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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

Reply for ‘Letter to the Editor’, “B vitamins for NASH: use methylcobalamin, not cyanocobalamin” written by Dr. J. David Spence.
We appreciate the letter by Dr. Spence advocating the use of methylcobalamin or hydroxycobalamin rather than the cyanocoblamin form of vitamin B12 (B12) in future clinical trials investigating the efficacy of B vitamins to prevent or treat NASH. This is similar to the concern that he raised previously for studies that employed B12 in the prevention of stroke 1,2. Although several large trials previously showed no benefit of folate and/or B vitamins (B6 and B12) in reducing cardiovascular events 3, reanalysis of data from one of them (the VISP trial), showed there was a 34% reduction stroke/myocardial infarction events over...
Source: Journal of Hepatology - October 14, 2022 Category: Gastroenterology Authors: Madhulika Tripathi, Brijesh Kumar Singh, Paul M. Yen Tags: Letter to the Editor Source Type: research

Reply to: “B vitamins for NASH: Use methylcobalamin, not cyanocobalamin”
We appreciate the letter by Dr. Spence advocating the use of methylcobalamin or hydroxycobalamin rather than the cyanocobalamin form of vitamin B12 (B12) in future clinical trials investigating the efficacy of B vitamins to prevent or treat NASH.1 This is similar to the concern that he raised previously regarding studies that employed B12 for the prevention of stroke.3,4 Although several large trials previously showed no benefit of folate and/or B vitamins (B6 and B12) in reducing cardiovascular events,4 reanalysis of data from one of them (the VISP trial) showed there was a 34% reduction in stroke/myocardial infarction ev...
Source: Journal of Hepatology - October 14, 2022 Category: Gastroenterology Authors: Madhulika Tripathi, Brijesh Kumar Singh, Paul Michael Yen Tags: Letter to the Editor Source Type: research

Beta-blockers in refractory ascites – is it truly the end of the road?
We read with great interest the study by Tellez et  al.1 highlighting mechanisms of hemodynamic alterations and associated renal dysfunction with the use of a 4-week non-selective beta-blocker (NSBB) therapy in refractory ascites (RA) and diuretic responsive ascites (DRA).1 They proposed ejection intra-ventricular pressure difference (EIVPD) as a n ovel load-independent measure that predicts LV systolic function decline better than standard load-dependent measures (ejection fraction and stroke volume).
Source: Journal of Hepatology - August 26, 2020 Category: Gastroenterology Authors: Rohit Mehtani, Akash Roy, Nipun Verma, Madhumita Premkumar, Virendra Singh Tags: Letter to the Editor Source Type: research

Relationship of sitting time and physical activity with non-alcoholic fatty liver disease
Physical activity is well-recognized to reduce the incidence and mortality of various chronic diseases, including cardiovascular disease, diabetes, stroke and several types of cancer [1–3]. More than one half of the average person’s waking day involves sedentary activities associated with prolonged sitting such as watching TV and using the computer [4]. Recently, the deleterious effects of sedentary behavior regardless of additional physical activity have received a great deal of attention [5–8].
Source: Journal of Hepatology - September 14, 2015 Category: Gastroenterology Authors: Seungho Ryu, Yoosoo Chang, Hyun-Suk Jung, Kyung Eun Yun, Min-Jung Kwon, Yuni Choi, Chan-Won Kim, Juhee Cho, Byung-Seong Suh, Yong Kyun Cho, Eun Chul Chung, Hocheol Shin, Yeon Soo Kim Tags: Research Article Source Type: research

Mindin deficiency protects the liver against ischemia/reperfusion injury
Hepatic ischemia/reperfusion (I/R) injury often occurs during liver surgery and may cause liver failure. Our previous studies revealed that Mindin is involved in the pathogenesis of ischemic stroke. However, the function of Mindin in hepatic I/R injury remains unknown.
Source: Journal of Hepatology - July 9, 2015 Category: Gastroenterology Authors: Peng Sun, Peng Zhang, Pi-Xiao Wang, Li-Hua Zhu, Yibao Du, Song Tian, Xueyong Zhu, Hongliang Li Source Type: research

Heatstroke Induces Liver Injury via IL-1β and HMGB1-Induced Pyroptosis
Liver injury is a common complication of heat stroke (HS), and often constitutes a direct cause for patient death. The cellular and molecular mechanism underlying HS-induced liver injury remains unclear. Recent evidence indicates that inflammasome plays an important role in mediating sterile inflammation triggered by tissue damage. Using a rat HS model, we identified a novel mechanism by which inflammasome-dependent interleukin-1β (IL-1β) activation and hepatocyte pyroptosis mediate HS-induced liver injury.
Source: Journal of Hepatology - April 27, 2015 Category: Gastroenterology Authors: Yan Geng, Qiang Ma, Ya-Nan Liu, Na Peng, Fang-Fang Yuan, Xing-Gui Li, Ming Li, Ying-Song Wu, Bing-ling Li, Wei-bing Song, Wei Zhu, Wei-Wen Xu, Jie Fan, Lei Su Source Type: research