scholarly journals Covert hepatic encephalopathy and spontaneous portosystemic shunts increase the risk of developing overt hepatic encephalopathy

2020 ◽  
Vol 40 (12) ◽  
pp. 3093-3102
Author(s):  
Robin Greinert ◽  
Alexander Zipprich ◽  
Macarena Simón‐Talero ◽  
Franz Stangl ◽  
Christiane Ludwig ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Portosystemic Shunts ◽  
Overt Hepatic Encephalopathy ◽  
Covert Hepatic Encephalopathy

scholarly journals Additional L-carnitine Reduced the Risk of Hospitalization in Patients with Overt Hepatic Encephalopathy on Rifaximin

2021 ◽  
Author(s):  
Kousuke Kubota ◽  
Haruki Uojima ◽  
Xue Shao ◽  
Shuichiro Iwasaki ◽  
Hisashi Hidaka ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Overt Hepatic Encephalopathy

Persistence of Cognitive Impairment After Resolution of Overt Hepatic Encephalopathy

2014 ◽  
Vol 109 (7) ◽  
pp. 1011-1019 ◽  
Author(s):  
Sridharan Umapathy ◽  
Radha K Dhiman ◽  
Sandeep Grover ◽  
Ajay Duseja ◽  
Yogesh K Chawla
Keyword(s):  
Cognitive Impairment ◽  
Hepatic Encephalopathy ◽  
Overt Hepatic Encephalopathy

Should We Treat Minimal/Covert Hepatic Encephalopathy, and with What?

2015 ◽  
Vol 19 (3) ◽  
pp. 487-495 ◽  
Author(s):  
Phillip K. Henderson ◽  
Jorge L. Herrera
Keyword(s):  
Hepatic Encephalopathy ◽  
Covert Hepatic Encephalopathy

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

scholarly journals Neuroprotective Effect of Nortriptyline in Overt Hepatic Encephalopathy Through Attenuation of Mitochondrial Dysfunction

ASN NEURO ◽  
2018 ◽  
Vol 10 ◽  
pp. 175909141881058 ◽  
Author(s):  
Ji Heun Jeong ◽  
Do Kyung Kim ◽  
Nam-Seob Lee ◽  
Young-Gil Jeong ◽  
Ho Won Kim ◽  
...  
Keyword(s):  
Cell Death ◽  
Hepatic Encephalopathy ◽  
Substantia Nigra ◽  
Mitochondrial Dysfunction ◽  
Mitochondrial Permeability Transition ◽  
Neuroprotective Effect ◽  
Motor Deficits ◽  
Apoptotic Pathway ◽  
Duct Ligation ◽  
Overt Hepatic Encephalopathy

Hyperammonemia associated with overt hepatic encephalopathy (OHE) causes excitotoxic neuronal death through activation of the cytochrome C (CytC)-mediated mitochondria-dependent apoptotic pathway. We tested the therapeutic effect of nortriptyline (NT), a mitochondrial permeability transition pore (mPTP) blocker that can possibly inhibit mitochondrial CytC efflux to the cytosol on in vivo and in vitro OHE models. After ensuring the generation of OHE rats, established by bile duct ligation (BDL), they were intraperitoneally administered either 20 mg/kg NT (i.e., BDL+NT) or another vehicle (i.e., BDL+VEH) for 14 days. Compared with the control, BDL+VEH showed an increment of motor deficits, cell death, synaptic loss, apoptosis, and mitochondria with aberrant morphology in substantia nigra compacta dopaminergic (DA-ergic) neurons. However, the extent was significantly reversed in BDL+NT. Subsequently, we studied the neuroprotective mechanism of NT using PC-12 cells, a DA-ergic cell line, which exposed glutamate used as an excitotoxin. Compared with the control, the cells exposed to 15 mM glutamate (i.e., GLU) showed incremental cell death, apoptosis, and demise in mitochondrial respiration. Importantly, efflux of CytC from mitochondria to cytosol and the dissipation of mitochondrial membrane potential (△Ψm), an indicator of mPTP opening, were prominent in GLU. However, compared with the GLU, the cells cotreated with 10 μM NT (i.e., GLU+NT) showed a significant reduction in the aforementioned phenomenon. Together, we concluded that NT can be used for OHE therapeutics, mitigating the excitotoxic death of substantia nigra compacta DA-ergic neurons via mPTP-associated mitochondrial dysfunction inhibition.

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