scholarly journals Role of probiotics in the treatment of minimal hepatic encephalopathy in patients with HBV-induced liver cirrhosis

2018 ◽  
Vol 46 (9) ◽  
pp. 3596-3604 ◽  
Author(s):  
Xiaoxue Xia ◽  
Jiang Chen ◽  
Jiayun Xia ◽  
Bin Wang ◽  
Hua Liu ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Minimal Hepatic Encephalopathy ◽  
Treated Group ◽  
Mucosal Barrier ◽  
Overt Hepatic Encephalopathy ◽  
Probiotic Treatment ◽  
B Virus ◽  
Number Connection Test

Objective This study was performed to investigate the role of probiotics ( Clostridium butyricum combined with Bifidobacterium infantis) in the treatment of minimal hepatic encephalopathy (MHE) in patients with hepatitis B virus (HBV)-induced liver cirrhosis. Methods Sixty-seven consecutive patients with HBV-induced cirrhosis without overt hepatic encephalopathy were screened using the number connection test and digit symbol test. The patients were randomized to receive probiotics (n = 30) or no probiotics (n = 37) for 3 months. At the end of the trial, changes in cognition, intestinal microbiota, venous ammonia, and intestinal mucosal barriers were analyzed using recommended systems biology techniques. Results The patients’ cognition was significantly improved after probiotic treatment. The predominant bacteria ( Clostridium cluster I and Bifidobacterium) were significantly enriched in the probiotics-treated group, while Enterococcus and Enterobacteriaceae were significantly decreased. Probiotic treatment was also associated with an obvious reduction in venous ammonia. Additionally, the parameters of the intestinal mucosal barrier were obviously improved after probiotic treatment, which might have contributed to the improved cognition and the decreased ammonia levels. Conclusion Treatment with probiotics containing C. butyricum and B. infantis represents a new adjuvant therapy for the management of MHE in patients with HBV-induced cirrhosis.

Prevalence of Helicobacter pylori Infection in Patients with Minimal Hepatic Encephalopathy

2016 ◽  
Vol 25 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Christian Schulz ◽  
Kerstin Schütte ◽  
Nino Reisener ◽  
Julia Voss ◽  
Peter Malfertheiner
Keyword(s):  
Helicobacter Pylori ◽  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Frequency Analysis ◽  
Minimal Hepatic Encephalopathy ◽  
Critical Flicker Frequency ◽  
Blood Ammonia ◽  
Flicker Frequency ◽  
H Pylori ◽  
Number Connection Test

Background: Ammonia is a critical factor in the pathogenesis of minimal hepatic encephalopathy (MHE). Most of the ammonia is from bacterial production in the intestinal tract. Non-absorbable antibiotics and non-absorbable disaccharides are therefore the therapy of choice. A few studies have addressed the effect of ammonia produced by H. pylori in the pathogenesis of MHE. Methods: In this prospective clinical trial, 84 consecutive patients with liver cirrhosis (LC) underwent laboratory, psychometric und neurophysiological testing to determine serological H. pylori status, MHE and blood ammonia levels. Relevant clinical and demographic characteristics were documented. Results: Out of 84 LC patients (83% male), 29% presented with MHE as assessed by critical flicker frequency analysis (CFF). The prevalence of H. pylori infection in the cohort was 21%; 22% of H. pylori-infected patients presented with MHE according to the criterion of a positive CFF result. If the criterion for MHE was a positive CFF and a positive NCT-A result, then 17% of H. pylori positive patients suffered from MHE. The prevalence of MHE in H. pylori-negative patients, based on CFF alone and on the combination, was 30%. A proportion of 19% of the patients with MHE had increased blood ammonia levels. Conclusion: The amount of ammonia produced by H. pylori does not affect venous ammonia levels. Therefore, an additional benefit of H. pylori eradication in the treatment of hepatic encephalopathy in patients with LC is unlikely to occur. Key words:  –  –  –  –  – . Abbreviations: CFF: critical flicker frequency analysis; GCP: good clinical practice; GI : gastrointestinal; HE: hepatic encephalopathy; H. pylori: Helicobacter pylori; LC: liver cirrhosis; MHE: minimal hepatic encephalopathy; NASH: non-alcoholic steatohepatitis; NCT-A: number connection test-A; NCT-B: number connection test-B; PHES: Psychometric hepatic encephalopathy score.

scholarly journals Innumerable cerebral microbleeds in hepatitis B virus-related decompensated liver cirrhosis: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chi Hyuk Oh ◽  
Jin San Lee
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Brain Mri ◽  
Cerebral Microbleeds ◽  
Amyloid Angiopathy ◽  
Decompensated Liver Cirrhosis ◽  
B Virus ◽  
The Brain

Abstract Background Cerebral microbleeds (CMBs) are small, rounded, dark-signal lesions on brain MRI that represent cerebral hemosiderin deposits resulting from prior microhemorrhages and are neuroimaging biomarkers of cerebral amyloid angiopathy (CAA). Here, we report a case of innumerable CMBs in a patient with hepatic encephalopathy underlying decompensated liver cirrhosis. Case presentation An 83-year-old woman diagnosed with hepatitis B virus-related liver cirrhosis 40 years before was referred to our neurology clinic for progressive disorientation of time and place, personality changes, and confusion with somnolence over 2 weeks. Based on the laboratory, neuroimaging, and electrophysiological findings, we diagnosed the patient with hepatic encephalopathy, and her symptoms recovered within 12 h after proper medical management. Brain MRI showed innumerable CMBs in the bilateral frontal, parietal, temporal, and occipital lobes. Since the distribution of CMBs in the patient was mainly corticosubcortical and predominantly in the posterior cortical regions, and the apolipoprotein E genotype was ε4/ε4, we speculated that CAA and hepatic encephalopathy coexisted in this patient. Conclusions We suggest that severe liver dysfunction associated with long-term decompensated liver cirrhosis may be related to an increased number of CMBs in the brain. Our findings indicate that decompensated liver cirrhosis may be a risk factor for the development of CMBs and corroborate a link between the liver and the brain.

scholarly journals Normalisation of the psychometric encephalopathy score within the Cameroonian population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Larissa Pessidjo Djomatcho ◽  
Mathurin Pierre Kowo ◽  
Antonin Ndjitoyap Ndam ◽  
Sylvain Raoul Simeni Njonnou ◽  
Gabin Ulrich Kenfack ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Healthy Volunteers ◽  
Clinical Signs ◽  
Minimal Hepatic Encephalopathy ◽  
Education Level ◽  
Multicentric Study ◽  
Tracing Test ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Number Connection Test

Abstract Background Minimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests. Psychometric Hepatic Encephalopathy Score (PHES) is a gold standard test for the early diagnosis of MHE in cirrhotic patients. The aim of this study was to standardize the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among cirrhotic patients. Methods This was a prospective, multicentric study from 1 December 2018 to 31 July 2019 in two groups: healthy volunteers and cirrhotic patients without clinical signs of hepatic encephalopathy. The results of the number connection test-A, number connection test-B, serial dotting test, line tracing test were expressed in seconds and those of the digit symbol test in points. Results A total of 102 healthy volunteers (54 men, 48 women) and 50 cirrhotic patients (29 men, 31 women) were included. The mean age was 38.1 ± 12.55 years in healthy volunteers and 49.3 ± 15.6 years in cirrhotic patients. The mean years of education level was 11.63 ± 4.20 years in healthy volunteers and 9.62 ± 3.9 years in cirrhotic patients. The PHES of the healthy volunteer group was − 0.08 ± 1.28 and the cut-off between normal and pathological values was set at − 3 points. PHES of the cirrhotic patients was − 7.66 ± 5.62 points and significantly lower than that of volunteers (p < 0.001). Prevalence of MHE was 74% among cirrhotic patients. Age and education level were associated with MHE. Conclusion PHES cut-off value in Cameroonians is − 3, with MHE prevalence of 74% among cirrhotic patients.

scholarly journals L-Carnitine for the Treatment of Overt Hepatic Encephalopathy in Patients with Advanced Liver Cirrhosis

2018 ◽  
Vol 64 (5) ◽  
pp. 321-328 ◽  
Author(s):  
Kazuto TAJIRI ◽  
Yuka FUTSUKAICHI ◽  
Saito KOBAYASHI ◽  
Satoshi YASUMURA ◽  
Terumi TAKAHARA ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Overt Hepatic Encephalopathy ◽  
Advanced Liver Cirrhosis

Sarcopenia predicts minimal hepatic encephalopathy in patients with liver cirrhosis

2017 ◽  
Vol 47 (13) ◽  
pp. 1359-1367 ◽  
Author(s):  
Tatsunori Hanai ◽  
Makoto Shiraki ◽  
Satoshi Watanabe ◽  
Takahiro Kochi ◽  
Kenji Imai ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Minimal Hepatic Encephalopathy

scholarly journals The Role of L-ornithine-L-aspartate in the Management of Minimal Hepatic Encephalopathy among Patients with Liver cirrhosis: a Systemic review and Meta-analysis

2018 ◽  
Vol 52 (1) ◽  
Author(s):  
Henry Winston C. Li ◽  
Maria Ana Louise M. Naidas ◽  
Karen Anjela M. Mondragon ◽  
Ruter M. Maralit
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Meta Analysis ◽  
Block Design ◽  
Cochrane Collaboration ◽  
Minimal Hepatic Encephalopathy ◽  
Systemic Review ◽  
Cochrane Library ◽  
P Value ◽  
Picture Completion

Objective. To evaluate the efficacy of L-ornithine-L-aspartate (LOLA) in improving minimal hepatic encephalopathy in adult patients with liver cirrhosis. Methods. A search in PubMed, Cochrane Library, Google Scholar, and Medline was made obtaining four qualified randomized controlled trials. Studies included adult cirrhotic patients with minimal hepatic encephalopathy measured by the number connection test (NCT-A, B), figure connection test (FCT-A, B), picture completion, block design test, and critical flicker frequency (CFF) testing with a cut-off score of <39Hz. Methodologic assessment of studies was performed using Cochrane Collaboration Risk of Bias Tool and Review Manager (RevMan) version 5.3 for statistical analysis. Results. Of the 29 studies identified, 4 fulfilled the inclusion criteria, which entailed analysis of 238 participants (LOLA: 116, Control: 122). Three out of the four studies were used in meta-analysis and one study was analyzed separately due to a difference in the neuropsychometric measure. The metaanalysis favored experimental group (LOLA), with a mean difference of 2.29 (95% CI 0.72 – 3.86), p-value = 0.004, and an I2 of 18%. Conclusion. LOLA provided great potential in managing encephalopathy since treating earlier related to better survival and prevention of disease progression. The results of our study supported such evidence and its use may be encouraged.

Sign in / Sign up

Export Citation Format

Share Document