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Author: Prabha Sawant Publisher: Elsevier Health Sciences ISBN: 8131231836 Category : Medical Languages : en Pages : 104
Book Description
Hepatic encephalopathy is the clinical syndrome resulting from increased ammonia levels in blood. The most common cause of HE is chronic liver disease. However, acute liver failure, Reye’s syndrome, or metabolic defects are other causes. The true prevalence of overt HE is difficult to establish because of the considerable heterogeneity in etiology and disease severity. However, HE has been reported to be present in around 50% of patients with cirrhosis or with porto-caval shunts at some time during their illness. It is less common in patients with portosystemic shunts without liver disease. Thirty percent of patients dying of end-stage liver disease experience significant encephalopathy, approaching coma. After TIPS placement, approximately 1/3 of patients will experience overt HE. Minimal HE (MHE) is difficult to diagnose due to lack of standard diagnostic tests. Its clinical significance with regards to progression to overt encephalopathy has however, not been established. Conventional treatment of hepatic encephalopathy relies primarily on reducing the production and absorption of ammonia. Identification and correction of the precipitating factors and general supportive measures are important management steps. There are very few randomized controlled trials (RCT) of therapies and even these are bugged by lack of a control group and small sample sizes.
Author: Prabha Sawant Publisher: Elsevier Health Sciences ISBN: 8131231836 Category : Medical Languages : en Pages : 104
Book Description
Hepatic encephalopathy is the clinical syndrome resulting from increased ammonia levels in blood. The most common cause of HE is chronic liver disease. However, acute liver failure, Reye’s syndrome, or metabolic defects are other causes. The true prevalence of overt HE is difficult to establish because of the considerable heterogeneity in etiology and disease severity. However, HE has been reported to be present in around 50% of patients with cirrhosis or with porto-caval shunts at some time during their illness. It is less common in patients with portosystemic shunts without liver disease. Thirty percent of patients dying of end-stage liver disease experience significant encephalopathy, approaching coma. After TIPS placement, approximately 1/3 of patients will experience overt HE. Minimal HE (MHE) is difficult to diagnose due to lack of standard diagnostic tests. Its clinical significance with regards to progression to overt encephalopathy has however, not been established. Conventional treatment of hepatic encephalopathy relies primarily on reducing the production and absorption of ammonia. Identification and correction of the precipitating factors and general supportive measures are important management steps. There are very few randomized controlled trials (RCT) of therapies and even these are bugged by lack of a control group and small sample sizes.
Author: Kevin D. Mullen Publisher: Springer Science & Business Media ISBN: 1617798363 Category : Medical Languages : en Pages : 251
Book Description
Because of the increasing burden of hepatitis C and fatty liver disease, there is an explosion in the prevalence of chronic liver failure and hence its complications. The onset of Hepatic Encephalopathy (HE) in these patients has a significant impact on the quality of life, morbidity and mortality. Unfortunately, the approach observed by most clinicians to this complex disorder is minimalistic. This book provides a comprehensive review on pathophysiology and clinically important aspects in HE. Topics in basic physiology, nitrogen metabolism, new insights into pathogenesis and brain edema are covered in great detail. The authors have made a special effort by simplifying the complex aspects of pathogenesis and diagnosis so that it can be easily understood and applied clinically. This volume also focuses on recent developments regarding diagnoses of subtle forms of HE, also known as minimal or covert HE as well as on new treatments. Hepatic Encephalopathy will be of great value to gastroenterologists, hepatologists, pathologists, medical residents, fellows, internists and general practitioners who treat patients with hepatic encephalopathy.
Author: Philip Abraham Publisher: Elsevier Health Sciences ISBN: 8131231844 Category : Medical Languages : en Pages : 168
Book Description
Alcoholic liver disease involves an acute or chronic inflammation of liver occurring as a consequence of alcohol abuse. The pathological changes occur in 3 stages namely, fatty liver, alcoholic liver disease and cirrhosis, with the final stage traditionally considered to be irreversible. Alcoholic liver disease is responsible for a significant number of premature deaths per annum all around the globe. There is an urgent need to educate the masses about the hazards of alcohol abuse. An efficient system to encourage and prolong the period of alcohol abstinence is the need of the hour. The importance of lifestyle modifications like weight reduction and cessation of smoking in the progression of liver disease needs to be communicated to the patients and the medical community as well. Moreover, realization of the role of nutrition in the management and recovery of ALD would enhance the treatment strategies for this condition. This book has been designed to update the readers on the important aspects of ALD and is a step forward to enable the society in combating the social and economic losses that occur as a result of alcohol abuse. The book has stressed upon various aspects of ALD like the role of nutrition, epidemiology and pathogenesis, and the possible therapeutic strategies involved. Supportive case scenarios have also been incorporated with relevance to the topics covered under the book. Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians in the country.
Author: Livio Capocaccia Publisher: Springer Science & Business Media ISBN: 1468447874 Category : Medical Languages : en Pages : 382
Book Description
The meeting which took place in Rome on November 19th and 20th of 1982 is easily the best meeting on hepatic coma that I have ever attended, and I have attended many. It was an exceedingly we- planned meeting with prolonged opportunity for discussion, and there was genuine interplay and exchange of ideas (not the usual picture of a rushed meeting with investigators presenting their own point of view and talking past each other without a meaningful ex change) which took place in Rome. My co-editors and I hope that the published transcript, which of course can only reflect what transpired in Rome on those two days, does justice to a very intellectually exciting and gratifying ex change of ideas. L. Capocaccia, J. E. Fischer and F. Rossi-Fanelli v CONTENTS Introduction 1 SECTION 1: PATHOGENETIC PROBLEMS IN HEPATIC ENCEPHALOPATHY Ammonia: The old and the new • • . • • • . • . • • • . • . • 5 L. Zieve Role of synergism in the pathogenesis of hepatic encephalopathy • • • • . • • . . . . • 15 L. Zieve y-Aminobutyric acid receptors in experimental hepatic encephalopathy •. •. • • 25 M. L. Zeneroli, ~. Baraldi,and E. Ventura A possible role for excitatory neurotoxic amino acids in the pathogenesis of hepatic en 41 cephalopathy • • • • • • • • • • • • • • • F. Moroni, G. Lombardi, G. Moneti, D. Pellegrini and C.
Author: Uday C Ghoshal Publisher: Elsevier Health Sciences ISBN: 8131231828 Category : Medical Languages : en Pages : 121
Book Description
Irritable bowel syndrome is a part of the family of gastrointestinal motility disorders and is characterized by abdominal pain and altered bowel habits. It is highly prevalent throughout the world with the reported prevalence rates lying between 9% and 25%. The incidence of IBS varies between different ethnic groups and the incidence has also been reported to be different in males and females. The incidence also varies between various clinical subgroups (diarrhea-predominant/constipation-predominant) of the disorder. This is a chronic condition and is the most frequent symptom complex in patients who visit gastroenterologists throughout the world. However, this is one of the least understood GI disorders as it is not a disease but a complex of symptoms. The symptoms are often severe and quite bothersome, and thus have a negative effect on the patient’s quality of life and activity level, often leading to psychiatric complications. Besides this, a substantial economic burden of the disease and its impact in terms of man hours lost per annum make it one of the most troublesome symptom complexes in medicine, which need to be solved. This book has been designed to update the readers on the extensive research done over these years and on the many new potential mechanisms of pathogenesis of this troublesome condition. The reader will also be updated on the changing epidemiology of the condition. Diagnostic approach and management of IBS have also been thoroughly reviewed with an emphasis on the recent updates in the field. Typical supportive case scenarios have been included to exemplify and highlight various points discussed. Thus, it provides an excellent opportunity to widen one’s perspective in this area.
Author: Prabha Sawant
Author: Prabha Sawant
Author: Deepak Amarapurkar
Author: Sanjiv Saigal
Author: Roger F. Butterworth
Author: Kevin D. Mullen
Author: Philip Abraham
Author: Livio Capocaccia
Author: Andres T. Blei
Author: Ravi Prakash
Author: Uday C Ghoshal