Hepatic encephalopathy: A review

Lizardi-Cervera, Javier; Almeda, P; Guevara, Luis; Uribe, Misael

doi:10.1016/s1665-2681(19)32137-4

Cited by 66 publications

(27 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus the mainstay treatment for HE revolves about reducing the production and absorption of ammonia in the gut, and to improve its excretion by drug therapy or diet modification. Currently, lactulose and nonabsorbable antibiotics are most commonly used therapeutics to treat HE 1-3. Several placebo-controlled trials of lactulose have reported no proof of superiority versus a placebo.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Rifaximin and Lactulose for the Treatment of Hepatic Encephalopathy: A Prospective Randomized Study

et al. 2005

View full text Add to dashboard Cite

Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe. However, it is unknown whether Rifaximin is effective for the treatment of HE in Koreans, therefore we conducted a open-label prospective randomized study to evaluate the efficacy of rifaximin versus lactulose in Korean patients. Fifty-four patients with liver cirrhosis and hepatic encephalopathy were enrolled. Thirty-two patients were randomized to receive rifaximin and 22 to receive lactulose both over a 7-day periods. Before and at the end of treatment, gradation of blood ammonia, flapping tremor, mental status, number connection test (NCT) were performed and estimation of HE indexes determined. Both rifaximin and lactulose were effective in the majority of patients (84.4% and 95.4%, respectively, p=0.315). Blood NH3, flapping tremor, mental status, and NCT was significantly improved by rifaximin and lactulose, and the posttreatment levels of these measures were similar for the rifaximin and lactulose-treated groups, as was the HE index (rifaximin group (10.0→4.2, p=0.000); lactulose group (11.3→5.0, p=0.000)). One patient treated with rifaximin complained of abdominal pain, which was easily controlled. There was no episode of renal function impairment in either treatment group. Rifaximin proved to be as safe and as effective as lactulose for the treatment of Korean patients with hepatic encephalopathy.

show abstract

Section: Discussionmentioning

confidence: 99%

“…It is frequently observed in those with both acute liver failure and liver cirrhosis 1. The pathogenesis of the syndrome is complex, but ammonia produced by intestinal bacteria is known to play an important role in its pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Rifaximin and Lactulose for the Treatment of Hepatic Encephalopathy: A Prospective Randomized Study

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Other causes of acutely altered mentation in heavy drinkers include cerebral trauma [9], meningitis [10], hypoglycemia [11], hepatic encephalopathy [12], alcoholic ketoacidosis [13] and concomitant use of other agents such as cocaine or heroin [1]. Marchiafava-Bignami disease, a rare disorder nearly always diagnosed in alcoholics, causes mania, depression, paranoia, and dementia, plus seizures, paresis, and ataxia, and often progresses to coma and death within a few months; symptoms are not readily explained by the prominent corpus callosum demyelination that is the pathological hallmark of this poorly understood disease [14].…”

Section: Indirect Effectsmentioning

confidence: 99%

Ethanol and Cognition: Indirect Effects, Neurotoxicity and Neuroprotection: A Review

Brust

2010

IJERPH

202

127

View full text Add to dashboard Cite

Ethanol affects cognition in a number of ways. Indirect effects include intoxication, withdrawal, brain trauma, central nervous system infection, hypoglycemia, hepatic failure, and Marchiafava-Bignami disease. Nutritional deficiency can cause pellagra and Wernicke-Korsakoff disorder. Additionally, ethanol is a direct neurotoxin and in sufficient dosage can cause lasting dementia. However, ethanol also has neuroprotectant properties and in low-to-moderate dosage reduces the risk of dementia, including Alzheimer type. In fetuses ethanol is teratogenic, and whether there exists a safe dose during pregnancy is uncertain and controversial.

show abstract

“…[6] Hyperammonemia leads to increased levels of ammonia in brain, which is responsible for the development of HE. [67] OA produces relief in the symptoms of HE by reducing elevated levels of ammonia both peripherally and centrally. [89] Although a number of studies are available for the action of OA on HE, data on its direct action on the liver are lacking.…”

Section: Introductionmentioning

confidence: 99%

Effect of l-ornithine l-aspartate against thioacetamide-induced hepatic damage in rats

et al. 2010

View full text Add to dashboard Cite

Objective:To investigate the hepatoprotective activity of L-ornithine-L-aspartate against thioacetamide (TAA)-induced hepataopathy in rats.Materials and Methods:The hepatoprotective activity of L-ornithine-L-aspartate (OA) at a dose of 2 g/kg, p.o. for 10 days was evaluated against TAA (250 mg/kg, i.p. for 2 days) induced hepatopathy in rats. Biochemical parameters such as serum aspartate transaminase, alanine transaminase, alkaline phosphatase, bilirubin and glutathione, thiobarbituric acid reactive substances, and protein in liver tissues were estimated to assess the liver function.Results:TAA-induced pathogenic changes in the levels of the above indices were significantly (P < 0.01) reversed by the OA treatment. OA treatment also exhibited significant restoration of the hepatic architecture and lobular structure in histological evaluation of the rat liver sections.Conclusion:Ornithine aspartate exhibited significant hepatoprotective activity against TAA-induced hepatic damage in rats.

show abstract

Hepatic encephalopathy: A review

Cited by 66 publications

References 26 publications

Comparison of Rifaximin and Lactulose for the Treatment of Hepatic Encephalopathy: A Prospective Randomized Study

Comparison of Rifaximin and Lactulose for the Treatment of Hepatic Encephalopathy: A Prospective Randomized Study

Ethanol and Cognition: Indirect Effects, Neurotoxicity and Neuroprotection: A Review

Effect of l-ornithine l-aspartate against thioacetamide-induced hepatic damage in rats

Contact Info

Product

Resources

About