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         Portal-systemic Encephalopathy:     more detail
  1. Chronic portal-systemic encephalopathy: An experimental study with special reference to brain serotonin (Bulletin No. 66 from the Department of Surgery, Lund University) by Finn Bengtsson, 1987

61. Karger Publishers
portalsystemic encephalopathy (PSE) results from portal-systemic shunting ofvenous blood that arises either spontaneously or due to surgical portacaval
http://content.karger.com/ProdukteDB/produkte.asp?Doi=51414

62. Portal-Systemic Myelopathy After Transjugular Intrahepatic Portosystemic Shunt C
Abbreviations PSE = portalsystemic encephalopathy, PSM = portal-systemicmyelopathy, TIPS = transjugular intrahepatic portosystemic shunt. ABSTRACT
http://www.jvir.org/cgi/content/abstract/12/7/879

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HELP FEEDBACK SUBSCRIPTIONS ... TABLE OF CONTENTS This Article Full Text Full Text (PDF) Alert me when this article is cited ... Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager PubMed PubMed Citation Articles by Wang, M. Q. Articles by Gao, Y. A. Journal of Vascular and Interventional Radiology
BRIEF REPORTS
Portal-Systemic Myelopathy after Transjugular Intrahepatic Portosystemic Shunt Creation: Report of Four Cases
Mao Qiang Wang, MD Michael D. Dake, MD Zhi Peng Cui, MD Zhi Qiang Wang, MD and Yu Ao Gao, MD From the Division of Cardiovascular and Interventional Radiology (M.Q.W., M.D.D.), Stanford University Medical Center, Stanford, California, and Departments of Diagnostic Radiology (M.Q.W., Z.P.C., Y.A.G.) and Gastroenterology (Z.Q.W.), Chinese PLA General Hospital, Beijing, China. Received June 14, 1999; revision requested July 17; final revision received February 5, 2001; accepted February 6. Address correspondence to M.D.D., Division of Cardiovascular and Interventional Radiology, Stanford University Medical Center, Rm H-3647, 300 Pasteur Dr., Stanford, CA 94305; E-mail: mddake@ leland.stanford.edu

63. Product Abstract:Branch Chain Amino Acids
The value of the portalsystemic encephalopathy index was chosen as main outcome,because of lack of more significant clinical outcomes.
http://www.lef.org/prod_hp/abstracts/php-ab224.html
var WebSiteBaseURL = "http://www.lef.org" var ThisPageFullURL = "http://www.lef.org/prod_hp/abstracts/php-ab224.html" translation by SYSTRAN MEMBERSHIP PRODUCTS MAGAZINE ... CHECKOUT
BRANCH CHAIN AMINO ACIDS
Oral supplementation with branched-chain amino acids improves transthyretin turnover in rats with carbon tetrachloride-induced liver cirrhosis Overview of randomized clinical trials of oral branched-chain amino acid treatment in chronic hepatic encephalopathy Leucine metabolism in rats with cirrhosis. Nutrient-induced thermogenesis and protein-sparing effect by rapid infusion of a branched chain-enriched amino acid solution to cirrhotic patients. ... Alanylglutamine-enriched total parenteral nutrition improves protein metabolism more than branched chain amino acid-enriched total parenteral nutrition in protracted peritonitis
Oral supplementation with branched-chain amino acids improves transthyretin turnover in rats with carbon tetrachloride-induced liver cirrhosis Journal of Nutrition (USA), 1996, 126/5 (1412-1420)
Overview of randomized clinical trials of oral branched-chain amino acid treatment in chronic hepatic encephalopathy Journal of Parenteral and Enteral Nutrition (USA), 1996, 20/2 (159-164)

64. FIRSTConsult - Sdfdsf
Hepatic encephalopathy Medical Condition File. portal-systemic encephalopathy *Hepatic coma. Human immunodeficiency virus (HIV) test.
http://www.firstconsult.com/?action=view_article&id=1014781&type=101&bref=1

65. FIRSTConsult - Sdfdsf
of patients with cirrhosis and chronic portalsystemic encephalopathy, and neomycin in the treatment of chronic portal-systemic encephalopathy.
http://www.firstconsult.com/?action=view_article&id=1014768&type=101&bref=1

66. Hepatitis C (Steve Harris, M.D.; David Rind)
In portalsystemic encephalopathy resulting from c hronic liver failure, astrocytesmanifest altered expression of several key proteins and enzymes
http://yarchive.net/med/hepatitis_c.html
Index Home About Search for Google's copy of this article Index Home About From: sbharris@ix.netcom.com(Steven B. Harris) Subject: Re: HELP FOR CIRRHOSIS (Hepatitis C) Date: 30 Sep 1996 Newsgroups: alt.health.oxygen-therapy,alt.health,misc.health.alternative,misc.health,own.health.herbs,sci.med On Wed, 25 Sep 1996 21:52:38, JPear@gnn.com (John Pearson) wrote: >>A close friend of mine was recently diagnosed with hepatitis and >>cirrhosis of the liver, and only has about 20% usage of his liver. >>His doctor says he is too far gone to do a liver transplant, but will >>give him interferon. He does not drink. There is no such thing as a person "too far gone" for a liver transplant. That's ridiculous. People have been saved by liver transplants when they are so far gone in hepatic coma that some of their doctors thought they were brain dead (in one famous case, a "brain-dead" man presented as a potential heart donor, ended up being a liver *recipient*, and did well). If your friend is getting interferon, he's probably got hepatitis C. A couple of antivirals also seem to work for hepatitis C, though neither is used routinely in the US. One is ribavirin (Virazole), which is used with interferon in England, and has a number of studies behind it. Another is amantidine, which is used in the US against influenza A, but also has activity against hep C. In a preliminary study done by Jill P. Smith at Hershey medical center in Pennsylvania was presented in May at the Digestive Disease Week Conferences in San Francisco, amantidine seems to be worth looking into. In this study, 8 out of 20 patients who completed the study had a partial response to 6 months of amantidine, and another 6 had complete response (liver enzymes normalized). This is as good as the results of interferon, and at about 4% of the price. Neither amantidine or ribivirin is very toxic at the doses used for hep C (1.2 grams/d for ribivirin, and 200 mg/d for amantidine). Ribivirin can be bought as the drug "Vilona" in Mexico and brought across the border quite legally. Amantidine is a standard pharmaceutical available anywhere in the US on prescription. If I had hep C and was a layman, I'd be looking for a doctor willing to follow my liver enzymes with me as I experimented with both medications, singly and in combination, PLUS interferon alfa-2b. Viral load tests for hep C are also now available, and can probably help customize treatment with antivirals, in much the same way they are doing for AIDS/HIV patients. Specialist help is needed for this, and also because interferon has side effects which can be managed with other drugs. FIND A DOCTOR WHOSE PRACTICE IS MAINLY TREATING CHRONIC INFECTIOUS HEPATITIS PATIENTS. These exist. Good luck. Your friend may also want to try the American Liver Foundation Hotline at 1-800-223-0179. They keep track of the latest research. Search for Google's copy of this article Search for Google's copy of this article Search for Google's copy of this article Search for Google's copy of this article ... About

67. Help! Green Plasma?
Books Chronic portalsystemic encephalopathy with normal portal vein pressure 20-year history of chronic progressive portal-systemic encephalopathy.
http://mailman1.u.washington.edu/pipermail/hlib-nw/2000-February/004510.html
Help! Green plasma?
Nancy Press pressno at u.washington.edu
Tue Feb 29 14:28:24 PST 2000 PNC librarians; One of my pathologists is asking me to find information on "green plasma" or "green serum". When I searched on Medline via PubMed, I get information on green tea and effects on serum blood levels as well as green phosphorescence in plants. etc. He tells me this is a real disorder, but I can't find it in the physician's guide to rare diseases or any other reference book in my collection. I also tried the Internet and found many games have a theme about green plasma (a energy source?) in their descriptions, but nothing about a medical condition causing the serum plasma to appear green in color. Any ideas? I am uncertain where to look next. Maybe this is an early April fools joke, but I am hoping you can give me some help solving this medical mystery. Kathy Nelson Eastern Idaho Regional Medical Center Idaho Falls ID 83440 library at eirmc.org

68. Category Browsing Results
Cerebrospinal Fluid Taurine in portalsystemic encephalopathy (J. Lavoie, G.Therrien, and RF Butterworth). Cerebral Zinc Content in Hepatic Encepthalopathy
http://opamp.com/cf/browse.cfm?Main=SCIENCES&Sub1=CHEMISTRY

69. Gastro En La Red
Translate this page Dietary management of portal-systemic encephalopathy. In Conn HO, Bircher J,editors. Hepatic encephalopathy syndromes and therapies.
http://www.gastroenlared.com.ar/template.php?pagina=./Articulos/Educacion/Encefa

70. NEJM -- Sign In
Dietary management of portalsystemic encephalopathy. In Conn HO, Bircher J, eds.Hepatic encephalopathy syndromes and therapies.
http://content.nejm.org/cgi/content/full/337/26/1921-a

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71. Hepatic Encephalopathy: An Update Of Pathophysiologic Mechanisms -- Hazell And B
In portalsystemic encephalopathy resulting from chronic liver failure, astrocytesmanifest altered expression of several key proteins and enzymes including
http://www.ebmonline.org/cgi/content/abstract/222/2/99
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Society for Experimental Biology and Medicine
Review Article
Hepatic Encephalopathy: An Update of Pathophysiologic Mechanisms
Alan S. Hazell and Roger F. Butterworth
Hepatic encephalopathy (HE) is a neuropsychiatric disorder that occurs in both acute and chronic liver failure. Although the precise pathophysiologic mechanisms responsible for HE are not completely understood, a deficit in neurotransmission rather than a primary deficit in cerebral energy metabolism appears to be involved. The neural cell most vulnerable to liver failure

72. Portal Systemic Encephalopathy - General Practice Notebook
portal systemic encephalopathy. Hepatic encephalopathy is a metabolic disorderof the central nervous system and neuromuscular system that may complicate
http://www.gpnotebook.co.uk/cache/-1087045620.htm
portal systemic 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.
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73. Portal Systemic Encephalopathy - General Practice Notebook
portal systemic encephalopathy. Medical search. Hepatic encephalopathy is ametabolic disorder of the central nervous system and neuromuscular system that
http://www.gpnotebook.co.uk/medwebpage.cfm?ID=-1087045620

74. Portal Systemic Encephalopathy
Complete online version of The Encyclopaedia of Medical Imaging including textand images from The Encyclopaedia of Medical Imaging s eight book volumes
http://www.amershamhealth.com/medcyclopaedia/medical/Volume VI 1/PORTAL SYSTEMIC

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our commitment our company Search Medcyclopaedia for: Search marked text (mark text before you click) Browse entry words starting with: A B C D ... amershamhealth.com Portal systemic encephalopathy, see bilirubin encephalopathy
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75. Penn State Faculty Research Expertise Database (FRED)
encephalopathy, Portal Systemic, Hepatic Comas. Hepatic Encephalopathies,Hepatic Stupors. Hepatocerebral Encephalopathies, Portal Systemic encephalopathy
http://fred.hmc.psu.edu/ds/retrieve/fred/meshdescriptor/D006501

76. Evaluation Of The Efficacy And Safety Of Flumazenil In The Treatment Of Portal S
BACKGROUND Portal systemic encephalopathy (PSE) is a complex neuropsychiatricsyndrome associated with hepatic failure. Small scale studies have shown the
http://gut.bmjjournals.com/cgi/content/abstract/39/2/319

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PAPERS
Evaluation of the efficacy and safety of flumazenil in the treatment of portal systemic encephalopathy: a double blind, randomised, placebo controlled multicentre study
K Gyr, R Meier, J Haussler, P Bouletreau, WE Fleig, A Gatta, A Holstege, G Pomier-Layrargues, SW Schalm, M Groeneweg, G Scollo-Lavizzari, E Ventura, ML Zeneroli, R Williams, Y Yoo and R Amrein
Department Innere Medizin, Medizinische Universitats-Poliklinik, Kantonsspital Basel.

77. HEPATIC ENCEPHALOPATHY
HEPATIC encephalopathy. PORTAL SYSTEMIC encephalopathy (PSE). Background.PSE is defined as a change in mentation in a patient with cirrhosis and portal
http://www.columbia.edu/~jj2085/residency/fulltext/HEPATICXENCEPHALOPATHYX3.html
HEPATIC ENCEPHALOPATHY PORTAL SYSTEMIC ENCEPHALOPATHY (PSE) Background:
  • PSE is defined as a change in mentation in a patient with cirrhosis and portal hypertension
  • Cause of PSE remains contentious (? Ammonia, GABA, Mercaptans)
  • CNS lesion is Astrocyte hyperplasia (Alzheimer type II astrocyte change)
Stages of Hepatic Encephalopathy
STAGE MENTAL STATUS PHYSICAL EXAM
I Euphoria/Depression, Day-Night Sleep reversal, Mild asterixis (may be absent) poor concentration, mild confusion, slurred speech II Increased drowsiness, confusion, inability to sustain Significant Asterixis, Concentration Brisk reflexes III Marked confusion, arousable but sleeping continuously Asterixis, clonus Asterixis absent Risk factors:
  • High protein load (i.e. GI bleeding, increase in protein intake)
  • SBP
  • Infection
  • Constipation
  • Hypokalemia
  • Narcotics, Benzodiazepines
  • Liver failure
  • Post TIPS
  • Portal vein thrombosis

Treatment:
  • Cure constipation (enema, Mg Citrate, MOM)
  • Consider Branched chain amino acid nutritional supplements (Hepatic Aid/Nutrahep/Hepatamine)
  • Lactulose 30 cc po every 1-2 hrs until soft bowel movement, titrate to achieve 2-3 soft bowel movements a day

78. Portal Toolkit Invalid Site URL
Recently, one case of portal systemic encephalopathy was reported, INOUE E,HORI S, NARUMI Y. Portal systemic encephalopathy presence of basal ganglia
http://ppv.ovid.com/pt/re/obes/fulltext.00000132-200208000-00007.htm
Sorry, the URL specified, http://ppv.ovid.com:80/pt/re/obes/fulltext.00000132-200208000-00007.htm , is invalid.

Thank you

79. Log In Problems
Portal systemic encephalopathy or hepatic encephalopathy is a The diagnosisof portal systemic encephalopathy is made on a clinical basis but can be
http://www.medscape.com/viewarticle/501977_2
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80. LAXETTE SOLUTION
In portal systemic encephalopathy administration of large doses of LAXETTE results Portal systemic encephalopathy, hepatic coma or precoma stages where
http://home.intekom.com/pharm/cipla/laxette.html

INDICATIONS
CONTRA-INDICATIONS DOSAGE SIDE-EFFECTS PREGNANCY OVERDOSE IDENTIFICATION PATIENT INFORMATION
LAXETTE SOLUTION
SCHEDULING STATUS:
Not scheduled
PROPRIETARY NAME
(and dosage form):
LAXETTE SOLUTION
COMPOSITION:
Each 5 mL LAXETTE contains 3,3 g lactulose
PHARMACOLOGICAL CLASSIFICATION:
A 11.5 Laxatives. PHARMACOLOGICAL ACTION: LAXETTE is a synthetic disaccharide of fructose and galactose, which is not split into its monosaccharide constituents in the small intestine due to the lack of a specific enzyme. It reaches the colon unchanged where it is broken down by the saccharolytic flora into organic acids, such as lactic acid and acetic acid - acids formed in the colon under physiological conditions. Due to this local osmotic effect in the colon, water is retained, the faecal mass softened and normal colonic peristalsis restored. In portal systemic encephalopathy administration of large doses of LAXETTE results in a significant reduction in the pH of the colonic contents. Lowering the pH promotes conversion of non-ionised ammonia into ionised form. The latter form being non-absorbable leads to reduction of absorption of ammonia from the intestine into the portal circulation and may even promote the excretion of ammonia from the circulation into the faeces. LAXETTE cannot be hydrolysed in the intestine, thus very little absorption occurs. Small amounts of non-hydrolysed lactulose may be absorbed, but these are readily excreted via the kidneys.

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