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Journal Cover   Journal of Clinical and Experimental Hepatology
  [SJR: 0.142]   [H-I: 3]   [3 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0973-6883
   Published by Elsevier Homepage  [2586 journals]
  • Hepatic Encephalopathy
    • Authors: Radha K. Dhiman
      Abstract: This issue of the Journal contains several articles on hepatic encephalopathy (HE) that represent a tremendous effort to pay tribute to Joan (Juan) Cordoba, who was a dear colleague and friend of those involved in HE research. For this purpose, International Society for HE and Nitrogen Metabolism (ISHEN) and Indian National Association for the Study of the Liver (INASL) decided to bring a supplement issue of “Journal of Clinical and Experimental Hepatology” (JCEH) on HE in order to honor Juan's contribution to HE.
      Citation: Journal of Clinical and Experimental Hepatology 5, (2015)
      PubDate: 2015-03
      DOI: 10.1016/j.jceh.2015.02.001
      Issue No: Vol. 5 (2015)
       
  • Hepatobiliary Quiz—13 (2015)
    • Authors: Sahaj Rathi; Radha K. Dhiman
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-04-01
      DOI: 10.1016/j.jceh.2015.03.001
       
  • Hepatobiliary Quiz—13 (2015)
    • Authors: Sahaj Rathi; Radha K. Dhiman
      Abstract: Liver cells are the sole site of synthesis of albumin. Usual daily production is about 10–15 g per day, which may be increased 3–4 fold when required. Of the total body albumin, 30%–40% is retained in the intravascular compartment, while the rest 60–70% remains in the interstitial spaces.1 The half-life of albumin is 12.7–18.2 days in a young healthy adult. However, circulatory half-life of albumin is approximately 16–18 h as about 5% of albumin is exchanged between intravascular and interstitial spaces every hour.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-03-30
      DOI: 10.1016/j.jceh.2015.03.002
       
  • Non-alcoholic Fatty Liver Disease and Metabolic Syndrome—Position
           Paper of the Indian National Association for the Study of the Liver,
           Endocrine Society of India, Indian College of Cardiology and Indian
           Society of Gastroenterology
    • Authors: Ajay Duseja; Shivaram P. Singh, Vivek A. Saraswat, Subrat K. Acharya, Yogesh K. Chawla, Subhankar Chowdhury, Radha K. Dhiman, Rohinivilasam V. Jayakumar, Kaushal Madan, Sri P. Misra, Hrudananda Mishra, Sunil K. Modi, Arumugam Muruganathan, Banshi Saboo, Rakesh Sahay, Rajesh Upadhyay
      Abstract: Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-03-26
      DOI: 10.1016/j.jceh.2015.02.006
       
  • Portal Vein Thrombosis
    • Authors: Yogesh K. Chawla; Vijay Bodh
      Abstract: Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-03-26
      DOI: 10.1016/j.jceh.2014.12.008
       
  • Abdominal Pain Following Drug-Eluting Bead Transarterial Chemoembolisation
    • Authors: Abhihav Vasudevan; Manfred Spanger, John S. Lubel
      Abstract: Acute ischemic cholecystitis following DEB TACE.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-03-20
      DOI: 10.1016/j.jceh.2015.01.002
       
  • Abdominal Pain Following Drug-eluting Bead Transarterial Chemoembolization
    • Authors: Abhinav Vasudevan; Manfred Spanger, John S. Lubel
      Abstract: A 60 year old male presented with a two day history of fevers and right upper quadrant pain. His past medical history was significant for Child Pugh B cirrhosis secondary to chronic hepatitis B and he had received drug-eluting bead transarterial chemoembolization (DEB-TACE) for a 14 mm segment 7 hepatocellular carcinoma three weeks prior to this presentation. His other co-morbidities included a non-occlusive chronic portal vein thrombosis and stage III chronic kidney disease related to previous obstructive uropathy and nephrolithiasis.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-03-20
      DOI: 10.1016/j.jceh.2015.01.001
       
  • Antibiotics in Acute Liver Failure (ALF)
    • Authors: Shalimar
      Abstract: Constantine J. Karvellas,* Jorge Cavazos, ‡ Holly Battenhouse, § Valerie Durkalski, § Jody Balko, ‡ Corron Sanders, ‡ and William M. Lee, ‡ for the US Acute Liver Failure Study Group. Effects of Antimicrobial Prophylaxis and Blood Stream Infections in Patients with Acute Liver Failure: A Retrospective Cohort Study. Clin Gastroenterol Hepatol. 2014 Nov; 12(11):1942–9.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-03-11
      DOI: 10.1016/j.jceh.2015.01.004
       
  • The Riddle of Nonalcoholic Fatty Liver Disease: Progression From
           Nonalcoholic Fatty Liver to Nonalcoholic Steatohepatitis
    • Authors: Mithun Sharma; Shasikala Mitnala, Ravi K. Vishnubhotla, Rathin Mukherjee, Duvvur N. Reddy, Padaki N. Rao
      Abstract: Nonalcoholic fatty liver (NAFL) is an emerging global epidemic which progresses to nonalcoholic steatohepatitis (NASH) and cirrhosis in a subset of subjects. Various reviews have focused on the etiology, epidemiology, pathogenesis and treatment of NAFLD. This review highlights specifically the triggers implicated in disease progression from NAFL to NASH. The integrating role of genes, dietary factors, innate immunity, cytokines and gut microbiome have been discussed.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-03-04
      DOI: 10.1016/j.jceh.2015.02.002
       
  • Optimal Duration of Pegylated Interferon Plus Ribavirin Therapy for
           Chronic Hepatitis C Genotype 3 Patients who do not Achieve Rapid
           Virological Response
    • Authors: Ajit Sood; Vandana Midha, Omesh Goyal
      Abstract: Chronic hepatitis C (CHC) genotype-3 (G-3) patients treated with standard 24-week pegylated interferon plus ribavirin(PEG-RBV) therapy achieve sustained virological response(SVR) rate of 69–82%. Patients who do not achieve rapid virological response(RVR) have lower SVR rate. Data regarding optimal management of this subgroup is scarce. We aimed to determine the most appropriate treatment duration in CHC G-3 patients who do not achieve RVR.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-02-26
      DOI: 10.1016/j.jceh.2015.02.003
       
  • Reprint of: Nutrition in the Management of Cirrhosis and its Neurological
           Complications
    • Authors: Chantal Bémeur; Roger F. Butterworth
      Abstract: Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-02-20
      DOI: 10.1016/j.jceh.2015.02.004
       
  • Clinical and Biochemical Profile of Tuberculosis in Patients with Liver
           Cirrhosis
    • Authors: Praveen Sharma; Pankaj Tyagi, Vikas Singla, Naresh Bansal, Ashish Kumar, Anil Arora
      Abstract: There is paucity of data on tuberculosis and antituberculous therapy (ATT) induced hepatotoxicity in patients with chronic liver disease.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-02-05
      DOI: 10.1016/j.jceh.2015.01.003
       
  • Intrahepatic Cholangiocarcinoma Masquerading as Liver Abscess
    • Authors: Vinit Shah; Anil Arora, Pankaj Tyagi, Praveen Sharma, Naresh Bansal, Vikas Singla, Rinkesh K. Bansal, Varun Gupta, Ashish Kumar
      Abstract: Malignancy masquerading as liver abscess, and presenting with fever, is mainly described in patients with colorectal cancers with liver metastasis. Primary liver tumors such as hepatocellular carcinoma or intrahepatic cholangiocarcinoma presenting as non-resolving liver abscess is extremely uncommon and carries a dismal prognosis. We present a rare case of non-resolving liver abscess as a presenting manifestation of intrahepatic cholangiocarcinoma.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-02-02
      DOI: 10.1016/j.jceh.2014.12.006
       
  • Study of the Effects of Cyclooxygenase-2 Inhibitor on the Promotion of
           Hepatic Tumorigenesis in Rats Fed a High Fat Diet
    • Authors: Magda Hamzawy; Laila Elsaid, Asmaa Shams, Laila Rashid, Soheir Mahfouz, Nivin Sharawy
      Abstract: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The highest prevalence of hepatitis is an important risk factor contributing to development of HCCs. However, an increasing number of cases are associated metabolic disease and steatohepatitis. Inflammation associated with many liver disease, seems to be a necessary pre-requisite for successful tumor initiation. Mechanisms that link high fat diet and inflammation initial stage of HCC are not completely understood.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-01-29
      DOI: 10.1016/j.jceh.2014.12.010
       
  • Pregnancy and Vascular Liver Disease
    • Authors: Julien Bissonnette; François Durand, Emmanuelle de Raucourt, Pierre-François Ceccaldi, Aurélie Plessier, Dominique Valla, Pierre-Emmanuel Rautou
      Abstract: Vascular disorders of the liver frequently affect women of childbearing age. Pregnancy and the postpartum are prothrombotic states. Pregnancy seems to be a trigger for Budd–Chiari syndrome in patients with an underlying prothrombotic disorder. Whether pregnancy is a risk factor for other vascular liver disorders is unknown.In women with a known vascular liver disorder and a desire for pregnancy, stabilisation of the liver disease, including the use of a portal decompressive procedure when indicated, should be reached prior to conception.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-01-20
      DOI: 10.1016/j.jceh.2014.12.007
       
  • Amoebic Liver Abscess with Hepatic Artery Pseudoaneurysm: Successful
           Treatment by Interventional Radiology
    • Authors: Ajit K. Yadav; Saumya Gupta, Sudarsan Hariprasad, Ashish Kumar, Samarjit S. Ghuman, Arun Gupta
      Abstract: Amoebic liver abscess is most common extra-intestinal presentation of amoebiasis. It is rarely complicated with vascular involvement including thrombosis of hepatic vein or IVC and pseudo-aneurysm of hepatic artery. We describe a case of hepatic artery pseudo-aneurysm as a complication of amoebic liver abscess treated with percutaneous embolization.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-01-16
      DOI: 10.1016/j.jceh.2014.12.009
       
  • Gut Microbiota: Its Role in Hepatic Encephalopathy
    • Authors: Rahul Rai; Vivek A. Saraswat, Radha K. Dhiman
      Abstract: Ammonia, a key factor in the pathogenesis of hepatic encephalopathy (HE), is predominantly derived from urea breakdown by urease producing large intestinal bacteria and from small intestine and kidneys, where the enzyme glutaminases releases ammonia from circulating glutamine. Non-culture techniques like pyrosequencing of bacterial 16S ribosomal ribonucleic acid are used to characterize fecal microbiota. Fecal microbiota in patients with cirrhosis have been shown to alter with increasing Child-Turcotte-Pugh (CTP) and Model for End stage Liver Disease (MELD) scores, and with development of covert or overt HE.
      Citation: Journal of Clinical and Experimental Hepatology (2015)
      PubDate: 2015-01-06
      DOI: 10.1016/j.jceh.2014.12.003
       
  • Hepatic Encephalopathy: Historical Remarks
    • Authors: Piero Amodio
      Abstract: The history of hepatic encephalopathy (HE) is briefly reviewed since the beginning of western medicine by Hippocrates. For about 2000 years the main evidence was the mere association between jaundice, fever and delirium. A clear link between delirium and cirrhosis was proven in the 17th century by Morgagni. In subsequent times the focus was manly the descriptions of symptoms and the only pathophysiological improvement was the evidence that jaundice, per se, does not alter brain function. Only at the end of the 19th century Hann et al proved the role of portal-systemic shunt and pf nitrogenous derivates in the pathophysiology of the syndrome.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-12-25
      DOI: 10.1016/j.jceh.2014.12.005
       
  • Management in Acute Liver Failure
    • Authors: Shalimar; Subrat K. Acharya
      Abstract: Acute liver failure (ALF) is a rare, potentially fatal complication of severe hepatic illness resulting from various causes. In a clinical setting, severe hepatic injury is usually recognised by the appearance of jaundice, encephalopathy and coagulopathy. The central and most important clinical event in ALF is occurrence of hepatic encephalopathy (HE) and cerebral edema which is responsible for most of the fatalities in this serious clinical syndrome. The pathogenesis of encephalopathy and cerebral edema in ALF is unique and multifactorial.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-12-19
      DOI: 10.1016/j.jceh.2014.11.005
       
  • Minimal Hepatic Encephalopathy Impairs Quality of Life
    • Authors: Swastik Agrawal; Sridharan Umapathy, Radha K. Dhiman
      Abstract: Minimal hepatic encephalopathy (MHE) is the mildest form of the spectrum of neurocognitive impairment in cirrhosis. It is a frequent occurrence in patients of cirrhosis and is detectable only by specialized neurocognitive testing. MHE is a clinically significant disorder which impairs daily functioning, driving performance, work capability and learning ability. It also predisposes to the development of overt hepatic encephalopathy, increased falls and increased mortality. This results in impaired quality of life for the patient as well as significant social and economic burden for health providers and care givers.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-12-17
      DOI: 10.1016/j.jceh.2014.11.006
       
  • Definition and Nomenclature of Hepatic Encephalopathy
    • Authors: Narayan Dharel; Jasmohan S. Bajaj
      Abstract: Hepatic encephalopathy (HE) can manifest with a broad range of neuropsychiatric abnormalities of varying severity, acuity and time course with significant clinical implications. Lack of precise nomenclature and classification had hampered research in this complex clinical problem. A multiaxial classification system based on underlying etiology, clinical severity, time course and presence or absence of precipitating factors has been developed over the recent years and has been fully incorporated in the newly published AASLD-EASL guidelines on HE management.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-11-28
       
  • Acute-on-Chronic Liver Failure: Recent Concepts
    • Authors: Richard Moreau; Rajiv Jalan, Vicente Arroyo
      Abstract: A proportion of patients hospitalized for an acute complication of cirrhosis are at high risk of short-term death. The term Acute-on-Chronic Liver Failure (ACLF) is used to characterize these patients. Until recently there was no evidence-based definition of ACLF. In 2013 a definition has been proposed based on results of a large prospective observational European study, called “European Association for the Study of the Liver (EASL)–Chronic Liver Failure (CLIF) Consortium Acute-on-Chronic Liver Failure in Cirrhosis (CANONIC)” study.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-10-03
      DOI: 10.1016/j.jceh.2014.09.003
       
  • Encephalopathy in Wilson Disease: Copper Toxicity or Liver Failure'
    • Authors: Peter Ferenci; Tomasz Litwin, Joanna Seniow, Anna Czlonkowska
      Abstract: Hepatic encephalopathy (HE) is a complex syndrome of neurological and psychiatric signs and symptoms that is caused by portosystemic venous shunting with or without liver disease irrespective of its etiology. The most common presentation of Wilson disease (WD) is liver disease and is frequently associated with a wide spectrum of neurological and psychiatric symptoms. The genetic defect in WD leads to copper accumulation in the liver and later in other organs including the brain. In a patient presenting with Wilsonian cirrhosis neuropsychiatric symptoms may be caused either by the metabolic consequences of liver failure or by copper toxicity.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-09-20
      DOI: 10.1016/j.jceh.2014.09.002
       
  • Acute Portal Vein Thrombosis, No Longer a Contraindication for
           Transjugular Intrahepatic Porto-Systemic Shunt (TIPS) Insertion
    • Authors: Suraj Mammen; Shyamkumar N. Keshava, Sajith Kattiparambil
      Abstract: Portal vein thrombosis, once considered as a contraindication to transjugular intrahepatic porto-systemic shunt (TIPS) is now considered as an indication. We report a case with clinical and technical success in a patient with Budd Chiari syndrome and acute portal venous thrombosis. Though it is a well-established option, with the best of our knowledge, we could not find a report from India.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-09-20
      DOI: 10.1016/j.jceh.2014.08.008
       
  • Neuroinflammation in Hepatic Encephalopathy: Mechanistic Aspects
    • Authors: Arumugam R. Jayakumar; Kakulavarapu V. Rama Rao, Michael D. Norenberg
      Abstract: Hepatic encephalopathy (HE) is a major neurological complication of severe liver disease that presents in acute and chronic forms. While elevated brain ammonia level is known to be a major etiological factor in this disorder, recent studies have shown a significant role of neuroinflammation in the pathogenesis of both acute and chronic HE. This review summarizes the involvement of ammonia in the activation of microglia, as well as the means by which ammonia triggers inflammatory responses in these cells.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-08-05
      DOI: 10.1016/j.jceh.2014.07.006
       
  • Clinical Neurophysiology of Hepatic Encephalopathy
    • Authors: Piero Amodio; Sara Montagnese
      Abstract: Hepatic encephalopathy (HE) has relevant impact on the quality of life of patients and their caregivers and causes relevant costs because of hospitalizations and work days lost. Its quantification is important to perform adequate clinical trials on this relevant complication of cirrhosis and portal-systemic shunting. Clinical neurophysiology, which detects functional alterations of the nervous system, has been applied to the study of HE for over 60 years. This review aims at summarizing and clarifying the role of neurophysiologic techniques in the study of HE.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-08-03
      DOI: 10.1016/j.jceh.2014.06.007
       
  • Diagnosis of Minimal Hepatic Encephalopathy
    • Authors: Karin Weissenborn
      Abstract: Minimal hepatic encephalopathy (mHE) has significant impact upon a liver patient's daily living and health related quality of life. Therefore a majority of clinicians agree that mHE should be diagnosed and treated. The optimal means for diagnosing mHE, however, is controversial. This paper describes the currently most frequently used methods—EEG, critical flicker frequency, Continuous Reaction time Test, Inhibitory Control Test, computerized test batteries such as the Cognitive Drug Research test battery, the psychometric hepatic encephalopathy score (PHES) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)—and their pros and cons.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-07-31
      DOI: 10.1016/j.jceh.2014.06.005
       
  • Pathogenesis of Hepatic Encephalopathy: Role of Ammonia and Systemic
           Inflammation
    • Authors: Dominic R. Aldridge; Edward J. Tranah, Debbie L. Shawcross
      Abstract: The syndrome we refer to as Hepatic Encephalopathy (HE) was first characterized by a team of Nobel Prize winning physiologists led by Pavlov and Nencki at the Imperial Institute of Experimental Medicine in Russia in the 1890's. This focused upon the key observation that performing a portocaval shunt, which bypassed nitrogen-rich blood away from the liver, induced elevated blood and brain ammonia concentrations in association with profound neurobehavioral changes. There exists however a spectrum of metabolic encephalopathies attributable to a variety (or even absence) of liver hepatocellular dysfunctions and it is this spectrum rather than a single disease entity that has come to be defined as HE.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-06-30
      DOI: 10.1016/j.jceh.2014.06.004
       
  • Hepatic Encephalopathy and Sleepiness: An Interesting Connection'
    • Authors: Sara Montagnese; Matteo Turco, Piero Amodio
      Abstract: Sleep-wake abnormalities in patients with cirrhosis have been traditionally associated with hepatic encephalopathy (HE). In recent years, a certain amount of work has been devoted to the study of this relationship. This has lead to a modified picture, with weakening of the association between HE and poor night sleep, and the emergence of stronger links between HE and excessive daytime sleepiness. This brief review focuses on the evidence in favor of the interpretation of HE as a sleepiness syndrome, and on the diagnostic, therapeutic and social implications of such an interpretation.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-06-29
      DOI: 10.1016/j.jceh.2014.06.006
       
  • A Tribute to a Dear Colleague
    • Authors: Roger F. Butterworth
      Abstract: It was with great sadness that we learned that Joan (Juan) Cordoba, a dear colleague and friend had passed away. Born in Barcelona, Juan was quintessentially Spanish and a proud Catalan. He was the eldest of five children. Armed with his MD degree (cum laude in all subjects) from The University of Barcelona in 1987, Juan trained with the best on both sides of the Atlantic but it was the time he spent with Dr Andy Blei at North Western University in Chicago that fostered what was to become a career-long interest in hepatic encephalopathy (HE).
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-06-20
      DOI: 10.1016/j.jceh.2014.05.001
       
  • Approach to Clinical Syndrome of Jaundice and Encephalopathy in Tropics
    • Authors: Anil C. Anand; Hitendra K. Garg
      Abstract: A large number of patients present with jaundice and encephalopathy in tropical country like India and acute liver failure is the usual cause. Clinical presentation like ALF is also a complication of many tropical infections, and these conditions may mimic ALF but may have subtle differences from ALF. Moreover, what hepatologists see as acute liver failure in tropics is different from what is commonly described in Western Textbooks. Paracetamol overdose, which is possibly the commonest cause of ALF in UK and USA, is hardly ever seen in India.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-06-07
      DOI: 10.1016/j.jceh.2014.05.007
       
  • Management of Overt Hepatic Encephalopathy
    • Authors: Praveen Sharma; Barjesh C. Sharma
      Abstract: Hepatic encephalopathy (HE) is an important complication of cirrhosis with significant morbidity and mortality. Management of HE primarily involves avoidance of precipitating factors and administration of various ammonia-lowering therapies such as non-absorbable disaccharides, antimicrobial agents like rifaximin and l-ornithine l-aspartate. The non-absorbable disaccharides which include lactulose and lactitol are considered the first-line therapy for the treatment of HE and in primary and secondary prophylaxis of HE.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-05-08
      DOI: 10.1016/j.jceh.2014.04.004
       
  • Decellularization and Cell Seeding of Whole Liver Biologic Scaffolds
           Composed of Extracellular Matrix
    • Authors: Denver M. Faulk; Justin D. Wildemann, Stephen F. Badylak
      Abstract: The definitive treatment for patients with end-stage liver disease is orthotropic transplantation. However, this option is limited by the disparity between the number of patients needing transplantation and the number of available livers. This issue is becoming more severe as the population ages and as the number of new cases of end-stage liver failure increases. Patients fortunate enough to receive a transplant are required to receive immunosuppressive therapy and must live with the associated morbidity.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-03-31
      DOI: 10.1016/j.jceh.2014.03.043
       
  • Management of Covert Hepatic Encephalopathy
    • Authors: Abhijeet Waghray; Nisheet Waghray, Kevin Mullen
      Abstract: Hepatic encephalopathy is a reversible progressive neuropsychiatric disorder that encompasses a wide clinical spectrum. Covert hepatic encephalopathy is defined as patients with minimal hepatic encephalopathy and Grade I encephalopathy by West-Haven Criteria. Terminology such as “sub-clinical”, “latent”, and “minimal” appear to trivialize the disease and have been replaced by the term covert. The lack of clinical signs means that covert hepatic encephalopathy is rarely recognized or treated outside of clinical trials with options for therapy based on patients with episodic hepatic encephalopathy.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-02-27
      DOI: 10.1016/j.jceh.2014.02.007
       
  • Pathogenesis of Hepatic Encephalopathy and Brain Edema in Acute Liver
           Failure
    • Authors: Roger F. Butterworth
      Abstract: Neuropathologic investigations in acute liver failure (ALF) reveal significant alterations to neuroglia consisting of swelling of astrocytes leading to cytotoxic brain edema and intracranial hypertension as well as activation of microglia indicative of a central neuroinflammatory response. Increased arterial ammonia concentrations in patients with ALF are predictors of patients at risk for the development of brain herniation. Molecular and spectroscopic techniques in ALF reveal alterations in expression of an array of genes coding for neuroglial proteins involved in cell volume regulation and mitochondrial function as well as in the transport of neurotransmitter amino acids and in the synthesis of pro-inflammatory cytokines.
      Citation: Journal of Clinical and Experimental Hepatology (2014)
      PubDate: 2014-02-14
      DOI: 10.1016/j.jceh.2014.02.004
       
  • Magnetic Resonance Imaging and Spectroscopy in Hepatic Encephalopathy
    • Authors: Laia Chavarria; Juan Cordoba
      Abstract: Hepatic encephalopathy is a brain alteration associated to liver failure that produces cognitive impairments at long term. Neuroimaging are non-invasive methods for the study of the brain by means of spectroscopy and imaging techniques. These technologies give huge information about cerebral metabolism and water distribution to explore brain pathways involved in the pathogenesis of hepatic encephalopathy. Furthermore, new magnetic resonance implementations such as voxel-based morphometry or resting-state functional magnetic resonance imaging allow studying brain atrophy and neuronal connectivity of the cerebral network involved in the neurocognitive impairments observed in the patients.
      Citation: Journal of Clinical and Experimental Hepatology (2013)
      PubDate: 2013-10-28
       
 
 
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