61. All-Net | Fulminant Hepatic Failure: Encephalopathy If Stage III hepatic encephalopathy develops, endotracheal intubation for airway Patients with Stage IV hepatic encephalopathy should be intubated for http://pedsccm.wustl.edu/All-Net/english/gipage/liver/fhf-6.htm

ALL-NET Pediatric Critical Care Textbook R E L A T E D Hoofnagle JH , Carithers RL Jr, Shapiro C, Ascher N. Fulminant hepatic failure: summary of a workshop Hepatology Lee, WM. Acute Liver Failure N Engl J Med Munoz, SJ. Difficult management problems in fulminant hepatic failure Seminars in Liver Disease Bernuau J, Godeau A, Poynard T, et al. Multivariate analysis of prognostic factors in fulminant hepatitis B Hepatology P A G E S Fulminant Hepatic Failure index what is FHF? etiology of FHF prognosis of FHF FHF management cardiorespiratory evaluation grading encephalopathy access and airway fluids and sedation ... specific therapies FHF evaluation identify the etiology ongoing evaluation liver biopsy complications hepatic encephalopathy cerebral edema bleeding infection ... metabolic / nutrition liver transplant in FHF indications methods issues experimental therapies hepatic support plasmapheresis flumazenil Adrienne Randolph MD MSc , the Multidisciplinary ICU, and Maureen Jonas MD, Division of Hepatology, Children's Hospital Boston , 300 Longwood Avenue, Boston, Massachusetts USA Fulminant hepatic failure /severity of encephalopathy The stage of encephalopathy has great prognostic significance. Passage through these stages may be quite rapid; the early stages may not be appreciated.

62. Hepatic Encephalopathy (from Digestive System Disease) --  Encyclopædia Britan hepatic encephalopathy (from digestive system disease) hepatic encephalopathyrefers to changes in the brain that occur in patients with advanced acute or http://www.britannica.com/eb/article-45443

Home Browse Newsletters Store ... Subscribe Already a member? Log in Content Related to this Topic This Article's Table of Contents Expand all Collapse all Introduction Mouth and oral cavity ... Cancer Stomach Indigestion Ulcerative diseases Gastritis Cancer ... Cirrhosis Complications of advanced liver disease changeTocNode('toc45442','img45442'); Hepatic encephalopathy Portal hypertension Ascites Hepatorenal syndrome ... Tumours Biliary tract Gallstones Other biliary tract disorders Jaundice Unconjugated jaundice ... Cholestatic jaundice Pancreas Pancreatitis Chronic pancreatitis Cystic fibrosis Cancer ... Print this Table of Contents Shopping Price: USD $1495 Revised, updated, and still unrivaled. The Official Scrabble Players Dictionary (Hardcover) Price: USD $15.95 The Scrabble player's bible on sale! Save 30%. Merriam-Webster's Collegiate Dictionary Price: USD $19.95 Save big on America's best-selling dictionary. Discounted 38%! More Britannica products digestive system disease  Encyclopædia Britannica Article Page 57 of 72 Hepatic encephalopathy refers to changes in the brain digestive system disease...

63. Synbiotic Modulation Of Gut Flora Improves Minimal Hepatic Encephalopathy In Cir When the dysfunction is minor, it is called minimal hepatic encephalopathy (MHE) . Effect on Minimal hepatic encephalopathy in Patients With Cirrhosis. http://www.medicalnewstoday.com/medicalnews.php?newsid=8294

64. Hepatic Encephalopathy - Humana Press Humana Press publishes scientific and medical books, journals, ebooks, onlinejournals, and CD-ROMs for the research professional and physicians. http://www.humanapress.com/Product.pasp?txtCatalog=HumanaBooks&txtProductID=0-89

65. Protein Consumption And Hepatic Encephalopathy In Alcoholic Hepatitis. VA Cooper RESULTS Sixtythree percent of patients had hepatic encephalopathy at entry . Dietary management of hepatic encephalopathy in cirrhotic patients survey http://www.jacn.org/cgi/content/abstract/14/2/152

HOME HELP FEEDBACK SUBSCRIPTIONS ... TABLE OF CONTENTS QUICK SEARCH: [advanced] Author: Keyword(s): Year: Vol: Page: Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager ... Cited by other online articles PubMed PubMed Citation Articles by Morgan, T. R. Articles by Haas, R. CLINICAL TRIAL Protein consumption and hepatic encephalopathy in alcoholic hepatitis. VA Cooperative Study Group #275 T. R. Morgan, T. E. Moritz, C. L. Mendenhall and R. Haas VA Medical Center, Long Beach, CA 90822, USA. OBJECTIVE: Patients with alcoholic hepatitis frequently have moderate or severe malnutrition. Dietary protein intake may be restricted in these patients because of concurrent hepatic encephalopathy. To further evaluate the relationship between dietary protein intake and hepatic encephalopathy in alcoholic hepatitis, we evaluated prospectively gathered data from a study of 136 placebo-treated patients with moderate or severe alcoholic hepatitis conducted at eight Department of Veterans Affairs Medical Centers. METHODS: Physical examination, laboratory tests, and grade of

66. Hepatic Encephalopathy hepatic encephalopathy (HE) is a brain disorder caused by chronic liver failure,particularly in Characteristics and Diagnosis of hepatic encephalopathy http://www.niaaa.nih.gov/publications/arh27-3/240-246.htm

Your browser does not support JavaScript! Your browser does not support JavaScript! Text-only version Search NIAAA Search Tips - WHAT'S NEW - Updated Clinician's Guide NIAAA Newsletter Updated Website for Middle Schoolers Initiative on Underage Drinking NESARC Public Use Data Files Current NIAAA Newsletter College Drinking Prevention Web Site Leadership to Keep Children Alcohol Free Hepatic Encephalopathy Roger F. Butterworth, Ph.D., D.Sc. Key words: hepatic encephalopathy; toxic drug effect; neurotoxicity; alcoholic liver cirrhosis; symptom; diagnosis; brain damage; impaired balance and coordination; ammonia; manganese; neuroimaging; positron emission tomography; magnetic resonance imaging; drug therapy; dialysis; liver; organ transplantation This article describes the characteristics and diagnosis of HE and the changes in brain cell structure associated with this condition. The article also reviews imaging techniques that allow researchers to study changes in brain structure and function occurring in patients with HE and describes the contributions of ammonia and manganese to the development of HE, as elucidated by these techniques. Finally, the article explores some approaches currently used or being investigated for treating patients with HE resulting from alcoholic liver disease. Characteristics and Diagnosis of Hepatic Encephalopathy

67. Cells From Patient With Hepatic Encephalopathy Source Butterworth, RF hepatic encephalopathy. Alcohol Research Health27(3)240–246, 2003. Download this file as a PDF http://www.niaaa.nih.gov/gallery/neuroscience/astrocytesp242.htm

Your browser does not support JavaScript! Your browser does not support JavaScript! Text-only version Search NIAAA Search Tips - WHAT'S NEW - Updated Clinician's Guide NIAAA Newsletter Updated Website for Middle Schoolers Initiative on Underage Drinking NESARC Public Use Data Files Current NIAAA Newsletter College Drinking Prevention Web Site Leadership to Keep Children Alcohol Free Cells from patient with hepatic encephalopathy Brain cells called astrocytes from a 51-year-old alcoholic patient with cirrhosis who died in a coma (hepatic encephalopathy [HE]). The image shows both normal astrocytes (N), which have dark nuclei, and Alzheimer type II astrocytes (Alz), characteristic of HE, which have pale, enlarged nuclei. Source: Butterworth, R.F. Hepatic encephalopathy. Download this file as a PDF Prepared: February 2005 Home NIH Home DHHS Home National Institute on Alcohol Abuse and Alcoholism (NIAAA) 5635 Fishers Lane, MSC 9304

68. Disease - Hepatic Encephalopathy - Detroit, Michigan Disease hepatic encephalopathy - courtesy of Henry Ford Health System of Detroit,Michigan. http://www.henryfordhealth.org/13834.cfm

3D Tour of the Vattikuti Institute About the Institute The Vattikuti Institute Prostatectomy Prostate Cancer ... Health Encyclopedia Health Encyclopedia Back to main Health Information page Disease - Hepatic encephalopathy Digestive system organs Definition: Hepatic encephalopathy is brain and nervous system damage that occurs as a complication of liver disorders. It is characterized by various neurologic symptoms including changes in reflexes, changes in consciousness , and behavior changes that can range from mild to severe. Alternative Names: Hepatic coma; Encephalopathy - hepatic Causes And Risk: Hepatic encephalopathy is caused by disorders affecting the liver. These include disorders that reduce liver function (such as cirrhosis or hepatitis ) and conditions where blood circulation bypasses the liver. The exact cause of the disorder is unknown. However, when the liver cannot properly metabolize and detoxify substances in the body, toxic substances build up in the bloodstream. One substance believed to be particularly toxic to the central nervous system is ammonia , which is produced by the body when proteins are digested, but is normally detoxified by the liver. Many other substances may also accumulate in the body and contribute to damage to the nervous system.

69. Hepatic Encephalopathy hepatic encephalopathy is brain and nervous system damage that occurs as acomplication of liver disorders. It is characterized by various neurologic http://www.pennhealth.com/ency/article/000302.htm

Appointments Medical Services Health Information Find a Doctor Search: Search Encyclopedia: List of Topics Print This Page  Liver Disease Hepatic encephalopathy Digestive system organs Definition: Hepatic encephalopathy is brain and nervous system damage that occurs as a complication of liver disorders. It is characterized by various neurologic symptoms including changes in reflexes, changes in consciousness , and behavior changes that can range from mild to severe. Alternative Names: Hepatic coma; Encephalopathy - hepatic Causes, incidence, and risk factors: Hepatic encephalopathy is caused by disorders affecting the liver. These include disorders that reduce liver function (such as cirrhosis or hepatitis ) and conditions where blood circulation bypasses the liver. The exact cause of the disorder is unknown. However, when the liver cannot properly metabolize and detoxify substances in the body, toxic substances build up in the bloodstream. One substance believed to be particularly toxic to the central nervous system is ammonia , which is produced by the body when proteins are digested, but is normally detoxified by the liver. Many other substances may also accumulate in the body and contribute to damage to the nervous system.

70. Entrez PubMed Treatment of hepatic encephalopathy. Cordoba J, Blei AT. Department of Medicine,Veteran s Affairs Lakeside Medical Center and Northwestern University, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9

71. Entrez PubMed Research on hepatic encephalopathy is hampered by the imprecise definition ofthis disabling Clinical Trials; hepatic encephalopathy/classification http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1

72. Rural Nurse Organization Clinic Digital Library hepatic encephalopathy (MeSH browse) List of documents; hepatic encephalopathy (Keyword hepatic encephalopathy (Keyword search) Access document http://ruralnurseorganization-dl.slis.ua.edu/clinical/gastroenterology/hepatic/h

Clinical Resources by Topic: Gastroenterology Hepatic Encephalopathy Clinical Resources Pediatrics Clinical Guidelines News Miscellaneous Resources See also: Gastrointestinal Clinical Procedure Resources General Gastroenterology Clinical Resources The Merck Manual 17th Ed.-1999: Table of contents Chapter 38. Clinical Features of Liver Disease: Table of contents General: Access document Portal-Systemic Encephalopathy: Access document Family Practice Handbook 4th Ed.-2001: Table of contents Chapter 5: Gastroenterology and Hepatology: Table of contents Hepatic Encephalopathy: Access document Medicine, Ob/Gyn, Psychiatry, and Surgery (eMedicine): Table of contents Encephalopathy, Hepatic: Access document Portal-Systemic Encephalopathy: Access document Hepatic Failure: Access document Pediatrics Resources See also General Pediatrics Resources Pediatrics (eMedicine): Table of contents Fulminant Hepatic Failure: Access document Clinical Guidelines American College of Gastroenterology: Homepage Physician Resources: List of documents Hepatic Encephalopathy (2001): Access document (PDF) National Guideline Clearinghouse: MeSH browse Detailed search Hepatic Encephalopathy (MeSH browse): List of documents Hepatic Encephalopathy (Keyword search): List of documents News Resources Doctor's Guide to the Internet Homepage Hepatic and Biliary Disorders News: List of documents Hepatic Encephalopathy (Keyword search): Access document Miscellaneous Hepatic Encephalopathy Clinical Resources HealthWeb: Homepage Gastroenterology: Table of contents Specific Conditions:

73. Hepatic Encephalopathy - General Practice Notebook hepatic encephalopathy is a metabolic disorder of the central nervous system andneuromuscular system that may complicate liver failure from any cause. http://www.gpnotebook.co.uk/cache/1194655752.htm

hepatic encephalopathy Hepatic encephalopathy is a metabolic disorder of the central nervous system and neuromuscular system that may complicate liver failure from any cause. It is particularly associated with advanced cirrhosis on account of the diffuse parenchymal damage and portosystemic shunting. The features depend on the aetiology and precipitating factors, eventually developing into stupor and then coma. Some aetiologies of the hepatic failure, for example paracetamol overdose, can precipitate this condition within three or four days, with a very rapid progression through the grades of encephalopathy. Other aetiologies, for example viral hepatitis, are associated with a much more variable onset. The grade of the encephalopathy can be used to predict the prognosis - for example grades I and II have and excellent prognosis, grades III and IV have poorer prognoses with the development of complications. Click here for more information...

74. Dietary Management Of Hepatic Encephalopathy -- Seymour And Whelan 318 (7195): 1 hepatic encephalopathy is a syndrome of impaired mental status and abnormalneuromuscular Riordan SM, Williams R. Treatment of hepatic encephalopathy. http://bmj.bmjjournals.com/cgi/content/full/318/7195/1364

Home Help Search Archive ... Table of Contents Author Keyword(s) Vol Page [Advanced] This article Extract PDF Correction (v320,p234) Respond to this article ... View citation map Services Email this article to a friend Find similar articles in BMJ Find similar articles in PubMed Alert me to new issues of the journal ... Read articles citing this article PubMed PubMed Citation Articles by Seymour, C. A Articles by Whelan, K. Related content Liver, including hepatitis and cirrhosis Other nutrition and metabolism Related Articles BMJ 1999;318:1364-1365 ( 22 May ) Editorials Dietary management of hepatic encephalopathy Too many myths persist Papers p Myths are difficult to dispel and may delay good evidence based clinical practice. This is illustrated well by a paper in this week's issue on the dietary management of hepatic encephalopathy in patients with cirrhosis (p Protein restriction in symptomatic patients with hepatic encephalopathy has been the cornerstone of treatment since the 1950s

75. Resource Library Find Information On Hepatic Encephalopathy At Find information on hepatic encephalopathy at MerckSource. Learn more abouthepatic encephalopathy, hepatic encephalopathy is brain and nervous system http://www.mercksource.com/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcns

76. Liver Encephalopathy Also known as hepatic encephalopathy or hepatic coma, this condition can cause Symptoms of hepatic encephalopathy range from almost unnoticeable changes http://www.chclibrary.org/micromed/00054970.html

Main Search Index Definition Description Causes ... Resources Liver encephalopathy Definition Liver encephalopathy is a potentially life-threatening disease in which toxic substances accumulate in the blood. Also known as hepatic encephalopathy or hepatic coma , this condition can cause confusion, disorientation, abnormal neurological signs, loss of consciousness, and death Description A normally functioning liver metabolizes and detoxifies substances formed in the body during the digestive process. Impaired liver function allows substances like ammonia (formed when the body digests protein), some fatty acids, phenol, and mercaptans to escape into the bloodstream. From there, they may penetrate the blood-brain barrier, affect the central nervous system (CNS), and lead to hepatic coma. Hepatic coma is most common in patients with chronic liver disease. It occurs in 50-70% of all those with cirrhosis The cause of hepatic coma is unknown, but the condition is frequently associated with the following conditions: Acute or chronic liver disease Gastrointestinal bleeding Azotemia, the accumulation of nitrogen-containing compounds (such as urea) in the blood

77. Log In Problems The diagnosis is appropriate whenever a patient with liver disease has neurologicaland psychological symptoms that cannot be attributed to other http://www.medscape.com/viewarticle/406524

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78. Log In Problems Based on a randomized trial, synbiotic modulation of gut flora or use of fermentablefiber may be an alternative to lactulose. http://www.medscape.com/viewarticle/477736

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79. Nature Clinical Practice Gastroenterology & Hepatology | Is Acarbose An Effectiv hepatic encephalopathy, a complication of liver cirrhosis, is thought to be Acarbose is a safe and efficacious agent to treat hepatic encephalopathy in http://www.nature.com/ncpgasthep/journal/v2/n6/full/ncpgasthep0194.html

@import "/common/style/layout.css";/* do not edit this stylesheet */ @import "/common/style/main.css";/* do not edit this stylesheet */ @import "/clinicalpractice/style/layout_group.css";/* do not edit this stylesheet */ @import "/clinicalpractice/style/group.css";/* do not edit this stylesheet */ @import "/ncpgasthep/style/site.css";/* edit this stylesheet only */ Accessibility statement Jump to main content Jump to main navigation Jump to search ... ABOUT NPG E-MAIL: PASSWORD Save password Forgotten password? MY ACCOUNT E-ALERTS SUBSCRIBE ... REGISTER Text to search for Advanced search Home Archive Vol 2 No 6 ... Practice Point Extract Practice Point doi Is acarbose an effective drug for treating patients with cirrhosis and hepatic encephalopathy? Kevin D Mullen* and Randy Howard Correspondence *Case Western Reserve School of Medicine, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109-1998, USA Email kdm@po.cwru.edu This article has no abstract so we have provided the first paragraph of the full text. The study by Gentile et al . suggests that acarbose might be a useful agent for the treatment of (at least) mild hepatic encephalopathy. Unlike most treatment trials for hepatic encephalopathy, in this study acarbose was compared with placebo. Although the data presented are quite encouraging, there are a few points to consider before we can accept the study findings.

80. HerbChina2000.com - Herbal Remedies - Hepatic Encephalopathy DHE Herbal Remedy for hepatic encephalopathy, Hepatic coma, Liver coma. http://www.herbchina2000.com/therapies/DHE.shtml

Help Center View Basket Checkout Hepatic encephalopathy DESCRIPTION Hepatic encephalopathy is brain and nervous system damage that occurs as a complication of liver disorders. It is characterized by various neurologic symptoms including changes in reflexes, changes in consciousness, and behavior changes that can range from mild to severe. Hepatic encephalopathy is caused by disorders affecting the liver. These include disorders that reduce liver function (such as cirrhosis or hepatitis) and conditions where blood circulation bypasses the liver. The exact cause of the disorder is unknown. However, when the liver cannot properly metabolize and detoxify substances in the body, toxic substances build up in the bloodstream. One substance believed to be particularly toxic to the central nervous system is ammonia, which is produced by the body when proteins are digested, but is normally detoxified by the liver. Many other substances may also accumulate in the body and contribute to damage to the nervous system. In people with otherwise stable liver disorders, hepatic encephalopathy may be triggered by episodes of gastrointestinal bleeding, excessive intake of dietary protein, electrolyte abnormalities (especially decrease in potassium, which may result from vomiting or treatments such as diuretics or paracentesis), infections, renal disease, and procedures that shunt blood past the liver.

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