81. Arlene2 If the liver function becomes impaired the resulting toxic effect on the brainproduces the encephalopathy. Compare portal systemic encephalopathy. http://www.webspawner.com/users/arlene2/

A morbid portrait of telehealth in Ontario? THE ARLENE BERRY CASE The Arlene Berry Death Coverup, Part 2 KIRKLAND LAKE, ON The Arlene Berry Death Coverup, Part 2 by M. W. Everett • meverett@prweb.com "Fill their faces with shame, that they may seek thy name, O Lord". Psalms 83:16 Updated July 30, 2002 INVESTIGATIVE REPORT The Arlene Berry Case RE: Arlene H Berry Date of Death: May 24, 2000 Forward Submit that predisposing factors in hepatic encephalopathy include a history of blood in urine or stool, opiate use, infection, GI bleeding, dehydration or electrolyte abnormalities. Compare liver encephalopathy. http://www.principalhealthnews.com/topic/topic100587091 The liver metabolizes and detoxifies digestive products brought from the intestine by the portal vein. If the liver function becomes impaired the resulting toxic effect on the brain produces the encephalopathy. Compare portal systemic encephalopathy. http://www.merck.com/pubs/mmanual/section4/chapter38/38f.htm People who contract hepatitis typically develop flu-like symptoms within 10-40 days of exposure (the acute stage). They experience low grade fever, muscle aches, joint pain, headaches, malaise, anorexia, fatigue and abdominal pain. It is not uncommon for post-surgical patients to become infected. Compare liver cirrhosis. See signs and symptoms of hepatic dysfunction. http://www.hepnet.com/liver/disease.html Similarly, cancer treatments such as antineoplastic drugs or radiation therapy can also cause liver damage with mixed forms of hepatic dysfunction. In fact, flu-like and GI illness are common but unpleasant side effects of radiation therapy. http://www.emedicine.com/med/topic1184.htm

82. HOW ARE PORTAL HYPERTENSION AND VARICEAL BLEEDING MANAGED IN CIRRHOSIS? There are two types of surgical shunts A portal shunt, or portal systemic shunt Itposes a high risk for encephalopathy and does not appear to improve survival http://www.ucdmc.ucdavis.edu/ucdhs/health/a-z/75Cirrhosis/doc75portalhyper.html

HOW ARE PORTAL HYPERTENSION AND VARICEAL BLEEDING MANAGED IN CIRRHOSIS? Drugs Used to Prevent Initial and Recurring Bleeding Ongoing research is being conducted to determine if agents or procedures can prevent a first bleeding episode. Drugs known as beta-blockers are the only therapies to date that may have some preventive effects. Candidates for these agents are patients who have large varices (twisted blood vessels) or other risk factors for bleeding. Beta-blockers, typically propranolol (Inderal) or nadolol (Corgard), reduce the heart rate and can lower portal vein pressure and reduce variceal bleeding. Carvedilol (Coreg), a newer agent may be even more effective, but more research is needed. Beta-blockers are also used as a primary approach for prevention of recurring bleeding. It is not yet clear if these drugs are more effective against bleeding than procedures, such as sclerotherapy, but they are inexpensive and safe. They also appear to be more effective than procedures for preventing abdominal infection. Patients with diabetes type 1, asthma, emphysema, and chronic bronchitis should avoid them whenever possible. Isosorbide mononitrate has been given as the alternative agent for patients who cannot tolerate beta-blockers. Studies have failed to show any survival advantage with this agent when used alone, however. Studies on combinations of isosorbide mononitrate with beta-blockers suggest that they prevent rebleeding more effectively than beta-blockers alone, but it is not clear if combination improves any other aspects of the disease.

83. Gammagard Settlement Notice - Definitions Of Qualifying Conditions (E) Portal Systemic encephalopathy. Portal Systemic encephalopathy( PSE ) is a brain syndrome due to liver disease. Proof of this http://www.ssem.com/gammagard/settlement/notice/attachmenta.html

CLICK HERE Return to Settlement Notice ATTACHMENT A DEFINITIONS OF QUALIFYING CONDITIONS Settlement class members should note that the following medical terms necessarily involve technical words. You should consult your doctor about these medical conditions. (A) Ascites. Ascites is an abdominal fluid collection within the peritoneal cavity. Proof of this condition shall require all of the following: an abdominal ultrasound or computerized tomography ("CT") scan of the abdomen to confirm that ascitic fluid is present; an abdominal paracentesis that removes at least 500 milliliters of ascitic fluid; and paracentesis fluid analysis with all of the following tests and all of the following results: TEST RESULT Cytology Negative for malignancy Polymorphonuclear (PMN) cell count Serum-ascites albumin gradient (SAAG) (defined as ascites albumin subtracted from serum albumin) Protein Bacterial culture at bedside in blood culture bottles, aerobic and anaerobic No growth Mycobacterial culture No growth Amylase Ascites amylase less than serum amylase The following conditions are possible "Alternative Causes" of Ascites in a patient with or without HCV: malignancy, primary or metastatic; protein-losing enteropathy; heart failure; ruptured viscus; tuberculosis; dengue, cholera or schistosomiasis; pancreatitis; kidney failure; chlamydia infection; fungal or parasitic infection in the peritoneum; peritonitis (other than spontaneous bacterial peritonitis); Budd Chiari syndrome; portal vein thrombosis or occlusion (intra or extra luminal); use of amiodarone; exposure to or ingestion of hepatotoxin; or consumption of significant amounts of alcohol (consumption of enough alcohol for a sufficient period of time to produce, either separately or in a synergistic fashion with HCV, the progression of liver damage).

84. E-Doc: Importal Sachets levels. Portal systemic encephalopathy Adapt the dosage accordingto the severity of the condition and the patients response. As http://www.edoc.co.za/medilink/products/1151.html

Medicine Info Importal sachets Main Use: Symptomatic treatment of constipation. Treatment of chronic episodic and chronic persistent porto-systemic encephalopathy. Active Ingredients: Lactitol monohydrate LAXATIVES (GENERAL) Available Dosage forms: Importal sachets Notes: Please consult the pages with the Information for the Actives for more notes. The optimal dose in order to obtain 1 daily bowel movement in constipated patients and 2 daily bowel movement in cirrhotic patients should be determined. The laxative effect is predictable once the maintenance dose has been established. Can be added to foods and beverages. Can be given to diabetics. Constipation: Adults: (1 level 5ml medicine measure = 2g importal powder) Should be given in a single daily dose morning or evening, at a meal time, preferably mixed with food or drink. The laxative effect may occur within a few hours, but in some cases the first laxative response occurs only on the 2nd or 3rd day of treatment. Adjust dose to obtain 1 daily bowel movement. The initial daily dose should be 20g (2 10g sachets or 10 medicine measures) taken as a single dose at breakfast or dinnertime.

85. Pharmacology Laxatives may aid in the treatment of portal systemic encephalopathy by 1. increasingstool pH 2. increasing coliform bacteria 3. decreasing protein contact http://research.med.umkc.edu/pharm/tests/GI.html

Gastroenterology Send comments to willoughby@cctr.umkc.edu

86. Questions & Answers - Constipation Portal systemic encephalopathy, hepatic coma or precoma associated with hyperammonaemia.Dosage Usual starting doses, Maintenance. Adults 30ml, 15 30 ml. http://www.ciplamedpro.co.za/qa_constipation.asp

home e-mail us Categories Asthma and Allergies Malaria Anti-Microbials Worm Infestations ... Antacids / H2-Antagonist Constipation Constipation is defined as infrequent, irregular or incomplete bowel movements. Pain and straining from the passage of hard, dry stools are frequently associated with constipation. Soflax tablets For rapid relief of occasional constipation Laxette Ideal for chronic use Soflax Tablets (Contains Senna extract equivalent to 13,5 mg of Sennosides A and B) "TWICE THE STRENGTH AT HALF THE PRICE" How does Soflax work? Why use Soflax? Dosage Indications ... Composition How does Soflax® work? Stimulant laxatives, (Soflax®) also known as contact laxatives, encourage bowel movements by acting on the intestinal wall. They increase the muscle contractions (peristalsis) that move along the stool mass and promote accumulation of water and electrolytes in the colonic lumen, resulting in a comfortable bowel movement within 6 - 12 hours. Stimulant laxatives are popular for self-treatment, i.e. for the patient looking for a rapid evacuation - fast relief.

87. Portal Hypertension Selective shunts may be associated with a lower incidence of portal systemic encephalopathy(PSE), a confu­sional state commonly found in patients with http://surgery.4t.com/52.5.htm

Free Web site hosting - Freeservers.com Portal hypertension An elevation in portal pressure is most commonly found accompanying liver cirrhosis, although it may be present in patients with extra hepatic portal vein occlusion, intrahepatic veno-occlusive disease or occlusion of the main hepatic veins [Budd—Chiari syndrome (BCS)]. As portal hypertension produces no symptoms it is usually diagnosed following presentation with decompensated chronic liver disease and encephalopathy, ascites or variceal bleeding. Management of bleeding varices General resuscitation Varices usually present with the acute onset of a large volume haematemesis, the lower oesophagus being the most common site for variceal bleeding. The diagnosis may be suspected if the patient is known to have liver cirrhosis but needs to be confirmed following initial resuscitation of the patient. This involves obtaining peripheral and subsequently central venous access whilst adequate blood is obtained (initially 10 units). Liver function tests will reveal underlying liver disease and a coagulation profile will reveal any underlying coagulopathy. Vitamin K is administered (10 mg intravenously), but correction of a coagulopathy will require the administration of fresh frozen plasma. An associated thrombocytopenia is usually secondary to hypersplenism due to cirrhosis and is treated if the platelet count falls below 50x10 /litre. Variceal bleeding is often associated with hepatic encephalopathy, and endoscopic evaluation under these circumstances may require sedation and mechanical ventilation. Bronchial aspiration is a frequent complication of variceal bleeding.

88. British Liver Trust TIPSS stands for Transjugular Intrahepatic Portal Systemic Shunt. One of these complicationsis encephalopathy whereby the person may get a little bit drowsy http://www.britishlivertrust.org.uk/content/diseases/portal_hypotension.asp

Alcohol Autoimmune Cancer Cirrhosis ... Wilson's Disease Portal hypertension and bleeding of oesophageal varices One consequence of chronic liver disease can be portal hypertension. This is an increase in the blood pressure in the portal vein, which carries the blood from the bowel and spleen to the liver. The pressure in the portal vein may rise because there is a blockage, such as a blood clot, or because the resistance in the liver is increased because of scarring, or cirrhosis. As a result, the pressure in the portal vein rises – this is known as portal hypertension. As the blood tries to find another way back to the heart, new blood vessels open up. Among these vessels are those that run along the wall under the lining of the upper part of the stomach and the lower end of the oesophagus (gullet). These veins protrude into the gullet and the stomach and can bleed. This bleeding may be a gentle ooze in which case anaemia is the commonest symptom. Sometimes there can be a major bleed and the person has a haemorrhage and either vomits blood or passes blood through the bowels. This blood may appear to be black, since it is often changed as it passes through the body. There are many causes of cirrhosis, alcohol being the most common. Others include viral hepatitis, autoimmune liver disease, primary biliary cirrhosis, primary sclerosing cholangitis and some metabolic diseases. Please see our other leaflets on these specific conditions.

89. Volume 4 Number 1 Winter 98 procedure itself. The most common complication related to portalsystemicshunting is new or worsened hepatic encephalopathy. This can http://www.rad.uab.edu/Visions/Winter98/Winter98.htm

Master List Volume 4 Number 1 Winter 1998 IN THIS ISSUE UAB Radiology On The Web FAQs Transjugular Intrahepatic Portosystemic Shunts (TIPS) ... (Radiological Society of NA) UAB Radiology on the Web T Personnel within the radiology department have been taking advantage of the radiology intranet web server for the past year. Recently presented at the Radiological Society of North America (RSNA) annual meeting, this web server provides an up-to-date database with attending daily work schedules, faculty call schedules and resident rotation schedules. There is also a complete database of all radiology personnel (over 300 people), including beeper and phone numbers, a pictorial directory of the radiology residents and fellows, an events calendar, informational postings such as faculty meeting minutes, and a software distribution section with software updates and utilities. Maintained by Dr. Steve Willing, this page is currently available at http://vulcan.rad.uab.edu In contrast, the radiology department "home page" at http://www.rad.uab.edu is primarily aimed at users outside the department such as referring physicians and resident, fellow or faculty applicants. It provides general information about the radiology department and its training programs, as well as a web version of this newsletter and a pictorial faculty directory. There are links to other UAB sites and other radiology sites, as well as to our web based radiology teaching file.

90. Product Abstract: Ornithine Mental state gradation, portal systemic encephalopathy index (PSEI), and fastingammonia levels were estimated as additional efficacy parameters. http://www.lef.org/prod_hp/abstracts/php-ab061.html

LEF Site Search All categories Protocols Health Conditions Products LE Magazine Medical Abstracts What's Hot FDA Information About LEF LEF News Products Product Index Alphabetical List New Products Blood Testing ... Security Free Product Directory Click for a FREE copy of our Product Directory LEF Membership What is LEF? Benefits Become a Member Renewals ... Become a Subscriber Our call center has now expanded its hours Monday thru Friday: 8:30am to 12:00am EST 5:30am to 9:00pm PST Saturday hours are: 9:00am to 8:00pm EST 6:00am to 5:00pm PST Sunday hours are: 11:00am to 7:00pm EST 8:00am to 4:00pm PST If you'd like to order by phone or speak to a live person for help, just call toll free: Customer Service Info Privacy Policy We subscribe to the HONcode principles. Verify here LEF Shop Membership Browse ... Order History Ornithine Ornithine alpha-ketoglutarate in nutritional support Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: Results of a placebo-controlled, double-blind study

91. HEPATOLOGY PHASE 111 LECTURE NOTES 3 http://www.med.cam.ac.uk/Teaching/Lectures/HEPATOLOGY 3

Complications of Chronic liver disease Aims and Objectives 1. Major complications of chronic liver disease 2. Types of and management of ascites 3. Major neurological syndromes associated with acute/chronic liver disease 4. Management of variceal haemorrhage (link with management of upper GI bleeding) COMPLICATIONS OF CIRRHOSIS 1. Portal hypertension a) Ascites / Renal Impairment b) Gastrointestinal Haemorrhage c) Portal-Systemic Encephalopathy d) Primary Pulmonary Hypertension 2. Hepatocellular Carcinoma Epidemiologically associated with any cirrhosis, aflatoxin exposure, oral contraceptive, anabolic steroids. Relative risk between 10 and 50 X ASCITES TRANSUDATIVE ASCITES EXUDATIVE ASCITES Plasma-Ascites albumen difference Hepatic Malignancy Cirrhosis Metastatic liver tumour Subacute/Fulminant Hepatic Failure Peritoneal metastasis Hepatic venous outflow obstruction Lymphoma Cardiac Myeloma Biventricular heart failure 2.

92. IM Abstract 40-8 Original 1 Therapeutic Effect of Balloonoccluded Retrograde Transvenous Obliteration on Portal-systemicEncephalopathy in Patients with Liver Cirrhosis Tomohiro Kato http://www.naika.or.jp/im/im40/ab40-8/o400801.html

Therapeutic Effect of Balloon-occluded Retrograde Transvenous Obliteration on Portal-systemic Encephalopathy in Patients with Liver Cirrhosis Tomohiro Kato, Takahiro Uematsu, Yoichi Nishigaki*, Jun-ichi Sugihara*, Eiichi Tomita* and Hisataka Moriwaki From the First Department of Internal Medicine, Gifu University School of Medicine, Gifu and *the Department of Gastroenterology, Gifu Municipal Hospital, Gifu Objective Balloon-occluded retrograde transvenous obliteration (B-RTO) has recently been introduced as a new interventional modality to prevent fatal bleeding from solitary gastric varices. A large portal-systemic shunt including gastric varices also causes severe encephalopathy in some cirrhotic patients. In this study, we evaluated the effect of B-RTO as a candidate therapeutic method to treat chronic recurrent hepatic encephalopathy due mainly to a portal-systemic shunt. Patients and Methods Results In all 6 patients, encephalopathy had disappeared after B-RTO, and the patients were free of encephalopathy during the following 6 months. B-RTO significantly reduced blood ammonia levels at one month, 3 months, and 6 months later, without affecting serum aspartate aminotransferase activity, total bilirubin and albumin concentrations, and plasma prothrombin time. Encephalopathy relapsed in 4 patients between 6 and 30 months. Additional B-RTO was required and effective in 2 of them. Conclusion B-RTO is an effective treatment for chronic recurrent hepatic encephalopathy with an angiographically proven portal-systemic shunt.

93. Meat Eating Dig Dis Sci 1982 Dec;27(12)110916 Treatment of chronic portalsystemic encephalopathywith vegetable and animal protein diets. A controlled crossover study. http://www.ecologos.org/meat.htm

Meat J Intern Med 1993 May;233(5):385-92 Comment in: J Intern Med. 1993 May;233(5):369-71 J Intern Med. 1994 Jul;236(1):101-2 Vegetable versus animal protein diet in cirrhotic patients with chronic encephalopathy. A randomized cross-over comparison. Bianchi GP, Marchesini G, Fabbri A, Rondelli A, Bugianesi E, Zoli M, Pisi E. Institute of General Clinical Medicine, University of Bologna, Italy. In a randomized cross-over comparison, the effects of a mainly vegetable protein diet were compared with an animal protein diet in eight patients with cirrhosis and chronic permanent encephalopathy, under optimum lactulose therapy. After a run-in period, patients were fed two equi-caloric, equi-nitrogenous diets for 7 days (71 g total proteins), containing either 50 g protein of animal origin or 50 g vegetable proteins. In the last 3 days of each period, nitrogen balance was significantly better during the vegetable protein diet (+0.2 (SD 1.4) g vs. -1.7 (2.4); P

94. CONTENS PN.POPOV, SA.AZEVICH, SM.SCHEMILCHANOVA. PORTAL SYSTEMIC ENCEPHALOPATHYAND DIURETIC THERAPY IN PATIENTS WITH ALCOHOLIC LIVER CIRRHOSIS. http://www.med.pfu.edu.ru/_new/english/win/library/vestnik/v991e/00.htm

BULLETIN of Russian Peoples Friendship University Medicine. 1999 N 1. CONTENTS. EDITORIAL V.A.FROLOV, T.Ju.MOISEEVA. ANIMAL ORGANISM AS INFORMATIONAL THERMO DYNAMICS SYS-TEM. ORIGINAL ARTICLES A.M.AVANESOV, A.V.PASECHNIK, G.M.DROGOVA. PLASMA LYSOSOMAL ENZYMES ACTIVITY CHANGE IN THE DYNAMICS OF NECROTIZING ALLERGIC INFLAMMATION PAVLUC-PAVLUCHENKO L.L., BADR EDDIN MACHMUD, DROZDOVA G.A., OMELCHUK N.N., PASECHNIK A.V., FROLOV V.A. THE INFLUENCE OF LIPOSUCTION ON THE SOME INDICES OF LIPID'S METABOLISM. SAPRYKIN V.P. GALANKIN V.N. ULTRASTRUCTURAL CHARACTERISTICS OF NONFLOGOGENIC AND FLOGO-GENIC INTERACTION OF STAPHYLOCOCCUS AUREUS WITH PHAGOCYTES. I.Ya.SULTANOV. DEONTOLOGIC FACTOR AS A CAUSE OF DIAGNOSTIC MISTAKES IN THERAPEUTIC CLINIC. Ì.À. SOLOMATINA, V.Ê. ALPIDOVSKI. ANAEMIA AT CHRONIC DISEASES. Yu.S.MARTYNOV, N.A.CHUVACHINA, M,S.MALKINA, Hc.I.ERUSALIMTCHIC. PATHOPLOGIC REFLEXES. A.N.GRIBANOV. IMPORTANCE OF BASIC LEVEL OF HUMAN REGULATORY SYSTEM FOR HEMODINAMIC IN PATIENTS WITH MILD HYPERTENSION. N.D.KISLIY, M.MULLA OSMAN, N.N.OMELCHUK, G.R.ZLATINSKAJA. P.N.POPOV, S.A.AZEVICH, S.M.SCHEMILCHANOVA. PORTAL SYSTEMIC ENCEPHALOPATHY AND DIURETIC THERAPY IN PATIENTS WITH ALCOHOLIC LIVER CIRRHOSIS.

95. Bit - Enero 1994 (Vol. 2 Num. 1) Translate this page Lactitol, a second generation disaccharide for treatment of chromic portal-systemicencephalopathy a double-blind, crossover, randomized clinical trial. http://www.cfnavarra.es/WebGN/SOU/publicac/bj/biblio/v2n1b.htm

Protocolo de tratamiento del ulcus gastroduodenal 1.- Mones J. Omeprazol. Boletin Informativo del Servicio de Farmacia . Hospital Santa Creu i Sant Pau. Barcelona Junio 1991. 4.- Colley S. Modern management of peptic ulcer. Practitioner 1992; 236:956-61. 7.- Hentschel E, Brandstatter G, Dragaosics B. Effect of ranitidine and amoxillin plus metronidazol in the erradication of Helicobacter Pylori and the recurrence of duodenal ulcer. N Engl J Med 1993; 328:308-12. 8.- Houston CJ, Mills JG, Wood JR. Does presciption of sucralfato of gastric ulcus?. Am J Gastroenterol 1993;88:675-9. Terbinafina 5.- Balfour JA, Faulds D. Terbinafina:A Review Drugs 1992; 43 (2): 260-284. Lactitol 1.- Camma C, Fiorello F, Tine F, Marchesini G, Fabbri A, Pagliaro L. Lactitol in Treatment of Chronic Hepatic Encephalopathy. A Meta-Analisis. Dig Dis Sci 1993; 38, 916-22. 2.- Lactitol. P.A.M. 1993; 17: 279-86. 3.- Riggio O, Balducci G, Ariarto F, Merli M, et al. Lactitol in prevention of recurrent episodes of hepatic encephalopathy in cirrhotic patients with portal-systemic shunt. Dig Dis Sci 1989; 34: 823-29. 5.- Anonymous. Lactitol. (Editorial) Lancet 1987; 2: 81-83.

96. Transgender Care Health Information Archive : Medical/Hormonal : Drug Reference constipation. It is also used to treat a condition called portalsystemicencephalopathy that is associated with liver disease. Proper Use. http://www.transgendercare.com/medical/resources/genrx/l/gdr2186.htm

Carl W. Bushong, Ph.D., LMFT Richard A. Martin, Jr., M.D., FACEP Kimberly L. Westwood, CPE, CCE et al. medical/hormonal Transgender Care Health Information Archive Click item to view: Br. Imp. Complications Breast Implant Types Drug Reference Electrol. After-effects Electrolysis Glossary Electrolysis Guide Electrolysis-Overview Electrolysis Pain Feature on Clinics Genitals-Diagrams GRS Illustrations Hair Removal Meth. Hair System Medical Glossary Phys. Credentials Splendor of Gender Transgender Journey What is Gender Search TransGenderCare Enter word or phrase: ALL words ANY word EXACT phrase About TransGenderCare Our Web Site: TransGenderCare Our Staff Our History Contact TransGenderCare ... Generic Drug Reference GENERIC DRUG REFERENCE MEDICAL Choose the first letter of the drug/drug type you wish to look up. Next, choose the drug name from the listing shown. Brand names are not contained within the listing. Use the search tool, left, to locate an associated brand name with the generic drug product. UP L Lactulose, Oral

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