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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...
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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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Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

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Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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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

271
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...
271
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

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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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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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A Cell Culture Model for Producing High Titer Hepatitis E Virus Stocks
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[Hepatic encephalopathy].

Juan Córdoba1, Rafael Esteban Mur1

  • 1Servicio de Hepatología, Hospital Vall d'Hebron, Barcelona, España; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; CIBEREHD, Instituto de Salud Carlos III, Madrid, España.

Gastroenterologia Y Hepatologia
|August 5, 2014
PubMed
Summary
This summary is machine-generated.

Hepatic encephalopathy (EH) is a severe complication of cirrhosis. Treatment involves nonabsorbable disaccharides and rifaximin to manage ammonia levels and prevent episodes.

Keywords:
Barrera hematoencefálicaBlood-brain barrierEncefalopatía hepáticaHepatic encephalopathy

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Area of Science:

  • Hepatology
  • Neurology
  • Gastroenterology

Context:

  • Hepatic encephalopathy (EH) is a serious complication of hepatic cirrhosis.
  • It presents with diverse neuropsychiatric symptoms and is often triggered by specific factors in patients with advanced liver disease.
  • Minimal EH involves subtle cognitive deficits posing risks to patients.

Purpose:

  • To outline the pathophysiology, diagnosis, and management of hepatic encephalopathy.
  • To highlight the role of ammonia and blood-brain barrier dysfunction in EH pathogenesis.
  • To emphasize the diagnostic criteria for minimal EH and treatment strategies.

Summary:

  • The primary cause of EH is elevated blood ammonia, affecting blood-brain barrier integrity and astrocyte metabolism.
  • Diagnosis is primarily clinical, supported by neuroimaging, with specific neurocognitive tests for minimal EH.
  • Current treatment focuses on nonabsorbable disaccharides and rifaximin for acute episodes and prevention.

Impact:

  • Improved understanding of EH pathophysiology aids in developing targeted therapies.
  • Early diagnosis and management of minimal EH can prevent disease progression.
  • Effective treatment strategies reduce the incidence and severity of EH complications in cirrhosis patients.