cirrhosis were studied. Read More

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http://dx.doi.org/10.1111/jgh.14659DOI Listing
March 2019
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Characteristics, Risk Factors, and Adverse Outcomes of Hyperkalemia in Acute-on-Chronic Liver Failure Patients.

Biomed Res Int 2019 27;2019:6025726. Epub 2019 Feb 27.

Department of Hepatology, Tianjin Third Central Hospital, Tianjin Institute of Hepatobiliary Disease, Tianjin Key Laboratory of Artificial Cell, Tianjin, China.

Background: Hyperkalemia is a serious complication in cirrhotic patients. However, the clinical characteristics, risk factors, and its impact on the outcomes in acute-on-chronic liver failure (ACLF) patients remain unclear.

Methods: We retrospectively recruited 650 ACLF patients in this study. Read More

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http://dx.doi.org/10.1155/2019/6025726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415283PMC
February 2019
3 Reads

Serum Zinc Level in Decompensated Liver Disease and its Correlation with Stage of Hepatic Encephalopathy.

J Assoc Physicians India 2019 Jan;67(1):30-32

Senior Resident, Institute of Internal Medicine Madras Medical College, Chennai, Tamil Nadu.

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January 2019
3 Reads

Kinetic deterioration of short memory in rat with acute hepatic encephalopathy: Involvement of astroglial and neuronal dysfunctions.

Behav Brain Res 2019 Mar 27;367:201-209. Epub 2019 Mar 27.

Neuroscience, Pharmacology and Environment Unit (ENPE), faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco. Electronic address:

Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome resulting from acute or chronic hepatic impairments. The clinical features of HE include attention as well as a mild cognitive deficits associated with impaired attentional and executive networks in patients as well as in animal models of HE. The underlining pathomechanism of memory impairment in HE patients is still not fully understood; however, it may involve a possible gliopathy as well as neuropathy. Read More

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http://dx.doi.org/10.1016/j.bbr.2019.03.046DOI Listing
March 2019
4 Reads

Organ dysfunction in cirrhosis: a mechanism involving the microcirculation.

Eur J Gastroenterol Hepatol 2019 05;31(5):618-625

Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), State University of Rio de Janeiro.

Introduction: Microcirculation is essential for adequate tissue perfusion and organ function. Microcirculatory changes may occur in cirrhosis, inducing loss of multiorgan function. The aim was to evaluate preliver transplantation and postliver transplantation aspects of multiorgan function, microcirculation, inflammatory, and endothelial biomarkers and survival in a controlled study including cirrhotic outpatients. Read More

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http://dx.doi.org/10.1097/MEG.0000000000001366DOI Listing
May 2019
1 Read

Kratom-Induced Cholestatic Liver Injury and Its Conservative Management.

J Investig Med High Impact Case Rep 2019 Jan-Dec;7:2324709619836138

1 Stanford University, Stanford, CA, USA.

Drug-induced liver injury (DILI) is a common cause of hepatotoxicity associated with prescription-based and over-the-counter exposure to medications and herbal supplements. Use of unapproved and inadequately tested herbal supplements can cause DILI. Therefore, thorough history-taking on exposure to herbal supplements must be an integral part of clinical evaluation of DILI. Read More

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http://dx.doi.org/10.1177/2324709619836138DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440031PMC
March 2019
2 Reads

Microstructural brain abnormalities correlate with neurocognitive dysfunction in minimal hepatic encephalopathy: a diffusion kurtosis imaging study.

Neuroradiology 2019 Mar 27. Epub 2019 Mar 27.

Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China.

Purpose: To investigate the diffusion kurtosis imaging (DKI) in early minimal hepatic encephalopathy (MHE) diagnosis and evaluate the correlations between changes in DKI metrics and cognitive performance.

Methods: We enrolled 116 cirrhosis patients, divided into non-HE (n = 61) and MHE (n = 55), and 46 normal controls (NCs). All patients underwent cognitive testing before magnetic resonance imaging. Read More

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http://dx.doi.org/10.1007/s00234-019-02201-4DOI Listing
March 2019
4 Reads

Efficacy of orally administered sodium benzoate and sodium phenylbutyrate in dogs with congenital portosystemic shunts.

J Vet Intern Med 2019 Mar 27. Epub 2019 Mar 27.

Pharmacy Department, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.

Background: Hyperammonemia can result in hepatic encephalopathy, which in severe cases eventually can lead to coma and death. In dogs, congenital portosystemic shunts (CPSS) are the most common cause for hyperammonemia. Conservative treatment consists of a protein modified diet, nonabsorbable disaccharides, antibiotics, or some combinations of these. Read More

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http://dx.doi.org/10.1111/jvim.15477DOI Listing

Comparision between portosystemic shunts and endoscopic therapy for prevention of variceal rebleeding: A systematic review and meta-analysis.

Chin Med J (Engl) 2019 Mar 22. Epub 2019 Mar 22.

Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100005, China.

Background: Portosystemic shunts, including surgical portosystemic shunts and transjugular intrahepatic portosystemic shunts (TIPS), may have benefit over endoscopic therapy (ET) for treatment of variceal bleeding in patients with cirrhotic portal hypertension; however, whether there being a survival benefit among them remains unclear. This study was to compare the effect of three above-mentioned therapies on the short-term and long-term survival in patient with cirrhosis.

Methods: Using the terms ["variceal hemorrhage or variceal bleeding or variceal rebleeding" OR "esophageal and gastric varices" OR "portal hypertension"] and "liver cirrhosis", the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the references of identified trials were searched for human randomized controlled trials (RCTs) published in any language with full texts or abstracts (last search June 2017). Read More

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http://dx.doi.org/10.1097/CM9.0000000000000212DOI Listing
March 2019
2 Reads

β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial.

Lancet 2019 Mar 22. Epub 2019 Mar 22.

Centre for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), University of Alcalá, Madrid, Spain; Barcelona Hepatic Haemodynamic Laboratory, Liver Unit, Institute of Digestive and Metabolic Diseases, August Pi i Sunyer Institute of Biomedical Research, Hospital Clínic, Barcelona, Spain; Inselspital, Bern University, Switzerland.

Background: Clinical decompensation of cirrhosis is associated with poor prognosis. Clinically significant portal hypertension (CSPH), defined by a hepatic venous pressure gradient (HVPG) ≥10 mm Hg, is the strongest predictor of decompensation. This study aimed at assessing whether lowering HVPG with β blockers could decrease the risk of decompensation or death in compensated cirrhosis with CSPH. Read More

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http://dx.doi.org/10.1016/S0140-6736(18)31875-0DOI Listing
March 2019
2 Reads

Partial Splenic Embolization is a Safe and Effective Alternative in the Management of Portal Hypertension in Children.

J Pediatr Gastroenterol Nutr 2019 Mar 18. Epub 2019 Mar 18.

Department of Pediatrics, Columbia University Medical Center, New York, NY.

Objective: There are multiple approaches to manage the clinical complications of portal hypertension (PHTN) to treat/prevent spontaneous hemorrhage by mitigating thrombocytopenia. No single approach is ideal for all patients given the heterogeneity of this population. Our goal was to determine whether partial splenic embolization (PSE) was safe and effective in the pediatric population. Read More

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http://dx.doi.org/10.1097/MPG.0000000000002332DOI Listing
March 2019
5 Reads

Glucuronidated bilirubin: Significantly increased in hepatic encephalopathy.

Prog Mol Biol Transl Sci 2019 6;162:363-376. Epub 2019 Mar 6.

Systems Biology and Medicine Center for Complex Diseases, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Bilirubin is produced by the breakdown of hemoglobin in senescent erythrocytes by macrophages and carried by albumin from blood circulation to the liver for removal in normal physiology. Glucuronic acid modification of bilirubin by UDP-glucuronyltransferase in the liver is the key event for its subsequent elimination from human body. Conditions that accelerate the breakdown of erythrocytes may cause an elevated blood level of unconjugated bilirubin whereas the factors affect the glucuronidated bilirubin formation and subsequent elimination may cause decreased or increased blood level of glucuronidated bilirubin, the water soluble "direct bilirubin" measured by clinical blood test. Read More

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http://dx.doi.org/10.1016/bs.pmbts.2018.12.009DOI Listing
March 2019
1 Read

Serum α-l-fucosidase activities are significantly increased in patients with preeclampsia.

Prog Mol Biol Transl Sci 2019 8;162:349-362. Epub 2019 Mar 8.

Systems Biology and Medicine Center for Complex Diseases, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Fucosylated glycans are essential molecules that facilitate signal transductions in several signal pathways and play important roles in development, inflammation, infection, and tumor metastasis. The fucosylated glycans are difficult to be developed into clinical biomarkers due to their complicated structures, but the decreased or increased activities of serum α-l-fucosidase, the lysosomal enzyme required for fucosylated glycan degradation, are diagnostic biomarker for patients with fucosidosis and hepatocellular carcinoma, respectively. However, the relationship between serum α-l-fucosidase activities and other human diseases is largely unknown. Read More

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http://dx.doi.org/10.1016/bs.pmbts.2018.12.008DOI Listing
March 2019
2 Reads

The serum SA levels are significantly increased in sepsis but decreased in cirrhosis.

Prog Mol Biol Transl Sci 2019 6;162:335-348. Epub 2019 Mar 6.

Department of Internal Medicine, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Most of proteins in human blood circulation are glycoproteins with one or more covalently linked N- or O-linked glycans. Sialic acid (SA) generally occurs as the terminal monosaccharide on the glycans. SA in glycoproteins modulates a wide range of physiological and pathological processes and has been routinely measured in hospital since 1950s. Read More

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http://dx.doi.org/10.1016/bs.pmbts.2019.01.009DOI Listing
March 2019
1 Read

Glycated serum proteins: High in pancreatic cancer and low in preeclampsia.

Prog Mol Biol Transl Sci 2019 6;162:321-333. Epub 2019 Mar 6.

Department of Internal Medicine, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Glycated serum protein (GSP, measured as serum fructosamine concentration in μmol/L) is a product of glycation reaction between glucose and serum proteins in the blood circulation. GSP is used along with blood glucose, glycated hemoglobin (HbA1c), and glycated albumin as indicators of glycemic control for diabetic patients. However, a systematic comparison of the GSP levels in different types of human diseases has not been reported. Read More

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http://dx.doi.org/10.1016/bs.pmbts.2019.01.007DOI Listing
March 2019
2 Reads

Glycated albumin level is significantly decreased in patients suffering nephrotic syndrome.

Prog Mol Biol Transl Sci 2019 6;162:307-319. Epub 2019 Mar 6.

Systems Biology and Medicine Center for Complex Diseases, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Serum glycated albumin (GA) level is used along with that of glucose and glycated hemoglobin (HbA1c) as indicators of glycemic control for diabetic patients. Although serum GA levels are affected by blood glucose level, they are also influenced by serum albumin metabolism and other pathological conditions. However, a systematic comparison of the serum GA levels in different types of human diseases has not been reported. Read More

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http://dx.doi.org/10.1016/bs.pmbts.2019.01.006DOI Listing
March 2019
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Fasting blood glucose levels in patients with different types of diseases.

Prog Mol Biol Transl Sci 2019 6;162:277-292. Epub 2019 Mar 6.

Systems Biology and Medicine Center for Complex Diseases, Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Normal human physiology is dependent on a tight control of the fasting blood glucose (FBG) levels. The islets of pancreas maintains FBG levels within a narrow range of 4-6mmol/L by secreting various hormones, especially insulin and glucagon. However, the hormone secretions by the islets of pancreas are governed by a collective effort among pancreas-islet axis, brain-islet axis, liver-islet axis, gut-islet axis, and adipocyte/myocyte-islet axis. Read More

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http://dx.doi.org/10.1016/bs.pmbts.2019.01.004DOI Listing
March 2019
3 Reads

Updates on the pathophysiology and therapeutic targets for hepatic encephalopathy.

Curr Opin Gastroenterol 2019 May;35(3):145-154

Division of Hepatology, Baylor University Medical Center, Dallas, USA.

Purpose Of Review: Hepatic encephalopathy is one of the most debilitating clinical manifestations of cirrhosis and associated with increased morbidity and mortality. Treatment modalities available include the nonabsorbable disaccharides (lactulose) and the nonabsorbable antibiotics (rifaximin).

Recent Findings: Newer therapeutic targets under evaluation include ammonia scavengers (ornithine phenylacetate) and modulation of gut microbiota (fecal microbiota transplantation). Read More

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http://dx.doi.org/10.1097/MOG.0000000000000527DOI Listing
May 2019
4 Reads
4.289 Impact Factor

AARC-ACLF score: best predictor of outcome in children and adolescents with decompensated Wilson disease.

Hepatol Int 2019 Mar 19. Epub 2019 Mar 19.

Institute of Liver and Biliary Sciences, New Delhi, India.

Background And Aims: Doubts have been raised about efficacy of New Wilson's index (NWI) in predicting Liver Transplant (LT) or mortality in decompensated Wilson Disease (WD) patients. APASL ACLF Research Consortium (AARC) has introduced a new score (AARC-ACLF) which has not been studied in children.

Methods: Data of all pediatric WD cases were prospectively collected and analyzed. Read More

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http://dx.doi.org/10.1007/s12072-019-09938-3DOI Listing
March 2019
1 Read
2.468 Impact Factor

Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis.

EJIFCC 2019 Mar 1;30(1):99-105. Epub 2019 Mar 1.

Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.

A 28-year-old male with acute on chronic liver failure (ACLF) and hepatic encephalopathy had deranged liver function with curiously low level (0-15 IU/L) of serum alkaline phosphatase (ALP). Peripheral smear examination suggested hemolytic anemia. The finding of persistent low ALP, after ruling out pre-analytical causes, in ACLF has been reported in Wilson's disease (WD) with/ without autoimmune hemolytic anemia (AIHA). Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416816PMC
March 2019
5 Reads

Increasing Burden of Hepatic Encephalopathy Among Hospitalized Adults: An Analysis of the 2010-2014 National Inpatient Sample.

Dig Dis Sci 2019 Mar 13. Epub 2019 Mar 13.

Division of Gastroenterology and Hepatology, Alameda Health System - Highland Hospital, 1411 East 31st Street, Highland Hospital - Highland Care Pavilion 5th Floor, Endoscopy Unit, Oakland, CA, 94602, USA.

Background: Hepatic encephalopathy (HE) is associated with substantial morbidity and mortality, contributing significant burden on healthcare systems.

Aim: We aim to evaluate trends in clinical and economic burden of HE among hospitalized adults in the USA.

Methods: Using the 2010-2014 National Inpatient Sample, we identified adults hospitalized with HE using ICD-9-CM codes. Read More

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http://dx.doi.org/10.1007/s10620-019-05576-9DOI Listing
March 2019
3 Reads
2.550 Impact Factor

Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt to reduce hepatic encephalopathy.

World J Gastroenterol 2019 Mar;25(9):1088-1099

Department of Ultrasound, Air Force Medical Center of PLA, Beijing 100142, China.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is currently used for the treatment of complications of portal hypertension. The incidence of hepatic encephalopathy (HE) remains a problem in TIPS placement. It has been reported that the right branch mainly receives superior mesenteric venous blood while the left branch mainly receives blood from the splenic vein. Read More

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http://dx.doi.org/10.3748/wjg.v25.i9.1088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406189PMC
March 2019
2 Reads

Live donor liver transplantation for acute liver failure - Donor safety and recipient outcome.

Liver Transpl 2019 Mar 12. Epub 2019 Mar 12.

Department of Hepatology, Institute of Liver & Biliary Sciences.

In countries where deceased organ donation is sparse, emergency live donor liver transplantation(LDLT) is the only lifesaving option in selectpatients with acute liver failure(ALF). Aim of the current study is live liver donor safety and recipient outcomes following LDLT for ALF. Analysis of consecutive patients undergoing LDLT for ALF from March 2011 to February 2018was done. Read More

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http://dx.doi.org/10.1002/lt.25445DOI Listing
March 2019
2 Reads

Utility of the EncephalApp Stroop Test for covert hepatic encephalopathy screening in Chinese cirrhotic patients.

J Gastroenterol Hepatol 2019 Mar 12. Epub 2019 Mar 12.

Department of Gastroenterology, Peking University People's Hospital, Beijing, China.

Background And Aim: Considering the large size of the potential population and limitations of common detection methods, covert hepatic encephalopathy (CHE) is difficult to screen for routinely. The present study aims to explore EncephalApp Stroop Test as a smartphone-based CHE screening tool in China.

Methods: A multicenter, single-visit study was carried out. Read More

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http://dx.doi.org/10.1111/jgh.14656DOI Listing
March 2019
3 Reads