Article
Gastroenterology & Hepatology
Bryan D. Badal, Jasmohan S. Bajaj
Summary: The inclusion of acute encephalopathy in all society definitions of acute-on-chronic liver failure (ACLF) highlights its significance in the syndrome. Acute encephalopathy in ACLF is caused by severe inflammation, and it is important to identify reversible causes. Hepatic encephalopathy not only increases mortality in ACLF but also hinders evaluation for liver transplant due to patient instability. Further research is needed to identify at-risk individuals, develop better prognostic tools, and explore novel treatments. Optimal ICU care, palliative care services, and patient satisfaction should be considered in managing encephalopathic patients.
CLINICS IN LIVER DISEASE
(2023)
Article
Medicine, General & Internal
Piotr F. Czempik, Michal P. Pluta, Mariusz Hofman, Piotr S. Liberski, Tomasz Jaworski, Anna Szczepanska, Oskar Bozek
Summary: A 54-year-old male with impaired consciousness was admitted to the ICU. His medical history included alcohol dependence, liver cirrhosis, esophageal varices, previous banding procedures, and obesity. Imaging tests initially showed no abnormalities, but an urgent esophagogastroduodenoscopy revealed esophageal varices and scarification. Further investigations including neurologic assessment and MRI led to a diagnosis of hepatic encephalopathy. CT of the abdomen confirmed the diagnosis by showing intussusception of the ileum.
Review
Gastroenterology & Hepatology
William Bernal, Constantine Karvellas, Faouzi Saliba, Fuat H. Saner, Philippe Meersseman
Summary: Acute-on-chronic liver failure syndrome involves liver function deterioration, extrahepatic organ failure, and high mortality rate, requiring rapid and coherent management in the intensive care unit to improve patient outcomes.
JOURNAL OF HEPATOLOGY
(2021)
Article
Gastroenterology & Hepatology
Priti Vijay, Bikrant Bihari Lal, Vikrant Sood, Rajeev Khanna, Yashwant Patidar, Seema Alam
Summary: The study found that optic nerve sheath diameter (ONSD) is an effective indicator for detecting raised intracranial pressure in pediatric acute liver failure patients. An ONSD greater than 4.55 mm indicates elevated ICP. Timely reduction in ONSD can predict patient outcomes.
HEPATOLOGY INTERNATIONAL
(2021)
Article
Medicine, General & Internal
Liyuan Long, Hai Li, Guohong Deng, Xianbo Wang, Sihong Lu, Beiling Li, Zhongji Meng, Yanhang Gao, Zhiping Qian, Feng Liu, Xiaobo Lu, Haotang Ren, Jia Shang, Hai Li, Shaoyang Wang, Yubao Zheng, Huadong Yan, Shan Yin, Wenting Tan, Qun Zhang, Xin Zheng, Jinjun Chen, Sen Luo, Jinming Zhao, Wei Yuan, Tao Li, Rongjiong Zheng, Junping Liu, Xiaoxiao Liu, Wenyi Gu, Sumeng Li, Xue Mei, Ruochan Chen, Yan Huang
Summary: Hepatic encephalopathy has a significant impact on adverse outcomes in patients with acute-on-chronic liver diseases, especially in those with grades 3-4 hepatic encephalopathy. Patients with alcohol consumption are more likely to develop hepatic encephalopathy compared to those with hepatitis B virus infection, and the impact of different grades of hepatic encephalopathy on adverse outcomes increases progressively.
FRONTIERS IN MEDICINE
(2021)
Article
Biochemical Research Methods
Victoria Tatiana Kronsten, Debbie Lindsay Shawcross
Summary: Hepatic encephalopathy and depression share several clinical features and potential pathophysiological mechanisms, such as systemic inflammation and alterations in gut microbiota. The interaction between these conditions may have implications for treatment strategies and outcomes in patients with chronic liver disease.
ANALYTICAL BIOCHEMISTRY
(2022)
Article
Medicine, General & Internal
Yuki Nakahata, Tatsunori Hanai, Takao Miwa, Toshihide Maeda, Kenji Imai, Atsushi Suetsugu, Koji Takai, Masahito Shimizu
Summary: This study found that selenium deficiency is highly prevalent in patients with chronic liver disease (CLD) and is associated with an increased risk of overt hepatic encephalopathy (OHE) development. The serum selenium levels were lower in patients with cirrhosis compared to those with chronic hepatitis, and they were negatively correlated with several disease severity indicators. The ALBI score remained significantly associated with selenium deficiency, and selenium deficiency was associated with the occurrence of OHE during the follow-up period.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, Research & Experimental
Jun Weng, Xu Han, Fanhong Zeng, Yue Zhang, Lei Feng, Lei Cai, Kangyan Liang, Shusong Liu, Shao Li, Gongbo Fu, Min Zeng, Yi Gao
Summary: The study utilized a fiber scaffold bioreactor for high-density, 3D culture of porcine hepatocytes to construct a bioartificial liver and evaluated its protective effects in an ALF porcine model. The bioartificial liver treatment enhanced liver regeneration, alleviated systemic inflammatory response, and reduced extrahepatic organ injury, leading to prolonged survival in the ALF model.
Review
Medicine, General & Internal
Piero Amodio, Sara Montagnese
Summary: Hepatic encephalopathy is a form of brain dysfunction caused by liver insufficiency and/or portal-systemic shunting, with inconsistencies in its detection and management. Diagnosis of HE involves consideration of its phenotypes, risk factors, and differential diagnosis from other similar conditions.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Biochemistry & Molecular Biology
So Yeong Cheon, Juhyun Song
Summary: Hepatic encephalopathy and diabetic encephalopathy are emerging types of neurological diseases characterized by cognitive and motor impairments. The relationship between metabolic organs and the brain plays an important role in the pathogenesis of neurological diseases.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Review
Pediatrics
Johanna Ascher Bartlett, Rohit Kohli
Summary: Hepatic encephalopathy is a condition associated with both chronic and acute liver disease, characterized by mental status changes and neuropsychiatric impairment. It can be challenging to identify in children, but careful assessment is crucial as symptom progression may indicate cerebral edema and systemic deterioration. Hyperammonemia may be present, but its degree does not correlate with clinical severity. Current treatment options include addressing the underlying cause and reducing high ammonia levels with medications or extracorporeal liver support.
INDIAN JOURNAL OF PEDIATRICS
(2023)
Article
Gastroenterology & Hepatology
Chathur Acharya, Jasmohan S. Bajaj
Summary: Chronic liver disease is becoming epidemic due to factors such as obesity, nonalcoholic liver disease, and alcohol overuse. Understanding the relationship between gut microbiota and liver diseases is crucial for developing improved diagnostic and therapeutic approaches. Knowledge of intestinal microbiome and its impact on liver disease could provide valuable insights for practical application in healthcare.
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
Clinical Neurology
Isabel Charlotte Hostettler, Duncan Wilson, Catherine Arnold Fiebelkorn, Diane Aum, Sebastian Francisco Ameriso, Federico Eberbach, Markus Beitzke, Timothy Kleinig, Thanh Phan, Sarah Marchina, Romain Schneckenburger, Maria Carmona-Iragui, Andreas Charidimou, Isabelle Mourand, Sara Parreira, Gareth Ambler, Hans Rolf Jager, Shaloo Singhal, John Ly, Henry Ma, Emmanuel Touze, Ruth Geraldes, Ana Catarina Fonseca, Teresa Melo, Pierre Labauge, Pierre-Henry Lefevre, Anand Viswanathan, Steven Mark Greenberg, Juan Fortea, Marion Apoil, Marion Boulanger, Fausto Viader, Sandeep Kumar, Velandai Srikanth, Ashan Khurram, Franz Fazekas, Veronica Bruno, Gregory Joseph Zipfel, Daniel Refai, Alejandro Rabinstein, Jonathan Graff-Radford, David John Werring
Summary: Patients with cSAH associated with probable or possible CAA have a high risk of future ICH and recurrent cSAH. Convexity SAH associated with probable CAA is linked to increased risk of ICH and cSAH, but not ischemic stroke.
JOURNAL OF NEUROLOGY
(2022)
Article
Pediatrics
James E. Squires, Patrick J. McKiernan, Robert H. Squires
Summary: This study aims to develop criteria for acute liver dysfunction in critically ill children. Through a systematic review, criteria including duration of symptoms, biochemical evidence, and liver-based coagulopathy were proposed. The study also acknowledges the limitations of the research.
Review
Nursing
Juliette Ribaud, Siobhan McLernon, Georg Auzinger
Summary: This systematic review examines the use of targeted temperature management in patients with acute liver failure. The findings suggest that while targeted temperature management does not significantly improve survival, it can be effective in treating intracranial hypertension and stabilizing critically ill patients without increasing the risk of bleeding.
NURSING IN CRITICAL CARE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Steve Connor, Mustafa Anjari, Christian Burd, Amrita Guha, Mary Lei, Teresa Guerrero-Urbano, Irumee Pai, Paul Bassett, Vicky Goh
Summary: The study looked at the impact of HPV OPC status on predicting outcomes of HNSCC CRT with pretreatment DW-MRI, finding that HPV OPC diagnosis was a significant predictor of 2-year survival outcomes, while pretreatment ADC values did not predict survival in the HPV OPC subgroup.
BRITISH JOURNAL OF RADIOLOGY
(2022)
Letter
Gastroenterology & Hepatology
Thomas H. Tranah, Maria-Pilar Ballester, Juan Antonio Carbonell-Asins, Rajiv Jalan, Debbie L. Shawcross
JOURNAL OF HEPATOLOGY
(2023)
Letter
Gastroenterology & Hepatology
Thomas H. Tranah, Maria-Pilar Ballester, Juan Antonio Carbonell-Asins, Rajiv Jalan, Debbie L. Shawcross
JOURNAL OF HEPATOLOGY
(2023)
Letter
Gastroenterology & Hepatology
Thomas H. Tranah, Maria-Pilar Ballester, Juan Antonio Carbonell-Asins, Rajiv Jalan, Debbie L. Shawcross
JOURNAL OF HEPATOLOGY
(2023)
Editorial Material
Gastroenterology & Hepatology
Debbie L. Shawcross, Florence Wong
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Richard J. Aspinall, Mark Hudson, Stephen D. Ryder, Paul Richardson, Elizabeth Farrington, Mark Wright, Robert T. Przemioslo, Francisco Perez, Melanie Kent, Roland Henrar, Joe Hickey, Debbie L. Shawcross
Summary: In clinical practice in the UK, the use of RFX in patients with HE was associated with a 35% survival rate, high treatment adherence, 76% transplant-free survival rate, minimal healthcare resource utilization, and low rates of complications at 5 years post-initiation.
FRONTLINE GASTROENTEROLOGY
(2023)
Editorial Material
Gastroenterology & Hepatology
Debbie L. Shawcross, Dominique Thabut, Piero Amodio
JOURNAL OF HEPATOLOGY
(2023)
Letter
Gastroenterology & Hepatology
Thomas H. Tranah, Maria-Pilar Ballester, Juan Antonio Carbonell-Asins, Rajiv Jalan, Debbie L. Shawcross
JOURNAL OF HEPATOLOGY
(2023)
Review
Infectious Diseases
Blair Merrick, Chrysi Sergaki, Lindsey Edwards, David L. Moyes, Michael Kertanegara, Desiree Prossomariti, Debbie L. Shawcross, Simon D. Goldenberg
Summary: Antimicrobial resistance (AMR) presents a significant burden to the global healthcare system, particularly in Gram-negative organisms such as extended-spectrum beta-lactamase and carbapenemase-producing Enterobacterales (ESBL and CPE). These pathogens have limited treatment options, leading to poor clinical outcomes. Manipulating the gut microbiota through various methods, including diet, probiotics, bacteriophages, and fecal microbiota transplantation (FMT), can effectively restore colonization resistance and limit the spread of AMR organisms.
INFECTIOUS DISEASE REPORTS
(2023)
Meeting Abstract
Gastroenterology & Hepatology
James Liu Yin, William Griffiths, Debbie Shawcross, Michael Heneghan, Aftab Ala
Meeting Abstract
Gastroenterology & Hepatology
Maria Pilar Ballester, Thomas H. Tranah, Juan Antonio Carbonell-Asins, Annarein Kerbert, Goncalo Alexandrino, Paloma Poyatos-Garcia, Andra Caracostea, Jose Sanchez-Serrano, Carmina Montoliu, Karen L. Thomsen, Rajiv Jalan, Debbie L. Shawcross
JOURNAL OF HEPATOLOGY
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Tom H. Tranah, Maria Pilar Ballester, Juan Antonio Carbonell-Asins, Annarein Kerbert, Goncalo Alexandrino, Maria Capilla, Andra Caracostea, Desamparados Escudero-Garcia, Karen Louise Thomsen, Miguel Serra, Debbie L. Shawcross, Rajiv Jalan
JOURNAL OF HEPATOLOGY
(2022)
Article
Clinical Neurology
Steve E. J. Connor, Nicholas W. M. Thomas, Jonathan Shapey
Summary: This study revealed the impact of petroclival chondrosarcoma on the relationship between the VC and pICA, highlighting the need for an individualized approach. The pICA tends to be displaced anteriorly and superiorly, while the anterior genu usually remains superior to the VC but may be located within the canal.
ACTA NEUROCHIRURGICA
(2022)
Article
Gastroenterology & Hepatology
Victoria Tatiana Kronsten, Josepmaria Argemi, Ada Sera Kurt, Godhev Mannakat Vijay, Jennifer Marie Ryan, Ramon Bataller, Debbie Lindsay Shawcross
Summary: The study found that plasma levels of angiopoietin 2 (ANG2) were elevated in patients with severe alcoholic hepatitis and alcohol-related liver disease, suggesting its potential as a prognostic biomarker. Additionally, gene expression of ANG1 and ANG2 in liver tissue varied in different severities of liver disease.