No abstract available.
Hepatic Encephalopathy*

No abstract available.
Brain* ; Hepatic Encephalopathy* ; Manganese*

A study was carried out on 105 pediatric patients with hepatic coma in the national institute of pediatric during 1991-1995 has shown that the main cause of hepatic coma in children was acute hepatitis - hepatic failure, the treatment was not complete. It should limit the use of sedatives and antipyretic agents for pediatric patients with hepatic coma. The disease's progress was poor. The rate of remission and disease free was 4.7%. This rate in the group of acute hepatitis - hepatic failure induce coma was 1.23%.
Hepatic Encephalopathy ; Pediatrics

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

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 meta-analysis favored the 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.

A study on 105 patients diagnosed as hepatic coma due to the viral hepatitis in the Institute of Clinical Medicine and Tropical Diseases during 1989-1997 has shown that the rate of male patients was higher than this of female patients; most of cases were acute disease. The hepatic coma due to the viral hepatitis occurred mainly in ages of 15-45. The hepatic coma experienced the hyperuremia had apoor prognosis. The more low prothrombin, the more severer prognosis.
Hepatic Encephalopathy ; Hepatitis, Viral, Human

Hepatic Encephalopathy ; classification ; diagnosis ; Humans ; Terminology as Topic

54 patients with acute viral hepatitis of which hepatic coma (8), uncompensate cirrhosis (17) and liver cancer (14) participated to a study have shown that the serum gamma glutamyl transpeptidase ((-GT) activity was slightly increased in patients with viral hepatitis coma and uncompensate cirrhosis. This was a bad sign the (-GT was highly increased in patients with liver cancer. The average serum (-GT activity was increased about 3 times in the acute viral hepatitis. But diagnostic value of (-GT was lower than this of SGPT
Liver Diseases ; Serum ; gamma-Glutamyltransferase ; Hepatic Encephalopathy

Hepatic Encephalopathy ; diagnosis ; therapy ; Hepatitis, Viral, Human ; diagnosis ; therapy ; Humans

OBJECTIVETo determine the age-and education-corrected control values for the number connection test (NCT) and digit symbol test (DST) psychometric measures to increase their accuracy for diagnosis of minimal hepatic encephalopathy (MHE).

METHODSThe NCT Part A (NCT-A) and DST were administered to 843 healthy volunteers (age range:16-65 years; education:more than 1 year) and 429 patients with liver cirrhosis (with Child-Pugh classification of liver function). The normal values were defined as the mean ± 2 standard deviations (2SD);MHE was defined by abnormal results on at least one psychometric test. The statistical significance of differences in MHE diagnosis according to the various control values (age and education-corrected or not) was assessed by the chi-square test and logistic regression analysis.

RESULTSNCT-A and DST were found to be influenced by age (standard coefficient 0.405, P =0.000 and standard coefficient-0.527, P =0.000 respectively) and education (standard coefficient-0.347, P =0.000 and standard coefficient 0.405, P =0.000 respectively). Among the 120 patients with liver cirrhosis who were diagnosed with MHE (27.97%), 113 had abnormal NCT-A results (26.34%), 54 had abnormal DST results (12.59%),and 47 had abnormal results on both tests (10.96%). Among these 120 MHE-positive patients, 21 were classified as Child-Pugh A (19.81%), 46 as Child-Pugh B (23.71%), and 53 as Child-Pugh C (41.09%);the MHE-positive rate was significantly greater in the patients with Child-Pugh C classification than those with either Child-Pugh B or Child-Pugh A (P < 0.01). Logistic analysis showed that when the control data was corrected for age and education, the MHE diagnosis was related with liver function (P =0.000), regardless of age (P =0.328) and education (P =0.563). When the control data was uncorrected, the MHE diagnosis was not only influenced by liver function (P =0.000) but also by age (P =0.000) and education (P =0.005).

CONCLUSIONAge and education-corrected control values can increase the accuracy of MHE diagnosis by NCT-A and DST.

Hepatic Encephalopathy ; classification ; diagnosis ; therapy ; Humans ; Terminology as Topic