15,797 results match your criteria Portal-Systemic Encephalopathy


Treatment of liver failure post one anastomosis gastric bypass by revising to normal anatomy: A case report.

Int J Surg Case Rep 2021 Apr 27;82:105914. Epub 2021 Apr 27.

College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Eastern Province, Saudi Arabia.

Introduction: Obesity and the associated metabolic syndrome are global health problems. Significant weight loss after bariatric surgery can cause a substantial difference in those comorbidities in obese patients. In this case, we described a rare complication of a patient who developed acute liver failure after an uneventful one anastomosis gastric bypass treated conservatively and revision of the one anastomosis gastric bypass to normal anatomy. Read More

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Propranolol-induced hallucinations mimicking encephalopathy in a patient with liver cirrhosis.

Scand J Gastroenterol 2021 May 7:1-3. Epub 2021 May 7.

Department of Medicine, gastroenterology and hepatology unit, Sahlgrenska University Hospital, Gothenburg, Sweden.

Hepatic encephalopathy (HE) is a frequent complication of liver cirrhosis, which is mostly characterized by psychomotor slowing. However, psychotic symptoms such as visual and olfactory hallucinations may sometimes also be present. In contrast, auditory hallucinations are uncommon in chronic liver disease. Read More

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A Review of Liver Dysfunction in the Lung Transplant Patient.

Clin Transplant 2021 May 7:e14344. Epub 2021 May 7.

Division of Thoracic Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Liver dysfunction is an increasingly common finding in patients evaluated for lung transplantation. New or worsening dysfunction in the perioperative period, defined by presence of clinical ascites/encephalopathy, high model for end-stage liver disease (MELD) score, and/or independent diagnostic criteria, is associated with high short- and long-term mortality. Therefore, a thorough liver function assessment is necessary prior to listing for lung transplant. Read More

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Long-term albumin infusion in decompensated cirrhosis: A review of current literature.

World J Hepatol 2021 Apr;13(4):421-432

Department ofGastroenterology and Hepatology, Changi General Hospital, Singapore 529889, Singapore.

Decompensated cirrhosis is characterized by chronic inflammation and severe portal hypertension leading to systemic circulatory dysfunction. Albumin infusion has been widely used in decompensated cirrhosis in patients with spontaneous bacterial peritonitis, large-volume paracentesis and hepatorenal syndrome. Emerging data suggest long-term albumin infusion has both oncotic and non-oncotic properties which may improve the clinical outcomes in decompensated cirrhosis patients. Read More

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[Cirrhosis].

Dtsch Med Wochenschr 2021 May 6;146(10):684-697. Epub 2021 May 6.

The review summarizes the management and therapy of cirrhosis. Special focus is made on the complications of cirrhosis, like variceal bleeding, ascites, renal failure and hepatic encephalopathy. Read More

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CT-scan Based Liver and Spleen Volume Measurement as a Prognostic Indicator for Patients with Cirrhosis.

Am J Med Sci 2020 Nov 2. Epub 2020 Nov 2.

Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, United States; Roudebush Veterans Administration Medical Center, Indianapolis, IN, United States; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States. Electronic address:

Background: Complications of patients with liver disease generally occurs as the consequence of advanced fibrosis and portal hypertension. Non-invasive tools to predict the complications may allow for better risk-stratification and medical management in patients with cirrhosis. The goals of this study were to determine the utility of CT-scan based liver and spleen volume measurement in association with complications and outcomes in patients with cirrhosis. Read More

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November 2020

Atypical Reye syndrome: three cases of a problem that pediatricians should consider and remember.

Acta Biomed 2021 Apr 30;92(S1):e2021110. Epub 2021 Apr 30.

Institute of Pediatrics, Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Rome, Italy .

Introduction: Reye syndrome is a rare acquired metabolic disorder appearing almost always during childhood. Its aetiopathogenesis, although controversial, is partially understood. The classical disease is typically anticipated by a viral infection with 3-5 days of well-being before the onset of symptoms, while the biochemical explanation of the clinical picture is a mitochondrial metabolism disorder, which leads to a metabolic failure of different tissues, especially the liver. Read More

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Trihydroxycholanoyl-taurine in brains of rodents with hepatic encephalopathy.

J Mass Spectrom 2021 Jun;56(6):e4729

Department of Chemistry and Biochemistry, Baylor University, Waco, Texas, 76798, USA.

Hepatic encephalopathy (HE), a neurological disease resulting from liver failure, is difficult to manage and its causes are unclear. Bile acids have been postulated to be involved in the provenance and progression of various diseases including HE. Hence, the characterization of bile acid profiles in the brains of subjects with and without liver failure can provide important clues for the potential treatment of HE. Read More

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Proton pump inhibitor use is associated with increased rates of post-TIPS hepatic encephalopathy: Replication in an independent patient cohort.

Clin Imaging 2021 Apr 29;77:187-192. Epub 2021 Apr 29.

Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, DUMC 3808, Durham, NC 27710, USA. Electronic address:

Purpose: Proton pump inhibitor (PPI) use is a potential risk factor for hepatic encephalopathy (HE), but few studies have examined the effect on post-TIPS HE. The purpose of this study was to determine whether PPIs are associated with increased rates of post-TIPS HE in an independent patient cohort.

Materials And Methods: This single-institution retrospective study analyzed 86 patients (54 male, mean age 58. Read More

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MR T1 mapping for quantifying brain manganese deposition in type C hepatic encephalopathy rats.

Biometals 2021 Apr 29. Epub 2021 Apr 29.

Department of Radiology, Jinshan Hospital of Fudan University, 1508 Longhang Road, Shanghai, 201508, China.

To evaluate magnetic resonance (MR) T1 mapping for quantifying brain manganese (Mn) deposition in type C hepatic encephalopathy (CHE) rats and to investigate the mechanism of magnesium sulfate (MgSO) therapy. Thirty Sprague-Dawley rats were randomly assigned into normal control group (NC, n = 6) and CHE groups (n = 24). Thioacetamide (TAA) was used for modeling CHE rats. Read More

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Characteristics and Outcomes of Children With Cystic Fibrosis Hospitalized With Cirrhosis in the United States.

Am J Gastroenterol 2021 Apr 29. Epub 2021 Apr 29.

Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada; Department of Medicine, University of Washington, Seattle, Washington, USA.

Introduction: To describe the characteristics and outcomes of children with cystic fibrosis (CF) hospitalized with cirrhosis in the United States.

Methods: We conducted a population-based cohort study of hospitalizations among children with CF using the 2016 Kid's Inpatient Database.

Results: In total, 9,615 admissions were analyzed. Read More

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Early Normalization of Alanine Aminotransferase during Antiviral Therapy Reduces Risk of Hepatocellular Carcinoma in HBV Patients.

J Clin Med 2021 Apr 23;10(9). Epub 2021 Apr 23.

Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea.

Potent antiviral agents effectively reduce liver-related events in patients with chronic hepatitis B. This study aimed to determine whether alanine aminotransferase normalization using potent antiviral agents was related to hepatocellular carcinoma development. From 2007 to 2017, we included 610 patients with chronic hepatitis B who received entecavir or tenofovir disoproxil fumarate. Read More

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Ashwagandha (Withania somnifera) root extract attenuates hepatic and cognitive deficits in thioacetamide-induced rat model of hepatic encephalopathy via induction of Nrf2/HO-1 and mitigation of NF-kB/MAPK signaling pathways.

J Ethnopharmacol 2021 Apr 24:114141. Epub 2021 Apr 24.

Department of Pharmacology, Theodor Bilharz Research Institute, Kornaish El Nile, Warrak El-Hadar, Imbaba (P.O. 30), Giza, 12411, Egypt. Electronic address:

Ethnopharmacological Relevance: Ashwagandha (ASH) is one of the medicinal plants that is used in traditional Indian, Ayurvedic and Unani medicines for their broad range of pharmacological activities including tonic, aphrodisiac, energy stimulant, and counteracting chronic fatigue. Besides, it is used in the treatment of nervous exhaustion, memory related conditions, insomnia, as well as improving learning ability and memory capacity. ASH is preclinically proven to be efficient in hepatoprotection and enhancing cognitive impairment, however, its beneficial effects against hepatic encephalopathy (HE) is still unclear. Read More

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Bacterial infections adversely influence the risk of decompensation and survival in compensated cirrhosis.

J Hepatol 2021 Apr 24. Epub 2021 Apr 24.

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd); Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). University of Barcelona. Barcelona, Spain; Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver); University Clinic for Visceral Surgery and Medicine, Inselspital, Bern University, Switzerland.

Background & Aims: Prognosis of compensated cirrhosis is good until decompensation. In decompensated cirrhosis, bacterial infections (BIs) are common and increase the risk of death. The incidence and prognostic implications of BIs in compensated cirrhosis are less characterized. Read More

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[Analysis of clinical characteristics of 481 HBV-related liver cirrhotic patients with low viral load].

Zhonghua Gan Zang Bing Za Zhi 2021 Mar;29(3):227-233

Department of Infectious Disease, Infectious Disease Center of the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000, China.

To analyze the clinical characteristics of HBV-related liver cirrhotic patients with low viral load. A retrospective analysis on 481 inpatients with HBV-related cirrhosis with low viral load [HBV DNA≤2 000 IU/ml (10(4) copies/ml)] general condition, virological indicators, liver function-related indicators, complications, and incidence of complications were analyzed. The t-test was used to compare the average measurement data, and the (2) test was used to compare the count data. Read More

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[Risk and control management of endoscopic retrograde cholangiopancreatography in patients with liver cirrhosis].

Authors:
X M Li L G Lu X B Cai

Zhonghua Gan Zang Bing Za Zhi 2021 Mar;29(3):209-212

Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China.

Endoscopic retrograde cholangiopancreatography (ERCP) is the most direct and effective method for the diagnosis and treatment of biliary and pancreatic diseases. Compared with surgery, ERCP has the advantages of minimal trauma, shorter surgery time, fewer complications, and shorter hospital stay. Liver cirrhosis, as the advanced stage of liver disease, has reduced tolerance to surgical stresses, and complications such as hepatic encephalopathy, esophagogastric varices, and coagulation dysfunction may occur during the decompensated stage, which poses a challenge to ERCP, and thus increase the intraoperative risk and postoperative complications. Read More

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[An overlooked liver cirrhosis complications: portal vein thrombosis, sarcopenia and hepatic osteopathy].

Authors:
F Li L G Lu

Zhonghua Gan Zang Bing Za Zhi 2021 Mar;29(3):193-195

Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.

Liver cirrhosis can lead to a variety of complications. Ascites, hepatic encephalopathy, esophageal variceal bleeding, and hepatorenal syndrome have been well recognized. However, there are still some complications that have a high incidence, but are overlooked by clinicians. Read More

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2021 ISHEN Guidelines on Animal Models of Hepatic Encephalopathy.

Liver Int 2021 Apr 26. Epub 2021 Apr 26.

Hepato-Neuro Laboratory, CRCHUM, Université de Montréal, Montreal, Canada.

This working group of the International Society of Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) was commissioned to summarize and update current efforts in the development and characterization of animal models of hepatic encephalopathy (HE). As defined in humans, HE in animal models is based on the underlying degree and severity of liver pathology. Although hyperammonemia remains the key focus in the pathogenesis of HE, other factors associated with HE have been identified, together with recommended animal models, to help explore the pathogenesis and pathophysiological mechanisms of HE. Read More

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Brain Herniation and Intracranial Hypertension.

Neurol Clin 2021 05 31;39(2):293-318. Epub 2021 Mar 31.

Department of Neurology, Tufts University School of Medicine, Tufts Medical Center, 800 Washington Street, Box#314, Boston, MA 02111, USA.

This article introduces the basic concepts of intracranial physiology and pressure dynamics. It also includes discussion of signs and symptoms and examination and radiographic findings of patients with acute cerebral herniation as a result of increased as well as decreased intracranial pressure. Current best practices regarding medical and surgical treatments and approaches to management of intracranial hypertension as well as future directions are reviewed. Read More

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Review article: the role of nutrition in alcohol-associated liver disease.

Aliment Pharmacol Ther 2021 Apr 25. Epub 2021 Apr 25.

Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, IN, USA.

Background: Malnutrition is a commonly encountered issue in patients with alcohol-associated liver disease. The role of nutritional supplementation in the management of alcohol-associated liver disease is integral to patient outcomes-it has been shown to decrease rates of hepatic encephalopathy, improve outcomes post-liver transplant, reduce 90-day hospital readmissions and lower mortality. Despite these benefits, many studies have shown nutritional support to be an underutilised tool in the care of patients with alcohol-associated liver disease. Read More

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The impact of pretransplant hepatic encephalopathy, model for end-stage liver disease (MELD) scale on long-term survival following deceased donor liver transplantation: a retrospective study.

Ann Palliat Med 2021 Apr 19. Epub 2021 Apr 19.

Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

Background: Liver transplantation (LT) has the incidence of 30-day mortality about 5-10%, Jo et al. reported that 30-day mortality and 1-year mortality for DDLT were 30%, and 39% respectively. It is not easy to create a model for predicting post-transplantation outcomes based on pretransplant variables. Read More

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A pilot study of Golexanolone, a new GABA-A receptor modulating steroid antagonist, in patients with covert hepatic encephalopathy.

J Hepatol 2021 Mar 24. Epub 2021 Mar 24.

Umecrine Cognition AB, Stockholm, Sweden. Electronic address:

Background: Golexanolone is a novel small molecule GABA-A receptor modulating steroid antagonist under development for treatment of cognitive and vigilance disorders due to allosteric over-activation of GABA-A receptors by neurosteroids. It restored spatial learning and motor coordination in animal models of hepatic encephalopathy (HE) and mitigated the effects of intravenous allopregnanolone in healthy adults in a dose-dependent fashion. Here we report golexanolone safety, pharmacokinetics (PK) and effects on the electroencephalogram (EEG), subjective sleepiness and cognitive performance in adult patients with cirrhosis. Read More

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Risk Factors for the Incidence and Severity of Acute Kidney Injury After Liver Transplantation.

Turk J Gastroenterol 2021 Jan;32(1):82-87

Liver Transplantation and Research Center, 302 Hospital, Beijing, China.

Background/aims: To explore risk factors of acute kidney injury (AKI) and its severity after liver transplantation.

Materials And Methods: This was a retrospective cohort of consecutive adults undergoing orthotopic liver transplantation (OLT) at a referral hospital. Risk factors for AKI from 1week post-liver transplantation and 4-week outcomes were analysed. Read More

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January 2021

Mortality rates and risk factors in 1412 Japanese patients with decompensated hepatitis C virus-related cirrhosis: a retrospective long-term cohort study.

BMC Gastroenterol 2021 Apr 23;21(1):189. Epub 2021 Apr 23.

Department of Hepatology, Toranomon Hospital, Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan.

Background: Hepatitis C virus is the leading cause of liver cirrhosis and hepatocellular carcinoma in Japan. We aimed to examine the long-term (> 20 years) mortality and hepatocellular carcinoma rates and associated risk factors in 1412 Japanese patients with decompensated hepatitis C virus-related cirrhosis (Child-Pugh B or C).

Methods: Cumulative survival and hepatocellular carcinoma rates were determined using Kaplan-Meier analysis. Read More

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Ammonia Removal by Metabolic Scavengers for the Prevention and Treatment of Hepatic Encephalopathy in Cirrhosis.

Drugs R D 2021 Apr 22. Epub 2021 Apr 22.

Department of Medicine, University of Montreal, 45143 Cabot Trail, Englishtown, NS, B0C 1H0, Canada.

Effective lowering of circulating ammonia is the mainstay strategy in the prevention and treatment of hepatic encephalopathy in cirrhosis and there is increasing interest in agents with the metabolic potential for the active removal of ammonia by the liver and skeletal muscle by agents including L-ornithine L-aspartate, branched-chain amino acids, as well as the re-purposing of benzoate and phenylacetate currently employed for the control of hyperammonaemia in congenital urea-cycle enzymopathies. Based upon results of multiple systematic reviews with meta-analyses, L-ornithine L-aspartate demonstrably lowers circulating ammonia in patients with cirrhosis with concomitantly improved mental status. Distinct mechanisms responsible include optimisation of hepatic metabolic pathways for ammonia removal as well as direct hepatoprotective effects involving the release of glutathione and of nitric oxide with beneficial effects on hepatic microcirculation. Read More

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Transjugular Intrahepatic Portosystemic Shunt Creation for Treatment of Gastric Varices: Systematic Literature Review and Meta-Analysis of Clinical Outcomes.

Cardiovasc Intervent Radiol 2021 Apr 22. Epub 2021 Apr 22.

Department of Radiology, College of Medicine University of Illinois at Chicago, MC 931, 1740 West Taylor Street, Chicago, IL, 60612, USA.

Purpose: To quantify the pooled clinical outcomes of stent-graft transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of gastric varices (GVs) through systematic review of the literature and meta-analysis.

Materials And Methods: A PubMed and Embase search was performed from 2003 to 2020. Search terms included: (transjugular intrahepatic portosystemic shunt OR TIPS) AND (gastric varices OR fundal varices OR gastroesophageal varices OR gastroesophageal varices) AND (hemorrhage OR rebleeding OR rebleeding OR survival). Read More

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The Future of Quality Improvement for Cirrhosis.

Liver Transpl 2021 Apr 22. Epub 2021 Apr 22.

Division of Gastroenterology and Hepatology, University of Michigan.

Cirrhosis has a significant and growing impact on public health and patient reported outcomes. The increasing burden of cirrhosis has led to an emphasis on quality of care with the goal of improving overall outcomes in this high risk population. Existing evidence has shown the significant gaps in quality across process measures (e. Read More

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Applying Administrative Data-based Coding Algorithms for Frailty in Patients with Cirrhosis.

Liver Transpl 2021 Apr 19. Epub 2021 Apr 19.

Division of Gastroenterology and Hepatology, University of Michigan.

Background: Frailty is a powerful prognostic tool in cirrhosis. Claims-based frailty scores estimate the presence of frailty without the need for in-person evaluation. These algorithms have not been validated in cirrhosis. Read More

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Thyroid Disease-Induced Hepatic Dysfunction: A Clinical Puzzle.

ACG Case Rep J 2021 Apr 14;8(4):e00555. Epub 2021 Apr 14.

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

The diagnostic evaluation of an individual with clinical and laboratory evidence of thyroid dysfunction in the setting of acute liver injury is crucial. There is a complex relationship between the thyroid and the liver, and so, it requires a careful elucidation of the inciting disease process before instituting a treatment plan. We discuss a patient who had presented with coagulopathy, encephalopathy, and laboratory evidence of acute liver injury, hence adjudged to have developed drug-induced acute liver failure and transferred for liver transplant evaluation. Read More

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