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Related Concept Videos

Hepatic Encephalopathy01:29

Hepatic Encephalopathy

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DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic...
71
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Encephalitis l: Introduction01:19

Encephalitis l: Introduction

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Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
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Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

386
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
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Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

387
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
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Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug01:14

Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug

360
In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
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A Piglet Model of Neonatal Hypoxic-Ischemic Encephalopathy
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Minimal hepatic encephalopathy.

Laura M Stinton, Saumya Jayakumar

    Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie
    |October 10, 2013
    PubMed
    Summary
    This summary is machine-generated.

    Minimal hepatic encephalopathy (MHE), a subtle cognitive impairment in cirrhosis patients, impacts daily life and mortality. Early screening via tools like the EncephalApp Stroop Test is crucial for timely intervention.

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    Area of Science:

    • Hepatology
    • Neurology
    • Gastroenterology

    Background:

    • Minimal hepatic encephalopathy (MHE) is the earliest stage of hepatic encephalopathy, affecting up to 80% of patients with cirrhosis.
    • MHE presents with subclinical neurocognitive deficits in attention, vigilance, and executive function, impacting quality of life, driving ability, and mortality.
    • Despite its impact, MHE is often undiagnosed and untreated due to its lack of obvious clinical symptoms.

    Purpose of the Study:

    • To highlight the clinical significance of MHE in cirrhotic patients.
    • To discuss current diagnostic methods for MHE.
    • To introduce novel screening tools and treatment options for MHE.

    Main Methods:

    • Review of existing literature on MHE diagnosis and treatment.
    • Introduction of the EncephalApp Stroop Test as a potential smartphone-based screening tool.
    • Discussion of pharmacological and non-pharmacological interventions.

    Main Results:

    • MHE significantly affects patients' daily functioning, quality of life, and survival.
    • Traditional diagnostic methods include neuropsychological tests and the critical flicker frequency test.
    • A smartphone application (EncephalApp Stroop Test) shows promise as a screening tool for MHE.
    • Treatment options include lactulose, probiotics, and rifaximin, though liver transplantation may not fully reverse cognitive deficits.

    Conclusions:

    • MHE is a clinically relevant condition in cirrhotic patients that warrants diagnosis and management.
    • Novel tools like the EncephalApp Stroop Test can aid in early MHE detection.
    • While treatments exist, the long-term cognitive impact of MHE, even post-transplant, requires further investigation.