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Journal of Clinical and Experimental Hepatology

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https://read.qxmd.com/read/30774268/bile-acids-in-hepatic-encephalopathy
#1
Sharon DeMorrow
Hepatic encephalopathy describes the array of neurological complications that arise due to liver insufficiency and/or portal-systemic shunt. The pathogenesis of hepatic encephalopathy shares a longstanding association with hyperammonemia and inflammation. Recently, aberrant bile acid signaling has been implicated in the development of key features of hepatic encephalopathy due to acute liver failure including neuronal dysfunction, neuroinflammation and blood-brain barrier permeability. This review summarizes the findings of recent studies demonstrating a role for bile acids in hepatic encephalopathy and speculates on the possible downstream consequences of bile acid signaling...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30774267/methods-for-studying-gut-microbiota-a-primer-for-physicians
#2
REVIEW
Aditya N Sarangi, Amit Goel, Rakesh Aggarwal
Human gastrointestinal tract contains a large variety of microbes, in particular bacteria. Studies in recent years have strongly suggested a role for these microbes, collectively referred to as gut microbiota, in the maintenance of homeostasis during health. In addition, alterations in gut microbiota have been reported in several diseases, including those related to the gastrointestinal tract and several systemic conditions, and are believed to play a pathogenetic role in at least some of these. Given the close association between the human gut and liver, the association with gut microbiota appears to be particularly strong for a wide variety of liver diseases...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765947/how-to-design-a-multicenter-clinical-trial-in-hepatic-encephalopathy
#3
REVIEW
Lorenzo Ridola, Silvia Nardelli, Stefania Gioia, Oliviero Riggio
The design of clinical trials on Hepatic Encephalopathy (HE) is not an easy task, in fact there are several issues related to the performance of clinical trials in HE that have impeded progress in the field, mainly because most of the studies on HE therapy were performed before the era of rigorous Randomized Controlled Trials (RCTs). In this review we discuss the major problems affecting previously published trials on HE treatments aiming to provide evidences, suggestions and indications to prepare well designed RCTs in three different settings: (1) management of hospitalized patients with episodic HE; (2) secondary prophylaxis in patients following an episode of HE; and (3) management of minimal/covert HE...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765946/role-of-exercise-in-the-management-of-hepatic-encephalopathy-experience-from-animal-and-human-studies
#4
REVIEW
Luise Aamann, Puneeta Tandon, Chantal Bémeur
Sarcopenia and malnutrition are common features in patients with hepatic encephalopathy. Ammonia, a factor implicated in the pathophysiology of hepatic encephalopathy, may be cleared by the muscle via the enzyme glutamine synthetase when the liver function is impaired. Hence, optimizing muscle mass in patients suffering from hepatic encephalopathy is a potential strategy to decrease ammonia levels. Exercise could be an efficient therapeutic approach to optimize muscle mass and therefore potentially reduce the risk of hepatic encephalopathy in patients with chronic liver disease...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765945/hepatic-encephalopathy-and-sarcopenia-two-faces-of-the-same-metabolic-alteration
#5
REVIEW
Barbara Lattanzi, Daria D'Ambrosio, Manuela Merli
Sarcopenia is an important burden in liver cirrhosis representing a negative prognostic factor for mortality. Moreover, sarcopenia is an independent predictor of complications in patients with liver cirrhosis, including Hepatic Encephalopathy (HE). An association between sarcopenia and HE in liver cirrhosis has been reported in recent studies, indeed both these complications often affect patients with advanced liver cirrhosis and may exert a synergic effect in deteriorating patients' outcome. Episodes of HE occur more often in patients with muscle depletion...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765944/prognostic-implications-of-minimal-covert-hepatic-encephalopathy-large-scale-validation-cohort-studies
#6
REVIEW
Christopher R Flud, Andres Duarte-Rojo
Minimal or Covert Hepatic Encephalopathy (MHE/CHE), the preclinical phase of Hepatic Encephalopathy (HE), is strongly associated with poorer Quality of Life (QOL), Overt HE (OHE), and death. Several diagnostic tests have been developed that have prognostic value in predicting clinical outcomes such as OHE, cirrhosis progression, and death. However, dispute among clinicians and HE researchers have kept its application largely underutilized. Current issues contributing to the confusion include: lack of a formal definition for CHE, uncertainty of which diagnostic tools to use, and whether one or two abnormal tests are required for a diagnosis...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765943/minimal-covert-hepatic-encephalopathy-impact-of-comorbid-conditions
#7
REVIEW
Karin Weissenborn
Mild cognitive dysfunction as in minimal or covert hepatic encephalopathy (HE) can be found in a variety of metabolic disturbances, several neurological diseases, and even older age. Because liver cirrhosis usually is accompanied by one or the other of these, a differentiation between HE and cognitive decline because of comorbidities is difficult. Somehow discriminating is the impairment of motor speed and accuracy, which is more prominent in HE than in any of the comorbidities. The observation that, for example, diabetes mellitus, renal dysfunction, infections, or hyponatremia as well as older age increase the risk of developing HE indicates the interaction between these factors and liver dysfunction in the development of HE and the necessity to adjust the therapy accordingly...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765942/neurological-recovery-after-recovery-from-acute-liver-failure-is-it-complete
#8
REVIEW
Anil C Anand, Pankaj Singh
Neurologic dysfunction characterised by Hepatic Encephalopathy (HE) and cerebral oedema are the most dramatic presentations of Acute Liver Failure (ALF) and signify poor outcome. Improved critical care and wider availability of emergency Liver Transplantation (LT) has improved survivability in ALF. In most cases absence of clinically overt encephalopathy after spontaneous recovery from ALF or after LT is thought to indicate complete neurologic recovery. Recent data suggests that neurologic recovery may not always be complete...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765941/wilson-s-disease-clinical-practice-guidelines-of-the-indian-national-association-for-study-of-the-liver-the-indian-society-of-pediatric-gastroenterology-hepatology-and-nutrition-and-the-movement-disorders-society-of-india
#9
REVIEW
Aabha Nagral, Moinak S Sarma, John Matthai, Prashanth L Kukkle, Harshad Devarbhavi, Sanjib Sinha, Seema Alam, Ashish Bavdekar, Radha K Dhiman, Chundamannil E Eapen, Vinay Goyal, Neelam Mohan, Rukmini M Kandadai, Malathi Sathiyasekaran, Ujjal Poddar, Anupam Sibal, Srinivas Sankaranarayanan, Anshu Srivastava, Baburam R Thapa, Pettarusp M Wadia, Surendra K Yachha, Anil Dhawan
Clinical practice guidelines for Wilson's disease (WD) have been published by the American Association for the Study of Liver Diseases and European Association for the Study of the Liver in 2008 and 2012, respectively. Their focus was on the hepatic aspects of the disease. Recently, a position paper on pediatric WD was published by the European Society of Pediatric Gastroenterology Hepatology and Nutrition. A need was felt to harmonize guidelines for the hepatic, pediatric, and neurological aspects of the disease and contextualize them to the resource-constrained settings...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765940/long-term-survival-of-patients-undergoing-tips-in-budd-chiari-syndrome
#10
Amey D Sonavane, Deepak N Amarapurkar, Krantikumar R Rathod, Sundeep J Punamiya
Background: There has been significant improvement in understanding the etiology and management of Budd-Chiari Syndrome (BCS). Patients with chronic or acute-on-chronic BCS need radiological interventions in the form of angioplasty, hepatic vein/inferior vena cava stenting or Transjugular Intrahepatic Portosystemic Shunt (TIPS). Data regarding the long term follow up of patients undergoing TIPS is limited. We thus prospectively followed-up BCS patients who underwent TIPS at our center...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765939/the-changing-face-of-hepatocellular-carcinoma-forecasting-prevalence-of-nonalcoholic-steatohepatitis-and-hepatitis-c-cirrhosis
#11
Osmanuddin Ahmed, Lisa Liu, Antony Gayed, Amanjit Baadh, Mikin Patel, Jordan Tasse, Ulku Turba, Bulent Arslan
Background/objectives: The purpose of this research is to analyze the past and forecast the future prevalence of Hepatitis C Virus (HCV) and Nonalcoholic Steatohepatitis (NASH) and their respective contribution to Hepatocellular Carcinoma (HCC) incidence in the setting of novel anti-viral agents and rising obesity rates in the United States. Methods: Existing data of HCV and NASH prevalence in the United States utilizing the National Health and Nutrition Examination Survey (NHANES) and Organ Procurement and Transplantation Network (OPTN) was collected and analyzed to project future prevalence trends...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765938/potential-implications-of-detecting-hbsag-in-asymptomatic-people-in-an-endemic-community-through-medical-camps
#12
Gourdas Choudhuri, Varun Gupta, Tajinder Singh Negi, Rajesh Ojha
Background: In a developing country like India with intermediate level of prevalence of hepatitis B, most of the patients remain undiagnosed as they are asymptomatic. The purpose of the study was to diagnose asymptomatic HBsAg positive patients from the general population and evaluate further the potential clinical implications of IDAHS. Methods: Asymptomatic subjects with unknown HBV status were screened free of cost for hepatitis-B surface antigen. Those who tested positive for HBsAg were further tested to identify those who were potential candidates for anti-viral therapy...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765937/hepatitis-b-virus-infection-of-normal-hepatic-stem-progenitor-cells
#13
Wendy W Bautista, Carla Osiowy, Julianne Klein, Gerald Y Minuk
Background/Aims: Whether the hepatitis B virus (HBV) infects normal hepatic stem/progenitor cells (NSCs) and if so, whether such infections play a role in the pathogenesis of HBV-induced chronic liver disease (CLD) and/or hepatocellular carcinoma (HCC) remains to be determined. The objectives of this study were to determine whether HBV infects NSCs and whether such infections alter NSC activity in a manner likely to contribute to the development of CLD and/or HCC. Methods: Liver biopsies from five hepatitis B surface antigen (HBsAg) positive patients were co-stained for HBcAg and HBx and the stem cell markers EpCAM, Oct-4 and Nanog...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765936/evaluation-of-plasma-urokinase-type-plasminogen-activator-receptor-upar-in-patients-with-chronic-hepatitis-b-c-and-non-alcoholic-fatty-liver-disease-nafld-as-serological-fibrosis-marker
#14
Özlem Akdoğan, Ayşegül Atak Yücel, Zeynep Gök Sargin, Cemile Sönmez, Güldal Esendağli Yilmaz, Seren Özenirler
Background/aims: Progressive hepatic fibrosis is the main predictor of outcome and prognosis in chronic liver diseases. The importance of the coagulation cascade has been defined in liver fibrosis; however, the role of the fibrinolytic pathway has not been clear yet. We aimed to evaluate the association between the plasma levels of soluble urokinase Plasminogen Activator Receptor (uPAR) and the severity of liver fibrosis in chronic hepatitis B, C and Non-Alcoholic Fatty Liver Disease (NAFLD)...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765935/renal-dysfunction-in-patients-with-nonalcoholic-fatty-liver-disease-is-related-to-the-presence-of-diabetes-mellitus-and-severity-of-liver-disease
#15
Ram V Nampoothiri, Ajay Duseja, Manish Rathi, Swastik Agrawal, Naresh Sachdeva, Manu Mehta, Harpal S Dhaliwal, Radha K Dhiman, Yogesh Chawla
Background and aims: There is sparse data on the prevalence of renal dysfunction in patients with nonalcoholic fatty liver disease (NAFLD). The aim of the present study was to evaluate the presence of renal dysfunction in patients with NAFLD and correlate it with the severity of liver disease. Methods: One hundred nonalcoholic patients with ultrasound showing hepatic steatosis were enrolled into the study after exclusion of other causes. Presence of renal dysfunction was estimated by glomerular filtration rate and by evaluating 24 h urinary protein and microalbumin...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765934/controlled-attenuation-parameter-for-assessment-of-hepatic-steatosis-in-indian-patients
#16
Gyanranjan Rout, Saurabh Kedia, Baibaswata Nayak, Rajni Yadav, Prasenjit Das, Subrat K Acharya, Deepak Gunjan, Vishwajeet Singh, Mousumi Mahanta, Swatantra Gupta, Sandeep Aggarwal, Shalimar
Background/Aims: The gold standard method for measurement of hepatic steatosis is liver histology. Controlled Attenuation Parameter (CAP) can measure hepatic steatosis non-invasively. We aimed to assess the accuracy of CAP for detection of hepatic steatosis. Methods: A total of 462 patients (May 2012-January 2017)-89 non-alcoholic fatty liver disease, 182 chronic hepatitis B, 88 chronic hepatitis C and 103 patients with other etiologies who underwent simultaneous liver biopsy and CAP estimation using Transient Elastography (TE) were included...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765933/results-of-sofosbuvir-plus-ribavirin-in-patients-with-hepatitis-c-related-decompensated-cirrhosis
#17
Naveen Tmu, Ashish Kumar, Praveen Sharma, Vikas Singla, Naresh Bansal, Anil Arora
Background: Sofosbuvir (SOF), a direct acting antiviral, has revolutionized the treatment of chronic Hepatitis C Virus (HCV) infection. However, data is scarce about efficacy of SOF plus Ribavarin (RBV) in Indian patients with decompensated cirrhosis. We evaluated the efficacy of SOF plus RBV in decompensated cirrhosis, and compared the outcome with compensated cirrhosis and non-cirrhotics. Patients and methods: Consecutive decompensated cirrhotic patients of chronic HCV with detectable HCV RNA were treated with 24-week course of SOF (400 mg) plus weight based RBV...
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765932/special-section-update-in-hepatic-encephalopathy-part-iii
#18
EDITORIAL
Madhumita Premkumar, Radha K Dhiman
No abstract text is available yet for this article.
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30765931/the-ninth-year-of-jceh-the-year-of-expansion-and-growth
#19
EDITORIAL
Radha K Dhiman
No abstract text is available yet for this article.
January 2019: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/30568347/the-role-of-branched-chain-amino-acids-in-the-treatment-of-hepatic-encephalopathy
#20
REVIEW
Gitte Dam, Luise Aamann, Hendrik Vistrup, Lise Lotte Gluud
The relationship between intake of nutrients and Hepatic Encephalopathy (HE) dates back to the historical roots of experimental hepatology. Branched-Chain Amino Acids (BCAA; Isoleucine, leucine and valine) have attracted particular interest and in 1956 Müting described the amino acid pattern in patients with cirrhosis. The abnormal plasma pattern has been characterized by the ratio between BCAA and aromatic amino acids in plasma, the so called 'Fischer´s ratio'. This ratio has been associated with the grade of HE...
December 2018: Journal of Clinical and Experimental Hepatology
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