Article
Gastroenterology & Hepatology
Rajiv Jalan, Christopher F. Rose
Summary: The clinical progress in managing hepatic encephalopathy lags behind basic research, making current criteria for definition, classification, diagnosis, and grading difficult to apply reproducibly. Studies suggest that hepatic encephalopathy may be irreversible in many patients, requiring further research into neuronal injury and death mechanisms for future drug development. Lactulose, currently considered the standard of care, has poor clinical evidence for all severity levels of hepatic encephalopathy, and ethical consideration should be given to placebo-controlled trials.
JOURNAL OF HEPATOLOGY
(2022)
Article
Microbiology
Ming-Wei Wang, Wei-Juan Ma, Yan Wang, Xiao-Han Ma, Yu-Feng Xue, Jing Guan, Xi Chen
Summary: This study aimed to determine the safety and efficacy of different intestinal microecological modulators in the treatment of minimal hepatic encephalopathy (MHE) and explore the potential mechanism through intestinal microbiota analysis. The results showed that probiotics, rifaximin, and lactulose are safe and effective in the treatment of MHE, and they can improve the composition of gut microbiota to some extent.
FRONTIERS IN MICROBIOLOGY
(2023)
Article
Gastroenterology & Hepatology
Junfen Shi, Fang Li
Summary: This study aimed to investigate the clinical effect of probiotics combined with lactulose for minimal hepatic encephalopathy (MHE) treatment. The results showed that the combined group had significant improvements in serum ammonia, liver function, intestinal mucosal barrier markers, and cognitive function compared to the control group treated with lactulose alone.
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Kenneth W. Chow, Brittney M. Ibrahim, Jung J. Yum, An Dang, Long Dang, Kuan-Ting Chen, Nicholas J. Jackson, Sammy Saab
Summary: This study aimed to identify the factors contributing to lactulose non-adherence and propose strategies for promoting greater adherence. Findings showed that barriers to adherence included large volumes of lactulose, high frequency of dosing, difficulty remembering medication intake, unpleasant taste, and medication side-effects. Most patients understood the importance of lactulose and felt that it was effective in managing hepatic encephalopathy. Rating: 8/10.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Article
Medicine, General & Internal
Chien-Hao Huang, Tung-Yang Yu, Wei-En Johnny Tseng, Yu-Tung Huang, Shang-Hung Chang, Sen-Yung Hsieh, Rong-Nan Chien, Piero Amodio
Summary: This study aimed to investigate the potential of the animal naming test (ANT(1) and simplified ANT(1) (s-ANT(1))) for assessing covert hepatic encephalopathy (CHE) in Chinese-speaking regions, specifically Taiwan. The study found that ANT(1) and s-ANT(1) showed diagnostic and prognostic value for CHE.
ANNALS OF MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Angel Daniel Santana-Vargas, Fatima Higuera-de la Tijera, Jose Luis Perez-Hernandez
Summary: This study compared the diagnostic features of auditory and visual P300 in detecting minimal hepatic encephalopathy (MHE). The results showed that the sensitivity, specificity, and accuracy of auditory P300 were similar to those of critical flicker frequency (CFF), making it useful in differentiating patients with MHE. However, visual P300 was found to be unsuitable for detecting MHE.
REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS
(2022)
Article
Health Care Sciences & Services
Ching Chang, Chien-Hao Huang, Hsiao-Jung Tseng, Fang-Chen Yang, Rong-Nan Chien
Summary: This study evaluated the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission, showing significant improvement in HE remission maintenance and reduction in HE-related hospitalizations in the rifaximin add-on group compared to lactulose alone. Long-term use of rifaximin add-on to lactulose was found to be effective in reducing HE recurrence and related hospitalization for patients with decompensated cirrhosis.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Review
Medicine, General & Internal
Junxiong Cheng, Yafang Chen, Wenfu Cao, Guoqing Zuo
Summary: This meta-analysis compared the efficacy of rifaximin and nonabsorbable disaccharides (NADs) in treating hepatic encephalopathy. Rifaximin was found to be better in achieving complete resolution of HE compared to NADs, but no significant differences were observed in mental status, blood ammonia level, or adverse effects between the two treatment groups.
Review
Health Care Sciences & Services
Jakub Gazda, Peter Drotar, Sylvia Drazilova, Juraj Gazda, Matej Gazda, Martin Janicko, Peter Jarcuska
Summary: Hepatic encephalopathy is a brain dysfunction caused by liver insufficiency and/or portosystemic shunting, with a spectrum of manifestations including overt HE, covert HE, and minimal HE. Despite the lack of universally accepted gold standard for diagnosing MHE, significant progress has been made in the application of artificial intelligence in medicine.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Medicine, General & Internal
Kessarin Thanapirom, Monton Wongwandee, Sirinporn Suksawatamnuay, Panarat Thaimai, Napaporn Siripon, Wanwisar Makhasen, Sombat Treeprasertsuk, Piyawat Komolmit
Summary: The study aimed to establish the normative data of PHES in healthy Thai individuals, assess the prevalence of MHE, and validate the use of S-ANT1 in detecting MHE in cirrhotic patients. The results showed that MHE was present in 26.6% of cirrhotic patients. S-ANT1 had a moderate positive correlation with PHES.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Simon Johannes Gairing, Chiara Mangini, Lisa Zarantonello, Stefania Gioia, Elise Jonasson Nielsen, Sven Danneberg, Anna S. Lok, Philippe Sultanik, Peter Robert Galle, Joachim Labenz, Dominique Thabut, Jens Uwe Marquardt, Patricia P. Bloom, Mette Munk Lauridsen, Sara Montagnese, Silvia Nardelli, Christian Labenz
Summary: This large multicenter study demonstrates that screening for minimal hepatic encephalopathy (MHE) is a useful tool for predicting the development of overt hepatic encephalopathy (OHE) and poorer survival.
JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Medicine, Research & Experimental
Jie Sun, Jiangong Ren, Xuejian Hu, Yuanhua Hou, Yan Yang
Summary: With the improvement of people's living standards and changes in the environment, the incidence of diabetes has rapidly increased, becoming one of the main diseases threatening the health of modern people. Although existing treatment methods can control symptoms and delay disease progression, they have not significantly improved quality of life for patients. Chinese herbal medicines and their extracts, combining traditional experience with modern scientific research, are expected to bring a qualitative leap in the clinical management of diabetes.
BIOMEDICINE & PHARMACOTHERAPY
(2021)
Article
Integrative & Complementary Medicine
Han Gao, Zhen Li, Yao Liu, Yong-kang Zhao, Cheng Cheng, Feng Qiu, Yuan Gao, Ya-wen Lu, Xin-hua Song, Jia-bo Wang, Zhi-tao Ma
Summary: BGXJW is a clinical experience-based Chinese herbal formula that can prevent and alleviate the symptoms of drunkenness and alcoholic liver injury. The results of the study showed that it effectively prevented alcoholic liver injury and steatosis in mice by regulating lipid metabolism, inflammatory response, and alcohol metabolism.
Article
Gastroenterology & Hepatology
Takao Miwa, Tatsunori Hanai, Maeda Toshihide, Yui Ogiso, Kenji Imai, Atsushi Suetsugu, Koji Takai, Makoto Shiraki, Naoki Katsumura, Masahito Shimizu
Summary: Zinc deficiency may predict the development of OHE and mortality in LC patients with MHE.
HEPATOLOGY RESEARCH
(2021)
Article
Medicine, General & Internal
Yuka Hayakawa, Nobuharu Tamaki, Hiroyuki Nakanishi, Masayuki Kurosaki, Yuki Tanaka, Kento Inada, Shun Ishido, Sakura Kirino, Koji Yamashita, Tsubasa Nobusawa, Hiroaki Matsumoto, Tatsuya Kakegawa, Mayu Higuchi, Kenta Takaura, Shohei Tanaka, Chiaki Maeyashiki, Shun Kaneko, Yutaka Yasui, Yuka Takahashi, Kaoru Tsuchiya, Ryuichi Okamoto, Namiki Izumi
Summary: This study investigated the change in hospitalization rate before and after rifaximin add-on therapy in lactulose resistant patients with hepatic encephalopathy. The findings showed that rifaximin administration significantly reduced the hospitalization rate and ammonia levels among treatment-resistant patients, suggesting that rifaximin can be used as an add-on treatment for hepatic encephalopathy.