A longitudinal systems biology analysis of lactulose withdrawal in hepatic encephalopathy.

The pathogenesis of hepatic encephalopathy(HE) is unclear. However gut flora changes, inflammation and neuro-glial injury have been implicated. The aim was to evaluate factors that were associated with HE recurrence after lactulose withdrawal by analyzing the clinical phenotype, stool microbiome and systemic metabolome longitudinally.

The multi-dimensional burden of cirrhosis and hepatic encephalopathy on patients and caregivers.

Objectives: Cirrhosis and hepatic encephalopathy (HE) can adversely affect survival, but their effect on socioeconomic and emotional burden on the family is not clear. The aim was to study the emotional and socioeconomic burden of cirrhosis and HE on patients and informal caregivers.

Methods: A cross-sectional study in two transplant centers (Veterans and University) of cirrhotic patients and their informal caregivers was performed.

Rifaximin improves driving simulator performance in a randomized trial of patients with minimal hepatic encephalopathy.

Background & Aims: Patients with cirrhosis and minimal hepatic encephalopathy (MHE) have driving difficulties but the effects of therapy on driving performance is unclear. We evaluated whether performance on a driving simulator improves in patients with MHE after treatment with rifaximin.

Methods: Patients with MHE who were current drivers were randomly assigned to placebo or rifaximin groups and followed up for 8 weeks (n = 42).

Persistence of cognitive impairment after resolution of overt hepatic encephalopathy.

Background & Aims: In patients with cirrhosis, hepatic encephalopathy (HE) has acute but reversible as well as chronic components. We investigated the extent of residual cognitive impairment following clinical resolution of overt HE (OHE).

Methods: Cognitive function of cirrhotic patients was evaluated using psychometric tests (digit symbol, block design, and number connection [NCT-A and B]) and the inhibitory control test (ICT).