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Journal Cover Journal of Clinical and Experimental Hepatology
  [SJR: 0.283]   [H-I: 7]   [3 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 0973-6883
   Published by Elsevier Homepage  [3043 journals]
  • Effects of Anaerobic Exercise in Muscle Strength and Muscle Mass
           Optimization in Bile Duct Ligated Rats
    • Authors: Luise Aamann; Rafael Ochoa-Sanchez, Marianna M. Oliveira, Mélanie Tremblay, Chantal Bemeur, Gitte Dam, Hendrik Vilstrup, Niels Kristian Aagaard, Christopher F. Rose
      Abstract: Background: During chronic liver disease (CLD) ammonia clearance is reduced and skeletal muscle becomes an alternative source for ammonia detoxification. However, in CLD, sarcopenia is a common complication, which affects clinical outcomes. Hence, optimization of skeletal muscle is a potential important target to treat hyperammonemia. Exercise has demonstrated to stimulate protein synthesis and enhance muscle mass in various chronic diseases. However, in CLD there are few studies demonstrating a beneficial effect of exercise on muscle mass.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.118
      Issue No: Vol. 7 (2017)
       
  • Acute Ammonia Intoxication-Induced Seizures but not Ammonia Per Se
           Contribute to the Electrophysiological Changes in Rat Brain
    • Authors: G. Durgadevi
      Abstract: Background and Aim: Hepatic encephalopathy (HE) is a major complication in patients with mild to severe liver disease. HE is characterized by confusion, inverted sleep-wake cycles, disorientation, behavioral changes, impaired cognition, and motor disturbances, as well as increased brain edema and intracranial pressure. The molecular basis for these changes in HE remains unclear. Elevated blood and brain ammonia levels have been strongly implicated in its pathogenesis. Whether ammonia play any role in electrophysiological changes in HE that may be involved in neurobehavioral, biochemical and molecular changes observed in HE was examined.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.117
      Issue No: Vol. 7 (2017)
       
  • Arterial Ammonia Independently Predicts Outcome in Acute on Chronic Liver
           Failure
    • Authors: Shalimar; Saurabh Kedia, Ujjwal Sonika, Shekhar Jadaun, Sandeep Goyal, Baibaswata Nayak, Deepak Gunjan, Mona Pathak, Subrat Kumar Acharya
      Abstract: Background and Aim: Elevated ammonia correlates with outcome and complications in acute liver failure. However, role of arterial ammonia in predicting outcome of acute on chronic liver failure (ACLF) is unclear. We evaluated the association of arterial ammonia with complications and outcome in ACLF.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.110
      Issue No: Vol. 7 (2017)
       
  • Hyperammonemia Alters Glycine Receptors Activation, Cl− and Ca2+ and
           CaMKII and Impairs Learning. Restoration by Extracellular cGMP
    • Authors: Andrea Cabrera-Pastor
      Abstract: Background and Aim: Hyperammonemia contributes to cognitive impairment in patients with hepatic encephalopathy. Extracellular cGMP restores learning in hyperammonemic rats by mechanisms which remain unknown. We hypothesized that extracellular cGMP would restore learning by restoring the glutamate-nitric oxide (NO)-cGMP pathway function in cerebellum. The aims were: (1) assess whether extracellular cGMP restores the glutamate-NO-cGMP pathway in hyperammonemic rats in vivo; (2) identify the membrane molecule sensing extracellular cGMP and transducing the signal to the intracellular pathway and its alterations in hyperammonemia; (3) analyze intracellular steps modulated by extracellular cGMP and their alterations in hyperammonemia; (4) identify mechanisms by which hyperammonemia impairs the glutamate-NO-cGMP pathway.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.109
      Issue No: Vol. 7 (2017)
       
  • Tadalafil, A Phosphodiesterase-5 Inhibitor, Improves Erectile Dysfunction
           in Patients With Liver Cirrhosis
    • Authors: Jitender Thakur; Sahaj Rathi, Sandeep Grover, Madhu Chopra, Sunil Taneja, Ajay Duseja, Yogesh Chawla, Anil Bhansali, Radha K. Dhiman
      Abstract: Background and Aim: Erectile dysfunction (ED) is a common in patients with chronic liver disease (CLD). It may be a consequence of the disease per se, or a side effect of medications. Though ED leads to a significant deterioration in the quality of life, it is often neglected by most caregivers as well as researchers. This study evaluates the prevalence of ED in patients with CLD, associated factors, and response to therapy.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.108
      Issue No: Vol. 7 (2017)
       
  • Sleep Disturbances in Patients of Liver Cirrhosis With Minimal Hepatic
           Encephalopathy
    • Authors: Jatinderpal Singh; Barjesh Chander Sharma, Vinod Puri
      Abstract: Background: Minimal hepatic encephalopathy (MHE) represents the mildest form of hepatic encephalopathy without coagnitive impairment, but patients have abnormal neuropsychologic and/or neurophysiologic findings indicative of cerebral dysfunction. Sleep disturbances and excessive daytime sleepiness have been reported in patients with cirrhosis of liver. In this study we compared various sleep parameters including Polysomnography(PSG), Epworth sleepiness scale(ESS), Pittsburg sleep quality index(PSQI) and Health related quality of life(HRQOL) in patients of liver cirrhosis with and without MHE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.107
      Issue No: Vol. 7 (2017)
       
  • Elucidation of Pro-Inflammatory and Anti-Inflammatory Interleukins in
           Hepatic Encephalopathy in Patients Presenting With Hepatocellular
           Carcinoma
    • Authors: Gaurav Roy; Praveen Sharma, Anil Arora
      Abstract: Background: The objective of this study was to evaluate the expression profile of pro-inflammatory (IL-15 and IL-18) and anti-inflammatory (IL-10 and IL-13) interleukins at both transcriptional and translational levels in hepatic encephalopathy (HE) in patients presenting with hepatocellular carcinoma (HCC) and opting for living donor liver transplantation (LDLT) as a therapeutic regimen.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.106
      Issue No: Vol. 7 (2017)
       
  • Rifaximin for the Prevention and Treatment of Hepatic Encephalopathy: A
           Systematic Review With Meta-Analyses of Randomised Controlled Trials
    • Authors: Nina Kimer; Lise Lotte Gluud, Richard W. Morris, Marsha Y. Morgan
      Abstract: Background: The main licensed indication for rifaximin is the prevention of recurrent hepatic encephalopathy (HE) after an index event although many early trials showed it was an efficacious treatment for both acute and chronic HE. The aim of this study was to assess the efficacy and safety of rifaximin in patients with cirrhosis by undertaking meta-analyses of RCTs comparing rifaximin vs. placebo/no intervention or vs. non-absorbable disaccharides (NADs).
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.105
      Issue No: Vol. 7 (2017)
       
  • Driving Competency In Cirrhosis: Evaluation of An In-Office Screening Tool
    • Authors: Tara Pidborochynski; Puneeta Tandon, Bonnie Dobbs
      Abstract: Background: Clinicians lack a practical strategy to evaluate driving risk in patients with cirrhosis. A diagnosis of MHE has been linked to impairments in driving competency but MHE screening is not a routine part of clinical practice as it's time consuming, and a diagnosis of MHE is not uniformly associated with “at-risk driving”. The alternative strategy to identify at-risk individuals for declines in driving competency, which is testing cirrhosis patients with an on-road driving test, also is not cost or time-efficient.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.104
      Issue No: Vol. 7 (2017)
       
  • Ammonia Is A Predictor of HE and Mortality In Cirrhosis and Acute On
           Chronic Liver Failure (ACLF)
    • Authors: Mohammed Sheikh; Natalia Arias, Karen Thomsen, Rocio Gallego-Durán, Banwari Agarwal, Rajiv Jalan
      Abstract: Background & Aim: Acute-on-chronic liver failure (ACLF) is characterized by acute deterioration of cirrhosis, systemic inflammation and multi-organ failure. While the role of ammonia in the development of HE in acute liver failure (ALF) is well established, less is known about its relationship with ACLF and the progression of HE in this context. HE in cirrhosis and ACLF results in increased mortality, however the utility of serum ammonia in predicting severity of HE or mortality remains unclear.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.103
      Issue No: Vol. 7 (2017)
       
  • Minimal Hepatic Encephalopathy Is An Under Recognized Entity in Clinical
           Practice Of Bangladeshi Physicians
    • Authors: Mohammed Forhad Abedin; Mamun Al Mahtab, Sheikh Mohammad Fazle Akbar, Nooruddin Ahmad
      Abstract: Background and Aim: Minimal hepatic encephalopathy is characterized by subtle motor and cognitive deficits and impairs health related quality of life. Though the prevalence of minimal hepatic encephalopathy in cirrhotic patients is high, but awareness regarding minimal hepatic encephalopathy is not yet satisfactory. More over for diagnosis of minimal hepatic encephalopathy, the cutoff normative value for psychometric test is not yet established in Bangladesh. This is the first study in Bangladesh to find out the normative value for psychometric test and see the prevalence minimal hepatic encephalopathy in cirrhotic patients.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.102
      Issue No: Vol. 7 (2017)
       
  • The Neuronal TDP-43 and Tau Proteinopathies in Chronic Liver Failure: Role
           of Astrocytes and Microglia
    • Authors: A.R. Jayakumar; Michael D. Norenberg
      Abstract: Chronic hepatic encephalopathy (CHE) due to chronic liver failure, is characterized by mental confusion, disorientation, behavioral changes, impaired cognition, and motor disturbances. The molecular basis for this neuropsychiatric disorder remains elusive. Transactivating DNA-binding protein-43 (TDP-43) inclusions and the accumulation of phosphorylated and ubiquitinated Tau protein (p-Tau) have been identified in various neurological disorders (e.g., amyotrophic lateral sclerosis, fronto-temporal lobar degeneration, ischemia, Alzheimer's disease), and such changes have been strongly implicated in the development of the neurobehavioral deficits associated with these neurological disorders.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.101
      Issue No: Vol. 7 (2017)
       
  • Aetiology, Outcome and Predictors of Mortality of Viral Related Acute
           Liver Failure: A Single Centre Prospective Cohort Study
    • Authors: Chetan Kalal; Rakhi Maiwall, Shiv Sarin
      Abstract: Background: Acute liver failure (ALF)is a disease with high mortality. Intensive care and liver transplantation provide support and rescue. Cerebral edema forms the core of hepatic encephalopathy (HE) and poor outcome along with sepsis and multiorgan dysfunction. There is a paucity of studies on prognostic factors of viral-related ALF.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.100
      Issue No: Vol. 7 (2017)
       
  • Early Increase in Ammonia Is A Feature of Non-Alcoholic Fatty Liver
           Disease and the Ammonia Lowering Drug, Ornithine Phenylacetate (OCR002)
           Prevents Progression of Fibrosis in A Rodent Model
    • Authors: Francesco De Chiara; Abe Habtension, Nathan Davies, Fausto Andreola, Krista Rombouts, Natalia Arias, Karen Louise Thomsen, Rajiv Jalan
      Abstract: Background and Aim: Fibrosis is a key driver of increased mortality of patients with Non-Alcoholic Fatty Liver disease (NAFLD) (JHepatology 2015). Hepatic stellate cells (HSCs) are key cells involved in the development of fibrosis and its progression. Hyperammonemia provoked activation of human HSCs in vitro and in vivo, which was reduced upon Ornithine Phenylacetate (OCR002) administration (JHepatology 2016). In models of experimental NASH, gene and protein expression of the mitochondrial urea cycle enzyme ornithine transcarbamylase (OTC) is reduced significantly, resulting in hyperammonemia.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.099
      Issue No: Vol. 7 (2017)
       
  • Elevated Systemic Zonula Occludens 1 Is Positively Correlated With
           Hyperammonemia and Inflammation in Patients With Cirrhosis
    • Authors: Ashwini Karthikeyan; P. Pazhanivel Mohan, Balasubramaniyan Vairappan
      Abstract: Background/Aim: In liver cirrhosis, disruption of the intestinal barrier function increases intestinal permeability, which contributes to endotoxemia and derangement in liver cirrhosis. In acute liver failure, cerebral endothelial cells formed tight junctions are compromised, which may lead to increased paracellular permeability across the blood-brain barrier (BBB). The aim of this study was to assess and compare the blood concentrations of ZO-1 with systemic ammonia and inflammatory marker in patients with cirrhosis and healthy individuals.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.098
      Issue No: Vol. 7 (2017)
       
  • Prometheus Versus Plasma Exchange — A Comparison Of Efficiency Of Two
           Different Modalities Of Liver Detoxification In Patients With Acute On
           Chronic Liver Failure
    • Authors: Rakhi Maiwall; Guresh Kumar, Meenu Bajpai, Suman Lata Nayak, Ashok Chowdhury, Manoj Kumar Sharma, Brajesh Chander Sharma, Shiv Kumar Sarin
      Abstract: Background and Aim: Patients with Acute on Chronic Liver Failure (ACLF) have very high mortality in the absence of liver transplantation (LT). Artificial liver support (ALS) has been shown to provide an effective bridging therapy; though the data is conflicting. We evaluated the transplant-free survival in patients with ACLF treated with ALS; i.e. plasma-exchange (PE) or liver dialysis (FPSA) as compared to standard medical treatment (SMT) and predictors of survival. We also compared the efficacy of PE as compared to FPSA in patients with ACLF.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.097
      Issue No: Vol. 7 (2017)
       
  • Changes on Cerebral Hemodynamics in Cirrhotic Patients after Liver
           Transplantation
    • Authors: Ricardo Ulises Macías-Rodríguez; Astrid Ruiz-Margáin, Carlos Cantú-Brito, Francisco Javier Cubero, Octavio René García Flores, Elena Larrieta-Carrasco, Aldo Torre
      Abstract: Background and aims: Improvement in cognitive function after LT has been related to decreased cerebral white matter lesions induced by microvascular lesions (leukoaraiosis) secondary to low-grade cerebral edema and systemic inflammation. However most of studies have addressed these changes in the acute setting during and immediately after LT in cirrhosis as well as in acute liver failure and few have evaluated the long-term changes in cerebral hemodynamics in this population, therefore we aimed to investigate the long-term changes on cerebral hemodynamics in cirrhotic patients after LT.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.095
      Issue No: Vol. 7 (2017)
       
  • Extrapyramidal Signs and Health Related Quality of Life in Patients with
           Cirrhosis
    • Authors: Sunil Taneja; M.N. Pathak, Sahaj Rathi, Ajay Duseja, Yogesh K. Chawla, Radha K. Dhiman
      Abstract: Background & Aims: The spectrum of neurological dysfunction in cirrhosis varies from mild cognitive impairment to a full blown extrapyramidal syndrome referred to as hepatocerebral degeneration. However there is little information about the clinical significance of extrapyramidal signs associated with cirrhosis, and it is influence on the prevalence of MHE and daily-life activities or health-related quality of life (HRQOL) of patients. Hence this present study was carried out to elucidate the relationship between extrapyramidal signs and cognitive impairment with MHE and quality of life.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.094
      Issue No: Vol. 7 (2017)
       
  • Significant Increase in Intestinal Permeability in Acute-On-Chronic Liver
           Failure (ACLF) is Reversed after Slow Albuminfurosemide Infusion with or
           without Terlipressin
    • Authors: Vivek Saraswat; Gaurav Pandey, Dinesh Kumar, Umesh Kumar, Krishna Vp, Anupam Guleria
      Abstract: Background: Increased intestinal permeability (IP), increased bacterial translocation (BT), small intestinal bacterial overgrowth (SIBO) and gut dysbiosis are well known in liver cirrhosis (LC). In acute-on-chronic liver failure (ACLF), marked increase in IP and BT may occur due to a surge in portal hypertension. Control of large ascites in ACLF with the use of slow albumin-furosemide infusion with or without terlipressin (SAFI±T) may decongest the bowel mucosa and reduce the increased IP in these patients.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.093
      Issue No: Vol. 7 (2017)
       
  • Plasma Nitrotyrosine Level does not Differentiate between Patients with
           Minimal Hepatic Encephalopathy and without Minimal Hepatic Encephalopathy
           in Liver Cirrhosis
    • Authors: Ajmal Hasan; Deepak Gunjan, Jaya Benjamin, Mamta Bhusan Singh, Yogendra Kumar Joshi, Anoop Saraya
      Abstract: Background and Aim: Patients with minimal hepatic encephalopathy (MHE) have mild cognitive and psychomotor deficits with normal mental clinical examination. MHE is associated with increased morbidity and poor prognosis. There is no gold standard test for the diagnosis of MHE and existing tests are either time consuming or need sophisticated equipment. Reliable peripheral biomarker for MHE is lacking. Our aim is to study the use of plasma nitrotyrosine level for the diagnosis of MHE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.092
      Issue No: Vol. 7 (2017)
       
  • Functional Cortical Connectivity is Disturbed in Patients with Cirrhosis
           Even When Neuropsychometric Performance is Unimpaired
    • Authors: Harry Zacharias; Clive D. Jackson, Asbjørn M. Drewes, Marsha Y. Morgan, Søren S. Olesen
      Abstract: Introduction: Disordered brain connectivity, generally defined as failure of effective functional integration within/between brain areas, is thought to be the core deficit in several mental health disorders. Functional connectivity is the term used to define the temporal synchrony or correlation among signals of two or more segregated regions. Most methods for assessing functional connectivity within EEG analysis investigate the phase-relationships between the signals from different scalp electrodes.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.091
      Issue No: Vol. 7 (2017)
       
  • Can Liver Transplant be a Cure of Encephalopathy without End Stage Liver
           Disease or Liver Failure
    • Authors: Neelam Mohan; Sakshi Karkra, A.S. Soin
      Abstract: Introduction: Encephalopathy is manifested by an altered mental state that is sometimes accompanied by physical changes. Liver-transplantation (LT) cure for encephalopathy secondary to infections, metabolic-disorders, drugs and toxins with primary involvement of liver is a known entity. LT may also serve as a cure for certain non-hepatic-metabolic encephalopathy.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.090
      Issue No: Vol. 7 (2017)
       
  • Brain Metabolic Changes in Developing Brain Due to Chronic Liver Disease:
           An In Vivo Longitudinal and Multiparametric Study Using 31P MRS, 31P
           Magnetization Transfer and 1H MRS
    • Authors: Veronika Rackayova; Vladimir Mlynarik, Cristina Cudalbu
      Abstract: Motivation: Chronic liver disease(CLD) is a serious condition leading to increased toxins in the blood(e.g. ammonia, bilirubin, bile acids, inflammatory factors) which generate brain alterations accompanied by neurocognitive deficits referred to as chronic hepatic encephalopathy (CHE). Previous studies suggested that oxidative stress and energy metabolism perturbations can also play a crucial role in pathogenesis of CHE in addition to Gln and ammonium increase. Our previous studies on brain metabolism in adult brain did not show serious energy alterations caused by CLD.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.089
      Issue No: Vol. 7 (2017)
       
  • Prevalence of Minimal Hepatic Encephalopathy in Patients with Liver
           Cirrhosis: A Cross-Sectional, Clinico Epidemiological, Multicenter,
           Nationwide Study in India: The Predict Study
    • Authors: Sahaj Rathi; Madhu Chopra, Gourdas Chouduri, Praveen Sharma, Kaushal Madan, Mohinish Chhabra, Ramesh Roop Rai, Anurag Govil, Asokananda Konar, Mahesh Goenka, Manoj Agarwal, Jayanta Mukherjee, Vinay Thorat, Sanjay Salunkhe, Philip Abraham, Aabha Nagral, Ajay Jhaveri, Naresh Bhat, Joy Varghese, R.S. Arun, Ravishankar, Deevaguntla Chandrashekar Reddy, Radha K. Dhiman
      Abstract: Objectives: The study aimed to assess the prevalence and clinical profile of minimal hepatic encephalopathy (MHE) in patients with cirrhosis using neuropsychological assessment, and to understand the management practices of MHE in the Indian clinical setting.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.088
      Issue No: Vol. 7 (2017)
       
  • l-Ornithine l-Aspartate for Hepatic Encephalopathy: A Systematic Review
           with Meta-Analyses of Randomised Controlled Trials
    • Authors: Ee Teng Goh; Caroline S Stokes, Hendrik Vilstrup, Lise Lotte Gluud, Marsha Y. Morgan
      Abstract: Background and Aim: Ammonia plays a key role in the pathogenesis of hepatic encephalopathy (HE). l-Ornithine l-aspartate (LOLA) has documented ammonia-lowering properties. The aim of this study was to undertake a systematic review with meta-analysis of randomised controlled trials (RCTs) comparing LOLA versus placebo/no intervention or other active interventions to assess its efficacy and safety in the prevention and treatment of HE in patients with cirrhosis
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.087
      Issue No: Vol. 7 (2017)
       
  • Abnormalities in Skin Temperature and its 24-Hour Rhythm in Patients with
           Cirrhosis: Sleep-Wake and General Clinical Implications
    • Authors: Maria Garrido; Desy Saccardo, Michele De Rui, Elia Vettore, Alberto Verardo, Paolo Carraro, Nicola Di Vitofrancesco, Ali Reza Mani, Paolo Angeli, Massimo Bolognesi, Sara Montagnese
      Abstract: Background and aims: Sleep preparation/onset are associated with peripheral vasodilatation and a decrease in body temperature. It is possible that the hyperdynamic syndrome exhibited by patients with cirrhosis may impinge on sleep preparation mechanisms, thus contributing to the difficulties falling asleep exhibited by these patients. The aim of this study was the assessment of skin temperature/their 24-hour rhythm in patients with cirrhosis of varying severity, in relation to sleep-wake patterns.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.086
      Issue No: Vol. 7 (2017)
       
  • Nutritional Status Assessment in Patients with Chronic Liver Disease: A
           Pilot Study
    • Authors: Annie Lamoussenerie; Cassandra Picinbono-Larose, Melanie Tremblay, Catherine Demers, Catherine Vincent, Genevieve Huard, Christopher Rose, Chantal Bemeur
      Abstract: Background: Malnutrition is one of the most common complications in the increasing number of patients suffering from chronic liver disease (CLD) and is a leading cause of morbidity and mortality. Traditional tools used to evaluate nutritional status are not reliable in CLD due to limitations related to weight, which may be artificially increased by the presence of ascites, underestimating malnutrition. New strategies to assess nutritional status focusing on early malnutrition detection are an unmet clinical need.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.085
      Issue No: Vol. 7 (2017)
       
  • Impact of Nutritional Status on Hepatic Encephalopathy and Quality of Life
           in Patients with Chronic Liver Disease: Preliminary Results of a
           Prospective Study
    • Authors: Cassandra Picinbono-Larose; Annie Lamoussenerie, Mélanie Tremblay, Catherine Vincent, Geneviève Huard, Christopher F. Rose, Chantal Bémeur
      Abstract: Background: Malnutrition is an important prognostic factor potentially influencing clinical outcome of patients suffering from chronic liver disease (cirrhosis; CLD). Malnutrition may increase the risk of developing other complications including hepatic encephalopathy (HE). Malnutrition in cirrhosis may also affect patient's functional status and wellbeing or health-related quality of life (HRQOL). Management strategies focussing on nutritional status in relation to complications of cirrhosis are an unmet clinical need.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.084
      Issue No: Vol. 7 (2017)
       
  • Neutrophil Dysfunction Patterns in Early Cirrhosis could be used to Help
           Identify Patients with Hepatic Encephalopathy
    • Authors: Haw Lu; Jane Macnaughtan, Rohit Swahney, Helen Jones, Alba Moratalla, Francesco Figorelli, Marco Bondoc, Gavin Wright, Nathan Davies, Raj Mookerjee, Rajiv Jalan
      Abstract: Background and Aim: Neutrophil dysfunction has been described in cirrhosis and has been shown to worsen with severity of disease. There is a known link between the impairment of neutrophil function and the risk of infection. In patients with well compensated disease, the variations in neutrophil dysfunction between subgroups of patients have never been compared. The aim of this study was to evaluate neutrophil function in early cirrhosis and determine whether specific abnormalities were associated with hepatic encephalopathy.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.083
      Issue No: Vol. 7 (2017)
       
  • Critical Flicker Frequency Predicts Progression among Stages of Cirrhosis
    • Authors: Javier Ampuero; Virginia Aguilera, Carmina Montoliu, Macarena Simon-Talero, Carmen Sendra, Celina Marquez, Rodrigo Jover, Raquel Millan, Manuel Romero-Gomez
      Abstract: Background: Minimal hepatic encephalopathy (MHE) predicts poor survival in cirrhotic patients (Ampuero, Gastroenterology 2015). However, the direct impact of MHE on the cirrhosis progression is unknown.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.082
      Issue No: Vol. 7 (2017)
       
  • Cirrhotic Patients in ICU with Gastro-Intestinal Bleeding Managed
           According to Recent Guidelines Display Altered Brain Hemoglobin Oxygen's
           Saturation Assessed by near Infrared Spectroscopy
    • Authors: Maxime Mallet; Simona Tripon, Marika Rudler, Dominique Thabut, Nicolas Weiss
      Abstract: Background and aims: Near Infrared Spectroscopy (NIRS) is a non-invasive optical technique allowing a continuous measurement of brain's hemoglobin saturation in oxygen (rSO2). It is considered as a surrogate marker of cerebral insult, and recognized as a useful tool in cardiovascular surgery and neuromonitoring. A rSO2
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.081
      Issue No: Vol. 7 (2017)
       
  • Treatment of HE Through Selective Alpha 2A Adrenergic Receptor Antagonism
           Improves Higher Brain Function in Cirrhosis
    • Authors: Helen Jones; Natalia Arias, Nathan Davies, Rajiv Jalan, Rajeshwar P. Mookerjee
      Abstract: Background and aims: Hepatic encephalopathy (HE) has been shown to affect daily functioning, quality of life, driving and overall mortality. However, HE is a multifactorial disease not clinically easy to assess. Many mechanisms have been proposed, one of which is altered adrenergic signaling. One animal model available for studying HE resulting from cirrhosis is chronic administration of the hepatotoxin thioacetamide (TAA) which mimics the clinical characteristics of cirrhosis including portal hypertension and HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.080
      Issue No: Vol. 7 (2017)
       
  • Development of a New Animal Model of Obesity and Chronic Liver Disease for
           the Study of Hepatic Encephalopathy
    • Authors: Rafael Ochoa-Sanchez; Mélanie Tremblay, Marc-André Clément, Marcos Ocaña-Sanchez, Christopher F. Rose
      Abstract: Background: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome, a major complication of chronic liver disease (CLD/cirrhosis). With an increasing prevalence of obesity-induced cirrhosis and evidence linking blood-derived lipids to neurological impairment, we hypothesize that obesity increases the risk, severity and progression of HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.079
      Issue No: Vol. 7 (2017)
       
  • Towards a New Model of Ammonia-induced Brain Edema in the Mouse
    • Authors: Juan Bañares; Marta Puerto, Luis Ibañez, Rita García-Martínez, Rafael Bañares, Javier Vaquero
      Abstract: Background: The absence of adequate experimental models of hepatic encephalopathy (HE) in the mouse is a major hurdle for research on HE. Major pitfalls of current murine models of HE include difficult reproducibility, direct effects of hepatotoxic agents on the brain, or the potential influence of modified genes on liver injury itself. These problems seriously limit the use of transgenic mice in the field of HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.078
      Issue No: Vol. 7 (2017)
       
  • Metformin Modifies Glutamine Metabolism in an In Vitro and in Vivo Model
           of Hepatic Encephalopathy
    • Authors: Antonio Gil-Gomez; Ana Isabel, Gomez-Sotelo, Isidora Ranchal, Marta Garcia-Valdecasas, Angela Rojas, Rocio Gallego-Duran, Eduardo Vilar-Gomez, Javier Ampuero, Manuel Romero-Gomez
      Abstract: Introduction: It has been recently demonstrated that metformin protects cirrhotic patients against hepatic encephalopathy development. K-type glutaminase activity is increased in HE and it has been proposed as the main source of ammonia in liver disease. The aim of this work was to analyze the effect of metformin on ammonia production derived from glutamine metabolism in vitro and in vivo.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.077
      Issue No: Vol. 7 (2017)
       
  • Prevalence of Acute Kidney Injury at Presentation in Chronic Liver Disease
           Patients - A Prospective Study
    • Authors: Ajay Kumar Jain; Rahul Agrawal, Suchita Jain, Sandeep Ware, Sohini Sircar, Amit Bundiwal, Sandeep Kaulavakar, Suresh Hirani, Amit Joshi, Rushi Pipawat, Debi Chatterjee
      Abstract: Background: Acute kidney injury (AKI) constitutes an important cause of morbidity and mortality among patient with chronic liver disease (CLD). Its etiologies are varied and if diagnosed early, outcome may be good in majority. Hence we aimed this study.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.076
      Issue No: Vol. 7 (2017)
       
  • Model for Early Prediction of Mortality (MEPM) in Patients with Cirrhosis
           and Acute Decompensation
    • Authors: Tarana Gupta; Radha Dhiman, Sahaj Rathi, Swastik Agrawal, Ajay Duseja, Yogesh Chawla
      Abstract: Background and Aims: Compensated cirrhosis is a relatively stable state with a median survival of 12.2 years, whereas after decompensation the 1- and 2-year survival reduces to 60% and 45% respectively. Acute decompensation in cirrhosis changes the natural history of cirrhosis with poor outcome. We aimed to develop and validate a model for early prediction of mortality (MEPM) in acute decompensation and to compare it with various prognostic scores.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.075
      Issue No: Vol. 7 (2017)
       
  • A Randomized Double Blind Placebo Controlled Trial about the Effect of
           Probiotics on Cognitive Findings of Children with Portal Hypertension
    • Authors: Valeria Casotti; Lorenzo D’Antiga, Lorella Caffi, Stefano Quadri, Mara Colusso, Ave Biffi, Piero Amodio
      Abstract: Background/Aims: Children with portal hypertension develop portal systemic shunting resulting in minimal HE, even without the occurrence of cirrhosis. Recent data showed that probiotic treatment is effective to treat minimal HE in adults with cirrhosis. We, therefore, planned a trial to find the effect size and the variability of minimal HE findings in children with portal hypertension.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.074
      Issue No: Vol. 7 (2017)
       
  • Fecal Microbiota Transplantation in Management of Hepatic Encephalopathy
    • Authors: Sandeep Singh Sidhu; Sahil Nohria, Simran Sidhu
      Abstract: Background and Aim: Ammonia generated by the enteric bacteria is a critical driver of Hepatic Encepalopathy (HE) [1]. The microbiota in patients with liver cirrhosis have more urease-producing bacteria associated with increased production of ammonia and lipopolysaccharide (LPS) The current treatment is lactulose and/or rifaximin, both of which target the gut microbiota [2]. A recent case report describes improvement of covert HE with weekly FMT [3]. As gut dysbiosis is thought to contribute to HE, we hypothesized that manipulating the gut microbiome through fecal microbiota transplantation (FMT) could reverse intestinal dysbiosis and result in cognitive improvement in overt HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.073
      Issue No: Vol. 7 (2017)
       
  • Rifaximin in Chronic Liver Disease-induced Hepatic Encephalopathy: An In
           Vivo Longitudinal Study of Brain Metabolism on BDL Rats
    • Authors: Emmanuelle Flatt; Cristina Cudalbu, Olivier Braissant, Stefan Mitrea, Dario Sessa, Rolf Gruetter, Valérie McLin
      Abstract: Hepatic encephalopathy (HE) is a severe complication of chronic liver disease (CLD), the treatment of which focuses on reducing plasma ammonia levels implicated in HE pathogenesis. The non-absorbable antibiotic rifaximin inhibits the division of colonic bacteria responsible for urea deamination, reducing the production of gut ammonia. In humans, rifaximin has been shown to reduce the frequency of HE episodes, but the molecular mechanisms behind this effect are unknown. Therefore, our aim was to assess, in vivo and longitudinally, the effect of rifaximin on brain metabolites in bile duct ligated (BDL) rats using high-field proton Magnetic Resonance Spectroscopy (1H-MRS).
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.072
      Issue No: Vol. 7 (2017)
       
  • Statistical Multi-State Modelling of Progression from Acute Liver Failure
           to Intracranial Hypertension and Death
    • Authors: Peter Nissen Bjerring; Fin Stolze Larsen
      Abstract: Background and Aims: The clinical course of patients with acute liver failure (ALF) is associated with a high risk of intracranial hypertension and death. Efforts to investigate risk factors for developing intracranial hypertension (ICH) are challenged by the competing risk situation given by the high mortality. In this study we aim to identify risk factors of development of intracranial hypertension in a cohort of high-risk ALF patients by the use of multi-state modelling.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.071
      Issue No: Vol. 7 (2017)
       
  • Does Minimal Hepatic Encephalopathy Predict Development of Overt Hepatic
           Encephalopathy in Children with Chronic Liver Disease'
    • Authors: Anshu Srivastava; Saurabh Chaturvedi, Surender Kumar Yachha, Rakesh Kumar Gupta, Chandra M. Pandey
      Abstract: Introduction and aim: Minimal hepatic encephalopathy (MHE) predicts development of overt hepatic encephalopathy (OHE) in adults with chronic liver disease (CLD) 1. However, there is scarce data on MHE in children with CLD and no information regarding its role in the prediction of OHE. The aim was to evaluate if CLD children with MHE are at a higher risk of developing OHE than those without MHE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.070
      Issue No: Vol. 7 (2017)
       
  • Brain Glymphatic Clearance is Impaired in a Rat Model of Cirrhosis
    • Authors: Anna Hadjihambi; Ian Harrison, Giovanni Rizzo, Jane Macnaughtan, Nigel Beaton, Nathan Davies, Abeba Habtetion, Rajiv Jalan
      Abstract: Background and Aims: The “glymphatic system” is the global waste clearance pathway of the brain, which effectively eliminates metabolites and waste products from the CNS through cerebrospinal (CSF) and interstitial fluid (ISF) exchange. This process depends on the use of the perivascular tunnels, formed by astrocytes and it is mostly active during sleep. Evidence exist indicating altered clearance of the brain during certain pathologies such as Alzheimer's disease and traumatic brain injury. In patients with hepatic encephalopathy (HE) sleep disturbances are reported and changes in the cerebrospinal fluid composition have been identified, such as elevated acetylated compounds, amino acids and bile acids suggesting alterations in metabolic pathways.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.069
      Issue No: Vol. 7 (2017)
       
  • Monocyte HLA-DR Expression, Neutrophil Oxidative Burst Capacity and
           Cytokine Analysis in Patients with Decompensated Cirrhosis with and
           Without Acute-on-Chronic Liver Failure (ACLF)
    • Authors: Sandeep Satsangi; Ajay Duseja, Meenakshi Sachdeva, Shallu Tomer, Sunil Arora, Sunil Taneja, Radha K. Dhiman, Yogesh K. Chawla
      Abstract: Introduction: Patients with acute-on-chronic liver failure (ACLF) are at increased risk of infection due to a dysregulated immune response. The comparative data on the presence of such ‘immune paresis’ in patients with ACLF and decompensated cirrhosis without ACLF is not available.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.068
      Issue No: Vol. 7 (2017)
       
  • Lactulose Acceptance Varies between Indian and American Covert HE
           Patients: Implications for Comparing, Designing and Interpreting Global HE
           Trials
    • Authors: Sahaj Rathi; Andrew Fagan, James Wade, Melanie B. White, Dinesh Ganapathy, Radha K. Dhiman, Jasmohan S. Bajaj
      Abstract: Background: Lactulose is considered first-line for covert HE (CHE) but its acceptance rate widely differs between Western and Eastern HE studies, possibly due to cultural factors related to bowel movement frequencies. Cirrhosis patient preference for lactulose between different parts of the world has not been examined systematically.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.067
      Issue No: Vol. 7 (2017)
       
  • Impaired Cerebral Oxygenation, But Preserved Cerebrovascular Reactivity,
           In An Animal Model of Hepatic Encephalopathy
    • Authors: Patrick S. Hosford; Anna Hadjihambi, Rajiv Jalan, Alexander V. Gourine
      Abstract: Introduction: We have recently obtained evidence of energy deficiency, in the form of impaired lactate release, in the brains of cirrhotic animals with hepatic encephalopathy (HE). Previous reports of cerebral hypoperfusion in patients with HE indicated that cerebral oxygen supply could also be compromised [1]. Decreased lactate and reduced oxygen supply may lead to the CNS energy deficiency and have important neurological consequences, particularly in patients with advanced cirrhosis.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.066
      Issue No: Vol. 7 (2017)
       
  • Vitamin D Deficiency and Hepatic Encephalopathy in Patients with Chronic
           Liver Disease
    • Authors: Helen Vidot; Alison Potter, Robert Cheng, Margaret Allman-Farinelli, Nicholas Shackel
      Abstract: Background: Patients with chronic liver disease (CLD) develop a wide range of nutritional abnormalities associated with progression of their liver disease. Alterations in hepatic synthetic function, nutrient absorption and metabolism and worsening physical symptoms result in the nutritional comprise seen in this group. A major complication in patients with CLD is the development of hepatic encephalopathy (HE), which describes a complex array of neurological symptoms including cognitive decline, impaired motor function and fatigue.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.065
      Issue No: Vol. 7 (2017)
       
  • Outcomes of Grade 3 and 4 Encephalopathy in Acute Liver Failure: A Liver
           Intensive Care Unit Experience
    • Authors: Priya Kenkre; Vaishali Solao, Ruhi Kohli, Sanjay Walke, Sandeep Seth, Vibhor Borkar, Vishal Sachade, Mihir Vora, Parijat Gupte, Akash Shukla, Gaurav Chaubal, Somnath Chattopadhyay, Guruprasad Shetty, Ravi Mohanka, Samir Shah
      Abstract: Background and Aim: Cerebral edema followed by herniation is an important life threatening complication of Acute liver failure [ALF]. Hyperammonaemia is a major contributor to cerebral edema leading to mortality. Continuous renal replacement therapy [CRRT] is the preferred option now in several centres to decrease ammonia levels in presence of a raised intracranial pressure [ICP]. The aim of this analysis is to study the effectiveness of encephalopathy reduction measures and patient outcomes in ALF with grade 3 to 4 encephalopathy.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.064
      Issue No: Vol. 7 (2017)
       
  • Refractory Hepatic Encephalopathy and Hypothyroidism: A New Factor in the
           Ammonia Metabolism
    • Authors: Fernando Diaz-Fontenla; Marta Castillo, Arantxa Díaz-Gomez, Luis Ibañez, Pilar Gancedo, Juan Guzman de Villoria, Pilar Fernández, Rafael Bañares, Rita Garcia Martinez
      Abstract: Background: Hepatic encephalopathy (HE) remains a diagnosis of exclusion due to the lack of specific signs and symptoms. Refractory HE requires the search of hidden precipitating events and ruling out alternative diagnosis. Hypothyroidism share clinical manifestations with HE such as disturbances in memory and attention and is considered in the differential diagnosis of HE. However, little is known on whether hypothyroidism coexists or even precipitate HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.063
      Issue No: Vol. 7 (2017)
       
  • Burden of Cirrhosis and Minimal and Past History of Overt Hepatic
           Encephalopathy on Caregivers
    • Authors: Deepa Shrestha; Sandeep Grover, Sahaj Rathi, Ajay Duseja, Yogesh Kumar Chawla, Radha Krishan Dhiman
      Abstract: Background and Aims: Cirrhosis and hepatic encephalopathy (HE) have been well known to lead to a reduced survival, increased hospital admissions, and overall deterioration in the quality of life of the patients. However, the socioeconomic and emotional impact of cirrhosis, leading on to added burden on the patient as well as the caregiver, are not clearly defined. This cross-sectional study was carried out to assess the overall perceived burden of hepatic encephalopathy on the caregivers of patients with cirrhosis.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.062
      Issue No: Vol. 7 (2017)
       
  • The Association Between Serum Sodium and Rate of Hepatic Encephalopathy in
           Cirrhosis Patients With Ascites
    • Authors: Lars Bossen; Pere Ginès, Hendrik Vilstrup, Hugh Watson, Peter Jepsen
      Abstract: Background and Aims: Presence of hyponatremia is associated with development of hepatic encephalopathy (HE), but the dynamic relationship between S-sodium and rate of HE is unknown. We examined the association between S-sodium and changes in it, and HE occurrence in a large dataset from three randomised trials of satavaptan in cirrhosis patients with ascites.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.061
      Issue No: Vol. 7 (2017)
       
  • Implication of the Blood–Brain Barrier in the Physiopathology of Hepatic
           Encephalopathy in Cirrhosis
    • Authors: Sarah Mouri; Haquima El Mourabit, Charlotte Bouzbib, Augustin Schaefer, Chantal Housset, Nicolas Weiss, Dominique Thabut
      Abstract: Background: Hepatic encephalopathy (HE) is a severe complication of cirrhosis which independently influences prognosis. Pathophysiology of HE is still debated; hyperammonemia in conjunction with inflammation could play a central role. Improvements in cerebral imaging suggest also a vasogenic cerebral edema, suggesting alterations in blood-brain barrier (BBB) permeability. The aim of this work was to study the BBB permeability in rat HE models.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.060
      Issue No: Vol. 7 (2017)
       
  • The Improvement of Nutritional Status of Cirrhotic Patients After
           Transjugular Intrahepatic Portosysthemic Shunt is Associated With the
           Amelioration of Cognitive Impairment
    • Authors: Stefania Gioia; Silvia Nardelli, Barbara Lattanzi, Chiara Pasquale, Sabrina Torrisi, Francesca Greco, Manuela Merli, Oliviero Riggio
      Abstract: Introduction/Aim: Hepatic encephalopathy (HE) is a major problem after TIPS and is particularly frequent in patients affected by sarcopenia, hypothetically because a reduced muscle mass affects the ammonia metabolism. A well functioning TIPS, causing the disappearance of the complications of portal hypertension, may also induce an amelioration in nutritional state, including sarcopenia. The aim of the study was to investigate the relationship between cognitive impairment (overt and covert HE) and the increase in muscle mass occurring in patients with a well functioning TIPS.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.059
      Issue No: Vol. 7 (2017)
       
  • Blood–Brain Barrier Dysfunction Assessed By Protein S-100 Beta
           Levels in Cirrhotic Patients
    • Authors: Simona Tripon; Maxime Mallet, Denis Monneret, Francoise Imebert-Bismut, Marika Rudler, Nicolas Weiss, Dominique Thabut
      Abstract: Background and Aims: The protein S-100 beta (PS-100) is a small dimeric cytosolic protein synthetized in astrocytes and Schwann cells. High serum levels of PS-100 are associated with brain lesions and altered blood-brain barrier permeability in traumatic brain injury, ischemic stroke, cerebral tumors and subarachnoid hemorrhage. Early brain damage has been detected in patients with cirrhosis. We hypothesized that those insults could be detected by the PS-100 serum levels (normal values
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.058
      Issue No: Vol. 7 (2017)
       
  • Sodium Phenylbutyrate Administration to Avoid Neurological Worsening in
           Cirrhotic Patients With Hepatic Encephalopathy Admitted in ICU
    • Authors: Simona Tripon; Marion Lodey, Elsa Guiller, Maxime Mallet
      Abstract: Background and Aim: Hepatic encephalopathy (HE) is a major clinical problem in patients with cirrhosis, which influences short and long-term prognosis. About one third of patient with overt HE will display altered consciousness needing ICU admission and sometimes mechanical ventilation. Recently, glycerol phenylbutyrate or sodium phenylbutyrate (PB), which lowers ammonia by providing an alternate pathway to urea for waste nitrogen excretion, has shown to be effective in preventing the occurrence of HE in RCT.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.057
      Issue No: Vol. 7 (2017)
       
  • Time Course of Compromised Urea Synthesis in Patients With Alcoholic
           Hepatitis
    • Authors: Emilie Glavind; Niels Kristian Aagaard, Henning Grønbæk, Nikolaj Worm Ørntoft, Hendrik Vilstrup, Karen Louise Thomsen;
      Abstract: Background: We recently showed that the life-threatening disease alcoholic hepatitis (AH) markedly decreased the urea synthesis capacity, which may contribute to the patients’ poor prognosis. The course of the compromised essential liver function and its relation to survival and treatment remains unknown. Such knowledge may improve prognosis estimation and contribute towards mechanistic understanding of treatment effects.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.056
      Issue No: Vol. 7 (2017)
       
  • Does Diagnosis of Covert Hepatic Encephalopathy (CHE) With Two Testing
           Strategy Improving Prediction of Overt HE When Compared To Single
           Testing'
    • Authors: Andres Duarte-Rojo; SanathAllampati, Leroy R. Thacker, Jasmohan S. Bajaj
      Abstract: Background and Aims: Covert hepatic encephalopathy (CHE) impairs performance across several cognitive domains, what causes wide variations in the resultant cognitive impairment in cirrhotic patients. Since tests used to evaluate CHE address different cognitive abilities, current clinical practice guidelines have proposed using a consensus diagnosis with the use of two strategies, one of them being the psychometric hepatic encephalopathy score (PHES). We prospectively tested whether possible combinations among PHES, inhibitory control test (ICT) and StroopEncephalapp (StE), could increase the predictive capacity of single testing for OHE development.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.055
      Issue No: Vol. 7 (2017)
       
  • Protein Malnutrition Is Involved in A An Increased Prevalence of
           Neurocognitive Impairment in Compensated Cirrhotic Patients. A
           Retrospective Analysis Answering to the Proposal of the Last Consensus on
           Portal Hypertension (Baveno VI)
    • Authors: Barbara Lattanzi; Vincenza Di Gregorio, Daria D’Ambrosio, Stefania Gioia, Manuela Merli
      Abstract: Background and Aim: While is well known the high frequency and the poor prognostic effect of protein malnutrition in cirrhotic patients with advanced liver disease, data about the influence of muscle depletion in the setting of compensated liver cirrhosis are scarce. In this scenario, this topic has been included in the research agenda of the International Consensus on Portal Hypertension which was recently held in Baveno (Baveno VI). The aim of the study was to analyze rate of complications in relation to muscle depletion in compensated cirrhotic patients (Child Pugh A).
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.054
      Issue No: Vol. 7 (2017)
       
  • Overt Hepatic Encephalopathy Differentially Affects Cognitive Flexibility
           and Impairs Learning on the EncephalApp Stroop
    • Authors: Chathur Acharya; Andrew Fagan, Melanie White, Edith Gavis, Dinesh Ganapathy, James B. Wade, Jasmohan S. Bajaj
      Abstract: Background: Patients with cirrhosis and prior overt hepatic encephalopathy (OHE) could have persistent learning impairments. The Stroop App (EncephalApp), which has an easier “Off” and difficult “On” parts, has been used to define CHE in cirrhosis with the “Off” state being a sensitive measure of the subcortical impairment when compared to other gold standards. The “Off” state relies on psychomotor speed while cognitive flexibility, an indicator of pre-frontal cortex integrity, is also required for the “On” state.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.053
      Issue No: Vol. 7 (2017)
       
  • Hepatic Encephalopathy and the Gut Microbiota: An in Vitro Model to Study
           the Microbial and Ammonia Modulation Upon Prebiotic, Antibiotic and
           Probiotic Treatment
    • Authors: Andrea Mancini; Francesca Campagna, Piero Amodio, Cecilia Pravadelli, Kieran Tuohy
      Abstract: Background and Aim: The gut microbiota and their metabolites represent a core actor in human host physiology as well as in certain pathological states. Indeed gut microbiota alteration represents a key factor in cirrhosis progression and appear to be related to neuropsychiatric complications. In particular, gut ammonia production by microbial activities is one of the main factors implicated in hepatic encephalopathy (HE) develop. Even if widely studied, the gut microbial dynamics during HE treatment with prebiotics, antibiotics and probiotics is only partially understood due to the different experimental approaches and inter-patient variability.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.052
      Issue No: Vol. 7 (2017)
       
  • Impact of Hepatic- and Extrahepatic-Insults on the Outcome of
           Acute-on-Chronic Liver Failure
    • Authors: Tarana Gupta; Radha Dhiman, Sahaj Rathi, Swastik AgrawalSunil Taneja, Ajay Duseja, Yogesh Chawla
      Abstract: Aim: To study the differences in outcome and predictors of mortality in ACLF precipitated by hepatic- or extrahepatic-insults.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.051
      Issue No: Vol. 7 (2017)
       
  • Endothelial Nitric Oxide Synthase (Enos)Uncoupling-Dependent Lowering of
           
    • Authors: Krzysztof Milewski; Anna Czarnecka, Inez Fresko, Jan Albrecht, Magdalena Zielińska
      Abstract: Background: Pathomechanism of hepatic encephalopathy (HE) accompanying acute liver failure (ALF) is associated with both deregulation of NMDA/cGMP/NO signaling and oxidative/nitrosative stress (ONS) induction in the brain. In ALF, ammonia-induced over-stimulation of NMDA receptors and neuronal nitric oxide synthase (nNOS) activation leads to increase in NO synthesis and subsequent generation of reactive oxygen and nitrogen species (Hermenegildo et al., 2000; Kosenko et al., 2003). In turn, NO produced via endothelial NOS (eNOS) is the main endogenous regulator of microvascular blood flow.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.050
      Issue No: Vol. 7 (2017)
       
  • Reduced Expression of Glycine Transporter 1 in Cortical Neurons of
           Patients With Acute Liver Failure
    • Authors: Madhu Chopra; Kiran K. Thumburu, Rakesh K. Vasishta, Anuradha Chakraborti, Navneet Sharma, Ajay Duseja, Yogesh Chawla, Radha K. Dhiman
      Abstract: Background and Aim: Astrocyte swelling and altered astrocyte-neuronal trafficking of amino acids are characteristics of central nervous system in acute liver failure (ALF). In addition alteration in N-methyl D-aspartate (NMDA) mediated neurotransmission has been involved in the pathogenesis of hepatic encephalopathy due to ALF. Glycine, a positive allosteric modulator required for regulation of NMDA receptor. One of the glycine transporters (GlyT)-1 is expressed in both astrocytes as well as neurons of the cerebral cortex in association with regions of high NMDA receptor expression.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.049
      Issue No: Vol. 7 (2017)
       
  • Sleep Disorders in Cirrhotic Patients Are Related to Severity of Cirrhosis
           But Not to History of Hepatic Encephalopathy
    • Authors: Charlotte Bouzbib; Valérie Attali, Marika Rudler, Filomena Conti, Yvon Calmus, Nicolas Weiss, Dominique Thabut
      Abstract: Background and Aim: Sleep disorders are more frequent in cirrhotic patients than in the general population. They may impact quality of life and cause accidents in daily living. However, risk factors of sleep disorders and their relation to complications of cirrhosis, particularly hepatic encephalopathy (HE), are still unidentified. Aim: To assess the relation between sleep disorders and complications of cirrhosis.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.048
      Issue No: Vol. 7 (2017)
       
  • In Vivo Longitudinal 1H MRS Study of Hippocampal and Cerebellar Metabolic
           Changes in BDL Rats
    • Authors: Veronika Rackayova; Cristina Cudalbu, Corina Berset, Jocelyn Grosse, Rolf Gruetter, Valérie A. McLin, Olivier Braissant
      Abstract: Purpose: The pathophysiological mechanisms leading to chronic hepatic encephalopathy (CHE) due to liver cirrhosis are still incompletely understood. Ammonia is considered as main toxin, being responsible for glutamine increase in astrocytes followed by decrease of other brain osmolytes as osmoregulatory answer.1 Previous studies in hyperammonemia models have shown differences in glutamine between brain regions and that net glutamine synthesis rates differ between the cortex and hippocampus.2 Therefore, our aim was to investigate potential metabolic differences between the hippocampus and cerebellum, two key regions implicated in the cognitive and fine motor deficits of CHE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.047
      Issue No: Vol. 7 (2017)
       
  • The PHES Score Does Not Correlate With Blood Ammonia Levels, Circulating
           Endotoxins or Markers of Systemic Inflammation
    • Authors: Nina Kimer; Lise L. Gluud, Julie S. Pedersen, Juliette Tavenier, Søren Møller, Flemming Bendtsen, Marsha Y. Morgan
      Abstract: Background and Aims: The pathogenesis of hepatic encephalopathy (HE) remains unclear but impaired hepatic clearance of gut-derived neurotoxins and activation of systemic inflammatory responses are thought to play key roles. The diagnosis is based on detection of neurocognitive/neurophysiological abnormalities but the patterns of abnormalities even in individuals displaying equivalent degrees of neuropsychiatric impairment vary considerably. Interleukin 6, C-reactive protein (CRP) and tumour necrosis factor-α (TNFα) have been show to be independent predictors of abnormal PHES (Montagnese et al., 2011) but these finding have not been confirmed.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.046
      Issue No: Vol. 7 (2017)
       
  • Astrocytic Glutamine Transporter SN1 Deficiency as a Causative Factor
           Accompanying Acute Formation of Brain Edema in Acute Liver Failure
    • Authors: Mariusz Popek; Malgorzata Frontczak-Baniewicz, Jan Albrecht, Magdalena Zielinska
      Abstract: Brain edema which may consist of cytotoxic and/or vasogenic components is a fatal clinical complication of hepatic encephalopathy (HE) associated with acute liver failure. One of the cause of cytotoxic edema is an excessive accumulation of ammonia-derived glutamine in astrocytes ensuing astrocytic swelling. Decreased expression of the N system glutamine transporter SN1 which preferentially transfers this amino acid out of astrocytes has been hypothesized to be implicated in this effect. To test this hypothesis we used C57Bl6 mice in which acute HE was induced by single i.p.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.045
      Issue No: Vol. 7 (2017)
       
  • Radiology-guided Occlusion of Portosystemic Shunts for Treatment of
           Medically Refractory Hepatic Encephalopathy
    • Authors: Grace Aw; Christopher Rogan, Nicholas Shackel, Simone Strasser
      Abstract: Background: Spontaneous portosystemic shunts (PSS) are increasingly recognised as a cause of medically refractory hepatic encephalopathy (HE) in up to 70% of patients with cirrhosis. Plug or coil-assisted retrograde transvenous obliteration (RTO) of these shunts, as a modification of the balloon-occlusion retrograde transvenous obliteration technique initially developed for embolisation of bleeding gastric varices, has been used to occlude these shunts with resultant decrease in blood ammonia and resolution of HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.044
      Issue No: Vol. 7 (2017)
       
  • l-Arginine Improves the Diminished Cerebral Blood Flow in Rats With Acute
           Liver Failure: Uncertain Role of Asymmetric Dimethylarginine
    • Authors: Anna Czarnecka; Krzysztof Jasinski, Radoslaw Jazwiec, Wojciech Hilgier, Anna Gajos-Draus, Katarzyna Kalita, Andrzej Beresewicz, Magdalena Zielinska
      Abstract: Background and Aims: Dysregulated cerebral blood flow (CBF) contributes to neurological dysfunctions accompanying hepatic encephalopathy (HE). The well-documented increase in asymmetric dimethylarginine (ADMA) in CSF of patients and brains of animals with liver failure may impair CBF by inhibition of endothelial nitric oxide synthesis (eNOS). Therefore, the correction of l-arginine (l-arg)/ADMA ratio and thereby elevation of the availability of l-arg for NO production by l-arg supplementation may improve CBF.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.043
      Issue No: Vol. 7 (2017)
       
  • Neurotoxic Side Effects of Calcineurin Inhibitors in Patients After Liver
           Transplantation: Preliminary Results of a Quantitative MRI Study of the
           Brain
    • Authors: Lukas Goede; Henning Pflugrad, Birte Schmitz, Anita B. Tryc, Hannelore Barg-Hock, Jürgen Klempnauer, Karin Weissenborn, Heinrich Lanfermann, Xiao-Qi Ding
      Abstract: Background: Calcineurin inhibitors (CNI) are the most often used immunosuppressive drugs for the prevention of graft rejection after liver transplantation (LT). Long-term CNI treatment, however, is associated with cardiovascular disease and renal dysfunction. Considering the high frequency of neurotoxic side effects during the first weeks after treatment onset, long-term effects upon brain tissue structure and brain function must be expected. Aiming to estimate the long-term influence of CNI on cerebral microstructure and function after LT we carried out this quantitative MR study.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.042
      Issue No: Vol. 7 (2017)
       
  • Chronic Neurotoxicity of Calcineurin Inhibitors in Patients After Liver
           Transplantation
    • Authors: Henning Pflugrad; Anita B. Tryc, Anna-Kristina Schrader, Xiaoqi Ding, Heinrich Lanfermann, Elmar Jäckel, Harald Schrem, Jan Beneke, Hannelore Barg-Hock, Jürgen Klempnauer, Karin Weissenborn
      Abstract: Background and Aims: Orthotopic liver transplantation (OLT) usually requires lifelong calcineurin inhibitor (CNI) therapy to achieve immunosuppression. Due to extended survival of OLT patients, long-term side effects of this drug regime receive increasing attention. Renal dysfunction, malignancy and cardiovascular disease, each affecting about 25% of the patients 10 years after OLT, are predominantly considered. Although calcineurin inhibitors are known to induce neurotoxicity in the first weeks after OLT, long-term data is scarce.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.041
      Issue No: Vol. 7 (2017)
       
  • Resting-State Brain Networks in Elderly Cirrhotic Patients Reveal a
           Distinct Brain Response to Aging
    • Authors: Vishwadeep Ahluwalia; Melanie White, Andrew Fagan, Dinesh Ganapathy, James Wade, Joel L. Steinberg, Frederick G. Moeller, Jasmohan S. Bajaj
      Abstract: Background: The cirrhotic population is getting older, with a significant potential overlap of covert HE with pre-dementia mild cognitive impairment (MCI). The underlying functional basis of this cognitive impairment in elderly cirrhotics is unclear and could be related to altered resting-state networks (RSNs). RSNs are anatomically separate yet functionally connected brain regions. Default mode network (DMN) resting network is affected in younger cirrhotics but RSNs is unclear in older patients is understudied.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.040
      Issue No: Vol. 7 (2017)
       
  • Fecal Bacterial Microflora in Patients With Cirrhosis and the Effect of
           Lactulose Administration
    • Authors: Amit Goel; Aditya N. Sarangi, Ankur Singh, Avani Sasi, Rakesh Aggarwal
      Abstract: Background: Lactulose, used for treatment and prevention of hepatic encephalopathy (HE), is believed to act by inducing changes in gut flora. We studied the composition of gut flora in patients with cirrhosis and also assessed the effect of lactulose administration on gut flora.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.039
      Issue No: Vol. 7 (2017)
       
  • Early Primary Biliary Cholangitis is Characterised by Brain Abnormalities
           on Cerebral Magnetic Resonance Imaging
    • Authors: Jin U. Kim; Vijay P.B. Grover, Louise E. Southern, Jessica E. Dyson, Mary M.-E. Crossey, Marzena W. Arridge, Nayna Patel, Julie A. Fitzpatrick, Aluel Bak-Bol, Adam D. Waldman, Graeme J. Alexander, George F. Mells, Roger W. Chapman, David E.J. Jones, Simon D. Taylor-Robinson
      Abstract: Background: Brain change can occur in primary biliary cholangitis (PBC), potentially as a result of cholestatic and/or inflammatory processes. This change is linked to systemic symptoms of fatigue and cognitive impairment.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.038
      Issue No: Vol. 7 (2017)
       
  • A Pilot Evaluation of a Computer-Based Psychometric Test Battery Designed
           to Detect Impairment in Patients With Cirrhosis
    • Authors: Nicola A. Cook; Jin U. Kim, Yasmin Pasha, Mary M.-E. Crossey, Adrian J. Schembri, Brian T. Harel, Torben T. Kimhofer, Simon D. Taylor-Robinson
      Abstract: Background: Psychometric testing is used to identify patients with cirrhosis who have developed hepatic encephalopathy (HE). Most batteries consist of a series of paper-and-pencil tests, which are cumbersome for most clinicians. A modern, easy to use, computer-based battery would be a helpful clinical tool, given that in its minimal form, HE has an impact on both patient quality of life and the ability to drive and operate machinery (with societal consequences). Aim: We compared the CogstateTM computer battery testing with the Psychometric Hepatic Encephalopathy Score (PHES) tests, with a view to simplifying diagnosis.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.037
      Issue No: Vol. 7 (2017)
       
  • Spectral Electroencephalogram Analysis in Liver Cirrhosis With Minimal
           Hepatic Encephalopathy Before and After Lactulose Therapy
    • Authors: Jatinderpal Singh; Barjesh Chander Sharma, Vinod Puri
      Abstract: Background and Aim: Minimal hepatic encephalopathy (MHE) represents mildest form of hepatic encephalopathy. Spectral electroencephalogram (sEEG) analysis improves the recognition of MHE by decreasing inter-operator variability and providing quantitative parameters of brain dysfunction. We compared sEEG in patients of cirrhosis with and without MHE and the effects of lactulose on sEEG in patients with MHE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.036
      Issue No: Vol. 7 (2017)
       
  • Hepatic Encephalopathy in Patients With Non-Cirrhotic Portal Hypertension:
           Description, Prevalence and Risk Factors
    • Authors: Stefania Gioia; Valeria Nicoletti, Pierleone Lucatelli, Silvia Nardelli, Chiara Pasquale, Ilaria Pentassuglio, Adriano De Santis, Manuela Merli, Oliviero Riggio
      Abstract: Background: Hepatic encephalopathy (HE) is a common complication of cirrhosis but it's less studied in patients with non-cirrhotic portal hypertension (NCPH).
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.035
      Issue No: Vol. 7 (2017)
       
  • Brain-Type Fatty Acid Binding Protein (FABP7) and Neurological
           Complications of Acetaminophen-Induced Acute Liver Failure
    • Authors: Constantine J. Karvellas; Jaime L. Speiser, Melanie Tremblay, Wiliam M. Lee, Christopher F. Rose
      Abstract: Background: Acetaminophen (APAP)-induced Acute Liver Failure (ALF) is associated with significant morbidity and mortality related to cerebral edema (CE) and intracranial hypertension (ICH). Brain type fatty acid binding protein (FABP7) is a small (15kDa) cytoplasmic protein abundantly expressed in astrocytes where there is active fatty acid metabolism. FABP7 levels have not been previously reported in ALF patients at high risk of CE/ICH.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.034
      Issue No: Vol. 7 (2017)
       
  • Elevated Liver Fatty Acid Binding Protein (FABP1) Serum Levels Improve
           Prognostic Discrimination of King's College Criteria and the ALFSG Index
           
    • Authors: Constantine J. Karvellas; Jaime L. Speiser, Melanie Tremblay, William M. Lee, Christopher F. Rose
      Abstract: Background: Acetaminophen (APAP)-induced acute liver failure (ALF) is associated with significant mortality. To date, traditional prognostic scores lack discrimination in identifying patients with APAP-ALF who will die without liver transplant (LT), and those who will survive with medical management alone. Failure to identify those in need of LT results in a potentially preventable death while wrongly classifying prospective survivors as in need of LT subjects the patient to unnecessary LT. Liver-type fatty acid binding protein (FABP1) is a small (15kDa) cytoplasmic protein abundantly expressed in hepatocytes.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.033
      Issue No: Vol. 7 (2017)
       
  • Sarcopenia is Associated With Hyperammoniemia and Minimal Hepatic
           Encephalopathy in Cirrhosis
    • Authors: Silvia Nardelli; Barbara Lattanzi, Stefania Gioia, Chiara Pasquale, Ilaria Pentassuglio, Manuela Merli, Oliviero Riggio
      Abstract: Background and Aim: Muscle wasting is associated with a higher prevalence of cirrhosis’ complications, including minimal hepatic encephalopathy (MHE). The rationale for a relationship between muscle depletion and MHE derives from the possible involvement of muscle in ammonia metabolism and trafficking. The aim of the study was to investigate the incidence of minimal hepatic encephalopathy and the concentration of serum ammonia in cirrhotic patients with and without sarcopenia.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.032
      Issue No: Vol. 7 (2017)
       
  • A Randomized Controlled Trial Comparing Lactulose Plus Albumin Versus
           Lactulose Alone for Treatment of Hepatic Encephalopathy
    • Authors: Barjesh C. Sharma; Jatinderpal Singh, Alok Sangam, Alok K. Mantri, Nirupma Trehanpati, Shiv K. Sarin
      Abstract: Background and Aim: Hepatic encephalopathy (HE) is associated with poor prognosis and treatment of HE is primarily directed at the reduction of the blood ammonia levels. We evaluated the efficacy and safety of albumin plus lactulose versus lactulose alone for treatment of overt HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.031
      Issue No: Vol. 7 (2017)
       
  • Sarcopenia Represents a Risk Factor for the Development of Hepatic
           Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt
    • Authors: Silvia Nardelli; Barbara Lattanzi, Stefania Gioia, Sabrina Torrisi, Francesca Greco, Manuela Merli, Oliviero Riggio
      Abstract: Background and Aim: Hepatic encephalopathy (HE) is a major problem in patients treated with TIPS. The aim of our study was to investigate whether a decrease in muscle mass may independently influence the occurrence of HE after TIPS.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.030
      Issue No: Vol. 7 (2017)
       
  • Results of Portosystemic Shunt Embolization in Selected Patients with
           Cirrhosis and Recurrent Hepatic Encephalopathy
    • Authors: Narendra S. Choudhary; Sanjiv Saigal, Sanjay Saran Baijal, Amit Kumar, Neeraj Saraf, Deepak Jain, Vaibhav Jain, Anubhav Khandelwal, Abhay Kapoor, Rajesh Puri, Randhir Sud, Arvinder S. Soin
      Abstract: Backround and Aim: Large portosystemic shunts may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.028
      Issue No: Vol. 7 (2017)
       
  • Cognitive Function Following Hepatitis C Eradication in Patients Treated
           With Direct Antiviral Agents: Results From a Population-Based Study
    • Authors: Luis Ibañez-Samaniego; Lucía Cabrero, Seila García-Mulas, Cristina Navarrete, Adriana Ahumada, Laura Marquez, María Dolores Pérez-Valderas, Diego Rincón, Marta Rapado, Rafael Bañares, Rita García-Martínez
      Abstract: Background: Cognitive function in patients with chronic hepatitis C improved following treatment with interferon-based therapies. There is scarce data in patients with cirrhosis and in patients treated with direct antiviral agents (DAAs).
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.027
      Issue No: Vol. 7 (2017)
       
  • Goal Directed Ammonia Lowering Therapy in Acute on Chronic Liver Failure
           (ACLF) With Hepatic Encephalopathy (HE): A Randomized Trial
           (clinicaltrials.gov identifier: NCT02321371)
    • Authors: Tanmay S. Vyas; Rakhi Maiwall, Ankur Jinadal, Shivkumar Sarin
      Abstract: Background and Aims: HE in ACLF is associated with high mortality. There is limited data on the role of ammonia (NH3) and anti-ammonia measures in treating HE in ACLF. We prospectively studied the NH3 dynamics and effects of goal directed ammonia lowering therapy on short-term disease outcome in ACLF patients with grade III/IV HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.026
      Issue No: Vol. 7 (2017)
       
  • Oral Ornithine Phenylacetate Attenuates Muscle Mass Loss and Prevents
           Hepatic Encephalopathy in BDL Rats
    • Authors: Cristina R. Bosoi; Mariana Oliveira, Marc-André Clément, Mélanie Tremblay, Gabrie A.T. Have, Nicolaas Deutz, Christopher F. Rose
      Abstract: Background and Aims: Chronic liver disease (CLD) induces numerous complications including muscle mass loss and hepatic encephalopathy (HE) which negatively impact clinical outcomes. Hyperammonemia is considered the central component in the pathogenesis of HE, however recent studies have suggested ammonia to be toxic to other organs/tissues aside the brain, such as the muscle. The aim of this study was to investigate the effect of lowering ammonia on muscle mass in cirrhotic rats treated with an oral formulation of ornithine phenylacetate (OP; OCR-002).
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.025
      Issue No: Vol. 7 (2017)
       
  • Taurine Transporter Deficiency Induces Hyperammonemia, Oxidative Stress
           and Senescence in Mouse Liver
    • Authors: Niloufar Monhasery; Boris Görg, Jessica Oenarto, Hans J. Bidmon, Dieter Häussinger
      Abstract: Background and Aims Taurine is an amino acid involved in many biological processes such as cell volume regulation, defense against oxidative stress and protein stabilization. Investigations on taurine transporter knockout mice (TauT-KO) revealed that taurine depletion in liver induces chronic liver disease as indicated by hepatitis and fibrosis in an age dependent manner. In the present study, we analysed expression levels of biomarkers for oxidative stress, senescence and inflammation and studied expression levels as well as activity of glutamine synthetase (GS) in livers of 3 and 12 months old wildtype and TauT-KO mice.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.024
      Issue No: Vol. 7 (2017)
       
  • Effect of Resveratrol on Tight Junction Proteins and Hyperammonemia in
           Cirrhosis
    • Authors: Balasubramaniyan Vairappan; Ashwini Karthikeyan, Sundhar Mohandas
      Abstract: Background and Aim: We recently observed in human cirrhosis that systemic elevated tight junction protein zonula occludens -1 positively correlated with increased ammonia concentration, indeed the molecular mechanism unknown. The aim of this study was to determine the neuronal tight junction proteins integrity and hyperammonemia in CCl4 induced experimental cirrhosis with hepatic encephalopathy (HE) in mice. Furthermore, we identified the effect of resveratrol on neuronal tight junction protein expression and systemic ammonia in cirrhotic mice.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.023
      Issue No: Vol. 7 (2017)
       
  • Skeletal Muscle Abnormalities Increase the Risk of Overt Hepatic
           Encephalopathy and Hyperammonemia in Patients With Cirrhosis
    • Authors: Rahima A. Bhanji; Andres Duarte-Rojo, Christopher F. Rose, Aldo J. Montano-Loza
      Abstract: Background and Aim: Skeletal muscle abnormalities, such as sarcopenia and myosteatosis are frequent complications of cirrhosis and are associated with increased morbidity and mortality. Hyperammonemia plays a significant role in the pathogenesis of hepatic encephalopathy (HE). Skeletal muscle have a significant compensatory part in detoxifying ammonia during liver disease since it houses the enzyme glutamine synthetase, an important ammonia-removing pathway during the amination of glutamate to glutamine.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.022
      Issue No: Vol. 7 (2017)
       
  • Disturbances in the Microcirculation on the Surface of Rat Brain Induced
           Ammonium Chloride is Associated With Increased Periarteriolar Adenosine
           Concentration
    • Authors: Peter Nissen Bjerring; Esben Jannik Bjerrum, Fin Stolze Larsen
      Abstract: Background and Aims: Patients with liver failure develop hyperammonemia and abnormal regulation of cerebral blood flow. Ammonium affects both neuronal and glial function and leads to cerebral disturbances that indicate a dysfunctional neurovascular unit. The effect of ammonium on microcirculation and the periarteriolar adenosine tone on the brain surface of healthy rats was studied experimentally.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.021
      Issue No: Vol. 7 (2017)
       
  • Drugs Interactions and Metabolomic Profile During Liposome-Supported
           Peritoneal Dialysis (LSPD) in the Treatment of Severe Hyperammonemia
    • Authors: Giovanna Giacalone; Vincent Forster, Valentina Agostoni, Meriam Kabbaj, Nicola Zamboni, Jean-Christophe Leroux
      Abstract: Background and Aims: Transmembrane pH-gradient liposomes were previously found to efficiently entrap ammonia in the peritoneal space during peritoneal dialysis (PD), representing a promising alternative to hemodialysis for patients suffering from severe hyperammonemia.1 In this follow-up work, we investigated in vitro whether the uptake of ammonia was affected by drugs that could be administered to patients suffering from acute-on-chronic liver failure (ACLF), a condition in which high levels of blood ammonia typically occur.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.020
      Issue No: Vol. 7 (2017)
       
  • Derivation of Decision Algorithms for the Diagnosis of Hepatic
           Encephalopathy in Patients With Cirrhosis
    • Authors: Harry Zacharias; Clive D. Jackson, David Patch, Rachel H. Westbrook, Lynda Greenslade, Marsha Y. Morgan
      Abstract: Introduction: The presence of hepatic encephalopathy (HE), whether minimal or overt has a significant detrimental effect on patients’ quality of life, safety and survival. Current diagnostic tests are poorly validated or else are not generally applicable or practical for use in the clinical setting. This aim of this study was to identify simple, accurate algorithms for the diagnosis of HE in patients with cirrhosis that can be used in both clinical and research settings.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.019
      Issue No: Vol. 7 (2017)
       
  • EncephalApp and Critical Flicker Frequency are Associated With Accidental
           Falls in Liver Cirrhosis
    • Authors: Carmen Sendra; Virginia Aguilera, Javier Ampuero, Manuel Romero-Gomez
      Abstract: Background and Aim: To assess the impact of minimal hepatic encephalopathy (MHE), detected by critical flicker frequency (CFF), paper-pencil (PHES) and computerized psychometric test (EncephalApp) on the risk of accidental falls in liver cirrhosis.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.018
      Issue No: Vol. 7 (2017)
       
  • The Continuous Reaction Times Test for Minimal Hepatic Encephalopathy
           Validated by a Randomized Controlled Multi-modal Intervention
    • Authors: Mette Munk Lauridsen; Jeppe Gram, Hendrik Vilstrup, Ove B. Schaffalitzky de Muckadell
      Abstract: Background: Minimal hepatic encephalopathy (MHE) is clinically undetectable and the diagnosis requires psychometric tests. However, unclarity exists as to whether the tests are in fact able to detect changes in cognition.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.017
      Issue No: Vol. 7 (2017)
       
  • Increased Expression of GLUT 1 in Patients With Acute Liver Failure
    • Authors: Madhu Chopra; Kiran K. Thumburu, Rakesh K. Vasishta, Anuradha Chakraborti, Navneet Sharma, Ajay Duseja, Yogesh Chawla, Radha K. Dhiman
      Abstract: Background and Aim: Acute liver failure (ALF) resulting in cerebral edema and intracranial pressure has been shown to cause disturbances in brain oxidative metabolites. Spectroscopic and gene expression studies in experimental ALF models reveal that altered brain oxidative glucose metabolism and lactate synthesis may be implicated in the cerebral complications of ALF. Glucose transporter 1 (GLUT 1), a facilitative glucose transporter that transports glucose across the blood brain barrier is required to sustain brain energy metabolism.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.016
      Issue No: Vol. 7 (2017)
       
  • TGFβ1 Suppresses Neuronal IGF1 via a Let-7F-Dependent Mechanism During
           Azoxymethane-Induced Hepatic Encephalopathy in Mice
    • Authors: Matthew McMillin; Gabriel Frampton, Stephanie Grant, Farida Sohrabji, Fanyin Meng, Sharon DeMorrow
      Abstract: Background and Aim: Hepatic encephalopathy (HE) is a neurological complication that arises after a loss of liver function. HE is associated with increased cerebral edema, neuroinflammation and the onset of cognitive decline. We have previously shown that there is increased expression and secretion of transforming growth factor β1 (TGFβ1) from hepatocytes during the azoxymethane (AOM) model of acute liver failure and HE. Increased circulating TGFβ1 was shown to promote blood-brain barrier permeability and also led to progressive neurological complications via increased activation of its receptor TGFβR2.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.015
      Issue No: Vol. 7 (2017)
       
  • Neurological Impairment in Cirrhotic Patients Admitted to ICU: Hepatic
           Versus Drug-Induced Encephalopathy
    • Authors: Julie Assaraf; Dominique Thabut, Nicolas Weiss
      Abstract: Background and Aim: Neurological impairment, is commonly observed in patients with decompensated cirrhosis and/or portosystemic shunts admitted in ICU. Often ascribed to high plasmatic levels of ammonia, encephalopathy could also be induced by drugs or infection, due to altered blood-brain barrier (BBB) permeability. This latter setting is often underdiagnosed and encephalopathy related to hyperammonemia (so called hepatic encephalopathy-HE) being pointed out as the culpit of all neurological symptoms in cirrhotic patients.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.014
      Issue No: Vol. 7 (2017)
       
  • Changes in Brain Integrity Underlying Cognitive and Functional Recovery
           Following Liver Transplantation Plateaus After Six Months
    • Authors: Vishwadeep Ahluwlia; James B. Wade, Melanie White, Andrew Fagan, Edith Gavis, HoChong Gilles, Joel Steinberg, Frederick Gerard Moeller, Jasmohan S. Bajaj
      Abstract: Background: Cognitive improvement after liver transplant (LT) is individualized and often found within 6 months. However the relationship between continuing changes in brain integrity over the course of a year following LT on neurobehavioral function is unclear.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.013
      Issue No: Vol. 7 (2017)
       
  • Probiotic Treatment Improves Outcome of Chronic Hepatic Encephalopathy in
           BDL Rats, an In Vivo Longitudinal 1H MRS Study
    • Authors: Veronika Rackayova; Olivier Braissant, Corina Berset, Jocelyn Grosse, Daniela Capobianco, Paola Mastromarino, Valerie A. McLin, Cristina Cudalbu
      Abstract: Background: It is now accepted that intestinal dysbiosis is present in many diseases and plays an important role in their evolution/progression. Appropriate modulation of intestinal flora in patients with CLD may decrease intestinal ammonia production, reduce pro-inflammatory mechanisms in the gut thereby impacting intestinal permeability and consequent bacterial translocation. Therefore, our aim was to investigate the potential therapeutic effect of probiotic treatment with anti-inflammatory proprieties (VSL#3; actually available as Vivomixx® in EU and Visbiome in USA®) in CLD-induced HE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.012
      Issue No: Vol. 7 (2017)
       
  • The Neurosteroid Dheas Reverses the Concomitant Gliopathy and Dopaminergic
           Dysfunction in Mild Hepatic Encephalopathy: A Focus on Neuro-Glial
           Plasticities
    • Authors: Omar E.L. Hiba; Abdelaati E.L. Khiat, Halima Gamrani
      Abstract: Hepatic encephalopathy (HE) is a progressive and complex neuropsychiatric disorder resulting from acute as well as chronic hepatic failures and may impact negatively on the quality of life of HE patients. In spite of the progressive accomplishments in the understanding of the neuronal basis of such neuropathy, our knowledge is still very poor. Astroglia is a key element for understanding the neuropathology of HE, since it's ensures a crucial function upon the neuronal survival and functioning. Dopaminergic neurons are a particular population of neurons involved in HE symptoms, particularly parkinsonism, that have been largely studied and was a target for HE management.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.011
      Issue No: Vol. 7 (2017)
       
  • Comparative Effectiveness of Different Pharmacological Interventions for
           the Treatment of Minimal Hepatic Encephalopathy: A Systematic Review With
           Network Meta-analysis
    • Authors: Kiran K. Thumburu; Radha K. Dhiman, Madhu Chopra, Usha Dutta, Sahaj Rathi, Meenu Singh, Sunil Taneja, Ajay Duseja, Yogesh K. Chawla
      Abstract: Background and Aims: Minimal hepatic encephalopathy (MHE) is the mildest presentation of hepatic encephalopathy (HE), which includes a spectrum of neuropsychiatric manifestations ranging from subtle cognitive decline to deep coma. MHE has been shown to impair quality of life, predict overt HE (OHE), and even death. Various treatment modalities including lactulose, rifaximine, probiotics, branched chain amino acids and ammonia scavengers have shown benefit in MHE. However, due to a paucity of comparative studies, a clear consensus on the optimal treatment of MHE is yet to be reached.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.010
      Issue No: Vol. 7 (2017)
       
  • The Brain-Muscle Axis in Minimal Hepatic Encephalopathy (MHE): A
           Placebo-Controlled, Longitudinal Double-Blind Trial With l-Ornithine
           l-Aspartate (LOLA) – Preliminary Results
    • Authors: Yasmin Pasha; Robert Leech, Ines Ribeiro Violante, Nicola Cook, Mary M.E. Crossey, Simon D. Taylor Robinson
      Abstract: Background and Aim: LOLA promotes nitrogen elimination and experimentally, has been shown to reduce sarcopenia. We investigated effects of 12 weeks of oral LOLA in an outpatient series with compensated cirrhosis and mHE. Patients were pre-screened with PHES tests and included if they scored −4 or worse.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.009
      Issue No: Vol. 7 (2017)
       
  • Neuronal Dysfunction in Chronic Hepatic Encephalopathy: Role of Astrocytic
           Matricellular Proteins
    • Authors: Michael D. Norenberg; A.R. Jayakumar
      Abstract: Chronic hepatic encephalopathy (CHE), due to chronic liver failure, is characterized by confusion, disorientation, behavioral changes, impaired cognition, and motor disturbances. It is associated with defective neuronal integrity, leading to neurobehavioral and cognitive impairments. The mechanisms responsible for the neurological abnormalities in CHE, however, remain largely unknown. Since a reduction in astrocytic secretion of matricellular proteins (MCPs), including thrombospondin-1 (TSP-1), Hevin, Glypicans 4 and 6, and the CCN family of proteins (CYR61/CTGF/NOV), have been implicated in the neuronal dysfunction associated with various neurological conditions (e.g., ischemia, Alzheimer's disease, Down's syndrome), we examined whether astrocytic MCP synthesis and release may likewise be affected in CHE, and whether this event contributes to the defective neuronal integrity and associated neurobehavioral and cognitive impairments that occur in CHE.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.008
      Issue No: Vol. 7 (2017)
       
  • Role of Endothelial NMDA Receptors in the Pathogenesis of Hepatic
           Encephalopathy
    • Authors: Marta Skowronska; Arumugam R. Jayakumar, Jan Albrecht, Michael D. Norenberg
      Abstract: Background: Excessive accumulation of ammonia in the brain is the main etiological factor in hepatic encephalopathy (HE), a neuropsychiatric syndrome resulting from acute or chronic liver failure (ALF/CLF). Rapid progression of ALF is associated with brain edema, which often leads to death as a consequence of increased intracranial pressure and brain herniation. The brain edema is mainly cytotoxic, resulting from astrocytic swelling and ammonia was shown to be a key pathogenic factor. Recent findings, however, suggest that ammonia also impairs brain endothelial cells which may lead to a subtle increase in blood brain barrier (BBB) permeability, possibly contributing to the formation of brain edema.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.007
      Issue No: Vol. 7 (2017)
       
  • Ammonia Affects Iron Homeostasis in Cultured Rat Astrocytes and in Human
           Cerebral Cortex in Hepatic Encephalopathy
    • Authors: Ayşe Karababa; Boris Görg, Elina Schütz, Hans J. Bidmon, Dieter Häussinger
      Abstract: Background and Aim: Recent studies suggested a role of astrocyte senescence for persistence of cognitive impairment after resolution of an acute attack of hepatic encephalopathy in cirrhotic patients (Görg et al. 2015, Glia 63:37–50). Following studies showed that ammonia-induced astrocyte senescence is triggered through microRNA-dependent upregulation of heme oxygenase (HO)-1 (Oenarto et al. 2016, Sci Rep 6:18493), which is known to liberate iron from heme. The aim of the present study was to examine the effects of ammonia on the intracellular content of free ferrous iron [Fe2+]i and its relevance for ammonia-induced astrocyte senescence.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.006
      Issue No: Vol. 7 (2017)
       
  • Glutamine Synthetase in Endothelial Cells of the Blood–brain Barrier:
           Less But Not Insignificant'
    • Authors: Mariana Macedo Oliveira; Mélanie Tremblay, Christopher F. Rose
      Abstract: Background and Aim: The liver plays a major role in regulating ammonia levels in the blood. Therefore, during liver disease, the loss of hepatic function leads to hyperammonemia and consequently increased brain ammonia and hepatic encephalopathy (HE). Reducing ammonia neurotoxicity through systemic ammonia-lowering strategies remains the mainstay therapeutic strategy for HE. Ammonia, both as an ion (NH4+) and gas (NH3), easily crosses all plasma membranes, including the blood brain barrier (BBB); the interface between the blood and the brain.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.005
      Issue No: Vol. 7 (2017)
       
  • Ammonia Mediated Brain-oedema and Immune Dysfunction is Mediated by
           Toll-like Receptor (TLR) 9
    • Authors: Godhev K. Manakkat Vijay; Changyun Hu, Jian Peng, Irma Garcia Martinez, Rafaz Hoque, Xiaojun Zhang, Yun Ma, Wajahat Mehal, Debbie Shawcross, Li Wen
      Abstract: Background and Aim: Ammonia plays a central role in the pathogenesis of brain oedema in acute liver failure (ALF) and experimental models have unequivocally associated ammonia exposure with astrocyte swelling. Infection and systemic inflammation are common in ALF, drive the development of intracranial hypertension (ICH) and are major prognosticators. We have recently reported that patients with ALF and brain oedema have increased neutrophil TLR9 expression and that this can be induced synergistically by ammonia and IL-8.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.004
      Issue No: Vol. 7 (2017)
       
  • Ammonia Mediates Cortical Hemichannel Dysfunction in Rodent Models of
           Chronic Liver Disease
    • Authors: Anna Hadjihambi; Francesco De Chiara, Patrick S. Hosford, Abeba Habtetion, Anastassios Karagiannis, Nathan Davies, Alexander V. Gourine, Rajiv Jalan
      Abstract: Background and Aim: The pathogenesis of hepatic encephalopathy (HE) in cirrhosis is multifactorial and ammonia is thought to play a key role. Astroglial dysfunction is known to be present in HE and neuropathologically is the main cell type involved. Astrocytes are extensively connected by gap junctions formed of connexins, which may also exist as functional hemichannels allowing the exchange of molecules between the cytoplasm and the extracellular milieu. The astrocyte-neuron lactate shuttle hypothesis is a contested yet valuable concept suggesting that neuronal activity is fuelled (at least in part) by lactate provided by neighboring astrocyte.
      Citation: Journal of Clinical and Experimental Hepatology 7, (2017)
      PubDate: 2017-02
      DOI: 10.1016/j.jceh.2017.01.003
      Issue No: Vol. 7 (2017)
       
  • Gastric Varices in Cirrhosis vs. Extrahepatic Portal Venous Obstruction
           and Response to Endoscopic N-butyl-2-cyanoacrylate Injection
    • Authors: Barjesh C. Sharma; Shivakumar Varakanahalli, Jatinder P. Singh, Siddharth Srivastava
      Abstract: Gastric varices (GV) are found in patients with portal hypertension. Incidence of bleeding from GV is relatively low, but is severe, and associated with higher mortality.
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-03-03
      DOI: 10.1016/j.jceh.2016.09.002
       
  • Patulin Induced Oxidative Stress Mediated Apoptotic Damage in Mice, and
           its Modulation by Green Tea Leaves (GTL)
    • Authors: Girindrababu Venkattappa Jayashree; Krishnaswamy Krupashree, Puttasiddiah Rachitha, Farhath Khanum
      Abstract: The present study demonstrates the antioxidant and hepatic protective effects of Green tea leaves (GTL).
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-02-26
      DOI: 10.1016/j.jceh.2017.01.113
       
  • Potential Liver Transplant Recipients with Hepatitis C: Should They Be
           Treated Before or After Transplantation'
    • Authors: Anil C. Anand
      Abstract: Treatment of hepatitis C virus (HCV) with newer directly acting antivirals (DAAs) and lead to sustained viral response (SVR) in majority of patients and SVR has been documented to be associated with reversal of liver cirrhosis. The improved SVR rates and safety profiles of DAAs have led to the treatment of patients with decompensated cirrhosis awaiting liver transplantation (LT). Several clinical trials of DAAs in decompensated HCV patients have recently demonstrated SVR rates above 80%, which have been associated with significant improvements, in the Child–Pugh–Turcotte scores/or model for end-stage liver disease scores in a proportion of patients.
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-02-22
      DOI: 10.1016/j.jceh.2017.01.116
       
  • Role of Allopurinol in Optimizing Thiopurine Therapy in Patients with
           Autoimmune Hepatitis: A Review
    • Authors: Shivani Deswal; Anshu Srivastava
      Abstract: Autoimmune hepatitis (AIH) is a chronic immune mediated liver disease characterized by elevated transaminases, hyper gammaglobulinemia, presence of autoantibodies and interface hepatitis in the absence of a known etiology of liver disease. Thiopurines (azathioprine [AZA]/6-mercaptopurine [6MP]) and steroids remain the first line of treatment of AIH in both children and adults. However, a small proportion of AIH patients are either non-responders or develop side effects with AZA. The metabolism of AZA is complex and mediated by multiple enzymes.
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-02-21
      DOI: 10.1016/j.jceh.2017.01.115
       
  • Is Portal Venous Pressure Or Porto Systemic Gradient Really A Harbinger of
           Poor Outcomes After Living Donor Liver Transplantation'
    • Authors: Amol Vijay Kanetkar; Dinesh Balakrishnan, Sudhindran Sudhindran, Puneet Dhar, Unnikrishnan Gopalakrishnan, Ramachandran Menon, Othiyil Vayoth Sudheer
      Abstract: Portal hyperperfusion as a cause of small for size syndrome (SFSS) after living donor liver transplantation (LDLT) remains controversial. Portal venous pressure (PVP) is often measured indirectly and may be confounded by central venous pressure (CVP).
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-02-21
      DOI: 10.1016/j.jceh.2017.01.114
       
  • Spontaneous Bacterial Peritonitis by Burkholderia cepacia Complex: A Rare,
           Difficult to Treat Infection in Decompensated Cirrhotic Patients
    • Authors: Sunil Taneja; Pramod Kumar, Vikas Gautam, Ajay Duseja, Virendra Singh, Radha K. Dhiman, Yogesh Chawla
      Abstract: Burkholderia cepacia complex (Bcc) is non-fermenting Gram-negative bacillus and has been rarely reported to cause spontaneous bacterial peritonitis (SBP) in decompensated cirrhosis.
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-02-18
      DOI: 10.1016/j.jceh.2016.08.008
       
  • Can Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease
           Co-Exist'
    • Authors: Manu Mehta; Sandeep Satsangi, Ajay Duseja, Sunil Taneja, Radha K. Dhiman, Yogesh Chawla
      Abstract: Nonalcoholic fatty liver disease (NAFLD) by definition would require exclusion of significant alcohol intake. Present study was aimed to assess the prevalence of various components of metabolic syndrome (MS) in patients with alcoholic cirrhosis (AC) and to study the affect of its presence on the severity of liver disease, testing the hypothesis if alcoholic liver disease (ALD) and NAFLD could co-exist.
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-02-18
      DOI: 10.1016/j.jceh.2017.01.112
       
  • Liver Function Tests Abnormalities and Hepatitis B Virus & Hepatitis C
           Virus Co-infection in Human Immunodeficiency Virus (HIV)-infected Patients
           in India
    • Authors: P. Puri; P.K. Sharma, A. Lolusare, V.K. Sashindran, S. Shrivastava, A.K. Nagpal
      Abstract: While highly active anti-retroviral therapy (HAART) has improved survival of HIV-infected patients, there is increasing liver disease and progressive Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) related liver disease.
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-01-09
      DOI: 10.1016/j.jceh.2016.12.002
       
  • 2D Shear Wave Elastography of Liver in Patients with Primary Extrahepatic
           Portal Vein Obstruction
    • Authors: Kumble S. Madhusudhan; Raju Sharma, Ragini Kilambi, Sudhin Shylendran, Shalimar, Peush Sahni, Arun K. Gupta
      Abstract: To evaluate liver stiffness (LS) in patients of primary extrahepatic portal vein obstruction (EHPVO) using 2D shear wave elastography (SWE) and compare it with healthy volunteers.
      Citation: Journal of Clinical and Experimental Hepatology (2017)
      PubDate: 2017-01-05
      DOI: 10.1016/j.jceh.2016.12.001
       
  • Synchronous Gall Bladder and Bile Duct Cancer: A Short Series of Seven
           Cases and a Brief Review of Literature
    • Authors: Harshal Rajekar
      Abstract: Simultaneous presence of cancer in the gall bladder and in the biliary tree could be due to local spread, metastases, de novo multifocal origin, or as part of a field change. In the past, such an association has been described in patients with anomalous pancreatico-biliary ductal junction.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-12-02
       
  • Epigastric Pain in a Patient with Cirrhosis
    • Authors: Ying C. Lee; Yi C. Yeh, Yi Y. Chiou, Chieu A. Liu, Nai C. Chiu
      Abstract: An 83-year-old man with past history of hepatitis C presented with acute onset epigastric pain for 3 days. He was diagnosed with liver cirrhosis mainly by images study, and had not received treatment for hepatitis. Laboratory analysis revealed mild hypoalbuminemia (3.5g/dL) with no other abnormalities. Dynamic computed tomography was performed, showing a heterogeneous soft tissue mass in left hepatic lobe, arterial enhancement (Figure 1, arrow) and venous phase washout (Figure 2, arrow), with linear patchy calcification at the sigmoid colonic wall (Figure 3, arrow).
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-11-17
      DOI: 10.1016/j.jceh.2016.09.017
       
  • Impact of Hepatic and Extrahepatic Insults on the Outcome of
           Acute-on-Chronic Liver Failure
    • Authors: Tarana Gupta; Radha K. Dhiman, Sahaj Rathi, Swastik Agrawal, Ajay Duseja, Sunil Taneja, Yogesh Chawla
      Abstract: To study the differences in outcome and predictors of mortality in acute-on-chronic liver failure (ACLF) precipitated by hepatic or extrahepatic insults.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-11-16
       
  • Portal Inflow in Extensive Portomesenteric Thrombosis: Using the
           Pericholedochal Varix in Living Donor Liver Transplantation
    • Authors: Kishore Gurumoorthy Subramanya Bharathy; Shridhar Vasantrao Sasturkar, Piyush Kumar Sinha, Senthil Kumar, Viniyendra Pamecha
      Abstract: Extensive portomesenteric thrombosis presents a technical challenge in liver transplantation. Establishing portal inflow in living donor liver transplantation (LDLT) is indispensable to ensure regeneration of the graft. The use of a pericholedochal varix for inflow has been described only in a few case reports. Described herein is one such instance in the setting of LDLT, highlighting the nuances of this procedure in the light of available literature.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-11-11
       
  • Early Acute Severe HCV Recurrence After Transplantation: From Universal
           Mortality to Cure
    • Authors: Manav Wadhawan; Vivek Vij, Kausar Makki, Nalini Bansal, Ajay Kumar
      Abstract: Acute severe recurrence of hepatitis C virus (HCV) after solid organ transplant is associated with high mortality. Pegylated interferon and ribavirin are suboptimal in treatment of this severe form of recurrence. We report 4 cases of acute severe HCV recurrence (within 6 months after transplant), including 3 cases with fibrosing cholestatic hepatitis treated with sofosbuvir and ribavirin. All four patients achieved a rapid suppression of HCV RNA with a normalization of liver function tests within 4 weeks of starting therapy.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-11-11
       
  • Handgrip Strength as an Important Bed Side Tool to Assess Malnutrition in
           Patient with Liver Disease
    • Authors: Praveen Sharma; Abdul Rauf, Abdul Matin, Rachit Agarwal, Pankaj Tyagi, Anil Arora
      Abstract: Malnutrition is frequently present in patients with cirrhosis. Anthropometric measures such as body mass index (BMI), mid arm muscle circumference (MAMC), triceps skin fold thickness (TST) and subjective global assessment (SGA) have some limitations in assessment of malnutrition. This study aims to determine the prevalence of malnutrition in non-hospitalized cirrhotic and chronic hepatitis patients and to assess handgrip (HG) strength as a tool for identifying malnutrition.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-11-10
       
  • Living Donor Liver Transplantation for Acute Liver Failure With Fixed
           Pupils: Are We Fixed'
    • Authors: Shweta A. Singh; Anshuman Singh, Viniyendra Pamecha, Chandra Kant Pandey, Shiv Kumar Sarin
      Abstract: Living donor liver transplantation (LDLT) is fraught with the social and ethical dilemma of excising a part of the liver from a healthy first-degree relative. When LDLT is to be done for an acute liver failure (ALF), identification of a suitable donor is a race against time. Herein, we describe a unique challenge faced by the transplant team of whether to proceed with donor hepatectomy from a son, when the recipient (HBV-related ALF) developed non-reactive fully dilated pupils on the table, prior to beginning the surgery.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-11-02
      DOI: 10.1016/j.jceh.2016.09.014
       
  • Hepatitis E Virus Induced Acute Liver Failure with Scrub Typhus
           Coinfection in a Pregnant Woman
    • Authors: Nipun Verma; Megha Sharma, Manisha Biswal, Sunil Taneja, Nitya Batra, Abhay Kumar, Radha K. Dhiman
      Abstract: Coinfections contribute significantly to diagnostic challenges of acute febrile illnesses, especially in endemic areas. The confusion caused by overlapping clinical features impedes timely management. Herein, we report an unusual, previously unreported case of a pregnant woman suffering from a coinfection of scrub typhus and hepatitis E virus. A 25-year-old, 31-week pregnant woman presented with jaundice for 5 days and altered sensorium for 2 days. She had features of both viral acute liver failure (ALF) and tropical infections mimicking ALF, including hyperbilirubinemia, coagulopathy, anemia, thrombocytopenia, intravascular hemolysis, and hepatosplenomegaly.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-11-01
      DOI: 10.1016/j.jceh.2016.09.015
       
  • The Preliminary Study on Procurement Biliary Convergence from Donors with
           Complicated Bile Duct Variant in Emergency Right Lobe Living Donor Liver
           Transplantation
    • Authors: Sheng Ye; Jia-Hong Dong, Wei-Dong Duan, Wen-Bing Ji, Yu-Rong Liang
      Abstract: The incidence of biliary complications after living donor adult liver transplantation (LDALT) is still high due to the bile duct variation and necessity reconstruction of multiple small bile ducts. The current surgical management of the biliary variants is unsatisfactory. We evaluated the role of a new surgical approach in a complicated hilar bile duct variant (Nakamura type IV and Nakamura type II) under emergent right lobe LDALT for high model for end-stage liver disease score patients.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-10-20
      DOI: 10.1016/j.jceh.2016.09.016
       
  • Hepatocellular Carcinoma: An Unusual Complication of Longstanding Wilson
           Disease
    • Authors: Deepak Gunjan; Shalimar, Neeti Nadda, Saurabh Kedia, Baibaswata Nayak, Shashi B. Paul, Shivanand Ramachandra Gamanagatti, Subrat K. Acharya
      Abstract: Wilson disease is caused by the accumulation of copper in the liver, brain or other organs, due to the mutation in ATP7B gene, which encodes protein that helps in excretion of copper in the bile canaliculus. Clinical presentation varies from asymptomatic elevation of transaminases to cirrhosis with decompensation. Hepatocellular carcinoma is a known complication of cirrhosis, but a rare occurrence in Wilson disease. We present a case of neurological Wilson disease, who later developed decompensated cirrhosis and hepatocellular carcinoma.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-10-05
      DOI: 10.1016/j.jceh.2016.09.012
       
  • What is the Risk of Graft Reinfection in Case of Liver Transplantation for
           Patients With Acute HEV or HAV Infection'
    • Authors: Anil C. Anand; Neerav Goyal, Hitendra K. Garg, Shaleen K. Agarwal, Sudeep Khanna, Subhash Gupta
      Abstract: We are sharing the concerns expressed by some colleagues about the risk of graft reinfection in case of liver transplantation (LT) for patients with acute hepatitis E (HEV) or A (HAV) virus infection. It is well known that graft reinfection is nearly universal if LT is done for active hepatitis C virus (HCV) disease.1 Before the use of hepatitis B immunoglobulin (HBIG) and/or antiviral agents for prophylaxis, hepatitis B virus (HBV) re-infection occurred in more than 80% of patients resulting in dismal graft and patient survival.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-09-29
      DOI: 10.1016/j.jceh.2016.09.013
       
  • Acute Onset Significant Muscle Weakness in a Patient Awaiting Liver
           Transplantation: Look for Statins
    • Authors: Narendra S. Choudhary; Sanjiv Saigal, Neeraj Saraf, Arvinder S. Soin
      Abstract: Statins are commonly used drugs in patients with liver and cardiac disease. Statin-induced severe myopathy is a very uncommon presentation and rhabdomyolysis may occur in extreme cases which leads to renal failure. Patients with comorbidities like diabetes, hypothyroidism, and liver disease have higher chances of development of statin-induced myopathy. We describe a case of Child's C cirrhosis wherein the patient had acute onset significant muscle weakness and improved on statin discontinuation.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-09-28
      DOI: 10.1016/j.jceh.2016.09.007
       
  • Malignant Hepatic Epithelioid Hemangioendothelioma with Villaret Syndrome
    • Authors: Hanchanale Pavan; Joy Varghese, Kavya Harika, Mukul Vij, Venkataraman Jayanthi, Mohamed Rela
      Abstract: Malignant hepatic epithelioid hemangioendothelioma is a rare, vascular tumor of the liver with peak incidence in the middle age with a female preponderance and of unknown etiology. Majority of the tumors are asymptomatic. The gold standard for diagnosis of the tumor is liver histology showing presence of epithelioid tumor cells on a background of a hyaline stroma. Immunohistochemical positivity for CD31, CD34, Factor VIII, and Podoplanin (D2-40) is confirmatory. The treatment of choice is liver transplantation.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-09-28
      DOI: 10.1016/j.jceh.2016.09.006
       
  • Unusual Presentation of Tubercular Liver Abscess in an Immune-Competent
           Adult
    • Authors: Pramod Kumar; Sunil Taneja, Kirti Gupta, Ajay Duseja, Radha K. Dhiman, Yogesh K. Chawla
      Abstract: Isolated hepatobiliary tuberculosis (TB) has been uncommonly described with or without biliary involvement and accounts for less than 1% of all tubercular infections. Isolated hepatic TB is even rare and poses a great diagnostic challenge. We report a case of isolated tubercular liver abscess with extension into the chest wall in an immune-competent adult, which was diagnosed and managed successfully with antitubercular treatment.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-09-27
      DOI: 10.1016/j.jceh.2016.09.011
       
  • Giant Intrahepatic Portal Vein Aneurysm: Leave it or Treat it'
    • Authors: Amit Shrivastava; Jagdeesh S. Rampal, D. Nageshwar Reddy
      Abstract: Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-09-13
      DOI: 10.1016/j.jceh.2016.08.013
       
  • Rapid Onset of Fatal Lactic Acidosis Complicating Tenofovir Therapy in a
           Diabetic Patient with Cirrhosis: A Cautionary Tale
    • Authors: Ramesh Kumar; Shivani Agrawal
      Abstract: A nucleotide analogue (NA) has potential to cause mitochondrial (mt) toxicity which may lead to the development of lactic acidosis (LA).1 Tenofovir, a nucleotide analogue, induced LA is extremely rare because of its low affinity for mt DNA polymerase.2 We report a 45-year-old gentleman, with a background history of diabetes mellitus (DM) and hepatitis B virus related liver cirrhosis, who developed fatal LA after initiation of tenofovir. The patient had advanced cirrhosis with Model for End-stage Liver Disease score of 24, and he had not been on any anti-diabetic medication for 3 months.
      Citation: Journal of Clinical and Experimental Hepatology (2016)
      PubDate: 2016-09-06
      DOI: 10.1016/j.jceh.2016.08.010
       
 
 
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