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Letter to the Editor: An isolated insular stroke mimics a bout of overt hepatic encephalopathy in a patient with cirrhosis
The manifestations of hepatic encephalopathy (HE) vary from mild neuropsychiatric abnormalities to coma 1,2. Diagnosis and differential diagnosis can be challenging, especially in the hospital setting, where patients may suffer from other metabolic encephalopathies or neurological/psychiatric disorders 1,2,3. Moreover, HE might also occur on top of pre-existing disease, such as dementia 1. Any potential HE precipitating factor should be identified and treated promptly 1. In patients with delirium and cirrhosis, even those with a working diagnosis of HE, a set of laboratory tests including a full blood count, glucose, elect...
Source: Journal of Hepatology - March 19, 2023 Category: Gastroenterology Authors: Chiara Mangini, Roberta Gagliardi, Francesco Causin, Paolo Angeli, Sara Montagnese Tags: Letter to the Editor Source Type: research

An isolated insular stroke mimics a bout of overt hepatic encephalopathy in a patient with cirrhosis
The manifestations of hepatic encephalopathy (HE) vary from mild neuropsychiatric abnormalities to coma.1,2 Diagnosis and differential diagnosis can be challenging, especially in the hospital setting, where patients may suffer from other metabolic encephalopathies or neurological/psychiatric disorders.1 –3 Moreover, HE might also occur on top of pre-existing disease, such as dementia.1 Any potential HE precipitating factor should be identified and treated promptly.1 In patients with delirium and cirrhosis, even those with a working diagnosis of HE, a set of laboratory tests including a full blood count, glucose, electrol...
Source: Journal of Hepatology - March 19, 2023 Category: Gastroenterology Authors: Chiara Mangini, Roberta Gagliardi, Francesco Causin, Paolo Angeli, Sara Montagnese Tags: Letter to the Editor Source Type: research

Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort
Conclusion Compared with matched population controls, patients with biopsy-proven NAFLD had significantly higher incidence of MACE, including IHD, stroke, CHF and CV mortality. Excess risk was evident across all stages of NAFLD and increased with worsening disease severity.
Source: Gut - August 11, 2022 Category: Gastroenterology Authors: Simon, T. G., Roelstraete, B., Hagström, H., Sundström, J., Ludvigsson, J. F. Tags: Gut Hepatology Source Type: research

Complete alcohol abstinence increases the risk of NAFLD but not severity. A population analysis with transient elastography
CONCLUSION: Interestingly, modest alcohol consumption is associated with decreased odds of NAFLD. Further investigations are required to examine the relationship between alcohol consumption and NAFLD and subsequently the potential impact on NAFLD management.PMID:35944527 | DOI:10.1080/00365521.2022.2105168
Source: Scandinavian Journal of Gastroenterology - August 9, 2022 Category: Gastroenterology Authors: Jieling Xiao Cheng Han Ng Kai En Chan Ansel Shao Pin Tang Readon Teh Abel Ho Zhi Ling Jie Ning Yong Wen Hui Lim Darren Jun Hao Tan Caitlyn Tan Khin Maung Win Aung Hlaing Bwa Nicholas W S Chew Daniel Huang Yock Young Dan Mazen Noureddin Mohammad Shadab Sid Source Type: research

Cervicocerebral atherosclerosis and its hepatic and coronary risk factors in patients with liver cirrhosis
CONCLUSIONS: Our data suggest that LC confers protection against intracranial atherosclerosis, and that thrombocytopenia may be involved in this protection. High CAC score could serve as a potential surrogate for cervicocerebral vascular screening in asymptomatic cirrhotics.PMID:34637612 | DOI:10.3350/cmh.2021.0202
Source: Clinical and molecular hepatology - October 12, 2021 Category: Gastroenterology Authors: Jihyun An Hyung Don Kim Seon-Ok Kim Ha Il Kim Gi-Won Song Han Chu Lee Ju Hyun Shim Source Type: research

Tu1164 HYGIEACARE PREP FOR COLONOSCOPY CONSISTENTLY PROVIDES 97% ADEQUACY, AND IS AGNOSTIC TO PREDICTORS OF POOR ORAL BOWEL PREP
The quality of bowel preparation (BP) before colonoscopy plays a pivotal role in the safety, efficacy and quality of the outcome of colonoscopy. Inadequate BP is evident in more than 25% of all colonoscopies. High-quality BP is critical for detection of precancerous lesions.. Inadequate BP is correlated with patient-specific factors including age, male gender, medications, comorbidities such as chronic constipation, diabetes, gastrointestinal surgery, cirrhosis, stroke, and irritable bowel disease (IBD).
Source: Gastrointestinal Endoscopy - May 31, 2020 Category: Gastroenterology Authors: James A. Underwood, Pradeep Bekal, Orly Levitan, Dawn B. Burleson, David A. Johnson Tags: Poster abstracts Source Type: research

Risk of Stroke in Liver Cirrhosis: A Systematic Review and Meta-Analysis
Conclusions: Stroke is uncommon in cirrhotic patients. However, considering a positive relationship of liver cirrhosis with subarachnoid and intracranial hemorrhage, the prophylactic strategy may be selectively adopted in cirrhotic patients.
Source: Journal of Clinical Gastroenterology - December 7, 2019 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Lysosomal Acid Lipase Deficiency Leading to Liver Cirrhosis: a Case Report of a Rare Variant Mutation.
We describe the case of a 53-year-old Brazilian man who was referred to our center due to the diagnosis of liver cirrhosis of unknown etiology. He was asymptomatic and had normal body mass index. He had dyslipidemia, and family history of myocardial infarction and stroke. Abdominal imaging tests showed liver cirrhosis features and the presence of intrahepatic calcifications. Initial investigation of the etiology of the liver disease was not elucidated, but liver biopsy showed microgoticular steatosis and cholesterol esters deposits in Kuppfer cells. The dosage of serum lysosomal acid lipase was undetectable and we found th...
Source: Annals of Hepatology - May 24, 2019 Category: Gastroenterology Tags: Ann Hepatol Source Type: research

Direct Oral Anticoagulants in Cirrhotic Patients: Current Evidence and Clinical Observations.
Authors: Elhosseiny S, Al Moussawi H, Chalhoub JM, Lafferty J, Deeb L Abstract The introduction of Direct Oral Anticoagulants (DOACs) to the pharmaceutical market provided patients and clinicians with novel convenient and safe options of anticoagulation. The use of this class of medications is currently limited to venous thromboembolic therapy and prophylaxis, in addition to stroke prophylaxis in patients with nonvalvular atrial fibrillation. Despite their altered hemostasis, patients with cirrhosis are thought to be in a procoagulant state and thus prone to thrombus formation. Patients with cirrhosis might benefit...
Source: Canadian Journal of Gastroenterology - February 24, 2019 Category: Gastroenterology Tags: Can J Gastroenterol Hepatol Source Type: research

Acute Esophageal Necrosis: A View in the Dark
Acute esophageal necrosis (AEN), also known as Gurvits syndrome, black esophagus, or acute necrotizing esophagitis, is a rare clinical entity and an unusual reason for upper gastrointestinal bleeding. It is typically described in critically ill patients with multiple medical conditions, arising from a combination of ischemic insult to the esophageal mucosa due to low-flow vascular states, corrosive injury caused by reflux of acid and pepsin, and decreased function of the mucosal barrier systems and reparative mechanisms as occurs in malnourished and debilitated physical states. Patients with AEN tend to be older men, as me...
Source: Case Reports in Gastroenterology - January 16, 2019 Category: Gastroenterology Source Type: research

Lysosomal Acid Lipase Deficiency Leading to Liver Cirrhosis: a Case Report of a Rare Variant Mutation.
We describe the case of a 53-year-old Brazilian man who was referred to our center due to the diagnosis of liver cirrhosis of unknown etiology. He was asymptomatic and had normal body mass index. He had dyslipidemia, and family history of myocardial infarction and stroke. Abdominal imaging tests showed liver cirrhosis features and the presence of intrahepatic calcifications. Initial investigation of the etiology of the liver disease was not elucidated, but liver biopsy showed microgoticular steatosis and cholesterol esters deposits in Kuppfer cells. The dosage of serum lysosomal acid lipase was undetectable and we found th...
Source: Annals of Hepatology - January 2, 2019 Category: Gastroenterology Tags: Ann Hepatol Source Type: research

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