14,559 results match your criteria Portal-Systemic Encephalopathy


Is treating the gut microbiome the key to achieving better outcomes in cirrhosis?

Expert Rev Gastroenterol Hepatol 2019 Jan 13;13(1):1-2. Epub 2018 Nov 13.

a Liver Sciences, School of Immunology and Microbial Science, Faculty of Life Sciences and Medicine , King's College London , London , UK.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1080/17474124.2019.1543587DOI Listing
January 2019

The rise of Clostridioides difficile infections and fall of associated mortality in hospitalized advanced cirrhotics.

Liver Int 2019 Feb 21. Epub 2019 Feb 21.

Weill Cornell Medicine - New York Presbyterian Hospital, Division of Gastroenterology and Hepatology, 1305 York Avenue, 4th floor, New York, NY, 10021.

Background & Aims: Cirrhotics are at increased risk of Clostridioides difficile infection (CDI) and its associated high morbidity and mortality. However, the impact of CDI in cirrhotics over time remains unclear. This study analyzes prevalence and mortality in CDI in hospitalized patients with advanced cirrhosis over 15 years and identifies a trend. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/liv.14077DOI Listing
February 2019

Emergency Transjugular Intrahepatic Portosystemic Shunt: an Effective and Safe Treatment for Uncontrolled Variceal Bleeding.

J Gastrointest Surg 2019 Feb 21. Epub 2019 Feb 21.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan Province, China.

Background: Uncontrolled variceal bleeding (VB) remains a great challenge for clinical treatment. Emergency transjugular intrahepatic portosystemic shunt (TIPS) is a salvage procedure, but unsatisfactory clinical outcomes and a high incidence of complications have been reported. This study aimed to investigate the effect and safety of emergency TIPS performed in our institution during recent years. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11605-019-04146-8DOI Listing
February 2019

Analysis of Risk Factors for Patients with Liver Cirrhosis Complicated with Spontaneous Bacterial Peritonitis.

Iran J Public Health 2018 Dec;47(12):1883-1890

Tianjin Medical University General Hospital, Tianjin 300052, China.

Background: We aimed to explore risk factors for patients with liver cirrhosis complicated with spontaneous bacterial peritonitis (SBP).

Methods: The clinical data of 195 patients with liver cirrhosis complicated with SBP (study group), admitted from March 2014 to March 2018 in Tianjin Medical University General Hospital, Tianjin, China and 195 patients without liver cirrhosis complicated with SBP (control group) were retrospectively analyzed. Clinical manifestations of patients and laboratory findings were analyzed. Read More

View Article

Download full-text PDF

Source
December 2018

Prognostic significance of minimal hepatic encephalopathy in patients with liver cirrhosis in Japan: a propensity score-matching analysis.

J Gastroenterol Hepatol 2019 Feb 18. Epub 2019 Feb 18.

Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.

Background And Aim: Minimal hepatic encephalopathy (MHE) represents the mildest form of the hepatic encephalopathy spectrum. This study aimed to clarify the prognostic significance of MHE in cirrhotic patients.

Methods: This retrospective study evaluated 357 consecutive patients with liver cirrhosis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/jgh.14635DOI Listing
February 2019
1 Read

Liver Transplant in a Patient With Hemophagocytic Lymphohistiocytosis.

Exp Clin Transplant 2019 Jan;17(Suppl 1):226-229

From the Department of Transplantation, Baskent University, Ankara, Turkey.

Hemophagocytic lymphohistiocytosis is a rare and life-threatening systemic disease that can cause hepatic infiltration and present as acute liver failure. Here, we report a case of a 3-year-old pediatric patient who presented with acute liver failure and hepatic encephalopathy secondary to hemophagocytic lymphohistiocytosis. She had left lateral segment liver transplant from her father. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.6002/ect.MESOT2018.P80DOI Listing
January 2019

Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options.

Hepat Med 2019 25;11:23-34. Epub 2019 Jan 25.

The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Cochin, Kerala, India,

Portosystemic shunt (PS) syndrome encompasses a spectrum of disease manifestations ranging from asymptomatic portal hypertension to recurrent and refractory hepatic encephalopathy, ultimately culminating in progressive hepatic failure in patients of cirrhosis and associated large PSs. PSs commonly seen in cirrhosis include splenorenal, gastrorenal, and dilated paraumbilical veins, all of which can present with recurrent or refractory hepatic encephalopathy. In this exhaustive review, we describe the anatomy of PSs, elucidate new theories on their pathophysiology, discuss the clinical implications of PSs in cirrhosis, provide details on different techniques (classical and novel) of shunt embolization, and explore all the pertinent current literature on shunt embolization for refractory and recurrent hepatic encephalopathy, all of which are enumerated with extensive images and illustrations. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.2147/HMER.S169024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355170PMC
January 2019

Bile Acids in Hepatic Encephalopathy.

Authors:
Sharon DeMorrow

J Clin Exp Hepatol 2019 Jan-Feb;9(1):117-124. Epub 2018 May 4.

Department of Medical Physiology, Texas A&M College of Medicine, Temple, TX 76504, USA.

Hepatic encephalopathy describes the array of neurological complications that arise due to liver insufficiency and/or portal-systemic shunt. The pathogenesis of hepatic encephalopathy shares a longstanding association with hyperammonemia and inflammation. Recently, aberrant bile acid signaling has been implicated in the development of key features of hepatic encephalopathy due to acute liver failure including neuronal dysfunction, neuroinflammation and blood-brain barrier permeability. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2018.04.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363980PMC

PROFIT, a PROspective, randomised placebo controlled feasibility trial of Faecal mIcrobiota Transplantation in cirrhosis: study protocol for a single-blinded trial.

BMJ Open 2019 Feb 15;9(2):e023518. Epub 2019 Feb 15.

James Black Centre, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.

Introduction: Patients with advanced cirrhosis have enteric bacterial dysbiosis and translocation of bacteria and their products across the gut epithelial barrier. This culminates in systemic inflammation and endotoxaemia, inducing innate immune dysfunction which predisposes to infection, and development of complications such as bleeding, sepsis and hepatic encephalopathy. This feasibility study aims to assess the safety of administering faecal microbiota transplantion to patients with cirrhosis and explore the effect of the intervention on their prognosis by achieving restoration of a healthy gut microbiome. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-023518DOI Listing
February 2019
1 Read

Liver Transplant Recipients Older Than 60 Years Show Executive and Memory Function Improvement Comparable to Younger Recipients.

Psychosomatics 2019 Jan 23. Epub 2019 Jan 23.

Department of Psychiatry & Psychology, Mayo Clinic, Jacksonville, FL; Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL. Electronic address:

Background: Increasing numbers of patients over the age of 60 are undergoing liver transplantation.

Objective: We sought to determine whether age or clinical morbidities were associated with pre- and post-transplant executive and memory performance using the Brief Test of Adult Cognition by Telephone (BTACT).

Methods: Participants included 36 recipients with n = 20 in the older group (>60 y) and n = 16 in the younger group (≤60 years). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.psym.2019.01.008DOI Listing
January 2019
1 Read

Berardinelli-Seip syndrome and progressive myoclonus epilepsy.

Epileptic Disord 2019 Feb 15. Epub 2019 Feb 15.

Child Neurology and Psychiatry Unit, "Regina Montis Regalis" Hospital, Mondovì.

Berardinelli-Seip syndrome, or congenital generalized lipodystrophy type 2 (CGL2), is characterized by a lack of subcutaneous adipose tissue and precocious metabolic syndrome with insulin resistance, resulting in diabetes, dyslipidaemia, hepatic steatosis, cardiomyopathy, and acanthosis nigricans. Most reported mutations are associated with mild, non-progressive neurological impairment. We describe the clinical and EEG data of a patient with progressive myoclonus epilepsy (PME), CGL2, and progressive neurological impairment, carrying a homozygous BSCL2 nonsense mutation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1684/epd.2019.1038DOI Listing
February 2019
4 Reads

How to Design a Multicenter Clinical Trial in Hepatic Encephalopathy.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):137-145. Epub 2018 Mar 13.

Department of Clinical Medicine, Sapienza University of Rome, Italy.

The design of clinical trials on Hepatic Encephalopathy (HE) is not an easy task, in fact there are several issues related to the performance of clinical trials in HE that have impeded progress in the field, mainly because most of the studies on HE therapy were performed before the era of rigorous Randomized Controlled Trials (RCTs). In this review we discuss the major problems affecting previously published trials on HE treatments aiming to provide evidences, suggestions and indications to prepare well designed RCTs in three different settings: (1) management of hospitalized patients with episodic HE; (2) secondary prophylaxis in patients following an episode of HE; and (3) management of minimal/covert HE. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S09736883183003
Publisher Site
http://dx.doi.org/10.1016/j.jceh.2018.02.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363957PMC
March 2018
3 Reads

Role of Exercise in the Management of Hepatic Encephalopathy: Experience From Animal and Human Studies.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):131-136. Epub 2018 Aug 10.

Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, Canada.

Sarcopenia and malnutrition are common features in patients with hepatic encephalopathy. Ammonia, a factor implicated in the pathophysiology of hepatic encephalopathy, may be cleared by the muscle via the enzyme glutamine synthetase when the liver function is impaired. Hence, optimizing muscle mass in patients suffering from hepatic encephalopathy is a potential strategy to decrease ammonia levels. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2018.07.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363958PMC
August 2018
1 Read

Hepatic Encephalopathy and Sarcopenia: Two Faces of the Same Metabolic Alteration.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):125-130. Epub 2018 May 5.

Department of Clinical Medicine, Gastroenterology, Sapienza University of Rome, Italy.

Sarcopenia is an important burden in liver cirrhosis representing a negative prognostic factor for mortality. Moreover, sarcopenia is an independent predictor of complications in patients with liver cirrhosis, including Hepatic Encephalopathy (HE). An association between sarcopenia and HE in liver cirrhosis has been reported in recent studies, indeed both these complications often affect patients with advanced liver cirrhosis and may exert a synergic effect in deteriorating patients' outcome. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2018.04.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363954PMC
May 2018
1 Read

Prognostic Implications of Minimal/Covert Hepatic Encephalopathy: Large-scale Validation Cohort Studies.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):112-116. Epub 2018 May 4.

Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Minimal or Covert Hepatic Encephalopathy (MHE/CHE), the preclinical phase of Hepatic Encephalopathy (HE), is strongly associated with poorer Quality of Life (QOL), Overt HE (OHE), and death. Several diagnostic tests have been developed that have prognostic value in predicting clinical outcomes such as OHE, cirrhosis progression, and death. However, dispute among clinicians and HE researchers have kept its application largely underutilized. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2018.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363948PMC

Minimal/Covert Hepatic Encephalopathy - Impact of Comorbid Conditions.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):109-111. Epub 2018 Sep 17.

Clinic for Neurology, Hannover Medical School, Hannover, Germany.

Mild cognitive dysfunction as in minimal or covert hepatic encephalopathy (HE) can be found in a variety of metabolic disturbances, several neurological diseases, and even older age. Because liver cirrhosis usually is accompanied by one or the other of these, a differentiation between HE and cognitive decline because of comorbidities is difficult. Somehow discriminating is the impairment of motor speed and accuracy, which is more prominent in HE than in any of the comorbidities. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2018.08.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363959PMC
September 2018
1 Read

Neurological Recovery After Recovery From Acute Liver Failure: Is it Complete?

J Clin Exp Hepatol 2019 Jan-Feb;9(1):99-108. Epub 2018 Jun 22.

Indraprastha Apollo Hospital, New Delhi, India.

Neurologic dysfunction characterised by Hepatic Encephalopathy (HE) and cerebral oedema are the most dramatic presentations of Acute Liver Failure (ALF) and signify poor outcome. Improved critical care and wider availability of emergency Liver Transplantation (LT) has improved survivability in ALF. In most cases absence of clinically overt encephalopathy after spontaneous recovery from ALF or after LT is thought to indicate complete neurologic recovery. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2018.06.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363962PMC
June 2018
1 Read

Wilson's Disease: Clinical Practice Guidelines of the Indian National Association for Study of the Liver, the Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition, and the Movement Disorders Society of India.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):74-98. Epub 2018 Sep 3.

Department of Pediatrics and Pediatric Liver GI and Nutrition Center and Mowat Labs, King's College Hospital, London, UK.

Clinical practice guidelines for Wilson's disease (WD) have been published by the American Association for the Study of Liver Diseases and European Association for the Study of the Liver in 2008 and 2012, respectively. Their focus was on the hepatic aspects of the disease. Recently, a position paper on pediatric WD was published by the European Society of Pediatric Gastroenterology Hepatology and Nutrition. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2018.08.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363961PMC
September 2018
1 Read

Special Section: Update in Hepatic Encephalopathy- Part III.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):2-3. Epub 2019 Jan 25.

Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jceh.2019.01.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363951PMC
January 2019

Hepatic encephalopathy and traffic accidents: Vigilance is needed!

J Hepatol 2019 Feb 11. Epub 2019 Feb 11.

Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, USA; GI Section, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jhep.2019.01.017DOI Listing
February 2019

Functional Network-Based Statistics Reveal Abnormal Resting-State Functional Connectivity in Minimal Hepatic Encephalopathy.

Front Neurol 2019 29;10:33. Epub 2019 Jan 29.

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

Whole-brain functional network analysis is an emerging methodology for exploring the mechanisms underlying hepatic encephalopathy (HE). This study aimed to identify the brain subnetwork that is significantly altered within the functional connectome in minimal HE (MHE), the earliest stage of HE. The study enrolled 19 cirrhotic patients with MHE and 19 controls who underwent the resting-state functional magnetic resonance imaging and cognitive assessment based on the Psychometric Hepatic Encephalopathy Score (PHES). Read More

View Article

Download full-text PDF

Source
https://www.frontiersin.org/article/10.3389/fneur.2019.00033
Publisher Site
http://dx.doi.org/10.3389/fneur.2019.00033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362410PMC
January 2019
3 Reads

Management of HCV-related decompensated cirrhosis with direct-acting antiviral agents: who should be treated?

Hepatol Int 2019 Feb 13. Epub 2019 Feb 13.

Diagnostic Radiology, Zagazig University, Zagazig, Egypt.

Background: Medical treatment of decompensated cirrhosis due to hepatitis C virus (HCV) remains a clinical challenge even in the era of direct-acting antiviral drugs (DAAs). We evaluated the efficacy and safety of DAAs in the management of HCV genotype 4-related decompensated cirrhosis.

Methods: The study included a treatment group (n = 160) composed of HCV patients with decompensated cirrhosis who received DAAs for 3 months and a matched control group (n = 80) who preferred not to receive DAAs, follow-up was for 24-31 months. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12072-019-09933-8DOI Listing
February 2019
1 Read

Fatal Septic Shock Associated with Herpes Simplex Virus Hepatitis: A Case Report.

Eur J Case Rep Intern Med 2018 27;5(12):000982. Epub 2018 Dec 27.

Intensive Care Unit, Iris South Hospitals, Brussels, Belgium.

Herpes simplex viruses are endemic worldwide, with an estimated seroprevalence of approximately 70% in developed countries. However, it is less well known that they are one of the viral causes of fulminant hepatitis (<2%) and constitute <1% of all causes of acute liver failure. We describe the case of an 89-year-old man who developed sepsis caused by a urinary tract infection due to drug-sensitive . Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.12890/2018_000982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346974PMC
December 2018
1 Read

Epidemiology and risk factors for multi-drug resistant hospital-acquired urinary tract infection in patients with liver cirrhosis: single center experience in Serbia.

BMC Infect Dis 2019 Feb 12;19(1):141. Epub 2019 Feb 12.

Department of Anesthesiology, Clinical Center of Serbia, Belgrade, Serbia.

Background: Cirrhosis-associated immune dysfunction syndrome (CAIDS) has been identified in patients with liver cirrhosis (LC), predisposing them to a wide variety of infections. In patients with LC, healthcare-associated infections involving multi-drug resistant (MDR) bacteria have increased significantly over the last decades. Among them, hospital-acquired urinary tract infections (HA-UTI) are the most common. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-019-3761-5DOI Listing
February 2019

Novel Homozygous Mutation in the WWOX Gene Causes Seizures and Global Developmental Delay: Report and Review.

Transl Neurosci 2018 31;9:203-208. Epub 2018 Dec 31.

King Abdullah International Medical Research Centre (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs (MNGHA), Riyadh, Saudi Arabia.

The gene has a WW domain containing oxidoreductase, which is located at the common fragile site FRA16D at chromosome 16q23. is a tumor suppressor gene that has been associated with several types of cancer such as hepatic, breast, lung, prostate, gastric, and ovarian. Recently WWOX has been implicated in epilepsy, where studies show homozygous loss-of-function mutation lead to early-infantile epileptic encephalopathy, spinocerebellar ataxia, intractable seizures and developmental delay, and early lethal microcephaly syndrome with epilepsy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1515/tnsci-2018-0029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368664PMC
December 2018
2 Reads

Influence of proton pump inhibitors on microbiota in chronic liver disease patients.

Hepatol Int 2019 Feb 8. Epub 2019 Feb 8.

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.

Background: Current knowledge suggests that proton pump inhibitors (PPIs) are associated with an increased risk of hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP). These conditions and PPI use are related to gut microbiota. The aim of this study is to research the changes in gut microbiota caused by PPI in patients with chronic liver disease. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s12072-019-09932-9
Publisher Site
http://dx.doi.org/10.1007/s12072-019-09932-9DOI Listing
February 2019
2 Reads

Comprehensive Characterization of a Porcine Model of The "Small-for-Flow" Syndrome.

J Gastrointest Surg 2019 Feb 7. Epub 2019 Feb 7.

Transplant and Hepatobiliopancreatic Surgery Unit, Department of General and Digestive Surgery, Hospital General Universitario Gregorio Marañón - IiSGM, Madrid, Spain.

Introduction: The term "Small-for-Flow" reflects the pathogenetic relevance of hepatic hemodynamics for the "Small-For-Size" syndrome and posthepatectomy liver failure. We aimed to characterize a large-animal model for studying the "Small-for-Flow" syndrome.

Methods: We performed subtotal (90%) hepatectomies in 10 female MiniPigs using a simplified transection technique with a tourniquet. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11605-019-04130-2DOI Listing
February 2019
1 Read

Acetaminophen is Undetectable in Plasma From More Than Half of Patients Believed to Have Acute Liver Failure Due to Overdose.

Clin Gastroenterol Hepatol 2019 Feb 4. Epub 2019 Feb 4.

Division of Digestive and Liver Diseases, The University of Texas Southwestern Medical Center, Dallas, TX, United States; Grant Support-This study was supported by a grant from the National Institute for Diabetes and Digestive and Kidney Diseases (U01-DK-58369 ) to the University of Texas Southwestern Medical Center at Dallas.

Background Aims: Evaluation of patients with acute liver injury (ALI) or acute liver failure (ALF) often includes measurement of plasma levels of acetaminophen, to determine exposure and/or toxicity. However, once liver injury has developed, acetaminophen might be undetectable in plasma. We investigated the association between level of acetaminophen measured and outcomes of patients designated as having ALF or ALI due to acetaminophen toxicity. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cgh.2019.01.040DOI Listing
February 2019
1 Read

The Effect of Puncture Sites of Portal Vein in TIPS with ePTFE-Covered Stents on Postoperative Long-Term Clinical Efficacy.

Gastroenterol Res Pract 2019 9;2019:2935498. Epub 2019 Jan 9.

Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 Guangdong, China.

Purpose: To evaluate the effect of puncture sites of the portal vein in transjugular intrahepatic portosystemic shunt (TIPS) on long-term clinical efficacy.

Methods: A retrospective review was performed, including consecutive 171 patients who underwent TIPS with ePTFE-covered stents. All patients were divided into 3 groups according to the puncture site of the portal vein: intrahepatic bifurcation of the portal vein (group A, = 88), right branch of the portal vein (group B, = 48), and left branch of the portal vein (group C, = 35). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1155/2019/2935498DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343182PMC
January 2019
1 Read

Body mass index in early pregnancy and future risk of severe liver disease: a population-based cohort study.

Aliment Pharmacol Ther 2019 Feb 3. Epub 2019 Feb 3.

Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.

Background: In young men, high body mass index (BMI) has been linked to liver disease later in life, but it is unclear if this also applies to women.

Aim: To study the association between BMI early in life and development of liver disease later in life in women.

Methods: We obtained data on early pregnancy BMI from 1 139 458 Swedish women between 1992 and 2015. Read More

View Article

Download full-text PDF

Source
http://doi.wiley.com/10.1111/apt.15162
Publisher Site
http://dx.doi.org/10.1111/apt.15162DOI Listing
February 2019
3 Reads

Machine Learning-based Development and Validation of a Scoring System for Screening High Risk Esophageal Varices.

Clin Gastroenterol Hepatol 2019 Jan 29. Epub 2019 Jan 29.

Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA, 91342. Electronic address:

Background & Aims: Many patients with cirrhosis who undergo esophagogastroduodenoscopy (EGD) screening for esophageal varices (EVs) are found to have no or only small EVs. Endoscopic screening for EVs is therefore a potentially deferrable procedure that increases patient risk and healthcare cost. We developed and validated a scoring system, based on readily-available data, to identify patients with EVs varices that need treatment. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cgh.2019.01.025DOI Listing
January 2019
1 Read

Percutaneous transvenous shunt occlusion for portosystemic encephalopathy due to lenvatinib administration to a patient with hepatocellular carcinoma and portosystemic shunt.

Clin J Gastroenterol 2019 Jan 31. Epub 2019 Jan 31.

Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.

We report a 74-year-old male patient with compensated cirrhosis after hepatic C virus eradication. After the patient underwent hepatectomy for hepatocellular carcinoma, multiple lung and lymph node metastases were detected by computed tomography. Computed tomography also revealed a portosystemic shunt from the superior mesenteric vein to the right testicular vein. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12328-019-00938-2DOI Listing
January 2019
1 Read

L-Ornithine L-Aspartate (LOLA) for Hepatic Encephalopathy in Cirrhosis: Results of Randomized Controlled Trials and Meta-Analyses.

Drugs 2019 Jan 31. Epub 2019 Jan 31.

Liver Intensive Therapy Unit, Institute of Liver Sciences, School of Immunology and Microbial Sciences, Kings College London, London, UK.

This manuscript represents an appraisal of the evidence in support of L-ornithine-L-aspartate (LOLA) for the management and treatment of hepatic encephalopathy (HE) in cirrhosis. Meta-analyses of randomized controlled trials (RCTs) conducted over the last two decades generally reveal evidence of benefit of LOLA in a range of clinical presentations. This included improvement of mental state grade in overt HE (OHE) assessed by West Haven criteria as well as in minimal HE (MHE) assessed by psychometric testing where the oral formulation of LOLA was determined to be particularly effective. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40265-018-1024-1DOI Listing
January 2019
1 Read

Pharmacokinetic and Pharmacodynamic Properties of L-Ornithine L-Aspartate (LOLA) in Hepatic Encephalopathy.

Drugs 2019 Jan 31. Epub 2019 Jan 31.

Department of Gastroenterology, Hepatology and Diabetology, Brandenburg Medical School, Center of Internal Medicine II, University Hospital Brandenburg, Hochstraße 29, 14770, Brandenburg an der Havel, Germany.

L-Ornithine L-aspartate (LOLA), a stable salt of L-ornithine and L-aspartate, readily dissociates into its constituent amino acids that are readily absorbed by active transport, distributed, and metabolized. L-ornithine serves as an intermediary in the urea cycle in periportal hepatocytes in the liver and as an activator of carbamoyl phosphate synthetase, and, like L-aspartate, by transamination to glutamate via glutamine synthetase in perivenous hepatocytes as well as by skeletal muscle and brain. By way of these metabolic pathways, both amino acids participate in reactions whereby the ammonia molecule is incorporated into urea and glutamine and it is the nature, cellular, and biological location of these pathways that underpins the application of LOLA as an effective ammonia-lowering strategy widely used for the management and treatment of hepatic encephalopathy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40265-018-1023-2DOI Listing
January 2019
1 Read

Hepatic Encephalopathy in Cirrhosis: Pathology and Pathophysiology.

Drugs 2019 Jan 31. Epub 2019 Jan 31.

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

Neuropathology of hepatic encephalopathy (HE) in cirrhosis is primarily astroglial in nature characterized by Alzheimer type 2 astrocytosis together with activation of microglia indicative of neuroinflammation. Focal loss of neurons may also occur in the basal ganglia, thalamus and cerebellum. Pathophysiology of HE in cirrhosis is multifactorial, involving brain accumulation of ammonia and manganese, systemic and central inflammation, nutritional/metabolic factors and activation of the GABAergic neurotransmitter system. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40265-018-1017-0DOI Listing
January 2019
1 Read

L-Ornithine L-Aspartate (LOLA) as a Novel Approach for Therapy of Non-alcoholic Fatty Liver Disease.

Drugs 2019 Jan 31. Epub 2019 Jan 31.

Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.

L-ornithine L-aspartate (LOLA) has been known as an effective ammonia-lowering agent for more than 50 years with good evidence in hepatic encephalopathy. Administration of LOLA removes ammonia via two distinct mechanisms: by synthesis of urea and by the synthesis of glutamine via the enzyme glutamine synthetase. While LOLA has been used in cirrhosis and acute liver injury settings, it is less clear if LOLA could be used in non-alcoholic fatty liver disease (NAFLD). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40265-018-1020-5DOI Listing
January 2019
1 Read

L-Ornithine L-Aspartate (LOLA) for the Treatment of Hepatic Encephalopathy in Cirrhosis: Novel Insights and Translation to the Clinic.

Drugs 2019 Jan 31. Epub 2019 Jan 31.

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

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40265-018-1021-4DOI Listing
January 2019
1 Read

Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles.

Drugs 2019 Jan 31. Epub 2019 Jan 31.

Clinic for Neurology, Hannover Medical School, 30623, Hannover, Germany.

In general, hepatic encephalopathy (HE) is defined as a brain dysfunction caused by liver insufficiency and/or portal-systemic blood shunting. This article relates to the so-called type C HE: that is, HE in patients with liver cirrhosis. It manifests as a wide spectrum of neurological or psychiatric abnormalities, ranging from subclinical alterations, detectable only by neuropsychological or neurophysiological assessment, to coma. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40265-018-1018-zDOI Listing
January 2019
1 Read

Impact of Hepatic Encephalopathy in Cirrhosis on Quality-of-Life Issues.

Drugs 2019 Jan 31. Epub 2019 Jan 31.

Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.

Hepatic encephalopathy (HE) has a major impact on health-related quality of life (HRQOL) in patients, which has clinical and psychosocial consequences. HRQOL in cirrhosis has been measured by generic and liver-specific instruments, with most studies indicating a negative impact of HE. HRQOL abnormalities span daily functioning, sleep-wake cycle changes, and the ability to work. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s40265-018-1019-y
Publisher Site
http://dx.doi.org/10.1007/s40265-018-1019-yDOI Listing
January 2019
5 Reads

Associated vitamin D deficiency is a risk factor for the complication of HCV-related liver cirrhosis including hepatic encephalopathy and spontaneous bacterial peritonitis.

Intern Emerg Med 2019 Jan 31. Epub 2019 Jan 31.

Tropical Medicine Department, Faculty of Medicine, Zagazig University Hospitals, Zagazig, Egypt.

The influence of vitamin D, 25-hydroxyvitamin D (25(OH)D), deficiency on hepatitis C virus (HCV)-related cirrhosis had been poorly elucidated especially in patients with hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP). We aimed to investigate the association between vitamin D deficiency and the risk of SBP or HE, including the mortality rate. Serum 25(OH)D levels were prospectively determined in 135 patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11739-019-02042-2DOI Listing
January 2019
1 Read

Correlation analysis of collagen proportionate area in Budd-Chiari syndrome: A preliminary clinicopathological study.

World J Clin Cases 2019 Jan;7(2):130-136

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110016, Liaoning Province, China.

Background: Collagen proportionate area (CPA) is an important index for assessing the severity of liver fibrosis. Budd-Chiari syndrome can frequently progress to liver fibrosis and cirrhosis. CPA might play an important role in the pathological progress of Budd-Chiari syndrome. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.12998/wjcc.v7.i2.130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354089PMC
January 2019
1 Read

Temporal trends of cirrhosis associated conditions.

World J Hepatol 2019 Jan;11(1):74-85

Department of Internal Medicine, the Queen's Medical Center, Honolulu, HI 968132, United States.

Background: Chronic liver disease and cirrhosis is the 12 leading cause of death in the United States. Patients with decompensated-cirrhosis, especially with hepatic encephalopathy/coma (HC), have a higher rate of early readmission and contribute to higher healthcare cost.

Aim: To evaluate the national inpatient trends of discharges, mortalities and financial impacts associated with four common conditions of cirrhosis. Read More

View Article

Download full-text PDF

Source
https://www.wjgnet.com/1948-5182/full/v11/i1/74.htm
Publisher Site
http://dx.doi.org/10.4254/wjh.v11.i1.74DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354119PMC
January 2019
5 Reads

Prognostic Role of Ammonia in Cirrhotic Patients.

Hepatology 2019 Jan 31. Epub 2019 Jan 31.

Liver Failure Group, UCL Institute for Liver and Digestive Health, Division of Medicine, UCL Medical School, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.

Ammonia is thought to be central to the pathogenesis of hepatic encephalopathy (HE), but its prognostic role in cirrhotic patients with acute decompensation (AD) is unknown. The aims of this study were to determine the relationship between ammonia levels and severity of HE, association with organ dysfunction and short-term mortality. We identified 498 patients from two institutions as part of prospective observational studies in cirrhotic patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1002/hep.30534DOI Listing
January 2019
2 Reads

Predicting Overt Hepatic Encephalopathy for the Population with Cirrhosis.

Authors:
Elliot B Tapper

Hepatology 2019 Jan 31. Epub 2019 Jan 31.

Division of Gastroenterology and Hepatology, University of Michigan.

Hepatic encephalopathy (HE) is associated with poor quality of life, sharply increased mortality, repeated hospitalizations, falls, and motor vehicle accidents. HE manifests with a dynamic spectrum of severity. Overt HE is clinically obvious disorientation, even coma. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1002/hep.30533DOI Listing
January 2019
1 Read

Common NOD2 Risk Variants as Major Susceptibility Factors for Bacterial Infections in Compensated Cirrhosis.

Clin Transl Gastroenterol 2019 Jan;10(1):e00002

Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany.

Objectives: Common nucleotide-binding oligomerization domain containing 2 (NOD2) gene variants have been associated with bacterial infections (BIs) in cirrhosis, in particular, spontaneous bacterial peritonitis, and mortality. Our aim was to evaluate the independent association of NOD2 variants with BI according to the decompensation stage.

Methods: Consecutive patients with cirrhosis in 2 academic medical centers were included and genotyped for the NOD2 variants p. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.14309/ctg.0000000000000002DOI Listing
January 2019
1 Read

Superinfection of hepatitis E as a factor in the development of acute hepatic encephalopathy on the background of HBV-cirrhosis of the liver.

Ter Arkh 2018 Feb;90(2):102-104

Kirov Infectious Clinical Hospital, Kirov, Russia.

The article presents an analysis of the clinical case of superinfection of autochthonous acute hepatitis E against the background of HBV-cirrhosis of the liver. HEV infection was diagnosed in a 39 year old man who did not travel outside the region and the country for a long time and used unboiled water. The peculiarity of the disease in the non-endemic region was: a severe course of hepatitis E against the background of HBV etiology, with the development of the clinic for acute hepatic insufficiency and encephalopathy, the presence of severe cytolysis syndrome, cholestasis, hepatic-cell insufficiency and prolonged convalescence. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.26442/terarkh2018902102-104DOI Listing
February 2018
2 Reads

Minimal hepatic encephalopathy: current clinical and pathogenetic aspects.

Authors:
I V Damulin

Ter Arkh 2018 Feb;90(2):89-93

I.M. First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.

The review considers modern ideas about the clinic and pathogenesis of minimal hepatic encephalopathy (MHE). It is discussed the present of cognitive impairment in this category of patients. The data of functional MRI are analyzed, and these results allow taking a fresh look at the origin of clinical disorders in this condition. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.26442/terarkh201890289-93DOI Listing
February 2018
1 Read

Neurological Complications Occurring after Liver Transplantation: Role of Risk Factors, Hepatic Encephalopathy, and Acute (on Chronic) Brain Injury.

Liver Transpl 2019 Jan 29. Epub 2019 Jan 29.

Sorbonne Université, Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, INSERM, Centre de recherche Saint-Antoine, Maladies métaboliques, biliaires et fibro-inflammatoire du foie, Assistance Publique - Hôpitaux de Paris, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Service d'hépato-gastroentérologie, Unité de Soins Intensifs d'Hépato-gastroentérologie, Paris, France.

Orthotopic liver transplantation (LT) remains the only way to definitively cure patients with the most severe liver diseases. Since the survival rate is now fairly high, important questions about neurological sequelae or quality of life after LT have emerged. Indeed, LT represents a peculiar situation because up to 30% of patients present with neurological symptoms after LT compared with only 4% after cardiac transplant and 0. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1002/lt.25420DOI Listing
January 2019
1 Read

Lactulose Management of Minimal Hepatic Encephalopathy: A Systematic Review.

Gastroenterol Nurs 2019 Jan/Feb;42(1):84-94

Donna M. Zucker, PhD, RN, FAAN, Professor, University of Massachusetts Amherst College of Nursing, Amherst. Rhoda Redulla, DNP, RN-BC, Magnet Program Director, New York-Presbyterian/Weill-Cornell, New York, New York.

Minimal hepatic encephalopathy has been shown to increase risk of involvement in road traffic accidents and alter quality of life. This systematic review focused on the role of nonabsorbable disaccharides for the management of minimal hepatic encephalopathy. Randomized clinical trials that evaluated medical management of minimal hepatic encephalopathy were considered for inclusion. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/SGA.0000000000000429DOI Listing
January 2019
1 Read