16,448 results match your criteria Portal-Systemic Encephalopathy

Hepatic cortical blindness: a case report and comprehensive literature review.

Am J Med Sci 2022 May 16. Epub 2022 May 16.

Department of Gastroenterology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China.

Hepatic cortical blindness is an unusual clinical complication of hepatic encephalopathy, and its epidemiology has not been studied in detail. Herein, we present a case report of a 37-year-old male with liver cirrhosis and immunoglobulin A nephropathy who noted visual impairment after eating high-protein food. In addition to the case report, all previously documented cases of hepatic cortical blindness occurring across the globe published from inception until August 2019 were reviewed. Read More

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Transjugular intrahepatic portosystemic shunt for portal hypertension: 30 years' experience from China.

Liver Int 2022 May 20. Epub 2022 May 20.

Department of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi'an International Medical Center Hospital, Northwest University, Xi'an, China.

Liver diseases are major causes of illness and death worldwide. In China, liver diseases, primarily viral hepatitis, affect approximately 300 million people, thus having a major impact on the global burden of liver diseases. Portal hypertension is the most severe complications of chronic liver diseases, including ascites, hepatic encephalopathy and bleeding from gastroesophageal varices. Read More

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Clinical efficacy of transjugular intrahepatic portosystemic shunt created through left or right branches of the portal vein: A meta-analysis.

J Interv Med 2021 Nov 23;4(4):190-196. Epub 2021 Dec 23.

Gansu Province People's Hospital, Lanzhou, 730000, People's Republic of China.

Background And Aim: Transjugular intrahepatic portosystemic shunt (TIPS) is a technique successfully used to treat portal hypertension and its complications. However, the choice of the branch, left (L) or right (R), of the portal vein resulting in a better outcome is still under debate. Therefore, this meta-analysis aims to evaluate which branch has a better curative effect on patients treated with TIPS. Read More

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November 2021

Molecular targeted therapy causes hepatic encephalopathy in patients after Transjugular intrahepatic portosystemic shunt (TIPS): A case report and literature review.

J Interv Med 2022 Feb 26;5(1):37-39. Epub 2022 Feb 26.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.

We report two cases of hepatic encephalopathy caused by molecular targeted drugs after the Transjugular intrahepatic portosystemic shunt (TIPS) procedure in our center. The liver toxicities and anti-angiogenic effects induced by targeted drugs may generate an imbalance in ammonia metabolism, elevating blood ammonia levels. TIPS diverts partial blood supply from the liver, aggravates liver impairment, and shunts ammonia-rich blood from the intestine into the systemic circulation. Read More

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February 2022

Update on the diagnosis and management of the autosomal dominant acute hepatic porphyrias.

J Clin Pathol 2022 May 18. Epub 2022 May 18.

Medical Biochemistry and Immunology, University Hospital of Wales Healthcare NHS Trust, Cardiff, UK.

The autosomal dominant acute hepatic porphyrias (AHPs), acute intermittent porphyria, hereditary coproporphyria (HCP) and variegate porphyria (VP), are low penetrance adult onset disorders caused by partial deficiency of enzymes of haem biosynthesis. All are associated with acute neurovisceral attacks, which are a consequence of the increased hepatic demand for haem triggered by hormones, stress, drugs or systemic infections which leads to upregulation of the pathway and overproduction of haem precursors 5-aminolaevulinic acid (ALA) and porphobilinogen (PBG). Acute episodes are characterised by severe abdominal pain, nausea, vomiting, hyponatraemia, hypertension and tachycardia, behavioural disturbance and can progress to include seizures, peripheral motor neuropathy and posterior reversible encephalopathy syndrome if undiagnosed and untreated. Read More

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Construction and comprehensive analysis of a lncRNA-mRNA interactive network to reveal a potential lncRNA for hepatic encephalopathy development.

Hum Cell 2022 May 18. Epub 2022 May 18.

Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhi Zao Ju Road, Huangpu District, Shanghai, 200011, China.

Little is known about the role of lncRNA-mRNA regulatory relationships in hepatic encephalopathy (HE). Here, we aimed to construct the potential lncRNA and mRNA interactive network in forecasting HE development in patients with liver cirrhosis using different bioinformatic analysis method. Through analyses, we found that AL137857. Read More

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Thymol ameliorated neurotoxicity and cognitive deterioration in a thioacetamide-induced hepatic encephalopathy rat model; involvement of the BDNF/CREB signaling pathway.

Food Funct 2022 May 18. Epub 2022 May 18.

Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.

In the present study, we aimed to delineate the neuroprotective potential of thymol (THY) against neurotoxicity and cognitive deterioration induced by thioacetamide (TAA) in an experimental model of hepatic encephalopathy (HE). Rats received TAA (100 mg kg, intraperitoneally injected, three times per week) for two weeks. THY (30 and 60 mg kg), and Vit E (100 mg k) were administered daily by oral gavage for 30 days after HE induction. Read More

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Predictors of mortality at 28-days in infection associated acute kidney injury in cirrhosis.

World J Hepatol 2022 Mar;14(3):592-601

Independent Researcher, Kangra 176056, Himachal Pradesh, India.

Background: Acute kidney injury (AKI) in cirrhosis is important complication with poor outcomes. And infections are common cause for acute decompensation. Infections in cirrhosis lead to acute deterioration of hemodynamics leading to precipitation of AKI. Read More

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Effect of a specific strain on minimal/mild hepatic encephalopathy treatment.

World J Hepatol 2022 Mar;14(3):634-646

Department of Endocrinology, Bogomolets National Medical University, Kyiv 01601, Ukraine.

Background: Hepatic encephalopathy (HE) can be considered a result of dysregulated gut-liver-brain axis function, where cognitive impairment can be reversed or prevented by the beneficial effects induced by "gut-centric" therapies, such as the administration of nonabsorbable disaccharides, nonabsorbable antibiotics, probiotics and prebiotics.

Aim: To assess the short-term efficacy and safety of the probiotic (EcN) 1917 strain compared to lactulose and rifaximin in patients with minimal/mild HE.

Methods: From January 2017 to March 2020, a total of 45 patients with HE were enrolled in this prospective, single-centre, open-label, randomized study. Read More

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The assessment of mesenchymal stem cells therapy in acute on chronic liver failure and chronic liver disease: a systematic review and meta-analysis of randomized controlled clinical trials.

Stem Cell Res Ther 2022 May 16;13(1):204. Epub 2022 May 16.

Department of Hepatology, First Bethune Hospital of Jilin University, No. 71 XinMin Street, Changchun, 130021, Jilin, People's Republic of China.

Background: Mesenchymal stem cells (MSCs) therapy is showing potential therapeutic effects on liver function improvement in patients with chronic liver disease; however, the consensus on efficacy and safety of MSCs has not been reached.

Methods: We performed this systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of MSCs therapy for patients with chronic liver disease. A detailed search of the Cochrane Library, MEDLINE, Web of Science, and EMBASE databases was conducted to find studies published prior to September 15, 2021. Read More

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COVID-19 vaccines in patients with decompensated cirrhosis: a retrospective cohort on safety data and risk factors associated with unvaccinated status.

Infect Dis Poverty 2022 May 16;11(1):56. Epub 2022 May 16.

Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.

Background: Safety data reported from the large-scale clinical trials of the coronavirus disease 2019 (COVID-19) vaccine are extremely limited in patients with decompensated cirrhosis. The vaccination campaign in this specific population could be difficult due to uncertainty about the adverse events following vaccination. We aimed to assessed the COVID-19 vaccination rate, factors associated with unvaccinated status, and the adverse events following vaccination in patients with decompensated cirrhosis. Read More

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Association between multi-organ dysfunction and adverse outcome in infants with hypoxic ischemic encephalopathy.

J Perinatol 2022 May 16. Epub 2022 May 16.

Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Stanford, CA, USA.

Objective: To evaluate multi-organ dysfunction (MOD) in newborns treated with therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE), and to compare MOD in those with normal/mild magnetic resonance imaging (MRI) findings to those with moderate to severe MRI findings or death.

Study Design: Retrospective single-center observational study of infants treated with TH. A total of 16 parameters across 7 organ systems were analyzed. Read More

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Hepatic decompensation is accelerated in patients with cirrhosis and alpha-1 antitrypsin Pi∗MZ genotype.

JHEP Rep 2022 Jun 5;4(6):100483. Epub 2022 Apr 5.

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

Background & Aims: Alpha-1 antitrypsin deficiency is caused by mutations in , most commonly homozygosity for the Pi∗Z variant, and can present as liver disease. While heterozygosity for Pi∗Z (Pi∗MZ) is linked to increased risk of cirrhosis, whether the Pi∗MZ genotype is associated with an increased rate of decompensation among patients who already have compensated cirrhosis is not known.

Methods: This was a retrospective study of Michigan Genomics Initiative participants with baseline compensated cirrhosis. Read More

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Evaluation and management of emergencies in the patient with cirrhosis.

Rev Gastroenterol Mex (Engl Ed) 2022 May 12. Epub 2022 May 12.

División of Gastroenterología y Unidad de Hígado, University of Alberta Hospital, Edmonton, Alberta, Canada.

The approach to and management of critically ill patients is one of the most versatile themes in emergency medicine. Patients with cirrhosis of the liver have characteristics that are inherent to their disease that can condition modification in acute emergency treatment. Pathophysiologic changes that occur in cirrhosis merit the implementation of an analysis as to whether the overall management of a critically ill patient can generally be applied to patients with cirrhosis of the liver or if they should be treated in a special manner. Read More

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Ann Hepatol 2022 May 9:100708. Epub 2022 May 9.

Metabolic Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" ["Salvador Zubirán" National Institute of Medical Sciences and Nutrition], Mexico City, Mexico. Electronic address:

Cirrhosis is characterized by a prolonged asymptomatic period in which the inflammation persists, increasing as the disease progresses. Proinflammatory cytokines and pro-oxidant molecules are key in the development of organ dysfunction. Cirrhosis progression and worsening of portal hypertension bring about bacterial translocation and systemic dissemination via portal circulation of bacterial products, and molecular patterns associated with damage, which exacerbate the systemic Inflammation. Read More

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Fulminant Hepatic Failure in Dengue Fever Without Plasma Leakage: A Case Report.

Cureus 2022 Apr 8;14(4):e23964. Epub 2022 Apr 8.

Clinical Medicine, University Medical Unit, Teaching Hospital Batticaloa, Batticaloa, LKA.

Dengue is an important arboviral disease in the tropics and subtropics. Although mild to moderate elevation of liver transaminases is a common phenomenon, dengue infection leading to hepatic failure is a rare complication in adults. We present a case of dengue fever in a young adult, leading to the rare complication of acute liver failure, without dengue shock syndrome. Read More

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Role of Hepatitis C Infection in Acute Liver Injury/Acute Liver Failure in North America.

Dig Dis Sci 2022 May 11. Epub 2022 May 11.

Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center at Dallas, 5959 Harry Hines Blvd. Ste. 420, Dallas, TX, 75390-8887, USA.

Background: While hepatitis A and B are well-known causes of acute liver failure (ALF), few well-documented cases of hepatitis C virus (HCV) infection (absent preexisting liver disease or other liver insults) have been described that result in ALF. We reviewed the Acute Liver Failure Study Group registry for evidence of HCV as a primary or contributing cause to ALF.

Methods: From January 1998 to January 2017, 2,332 patients with ALF (INR ≥ 1. Read More

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Area Deprivation Index and Gut-Brain Axis in Cirrhosis.

Clin Transl Gastroenterol 2022 May 10. Epub 2022 May 10.

Microbiome Analysis Center, George Mason University, Manassas, Virginia, USA.

Background: Neighborhood deprivation has been associated with chronic diseases and with gut microbial alterations. While cirrhosis is associated with gut microbiome changes, and hepatic encephalopathy (HE); their association is unclear.

Methods: Demographics and cirrhosis details (MELD, prior HE, medications) were recorded from outpatients with cirrhosis. Read More

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Management of Hepatic Encephalopathy Associated with Advanced Liver Disease.

Clin Drug Investig 2022 May 10. Epub 2022 May 10.

Department of Digestive Diseases, Gregorio Marañon University General Hospital, 28007, Madrid, Spain.

Hepatic encephalopathy (HE) is a very prevalent condition in patients with advanced liver disease and has a high recurrence rate. The pathophysiology has a multifactorial origin where hyperammonaemia and inflammation become particularly relevant. There are no HE-specific diagnostic tests, and diagnosis is usually made by taking into account the presence of suggestive and compatible clinical symptoms, the existence of a predisposing liver condition and ruling out other causes with similar clinical manifestations. Read More

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Transjugular Intrahepatic Portosystemic Shunt for Refractory Ascites in Gaucher Disease.

Cureus 2022 Apr 8;14(4):e23941. Epub 2022 Apr 8.

Department of Gastroenterology and Hepatology, Jaslok Hospital and Research Centre, Mumbai, IND.

Gaucher disease is rare, inherited lysosomal storage disorder that leads to the excessive accumulation of certain lipids, especially within the bone marrow, liver, and spleen. We present a case of a 30-year-old man with Gaucher disease who underwent a splenectomy at the age of eight for severe cytopenia. His subsequent history was notable for recurrent avascular osteonecrosis and his liver disease progressed to portal hypertension, variceal bleeding, and refractory ascites. Read More

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Historical Perspective and Medical Maladies of Alexander the Great.

Cureus 2022 Apr 7;14(4):e23925. Epub 2022 Apr 7.

Neurology, Olive View - University of California Los Angeles Medical Center, Los Angeles, USA.

Alexander the Great (356 BC - 323 BC) was only 20 years old when he was named the next King of Macedonia after his father was assassinated. The following 11 years witnessed the evolution of an outstanding leader who expanded his empire from Egypt to the Indian frontier. Despite successfully conquering much of the world, he was afflicted with a febrile illness at the age of 32, which he battled for a mere 11 days before perishing. Read More

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Alterations in Autophagy and Mammalian Target of Rapamycin (mTOR) Pathways Mediate Sarcopenia in Patients with Cirrhosis.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):510-518. Epub 2021 May 21.

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

Background And Aims: The pathophysiology of sarcopenia in cirrhosis is poorly understood. We aimed to evaluate the histological alterations in the muscle tissue of patients with cirrhosis and sarcopenia, and identify the regulators of muscle homeostasis.

Methods: Computed tomography images at third lumbar vertebral level were used to assess skeletal muscle index (SMI) in 180 patients. Read More

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Spectrum of Neuroimaging Abnormalities in Brain in Patients of Acute-on-Chronic Liver Failure.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):343-352. Epub 2021 Aug 21.

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

Background And Aims: Acute-on-chronic liver failure (ACLF) is associated with high short-term mortality. There is a paucity of data about the spectrum of neuroimaging abnormalities in the brain in ACLF patients. The present study was aimed to study the prevalence of cerebral edema and other parenchymal changes in MR imaging of the brain in patients with ACLF. Read More

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Unconventional Shunts in Extrahepatic Portal Venous Obstruction-A Retrospective Review.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):503-509. Epub 2021 May 29.

Department of Surgical Gastroenterology, SGPGIMS, Lucknow, India.

Background: Proximal splenorenal shunt (PSRS) is one of the most commonly performed portosystemic shunt (PSS) in extrahepatic portal venous obstruction (EHPVO) for portal decompression. Sometimes various anatomical and surgical factors related to the splenic vein and/or left renal vein may make the construction of a PSRS difficult or impossible. Unconventional shunts are required to tide over such conditions. Read More

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Untangling the Web of Malnutrition, Sarcopenia, and Frailty in Chronic Liver Disease.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):268-271. Epub 2022 Mar 17.

Department of Hepatology, Pancreato-biliary Sciences and Liver Transplantation, Mahatma Gandhi Medical College and Hospital, Jaipur Rajasthan 302022, India.

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A Comparison of Different Frailty Scores and Impact of Frailty on Outcome in Patients With Cirrhosis.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):398-408. Epub 2021 Jul 21.

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

Background & Aims: There is no "gold standard" tool for the assessment of frailty in cirrhosis. This study compares Liver Frailty Index (LFI), Short Physical Performance Battery (SPPB), Fried Frailty Criteria (FFC), and Clinical Frailty Scale (CFS) for frailty assessment and ascertains its impact on predicting mortality and hospitalizations in a cohort of outpatients with cirrhosis.

Methods: 116 patients were enrolled in this prospective observational cohort study. Read More

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Clinical Implications, Evaluation, and Management of Hyponatremia in Cirrhosis.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):575-594. Epub 2021 Sep 16.

Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India.

Hyponatremia is the most common electrolyte abnormality in patients with decompensated cirrhosis on Liver Transplantation (LT) waiting list. Most of these patients have dilutional or hypervolemic hyponatremia secondary to splanchnic vasodilatation. Excessive secretion of the antidiuretic hormone also plays an important role. Read More

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September 2021

Gut Barrier and Microbiota in Cirrhosis.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):625-638. Epub 2021 Sep 3.

Department of Gastroenterology and Advanced GI Endoscopy, Center of Excellence in GI Sciences, Rajagiri Hospital, Chunangamvely, Aluva, Ernakulam, Kerala, India.

Gut microbiota and their homeostatic functions are central to the maintenance of the intestinal mucosal barrier. The gut barrier functions as a structural, biological, and immunological barrier, preventing local and systemic invasion and inflammation of pathogenic taxa, resulting in the propagation or causation of organ-specific (liver disease) or systemic diseases (sepsis) in the host. In health, commensal bacteria are involved in regulating pathogenic bacteria, sinister bacterial products, and antigens; and help control and kill pathogenic organisms by secreting antimicrobial metabolites. Read More

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September 2021

Rifaximin Vs. Norfloxacin for Spontaneous Bacterial Peritonitis Prophylaxis: A Randomized Controlled Trial.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):336-342. Epub 2021 Aug 18.

Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Background: Spontaneous bacterial peritonitis (SBP) heralds increased mortality in cirrhosis, mandating strategies for prophylaxis. Norfloxacin has been the recommended choice for SBP prevention. However, its use has raised concerns about antibiotic resistance. Read More

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