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Topic: Hepatic encephalopathy

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	Postgraduate Medicine: Hepatic encephalopathy
		Hepatic encephalopathy: metabolic consequence of cirrhosis often is reversible.
		Carnitine deficiency is a genetic syndrome manifested by hepatic encephalopathy.
		Hepatic encephalopathy is a well-recognized clinical complication of chronic liver disease.
	www.postgradmed.com /issues/2001/02_01/assi.htm (3841 words)

	Hepatic encephalophaty
		Hepatic encephalopathy is a reversible state of impaired cognitive function or altered consciousness that occurs in patients with liver disease or portosystemic shunts.
		Hepatic encephalopathy is a hallmark of deteriorating liver function, and patients should be assessed early for liver transplantation.
		The treatment of hepatic encephalopathy is empirical and relies largely on establishing the correct diagnosis, identifying and treating precipitating factors, emptying the bowels of blood, protein, and stool, attending to electrolyte and acid-base imbalance, and the selective use of benzodiazepine antagonists.
	home3.inet.tele.dk /omni/encephalopathy.htm (1479 words)

	Dopaminergic agonists for hepatic encephalopathy
		Hepatic encephalopathy occurs in patients with chronic liver disease or fulminant liver failure.
		Hepatic encephalopathy is associated with changes in mental state, ranging from minor signs of altered brain function to deep coma.
		Hepatic encephalopathy may be associated with an impairment of the dopaminergic neurotransmission.
	www.cochrane.org /reviews/en/ab003047.html (540 words)

	Dr. Koop - Hepatic encephalopathy
		Hepatic encephalopathy is caused by disorders affecting the liver.
		In people with otherwise stable liver disorders, hepatic encephalopathy may be triggered by episodes of gastrointestinal bleeding, excessive intake of dietary protein, electrolyte abnormalities (especially decrease in potassium, which may result from vomiting or treatments such as diuretics or paracentesis), infections, renal disease, and procedures that shunt blood past the liver.
		Hepatic encephalopathy may occur as an acute, potentially reversible disorder or as a chronic, progressive disorder associated with chronic liver disease.
	www.drkoop.com /ency/93/000302.html (446 words)

	A Review of Congenital Portosystemic Shunting and Hepatic Encephalopathy (Site not responding. Last check: 2007-09-07)
		Heptic encephalopathy is a neurologic disorder which may develop in animals who have advanced liver disease and/or severe portosystemic shunting.
		Hepatic encephalopathy develops because of failure of the diseased liver to synthesize factors that are necessary for normal brain function.
		The microscopic lesions in the brain and liver were consistent with hepatic encephalopathy secondary to the portal-caval venous shunt.
	www.addl.purdue.edu /newsletters/1997/winter/cps.shtml (599 words)

	eMedicine - Encephalopathy, Hepatic : Article by David C Wolf, MD, FACP, FACG
		Hepatic encephalopathy is a syndrome observed in patients with cirrhosis of the liver.
		The development of hepatic encephalopathy is explained, to some extent, by the effect of neurotoxic substances, which occurs in the setting of cirrhosis and portal hypertension.
		Hepatic encephalopathy accompanied by severe dysfunction of hepatic synthetic activity also is the hallmark of fulminant hepatic failure (FHF).
	www.emedicine.com /med/topic3185.htm (2737 words)

	Hepatic encephalopathy is a common and serious complication affecting patients with liver disease... (Site not responding. Last check: 2007-09-07)
		Hepatic encephalopathy is a common and serious complication affecting patients with liver disease...
		H pylori seropositivity in all subjects was 65 percent, in patients of liver disease with hepatic encephalopathy it was 78 percent, patients of liver disease without hepatic encephalopathy was 56 percent, and healthy controls was 48 percent (Table I).
		It was conducted to explore the significance of H pylori infection in hepatic encephalopathy.
	www.indegene.com /Gas/FeatArt/indGasFeat8.html (1139 words)

	Hepatitis Central, Subclinical Hepatic Encephalopathy Impairs Daily Functioning
		The prevalence of subclinical hepatic encephalopathy (SHE) is estimated to vary from 30% to 84% according to recent studies using appropriate methods.
		Patients are graded in the different stages of hepatic encephalopathy on account of their mean dominant frequency, and the relative powers of delta and theta activity.
		Patients with hepatic encephalopathy grade 1 can complain about, for example, sleep disturbances, impaired calculation, shortened attention, mild personality changes, and muscular incoordination.44 Patients with SHE (in literature, considered as a preclinical stage of hepatic encephalopathy) should therefore, although to a lesser extent, have similar complaints in daily life.
	hepatitis-central.com /hcv/symptoms/encephalopathy/subclinical.html (3686 words)

	Hepatic Encephalopathy
		Hepatic encephalopathy is a complex neuropsychiatric disorder that complicates acute and chronic liver failure.
		The diagnosis of hepatic encephalopathy is clinical and depends on documentation of the presence of mental status changes, fetor hepaticus (feculent-fruity odor of the breath), and asterixis (flapping motion of the hands caused by intermittent loss of extensor tone) in a patient with parenchymal liver disease with abnormal liver enzymes and elevated ammonia levels.
		In patients with compensated cirrhosis, encephalopathy may be precipitated by gastrointestinal bleeding, infection, hypokalemia, azotemia, excessive dietary protein, central nervous system depressants, (particularly opioids), constipation, and worsening liver disease.
	members.tripod.com /enotes/hepatic-encephalopathy.htm (735 words)

	Hyperprolactinemia in hepatic encephalopathy: the effect of infusion of an amino acid mixture with excess branched ... (Site not responding. Last check: 2007-09-07)
		Hyperprolactinemia in hepatic encephalopathy: the effect of infusion of an amino acid mixture with excess branched chain amino acids.
		Hyperprolactinemia in hepatic encephalopathy: the effect of infusion of an amino acid mixture with excess branched chain amino acids.After BCAA infusion the branched chain/aromatic amino acid ratio normalized.
		This suggests that the elevated PRL levels in hepatic encephalopathy are caused by a disturbance of hypothalamic neurotransmitter systems, due to altered amino acid-neurotransmitter precursor levels.
	www.pdg.cnb.uam.es /UniPub/iHOP/gp/4499742.html (157 words)

	UK Indymedia - IATROGENIC HEPATIC ENCEPHALOPATHY (Site not responding. Last check: 2007-09-07)
		·Iatrogenic hepatic encephalopathy (HE) is defined by the occurrence of brain dysfunction is a direct consequence of a medical intervention (shunt procedures, drugs) in a previously asymptomatic patient with liver disease.
		Hepatic encephalopathy (HE) is a syndrome of impaired brain function due to liver failure.
		Submit that predisposing factors in hepatic encephalopathy include a history of blood in urine or stool, opiate use, infection, GI bleeding, dehydration or electrolyte abnormalities.
	www.indymedia.org.uk /en/2002/08/38729.html (5747 words)

	Ammonia/Liver/hepatic encephalopathy
		It is always important to identify hepatic encephalopathy because it is a sign of advanced liver disease and because it can usually be treated effectively and safely.
		We typically treat hepatic encephalopathy with a medication called lactulose which is a syrup given by mouth.
		The diagnosis and evaluation of hepatic encephalopathy can be complex and typically a liver specialist or some one with experience with liver disease can be very helpful.
	www.medhelp.org /forums/hepatitis/messages/30098a.html (978 words)

	cirrhosis and its effect hepatic encephalopaty
		Chronic Hepatitis C (CHC) is one of the diseases that may lead to cirrhosis of the liver (the normal liver cells are irreversibly replaced by scar tissue).
		Cirrhosis may also lead to hepatic encephalopathy, which manifests as fatigue or confusion, and is caused by ammonia and other by-products of protein digestion which are not cleared properly by the liver from the bloodstream.
		Because of their location at the lower end of the oesophagus and/or the upper portion of the stomach, bleeding from these varices is often difficult to control.
	home3.inet.tele.dk /omni/cirrhosis2.htm (1445 words)

	All-Net \| fulminant hepatic failure: hepatic encephalopathy (Site not responding. Last check: 2007-09-07)
		Hypoxemia, hypoglycemia, sepsis, hypokalemia, and gastrointestinal bleeding exacerbate hepatic encephalopathy and should be identified and treated.
		Unfortunately, these medications are not as effective in FHF as they are in the treatment of hepatic encephalopathy associated with chronic liver disease.
		It occurs in 75% of patients with stage 4 hepatic encephalopathy.
	pedsccm.wustl.edu /All-Net/english/gipage/liver/fhf-15.htm (1059 words)

	Benzodiazepine receptor antagonists for hepatic encephalopathy (Cochrane Review) (Site not responding. Last check: 2007-09-07)
		Background: Hepatic encephalopathy may be associated with accumulation of substances that bind to a receptor-complex in the brain resulting in neural inhibition.
		Flumazenil had a significant beneficial effect on improvement of hepatic encephalopathy at the end of treatment (RD 0.28; 95% CI 0.20 to 0.37, eight trials).
		Considering the fluctuating nature of hepatic encephalopathy, future trials should use a parallel design and assess if treatment with flumazenil leads to a sustained improvement or increased recovery and survival.
	www.cochrane.org /cochrane/revabstr/ab002798.htm (497 words)

	Hepatic Encephalopathy: An Update of Pathophysiologic Mechanisms -- Hazell and Butterworth 222 (2): 99 -- Experimental ...
		Anderson B. A proposed theory for the encephalopathies of Reye's syndrome and hepatic encephalopathy.
		Hepatic encephalopathy in cirrhotic and portocaval-shunted dogs: Lack of changes in brain GABA uptake, brain GABA levels, and brain glutamic acid decarboxylase activity and brain postsynaptic GABA receptors.
		The peripheral benzodiazepine receptor and neurosteroids in hepatic encephalopathy.
	www.ebmonline.org /cgi/content/full/222/2/99 (7927 words)

	Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials -- Als-Nielsen et al. ...
		Lactitol vs. lactulose in the treatment of acute hepatic encephalopathy in cirrhotic patients: a double-blind, randomized trial.
		Efficacy of lactulose in cirrhotic patients with subclinical hepatic encephalopathy.
		The clinical efficacy of rifaximin in the treatment of hepatic encephalopathy (comparison with lactulose) [abstract].
	bmj.bmjjournals.com /cgi/content/full/328/7447/1046 (2836 words)

	Hemoglobin metabolites mimic benzodiazepines and are possible mediators of hepatic encephalopathy -- Ruscito and ...
		Flumazenil vs placebo in hepatic encephalopathy in patients with cirrhosis: a meta-analysis.
		Brain concentrations of benzodiazepines are elevated in an animal model of hepatic encephalopathy.
		Reversal of the behavioral and electrophysiological abnormalities of an animal model of hepatic encephalopathy by benzodiazepine receptor ligands.
	www.bloodjournal.org /cgi/content/full/102/4/1525 (2467 words)

	Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials -- Als-Nielsen et al. ...
		(lactulose and lactitol) in patients with hepatic encephalopathy.
		the use of non-absorbable disaccharides for hepatic encephalopathy.
		Hepatic Encephalopathy: An immunologic response to chronic endotoxemia?
	bmj.com /cgi/content/abstract/328/7447/1046 (305 words)

	Neomycin should not be used to treat hepatic encephalopathy -- Curioso and Monkemuller 323 (7306): 233 -- BMJ
		In their clinical review on portal hypertension Krige and Beckingham mention neomycin as treatment for hepatic encephalopathy.
		Lactulose-neomycin combination versus placebo in the treatment of acute hepatic encephalopathy.
		Evaluation of the efficacy and safety of rifaximin in the treatment of hepatic encephalopathy: a double-blind, randomized, dose-finding multi-centre study.
	bmj.com /cgi/content/full/323/7306/233 (371 words)

	Hepatitis Central, What Is Hepatic Encephalopathy?
		Oster proposes an explanation for some of the observed over-representation of males: the hepatitis B virus...
		In the current study, Oster presents new evidence, consistent with existing scientific literature, that carriers of the hepatitis B virus are 1.5 times more likely to have a male child.
		This is one of the most broad announcements regarding Hepatitis c I've seen in a long time.
	hepatitis-central.com /hcv/whatis/encephalopathy.html (971 words)

	Hepatic Encephalopathy in dogs (Site not responding. Last check: 2007-09-07)
		Prednisone is also used for some cases of hepatic encephalopathy, particularly cases of liver disease in which an immune mediated disorder is suspected.
		If I remember correctly I am guessing that your vet is treating for hepatic encephalopathy based on the treatment but I don't think that I know that for sure.
		If your vet does suspect liver disease leading to hepatic encephalopathy a liver biopsy may make it easier to produce a long-term management plan.
	www.vetinfo.com /dhepaticenceph.html (766 words)

	Dietary management of hepatic encephalopathy -- Seymour and Whelan 318 (7195): 1364 -- BMJ
		Hepatic encephalopathy is a syndrome of impaired mental status and abnormal neuromuscular function which results from major
		Dietary management of hepatic encephalopathy in cirrhotic patients: survey of current practice in United Kingdom.
		Eriksson LS, Persson A, Wahren J. Branched chain amino acids in the treatment of hepatic encephalopathy.
	www.bmj.com /cgi/content/full/318/7195/1364 (839 words)

	Hepatic Encephalopathy - Montaine Centre of Natural Therapies - Sydney, Australia (Site not responding. Last check: 2007-09-07)
		Hepatic Encephalopathy - Montaine Centre of Natural Therapies - Sydney, Australia
		Little is known of these neurotoxins causing encephalopathy, but they are thought to be nitrogenous substances produced mainly in the gut through protein decay, at least in part by bacterial action, which are normally metabolised by the healthy liver so that they don’t enter the systemic circulation.
		?span style="font:7.0pt "Times New Roman""> Episodes of encephalopathy are common in cirrhosis and are usually readily reversed until the terminal stages occur.
	www.montaine.com.au /enc/en_ht/ht_dt/hepatic_encephalopathy.htm (432 words)

	Branched-chain amino acids for hepatic encephalopathy (Cochrane Review)
		Background: Hepatic encephalopathy may be caused by a decreased plasma ratio of branched-chain amino acids (BCAA) to aromatic amino acids.
		Treatment with BCAA may therefore have a beneficial effect on patients with hepatic encephalopathy.
		Compared to the control regimens, BCAA significantly increased the number of patients improving from hepatic encephalopathy at the end of treatment (risk ratio (RR) 1.31, 95% confidence interval (CI) 1.04 to 1.66, nine trials).
	www.update-software.com /abstracts/AB001939.htm (449 words)

	Synbiotic modulation of gut flora improves minimal hepatic encephalopathy in cirrhotic patients
		Some cirrhotic patients develop brain dysfunction, called hepatic encephalopathy, which causes deficits in behavior, intelligence, consciousness and neuromuscular function.
		Since ammonia has been shown to play a key role in overt hepatic encephalopathy, treatment options for MHE have also focused on reducing ammonia levels in the body.
		A new study published in the May 2004 issue of Hepatology has shown that treating cirrhotic patients with synbiotics or fermentable fiber can alter the flora in the gut, lowering its pH levels as well as the ammonia levels in the blood.
	www.eurekalert.org /pub_releases/2004-05/jws-smo051304.php (704 words)

	MedlinePlus Medical Encyclopedia: Hepatic encephalopathy
		In people with otherwise stable liver disorders, hepatic encephalopathy may be triggered by episodes of gastrointestinal bleeding, excessive intake of dietary protein, electrolyte abnormalities (especially decrease in potassium, which may result from vomiting or treatments such as diuretics or paracentesis), infections, renal disease, and procedures that shunt (bypass) blood past the liver.
		In patients with severe, repeated cases of encephalopathy, the patient may be advised to reduce protein in the diet to reduce ammonia production.
		Call your health care provider if any change in mental state or other neurologic problem occurs, particularly if there is a known or suspected liver disorder.
	www.nlm.nih.gov /medlineplus/ency/article/000302.htm (989 words)

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