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Hepatic Encephalopathy (HE)

  Additional content on this specific disease state can be found in the:   Click on another disease specific
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Liver News Library
 
 
 
 
Target Audience
This activity has been designed to meet the educational needs of gastroenterologists, physician assistants, and nurse practitioners involved in the care of patients with chronic liver disease.

 View details
 
Statement of Need/Program Overview
To provide important clinical data on issues related to the management of cirrhosis
 
Educational Objectives
After completing this activity, the participants should be better able to:
Discuss the natural history and complications of cirrhosis
Evaluate the management of the complications of cirrhosis
 
 
Jointly sponsored by Purdue University School of Pharmacy and the Chronic Liver Disease Foundation
This activity supported by: Salix Pharmaceuticals
 
 
 
 
 
CME accreditation on key HE topics presented by the thought leaders in HE
 
Webcasts/Podcasts/Audiocasts
Teleconferences & Recorded Library
Slide & Print Library
 
 
Jointly sponsored by Purdue University School of Pharmacy and the Chronic Liver Disease Foundation
This activity supported by: Salix Pharmaceuticals
 
 
       

  

Hepatology 2009 Current Perspectives on Chronic Liver Disease   (Recorded East Coast Satellite Broadcast Webcast)
      No CME credit available

  

Overview on Hepatic Encephalopathy (HE)   (Webcast)
  Presented by: Dr. Steven Flamm, MD   No CME credit available

  

Emerging Concepts in Diagnosis and Management   (Satellite Symposium Webcast)
  of Hepatic Encephalopathy: Past, Present & Future   No CME credit available

  

Advances in the Diagnosis and Treatment of Hepatic   (Recorded Teleconference)
  Encephalopathy   No CME credit available

 
         
  Hepatic Encephalopathy: Natural History, Epidemiology and Treatment Modalities  
  Target Audience  
  This activity has been designed to meet the educational needs of hepatologists, gastroenterologists, physician assistants, and nurse practitioners involved in the care of patients with chronic liver disease.  
  Goal Statement  
  To provide important clinical data on issues related to the management of hepatic encephalopathy.  
  Educational Objectives  
  Upon completion of this activity, participants should be better able to:  
  Credit Designation Review the epidemiology and natural history of hepatic encephalopathy (HE)  
  1.0 AMA PRA
Category 1 Credit(s)
Outline how increases in arterial ammonia ultimately result in the neuropsychiatric abnormalities seen in HE  
  Differentiate between factors considered in the diagnosis of overt HE and those considered in the diagnosis of minimal HE  
    Describe treatment modalities used in the treatment of HE
 

 Download
Accreditation Statement  
  Please see page 1 of the monograph for full accreditation statement.  
Jointly sponsored by Purdue University School of Pharmacy and the Chronic Liver Disease Foundation.
This educational material was supported by a grant from Salix Pharmaceuticals.
 
  HE 2009 Slides
  Advances in the Diagnosis.and Treatment of HE  
 
 
  HE 2008 Slides
  Hepatic Encephalopathy  
 
 
 
  1. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy
    Bajaj JS, Schubert CM, Heuman DM, Wade JB, Gibson DP, Topaz A, Saeian K, Hafeezullah M, Bell DE, Sterling RK, Stravitz RT, Luketic V, White MB, Sanyal AJ. Gastroenterology. 2010 Jun;138(7):2332-40.

  2. Increase brain lactate in hepatic encephalopathy: cause or consequence?
    Rose CF. Neurochem Int. 2010 Jul 2. [Epub ahead of print]

  3. Risk factors for hepatic encephalopathy in patients with cirrhosis and refractory ascites: relevance of serum sodium concentration
    Guevara M, Baccaro ME, Ríos J, Martín-Llahí M, Uriz J, Ruiz Del Arbol L, Planas R, Monescillo A, Guarner C, Crespo J, Bañares R, Arroyo V, Ginès P. Liver Int. 2010 Jun 29. [Epub ahead of print]

  4. Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for Study of the Liver
    Dhiman RK, Saraswat VA, Sharma BK, Sarin SK, Chawla YK, Butterworth R, Duseja A, Aggarwal R, Amarapurkar D, Sharma P, Madan K, Shah S, Seth AK, Gupta RK, Koshy A, Rai RR, Dilawari JB, Mishra SP, Acharya SK; Indian National Association for Study of the Liver. J Gastroenterol Hepatol. 2010 Jun;25(6):1029-41.

  5. Two-dimensional MR spectroscopy of minimal hepatic encephalopathy and neuropsychological correlates in vivo
    Singhal A, Nagarajan R, Hinkin CH, Kumar R, Sayre J, Elderkin-Thompson V, Huda A, Gupta RK, Han SH, Thomas MA. J Magn Reson Imaging. 2010 Jul;32(1):35-43.

  6. Nutrition in hepatic encephalopathy
    Chadalavada R, Sappati Biyyani RS, Maxwell J, Mullen K. Nutr Clin Pract. 2010 Jun;25(3):257-64.

  7. Cerebral oedema in minimal hepatic encephalopathy due to extrahepatic portal venous obstruction
    Goel A, Yadav S, Saraswat V, Srivastava A, Thomas MA, Pandey CM, Rathore R, Gupta R. Liver Int. 2010 Jun 7. [Epub ahead of print]

  8. Prevalence of abnormal psychometric tests and critical flicker frequency after clinical recovery of overt hepatic encephalopathy
    Sharma P, Sharma BC, Sarin SK. Neurol India. 2010 Mar-Apr;58(2):220-4.

  9. Hepatic encephalopathy as a complication of liver cirrhosis: an Asian perspective
    Moriwaki H, Shiraki M, Iwasa J, Terakura Y. J Gastroenterol Hepatol. 2010 May;25(5):858-63.

  10. Diagnosis and Prognostic Significance of Minimal Hepatic Encephalopathy in Patients with Cirrhosis of Liver
    Dhiman RK, Kurmi R, Thumburu KK, Venkataramarao SH, Agarwal R, Duseja A, Chawla Y. Dig Dis Sci. 2010 May 28. [Epub ahead of print]

  11. Pathogenesis and diagnosis of subclinical hepatic encephalopathy
    Cie?ko-Michalska I, Mach T, S?owik A. Przegl Lek. 2010;67(2):131-4.

  12. Pathogenesis and diagnosis of hepatic encephalopathy
    McPhail MJ, Bajaj JS, Thomas HC, Taylor-Robinson SD. Expert Rev Gastroenterol Hepatol. 2010 Jun;4(3):365-78.

  13. Pharmacotherapy for hepatic encephalopathy
    Phongsamran PV, Kim JW, Cupo Abbott J, Rosenblatt A. Drugs. 2010 Jun 18;70(9):1131-48.

  14. The treatment of hepatic encephalopathy in the cirrhotic patient
    Sanyal AJ, Mullen KD, Bass NM. Gastroenterol Hepatol (N Y). 2010 Apr;6(4 Suppl 8):1-12.

  15. Clinical efficacy of transjugular intrahepatic portosystemic shunt created with covered stents with different diameters: Results of a randomized controlled trial
    Riggio O, Ridola L, Angeloni S, Cerini F, Pasquale C, Attili AF, Fanelli F, Merli M, Salvatori FM. J Hepatol. 2010 Apr 27. [Epub ahead of print]

  16. Stability of extemporaneously prepared rifaximin oral suspensions
    Cober MP, Johnson CE, Lee J, Currie K. Am J Health Syst Pharm. 2010 Feb 15;67(4):287-9.

  17. Pharmacotherapy of hepatic encephalopathy in cirrhosis
    Romero-Gómez M. Expert Opin Pharmacother. 2010 Jun;11(8):1317-27

  18. Nitric Oxide, Ammonia, and CRP Levels in Cirrhotic Patients With Hepatic Encephalopathy: Is There a Connection?
    Papadopoulos N, Soultati A, Goritsas C, Lazaropoulou C, Achimastos A, Adamopoulos A, Dourakis SP. J Clin Gastroenterol. 2010 May 20. [Epub ahead of print]

  19. Improving detection of Minimal Hepatic Encephalopathy Using the Inhibitory Control Task.
    Amodio P, Ridola L, Schiff S, Montagnese S, Pasquale C, Nardelli S, Pentassuglio I, Trezza M, Marzano C, Flaiban C, Angeli P, Cona G, Bisiacchi P, Gatta A, Riggio O. Gastroenterology. 2010 May 11. [Epub ahead of print]

  20. Development of a three-factor neuropsychological approach for detecting minimal hepatic encephalopathy
    Stewart CA, Enders FT, Schneider N, Felmlee-Devine D, Kamath PS, Smith GE. Liver Int. 2010 Apr 15. [Epub ahead of print]

  21. Reversibility of hepatic encephalopathy after liver transplantation
    Atluri DK, Asgeri M, Mullen KD. Metab Brain Dis. 2010 Mar 5. [Epub ahead of print]

  22. Predictors of the recurrence of hepatic encephalopathy in lactulose-treated patients
    Bajaj JS, Sanyal AJ, Bell D, Gilles H, Heuman DM. Aliment Pharmacol Ther. 2010 Feb 5. [Epub ahead of print]

  23. Persistence of Cognitive Impairment After Resolution of Overt Hepatic Encephalopathy
    Bajaj JS, Schubert CM, Heuman DM, Wade JB, Gibson DP, Topaz A, Saeian K, Hafeezullah M, Bell DE, Sterling RK, Stravitz RT, Luketic V, White MB, Sanyal AJ. Gastroenterology. 2010 Feb 20. [Epub ahead of print]

  24. Evidence for oxidative/nitrosative stress in the pathogenesis of hepatic encephalopathy
    Bemeur C, Desjardins P, Butterworth RF. Metab Brain Dis. 2010 Mar 2. [Epub ahead of print]

  25. Hyponatremic and hepatic encephalopathies: similarities, differences and coexistence
    Córdoba J, García-Martinez R, Simón-Talero M. Metab Brain Dis. 2010 Mar 9. [Epub ahead of print]

  26. Cyclic GMP pathways in hepatic encephalopathy. Neurological and therapeutic implications
    Montoliu C, Rodrigo R, Monfort P, Llansola M, Cauli O, Boix J, Elmlili N, Agusti A, Felipo V. Metab Brain Dis. 2010 Mar 2. [Epub ahead of print]

  27. Pain Management in the Cirrhotic Patient: The Clinical Challenge
    Watt KD, Chandok N. Mayo Clin Proc. 2010 Mar 31. [Epub ahead of print]

  28. Encephalopathy assessment in children with extra-hepatic portal vein obstruction with MR, psychometry and critical flicker frequency
    Yadav SK, Srivastava A, Srivastava A, Thomas MA, Agarwal J, Pandey CM, Lal R, Yachha SK, Saraswat VA, Gupta RK. J Hepatol. 2010 Mar;52(3):348-54. Epub 2010 Jan 6.

  29. Rifaximin Treatment in Hepatic Encephalopathy
    Bass NM, Mullen KD, Sanyal A, Poordad F, Neff G, Leevy C, Sigal S, Sheikh MY, Beavers K, Fredrick T, Teperman L, Hillebrand D, Huang S, Merchant K, Shaw A, Bortey E, and Forbes WP. N Engl J Med 2010;362:1071-1081.

  30. Review article: modern management of hepatic encephalopathy
    Bajaj J. Aliment Pharmacol Ther.. [Epub ahead of print]

  31. The effect of fatigue on driving skills in patients with hepatic encephalopathy
    Bajaj JS, Hafeezullah M, Zadvornova Y, Martin E, Schubert CM, Gibson DP, Hoffmann RG, Sanyal AJ, Heuman DM, Hammeke TA, Saeian K. Am J Gastroenterol. 2009 Apr;104(4):898-905. Epub 2009 Mar 10

  32. Minimal hepatic encephalopathy is associated with motor vehicle crashes: the reality beyond the driving test
    Bajaj JS, Saeian K, Schubert CM, Hafeezullah M, Franco J, Varma RR, Gibson DP, Hoffmann RG, Stravitz RT, Heuman DM, Sterling RK, Shiffman M, Topaz A, Boyett S, Bell D, Sanyal AJ. Hepatology. 2009 Oct;50(4):1175-83

  33. Motor impairment in liver cirrhosis without and with minimal hepatic encephalopathy
    Butz M, Timmermann L, Braun M, Groiss SJ, Wojtecki L, Ostrowski S, Krause H, Pollok B, Gross J, Südmeyer M, Kircheis G, Häussinger D, Schnitzler A. Acta Neurol Scand.. [Epub ahead of print]

  34. Extrapyramidal signs predict the development of overt hepatic encephalopathy in patients with liver cirrhosis
    Compañy L, Zapater P, Pérez-Mateo M, Jover R. Eur J Gastroenterol Hepatol.. [Epub ahead of print]

  35. Neurologic presentations of hepatic disease
    Harris MK, Elliott D, Schwendimann RN, Minagar A, Jaffe SL. Neurol Clin. 2010 Feb;28(1):89-105

  36. GASTROINTESTINAL ADVERSE EFFECTS OF LACTULOSE CAN PRECIPITATE RECURRENT HEPATIC ENCEPHALOPATHY THROUGH NON-COMPLIANCE OR OVERUSE J. Bajaj, D. Bell, A. Sanyal, E. Gavis, D. Heuman. J Hepatology 2009:50(Suppl 1, Poster 177).

  37. SAFETY OF RIFAXIMIN IN PATIENTS WITH HEPATIC ENCEPHALOPATHY: RESULTS OF A RANDOMIZED, PHASE 3, PLACEBO-CONTROLLED CLINICAL TRIAL
    K. Mullen, S. Sigal, M. Sheikh, N. Bass, F. Poordad, K. Merchant, S. Huang, A. Shaw, E. Bortey, W. Forbes EASL 2009 poster Case Western Reserve University, Cleveland, OH, Weill Medical College of Cornell University, New York, NY, University of California San Francisco, Fresno, University of California San Francisco, San Francisco, Cedars-Sinai Medical Center, Los Angeles, CA, Salix Pharmaceuticals, Inc, Morrisville, NC, USA

  38. Peripheral and Splanchnic Indole and Oxindole Levels in Cirrhotic Patients: A Study on the Pathophysiology of Hepatic Encephalopathy
    Riggio O, Mannaioni G, Ridola L, Angeloni S, Merli M, Carlà V, Salvatori FM, Moroni F. Am J Gastroenterol 2010 Feb 2.

  39. Predictors of nonresponse to lactulose in patients with cirrhosis and hepatic encephalopathy Sharma P, Sharma BC, Sarin SK. Eur J Gastroenterol Hepatol.. [Epub ahead of print]

  40. Critical flicker frequency for diagnosis and assessment of recovery from minimal hepatic encephalopathy in patients with cirrhosis
    Sharma P, Sharma BC, Sarin SK. Hepatobiliary Pancreatic Dis Int. 2010 Feb 9(1):27-32.

  41. A Sustained Viral Response Is Associated With Reduced Liver-Related Morbidity and Mortality in Patients With Hepatitis C Virus
    Singal AG, Volk ML, Jensen D, Di Bisceglie AM, Schoenfeld PS. Clin Gastroenterol Hepatol. 2009 Nov 27. [Epub ahead of print]

  42. What are the implications of the spontaneous spleno-renal shunts in liver cirrhosis?
    Tarantino G, Citro V, Conca P, Riccio A, Tarantino M, Capone D, Cirillo M, Lobello R, Iaccarino V. BMC Gastroenterol. 2009 Nov 24;9:89

  43. Considerations on the Impact of Hepatic Encephalopathy Treatments in the Pretransplant Setting
    Teperman LW, Peyregne VP. Transplantation. 2010 Jan27

  44. Pentoxifylline Does Not Decrease Short-Term Mortality But Does Reduce Complications in Patients With Advanced Cirrhosis
    Thabut D, Oberti F, Perarnau JM, Condat B, Barraud H, Saliba F, Carbonell N, Renard P, Ramond MJ, Moreau R, Poynard T; Pentocir Group. Gastroenterology. 2010 Jan 23

  45. Hepatic encephalopathy: current management strategies and treatment, including management and monitoring of cerebral edema and intracranial hypertension in fulminant hepatic failure
    Zafirova Z, O'connor M. Curr Opin Anaesthesiol. 2010 Feb 1

  46. Refractory hepatic encephalopathy due to concomitant transjugular intrahepatic portosystemic shunt and spontaneous mesocaval shunt controlled by embolization of the competitive portosystemic shunt
    Cura M. Clin Imaging. 2009;33:231-3.

  47. Minimal hepatic encephalopathy runs a fluctuating course: results from a three-year prospective cohort follow-up study.
    Tan HH, Lee GH, Thia KT, Ng HS, Chow WC, Lui HF. Singapore Med J. 2009 Mar;50(3):255-60.

  48. Natural history of minimal hepatic encephalopathy in patients with extrahepatic portal vein obstruction.
    Sharma P, Sharma BC, Puri V, Sarin SK. Am J Gastroenterol. 2009 Aprl;104:885-90.

  49. Deep sedation with propofol does not precipitate hepatic encephalopathy during elective upper endoscopy
    Amorós A, Aparicio JR, Garmendia M, Casellas JA, Martínez J, Jover R. Gastrointest Endosc 2009 Apr 23 (Epub ahead of print)

  50. Rare and unusual...Or are they? Less commonly diagnosed encephalopathies associated with systemic disease.
    Weathers AL, Lewis SL. Semin Neurol. 2009 Apr;29(2):136-53. Epub 2009 Apr 15.

  51. Postshunt Hepatic Encephalopathy in Liver Transplant Recipients
    Braun M, Marius; Bar-Nathan, Nathan; Shaharabani, Ezra; Aizner, Sigal; Tur-Kaspa, Ran; Belenky, Alexander; Mor, Eitan; Ben-Ari Z, Ziv. Transplantation 2009;87:734-739.

  52. Pathophysiology of hepatic encephalopathy: The concept of synergism.
    Butterworth RF. Hepatol Res. 2008;38:S116-S121.

  53. Analysis of Hospitalization Comparing Rifaximin Versus Lactulose in the Management of Hepatic Encephalopathy
    Neff GW, Kemmer N, Zacharias VC et al. Transplantation Proceedings 2006;38:3552-3555.

  54. Hospitalizations during the Use of Rifaximin Versus Lactulose for the Treatment of Hepatic Encephalopathy
    Leevy CB and Phillips JA. Dig Dis Sci 2007;52:737-741.

  55. Management Options for Minimal Hepatic Encephalopathy
    Bajaj JS. Expert Rev. Gastroenterol Hepatol 2008;2(6):785-790.

  56. Rifaximin for the Treatment of Hepatic Encephalopathy
    Lawrence KR and Klee JA. PHARMACOTHERAPY 2008;28(8):1019-1032.

  57. Comparison of rifaximin and lactitol in the treatment of acute hepatic encephalopathy: results of a randomized, double-blind, double-dummy, controlled clinical trial
    Mas A, Rodés, Sunyer L et al. J Hepatol 2003;38 :51-58.

  58. Subclinical Hepatic Encephalopathy Predicts the Development of Overt hepatic Encephalopathy
    Romvero-Gomez M, Boza F, Garcia-Valdecasas M et al. Am J Gastroenterol 2001;96(9):2718-23.

  59. Minimal Hepatic Encephalopathy Matters in Daily Life
    Bajaj JS. World J Gastroenterol 2008 June 21;(14)23:3609-3615

  60. Inhibitory Control Test Is a Simple Method to Diagnose Minimal Hepatic Encephalopathy and Predict Development of Overt Hepatic Encephalopathy
    Bajaj J, Saeian K, Verber M, Hischke D, Hoffmann R, Franco J, Varma R and Rao S. Am J Gastroenterol 2007;102;754-760.

  61. Minimal Hepatic Encephalopathy: Simplifying Its Diagnosis
    Iduru S, Hisamuddin K, Mullen K. Am J Gastroenterol 2007;102:1537-1538.

   

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