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Valproate-Induced Hyperammonemic Encephalopathy Successfully Treated With Levocarnitine in an Elderly Patient Without Liver Dysfunction.
Cureus
December 2024
Department of Internal Medicine and Hematology, Uwajima City Hospital, Uwajima, JPN.
An 87-year-old male with a history of seizure disorder on long-term prophylaxis with valproate and concomitant levetiracetam presented with impaired consciousness and anorexia. The evaluation revealed a markedly elevated blood ammonia level of 518 μmol/L and decreased serum carnitine levels, leading to a diagnosis of valproate-induced hyperammonemic encephalopathy in the absence of liver dysfunction. Discontinuation of valproate, continuation of levetiracetam, and initiation of levocarnitine supplementation and branched-chain amino acid infusion resulted in a durable resolution of symptoms.
View Article and Find Full Text PDFPerformance of 1-year-old camel calves fed a basal ration of alfalfa hay supplemented with different levels of concentrate.
BMC Vet Res
January 2025
Animal Production Department, National Research Centre, Cairo, Egypt.
Background: The use of a high-concentrate diet in fattening camels may have significant effects on growth performance and digestion as well as economic returns. This experiment was designed to study the effects of feeding different levels of concentrate in their diet on growth performance and digestion in a desert climate.
Methods: Eighteen 12-month-old male camel calves were used, and divided into three treatments of six each.
A case report of hyperammonemic encephalopathy induced by high-dose continuous infusion of 5-fluorouracil in a patient with rectal cancer.
AME Case Rep
October 2024
Department of Oncology, Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University, Wenzhou, China.
Article Synopsis
- Hyperammonemic encephalopathy, a rare but serious side effect from high-dose 5-fluorouracil (5-FU) chemotherapy in rectal cancer patients, occurs in about 5.7% of cases and can cause severe neurological symptoms.
- A patient experienced significant consciousness disorders and raised ammonia levels after 5-FU treatment, but recovered within 12 hours after stopping the drug and providing supportive care.
- To reduce the risk of hyperammonia-induced encephalopathy, pre-chemo evaluations of liver and kidney function are essential, and monitoring drug levels during treatment is recommended to adjust 5-FU dosages as needed.
Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis.
Nutrients
January 2025
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
Decompensated cirrhosis is characterized by systemic inflammation and innate and adaptive immune dysfunction. Hepatic encephalopathy (HE) is a prevalent and debilitating condition characterized by cognitive disturbances in which ammonia and inflammation play a synergistic pathogenic role. Extraskeletal functions of vitamin D include immunomodulation, and its deficiency has been implicated in immune dysfunction and different forms of cognitive impairment.
View Article and Find Full Text PDFThe Circulatory Arrest Recovery Ammonia Problem (CARAP) Hypothesis: a H-MRS study of brain metabolism during neonatal cardiopulmonary bypass surgery.
J Thorac Cardiovasc Surg
January 2025
Departments of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305.
Objective: Congenital heart disease affects 1% of US births, with many babies requiring major cardiothoracic surgery under cardiopulmonary bypass (CPB), exposing the more critical patients to neurodevelopmental impairment. Optimal surgical parameters to minimize neuronal injury are unknown. We used H MRS and blood ammonia assays in a neonatal pig model of CPB to compare two approaches, complete circulatory arrest (CA) versus antegrade cerebral perfusion (ACP).
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