ammonium hydroxide and Cirrhosis, Liver studies

Research Excerpts

Excerpt	Relevance	Reference
"This study aimed to investigate the clinical effect of probiotics combined with lactulose for minimal hepatic encephalopathy (MHE) treatment."	9.69	Clinical study of probiotics combined with lactulose for minimal hepatic encephalopathy treatment. ( Li, F; Shi, J, 2023)
"Lactulose is effective in secondary prophylaxis of hepatic encephalopathy (HE)."	9.16	Secondary prophylaxis of hepatic encephalopathy in cirrhosis: an open-label, randomized controlled trial of lactulose, probiotics, and no therapy. ( Agrawal, A; Sarin, SK; Sharma, BC; Sharma, P, 2012)
", we determined the effect on chronic hepatic encephalopathy of long-term administration of Enterococcus faecium (SF68) versus lactulose."	9.08	Long-term effects of Enterococcus faecium SF68 versus lactulose in the treatment of patients with cirrhosis and grade 1-2 hepatic encephalopathy. ( Abbiati, R; Coltorti, M; Del Vecchio Blanco, C; Loguercio, C; Rinaldi, M; Romano, A, 1995)
"These findings demonstrated that ADSC-derived exosomes could efficiently alleviate hepatic fibrosis by suppressing HSCs activation and remodeling glutamine and ammonia metabolism mediated by hepatocellular glutamine synthetase, which might be a novel and promising anti-fibrotic therapeutics for hepatic fibrosis disease."	8.12	ADSCs-derived exosomes ameliorate hepatic fibrosis by suppressing stellate cell activation and remodeling hepatocellular glutamine synthetase-mediated glutamine and ammonia homeostasis. ( Feng, J; Fu, Q; Guo, J; Ling, B; Ning, K; Wang, J; Wu, B; Xiu, G; Xu, J, 2022)
"The aim of this study was to determine whether oral L-carnitine administration reduces the blood ammonia concentration and number of hospital admissions for hepatic encephalopathy in patients with advanced cirrhosis."	8.02	L-carnitine reduces hospital admissions in patients with hepatic encephalopathy. ( Fujita, K; Himoto, T; Kobara, H; Masaki, T; Mimura, S; Morishita, A; Nakahara, M; Nomura, T; Oura, K; Sakamoto, T; Tadokoro, T; Takuma, K; Tani, J; Yoneyama, H, 2021)
"The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites."	7.88	Impact of continued administration of tolvaptan on cirrhotic patients with ascites. ( Kodama, K; Kogiso, T; Sagawa, T; Taniai, M; Tokushige, K, 2018)
" Low-grade chronic liver failure (CLF) was induced in 3-month old Sprague-Dawley male rats using thioacetamide (TAA, 50 mg·kg-1·day-1) intraperitoneally for 2 weeks."	7.85	Candesartan, rather than losartan, improves motor dysfunction in thioacetamide-induced chronic liver failure in rats. ( Ali, SS; Gazzaz, ZJ; Ibraheem, MS; Murad, HA, 2017)
" L-Carnitine is a vitamin-like substance and several reports have described the usefulness of L-carnitine supplementation in cases of cirrhosis, with confirmed effectiveness against refractory hepatic encephalopathy."	7.81	Usefulness of Levocarnitine and/or Branched-Chain Amino Acids during Invasive Treatment for Hepatocellular Carcinoma. ( Hasegawa, H; Ishihara, T; Iwasa, M; Kobayashi, Y; Mifuji-Moroka, R; Sekoguchi-Fujikawa, N; Sugimoto, R; Takei, Y; Tanaka, H; Yoshikawa, K, 2015)
"In cirrhotic patients, an oral glutamine load improves the psychometric diagnostic performance for minimal hepatic encephalopathy."	7.79	Oral glutamine challenge improves the performance of psychometric tests for the diagnosis of minimal hepatic encephalopathy in patients with liver cirrhosis. ( Cojocariu, C; Irimia, R; Sfarti, C; Stanciu, C; Trifan, A, 2013)
"To investigate the influence of metformin use on liver dysfunction and hepatic encephalopathy in a retrospective cohort of diabetic cirrhotic patients."	7.78	Metformin inhibits glutaminase activity and protects against hepatic encephalopathy. ( Ampuero, J; Bautista, JD; Camacho, I; del Campo, JA; Díaz-Herrero, Mdel M; Figueruela, B; Maraver, M; Nuñez, D; Ranchal, I; Rojas, Á; Romero-Gómez, M, 2012)
"Intestinal bacteria metabolize tryptophan into indole, which is then further metabolized into oxindole, a sedative compound putatively involved in the pathophysiology of hepatic encephalopathy (HE)."	7.76	Peripheral and splanchnic indole and oxindole levels in cirrhotic patients: a study on the pathophysiology of hepatic encephalopathy. ( Angeloni, S; Carlà, V; Mannaioni, G; Merli, M; Moroni, F; Ridola, L; Riggio, O; Salvatori, FM, 2010)
"Lactitol, a non-absorbable synthetic disaccharide, was administered at a dose of 36g/day for 3-4 weeks to 8 patients with liver cirrhosis and hepatic encephalopathy in order to investigate its effects on fecal bacterial flora and clinical symptoms of hepatic encephalopathy."	7.69	[Effects of lactitol on fecal bacterial flora in patients with liver cirrhosis and hepatic encephalopathy]. ( Hayashi, M; Ito, Y; Okawa, S; Tamai, S; Tarao, K, 1995)
"We successfully anesthetized a 53-year-old female with hypercitrullinemia and severe liver cirrhosis."	7.69	[Anesthetic management for a patient with citrullinemia and liver cirrhosis]. ( Igarashi, M; Iwasaki, H; Kawana, S; Namiki, A, 1995)
"Significant elevation of glutamic acid and glutamine concentrations in CSF was observed in hepatic encephalopathic patients with fulminant hepatitis and liver cirrhosis."	7.67	Glutamic acid and glutamine levels in serum and cerebrospinal fluid in hepatic encephalopathy. ( Fujiwara, M; Higashi, T; Nagashima, H; Nakatsukasa, H; Sakata, T; Shiota, T; Takei, N; Watanabe, A, 1984)
"Propranolol (20 mg 4 times a day) was given to patients with liver cirrhosis or fatty infiltration of the liver."	7.66	Propranolol increases arterial ammonia in liver cirrhosis. ( Koorevaar, G; Silberbusch, J; van Buuren, HR; van der Velden, PC, 1982)
"Hepatic encephalopathy in patients with severe liver disease was associated with marked elevation of either serum methionine or blood ammonia levels or with simultaneous moderate increases in both parameters."	7.66	Impaired metabolism of methionine in severe liver diseases. II. Clinical and experimental studies on role of impaired methionine metabolism in pathogenesis of hepatic encephalopathy. ( Higashi, T, 1982)
"It has been recently proposed that hepatic encephalopathy could be due to the accumulation of octopamine acting as a false neurotransmitter, and the increase of ammonia might reflect this accumulation."	7.65	Octopamine and ammonia plasma levels in hepatic encephalopathy. ( Angelico, M; Attili, AF; Cangiano, C; Capocaccia, L; Cascino, A; Rossi Fanelli, F, 1977)
"The aim of this study was to specify the mechanism of hepatic encephalopathy which may occur in some cirrhotics treated by Spironolactone."	7.65	[Hyperammonemia and hepatic encephalopathy in cirrhotics receiving spironolactone (author's transl)]. ( Imler, M; Schlienger, JL, 1977)
"When propranolol was administered to patients with alcoholic cirrhosis and marginal liver function, as reflected by ammonia levels above 60 microM, it caused a significant increase in ammonia levels in arterialized-venous and arterial, but not in venous, blood (p less than 0."	6.66	Venous, arterial, and arterialized-venous blood ammonia levels and their relationship to hepatic encephalopathy after propranolol. ( Lieber, CS; Snady, H, 1988)
"This study aimed to investigate the clinical effect of probiotics combined with lactulose for minimal hepatic encephalopathy (MHE) treatment."	5.69	Clinical study of probiotics combined with lactulose for minimal hepatic encephalopathy treatment. ( Li, F; Shi, J, 2023)
"The current therapies for hepatic encephalopathy (HE) are not completely effective in all patients, probably due to the physiopathological heterogeneity and the different conditions underlying the bout of HE."	5.56	Oral glutamine challenge is a marker of altered ammonia metabolism and predicts the risk of hepatic encephalopathy. ( Ampuero, J; Camacho, I; Gil, A; Millán, R; Rico, MC; Romero-Gómez, M; Viloria, MDM, 2020)
"Sarcopenia has a negative impact on the prognosis of patients with liver cirrhosis (LC)."	5.56	Skeletal muscle volume loss among liver cirrhosis patients receiving levocarnitine predicts poor prognosis. ( Abe, K; Fujita, M; Hayashi, M; Ohira, H; Takahashi, A, 2020)
"Hepatic encephalopathy is a major complication in patients with advanced cirrhosis and is associated with poor prognosis."	5.48	L-Carnitine for the Treatment of Overt Hepatic Encephalopathy in Patients with Advanced Liver Cirrhosis. ( Futsukaichi, Y; Kobayashi, S; Minemura, M; Sugiyama, T; Tajiri, K; Takahara, T; Yasumura, S, 2018)
"Minimal hepatic encephalopathy is associated with poor prognosis and mortality in patients with cirrhosis."	5.46	Lactulose reduces bacterial DNA translocation, which worsens neurocognitive shape in cirrhotic patients with minimal hepatic encephalopathy. ( Ampuero, J; Bellot, P; Figueruela, B; Francés, R; Gallego-Durán, R; González-Navajas, JM; Martínez-Moreno, B; Moratalla, A; Roger, M; Romero-Gómez, M; Such, J; Zapater, P, 2017)
"MHE was diagnosed with psychometric hepatic encephalopathy score (PHES) ≤ -5."	5.46	Sleep disturbances in patients of liver cirrhosis with minimal hepatic encephalopathy before and after lactulose therapy. ( Puri, V; Sachdeva, S; Sharma, BC; Singh, J; Srivastava, S, 2017)
"Spironolactone is an aldosterone receptor antagonist used to control fluid overload in cirrhotic patients although recent studies suggest that it also inhibits angiogenesis."	5.42	The Impact of Spironolactone on the Severity of Portal-Systemic Collaterals and Hepatic Encephalopathy in Cirrhotic Rats. ( Chang, CC; Ho, HL; Hsin, IF; Hsu, SJ; Huang, HC; Huo, TI; Lee, FY; Lee, SD; Lin, HC; Wang, SS, 2015)
"Minimal hepatic encephalopathy (MHE) impairs health-related quality of life and predicts overt hepatic encephalopathy (HE) in cirrhotic patients."	5.35	Predictors of nonresponse to lactulose for minimal hepatic encephalopathy in patients with cirrhosis. ( Sarin, SK; Sharma, BC; Sharma, P, 2009)
"HE in the presence of liver cirrhosis and/or portal-systemic shunting has been termed portal-systemic encephalopathy (PSE)."	5.30	Sleep disorders and portal-systemic encephalopathy following transjugular intrahepatic portosystemic stent shunt in patients with liver cirrhosis. Relation to plasma tryptophan. ( Bahn, E; Hajak, G; Nolte, W; Pilz, J; Ramadori, G; Rüther, E; von Heppe, J; Wiltfang, J, 1999)
"Lactulose is effective in secondary prophylaxis of hepatic encephalopathy (HE)."	5.16	Secondary prophylaxis of hepatic encephalopathy in cirrhosis: an open-label, randomized controlled trial of lactulose, probiotics, and no therapy. ( Agrawal, A; Sarin, SK; Sharma, BC; Sharma, P, 2012)
", we determined the effect on chronic hepatic encephalopathy of long-term administration of Enterococcus faecium (SF68) versus lactulose."	5.08	Long-term effects of Enterococcus faecium SF68 versus lactulose in the treatment of patients with cirrhosis and grade 1-2 hepatic encephalopathy. ( Abbiati, R; Coltorti, M; Del Vecchio Blanco, C; Loguercio, C; Rinaldi, M; Romano, A, 1995)
"To investigate the efficacy and the acceptability of different doses of lactitol in patients with subclinical hepatic encephalopathy, 28 patients with cirrhosis were enrolled in a controlled clinical trial comparing 5-month therapies with lactitol at two different doses: 0."	5.07	Effects of long-term administration of low-dose lactitol in patients with cirrhosis but without overt encephalopathy. ( Benetti, G; Maggi, A; Moser, P; Salerno, F; Vitaliani, G, 1994)
"Crystalline lactulose (Laevolac Cristalli, CAS 4618-18-2), a pure form of the disaccharide widely employed in the therapy of complications of liver cirrhosis, was administered, after a pharmacological wash-out of 10 days and following a randomized design, to 10 cirrhotic patients for 30 days at the dosage of 60 g/d, while another 10 subjects with similar characteristics received no treatment."	5.07	Crystalline lactulose in the therapy of hepatic cirrhosis. Evaluation of clinical and immunological parameters. Preliminary results. ( Altamura, M; Altomare, E; Cirelli, F; De Vincentiis, A; Palasciano, G; Vendemiale, G, 1992)
"In a group of liver cirrhosis (LC) patients subjected to a rectal ammonium overload test, the effect of L-carnitine on ammoniemia and on the type A numerical connection and star clock psychomotor tests has been evaluated."	5.06	Effect of L-carnitine upon ammonia tolerance test in cirrhotic patients. ( Aparisi, L; Bixquert, M; Castillo, M; del Olmo, JA; Rodrigo, JM; Serra, MA; Wassel, A, 1990)
"The rationale for recommendation of branched-chain amino acids (BCAA; valine, leucine, and isoleucine) in treatment of liver failure is based on their unique pharmacologic properties, stimulatory effect on ammonia detoxification to glutamine (GLN), and decreased concentrations in liver cirrhosis."	4.89	Branched-chain amino acids and ammonia metabolism in liver disease: therapeutic implications. ( Holecek, M, 2013)
"Relative deficiencies of ornithine or arginine occur in the presence of excessive ammonia, excessive lysine, growth, pregnancy, trauma, or protein deficiency and malnutrition."	4.77	Conditional deficiencies of ornithine or arginine. ( Zieve, L, 1986)
"These findings demonstrated that ADSC-derived exosomes could efficiently alleviate hepatic fibrosis by suppressing HSCs activation and remodeling glutamine and ammonia metabolism mediated by hepatocellular glutamine synthetase, which might be a novel and promising anti-fibrotic therapeutics for hepatic fibrosis disease."	4.12	ADSCs-derived exosomes ameliorate hepatic fibrosis by suppressing stellate cell activation and remodeling hepatocellular glutamine synthetase-mediated glutamine and ammonia homeostasis. ( Feng, J; Fu, Q; Guo, J; Ling, B; Ning, K; Wang, J; Wu, B; Xiu, G; Xu, J, 2022)
"The aim of this study was to determine whether oral L-carnitine administration reduces the blood ammonia concentration and number of hospital admissions for hepatic encephalopathy in patients with advanced cirrhosis."	4.02	L-carnitine reduces hospital admissions in patients with hepatic encephalopathy. ( Fujita, K; Himoto, T; Kobara, H; Masaki, T; Mimura, S; Morishita, A; Nakahara, M; Nomura, T; Oura, K; Sakamoto, T; Tadokoro, T; Takuma, K; Tani, J; Yoneyama, H, 2021)
"The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites."	3.88	Impact of continued administration of tolvaptan on cirrhotic patients with ascites. ( Kodama, K; Kogiso, T; Sagawa, T; Taniai, M; Tokushige, K, 2018)
" Low-grade chronic liver failure (CLF) was induced in 3-month old Sprague-Dawley male rats using thioacetamide (TAA, 50 mg·kg-1·day-1) intraperitoneally for 2 weeks."	3.85	Candesartan, rather than losartan, improves motor dysfunction in thioacetamide-induced chronic liver failure in rats. ( Ali, SS; Gazzaz, ZJ; Ibraheem, MS; Murad, HA, 2017)
" L-Carnitine is a vitamin-like substance and several reports have described the usefulness of L-carnitine supplementation in cases of cirrhosis, with confirmed effectiveness against refractory hepatic encephalopathy."	3.81	Usefulness of Levocarnitine and/or Branched-Chain Amino Acids during Invasive Treatment for Hepatocellular Carcinoma. ( Hasegawa, H; Ishihara, T; Iwasa, M; Kobayashi, Y; Mifuji-Moroka, R; Sekoguchi-Fujikawa, N; Sugimoto, R; Takei, Y; Tanaka, H; Yoshikawa, K, 2015)
"In cirrhotic patients, an oral glutamine load improves the psychometric diagnostic performance for minimal hepatic encephalopathy."	3.79	Oral glutamine challenge improves the performance of psychometric tests for the diagnosis of minimal hepatic encephalopathy in patients with liver cirrhosis. ( Cojocariu, C; Irimia, R; Sfarti, C; Stanciu, C; Trifan, A, 2013)
"To investigate the influence of metformin use on liver dysfunction and hepatic encephalopathy in a retrospective cohort of diabetic cirrhotic patients."	3.78	Metformin inhibits glutaminase activity and protects against hepatic encephalopathy. ( Ampuero, J; Bautista, JD; Camacho, I; del Campo, JA; Díaz-Herrero, Mdel M; Figueruela, B; Maraver, M; Nuñez, D; Ranchal, I; Rojas, Á; Romero-Gómez, M, 2012)
"Intestinal bacteria metabolize tryptophan into indole, which is then further metabolized into oxindole, a sedative compound putatively involved in the pathophysiology of hepatic encephalopathy (HE)."	3.76	Peripheral and splanchnic indole and oxindole levels in cirrhotic patients: a study on the pathophysiology of hepatic encephalopathy. ( Angeloni, S; Carlà, V; Mannaioni, G; Merli, M; Moroni, F; Ridola, L; Riggio, O; Salvatori, FM, 2010)
" Significant decrease of myo-inositol in adults is probably due to cellular osmoregulation secondary to long-standing hyperammonemia."	3.76	Brain MR imaging and 1H-MR spectroscopy changes in patients with extrahepatic portal vein obstruction from early childhood to adulthood. ( Gupta, RK; Rathore, RK; Saksena, S; Saraswat, VA; Srivastava, A; Thomas, MA; Yadav, SK, 2010)
"To evaluate if ammonia release and glutamine metabolism by small intestinal mucosa contribute to hyperammonaemia in vivo in patients with liver cirrhosis."	3.70	Post-feeding hyperammonaemia in patients with transjugular intrahepatic portosystemic shunt and liver cirrhosis: role of small intestinal ammonia release and route of nutrient administration. ( Lochs, H; Plauth, M; Romaniuk, P; Roske, AE; Roth, E; Ziebig, R, 2000)
"The administration of sodium benzoate provides an alternative pathway for the disposal of waste nitrogen and this substance has been used to treat patients with urea cycle defects and more recently cirrhotics with hepatic encephalopathy."	3.70	Effect of sodium benzoate on blood ammonia response to oral glutamine challenge in cirrhotic patients: a note of caution. ( Efrati, C; Masini, A; Merli, M; Riggio, O; Valeriano, V, 2000)
"Lactitol, a non-absorbable synthetic disaccharide, was administered at a dose of 36g/day for 3-4 weeks to 8 patients with liver cirrhosis and hepatic encephalopathy in order to investigate its effects on fecal bacterial flora and clinical symptoms of hepatic encephalopathy."	3.69	[Effects of lactitol on fecal bacterial flora in patients with liver cirrhosis and hepatic encephalopathy]. ( Hayashi, M; Ito, Y; Okawa, S; Tamai, S; Tarao, K, 1995)
"We successfully anesthetized a 53-year-old female with hypercitrullinemia and severe liver cirrhosis."	3.69	[Anesthetic management for a patient with citrullinemia and liver cirrhosis]. ( Igarashi, M; Iwasaki, H; Kawana, S; Namiki, A, 1995)
"Significant elevation of glutamic acid and glutamine concentrations in CSF was observed in hepatic encephalopathic patients with fulminant hepatitis and liver cirrhosis."	3.67	Glutamic acid and glutamine levels in serum and cerebrospinal fluid in hepatic encephalopathy. ( Fujiwara, M; Higashi, T; Nagashima, H; Nakatsukasa, H; Sakata, T; Shiota, T; Takei, N; Watanabe, A, 1984)
" Plasma concentrations of amino acids, octopamine, and ammonia were assayed in order to document the metabolic change of hepatic encephalopathy."	3.67	Visual evoked potential: a diagnostic tool for the assessment of hepatic encephalopathy. ( Gollini, G; Messori, E; Penne, A; Pinelli, G; Ventura, E; Zani, G; Zeneroli, ML, 1984)
" For this purpose in 30 patients with liver cirrhosis the time in the NCT was determined and the serum ammonia level (NH3) was measured before the treatment with lactulose and neomycin was started."	3.67	[Ambulatory diagnosis and therapy control of portasystemic encephalopathy in patients with liver cirrhosis]. ( Haerting, J; Mantel, E; Nilius, R; Rink, C, 1985)
"Propranolol (20 mg 4 times a day) was given to patients with liver cirrhosis or fatty infiltration of the liver."	3.66	Propranolol increases arterial ammonia in liver cirrhosis. ( Koorevaar, G; Silberbusch, J; van Buuren, HR; van der Velden, PC, 1982)
"A new nutritional product (SF-1008C) containing a high proportion of branched chain amino acids (BCAA) and low proportion of aromatic amino acids (AAA) and methionine was tested to see its effect on the impaired protein metabolism and abnormal nutritional state frequently observed in patients with advanced liver cirrhosis."	3.66	Effect of a branched chain amino acid-enriched nutritional product on the pathophysiology of the liver and nutritional state of patients with liver cirrhosis. ( Nagashima, H; Okita, M; Shiota, T; Watanabe, A, 1983)
"Hepatic encephalopathy in patients with severe liver disease was associated with marked elevation of either serum methionine or blood ammonia levels or with simultaneous moderate increases in both parameters."	3.66	Impaired metabolism of methionine in severe liver diseases. II. Clinical and experimental studies on role of impaired methionine metabolism in pathogenesis of hepatic encephalopathy. ( Higashi, T, 1982)
"It has been recently proposed that hepatic encephalopathy could be due to the accumulation of octopamine acting as a false neurotransmitter, and the increase of ammonia might reflect this accumulation."	3.65	Octopamine and ammonia plasma levels in hepatic encephalopathy. ( Angelico, M; Attili, AF; Cangiano, C; Capocaccia, L; Cascino, A; Rossi Fanelli, F, 1977)
"According to the present studies it is shown that arginine ketoglutarate in sufficiently high dosage (3x3 g daily by mouth) produces a significant lowering of plasma ammonia and free serum phenols with a high-protein diet in patients with liver cirrhosis, compared to a previous day without this substance."	3.65	[Effect of arginine ketoglutarate on the detoxifying capacity of the liver in cirrhosis of the liver (author's transl)]. ( Horback, L; Müting, D, 1977)
"The aim of this study was to specify the mechanism of hepatic encephalopathy which may occur in some cirrhotics treated by Spironolactone."	3.65	[Hyperammonemia and hepatic encephalopathy in cirrhotics receiving spironolactone (author's transl)]. ( Imler, M; Schlienger, JL, 1977)
"To evaluate the role of tyramine in hepatic disorders, we used a radioimmunoassay to study plasma concentration of tyramine in eight healthy subjects, 20 hospitalized patients without liver disease, and 13 cirrhotic patients of whom seven had hepatic encephalopathy."	3.65	Hypertyraminemia in cirrhotic patients. ( Bowen, PA; Faraj, BA; Isaacs, JW; Rudman, D, 1976)
"Thirteen dogs with hepatic encephalopathy were found to have hyperammonemia and increased retention of plasma sulfobromophthalein."	3.65	Hyperammonemia and hepatic encephalopathy in the dog. ( Kaneko, JJ; Strombeck, KR; Weiser, MG, 1975)
"Patients with cirrhosis were found to be extremely sensitive to tranylcypromine, and the use of this drug for the treatment of depression in such patients is contraindicated."	3.65	Antidepressants and liver disease. ( Morgan, MH; Read, AE, 1972)
"33 g protein N/kg body weight (BW)((3/4)) per day, they excrete 10-15 mg urea N/h per kg BW((3/4))."	3.65	Maximal rates of excretion and synthesis of urea in normal and cirrhotic subjects. ( DiFulco, TJ; Galambos, JT; Rudman, D; Salam, AA; Smith, RB; Warren, WD, 1973)
"Plasma levels of tyrosine were assayed in the fasting state and after oral administration of either tyrosine (tyrosine tolerance test) or phenylalanine (phenlyalanine conversion test) in normal subjects and in patients with hepatitis, biliary obstruction, or cirrhosis."	3.64	Tyrosine metabolism in patients with liver disease. ( Conn, HO; Levine, RJ, 1967)
"Minimal hepatic encephalopathy (MHE) reflects cognitive impairment in patients with liver cirrhosis and is associated with poor prognosis."	3.30	Nutritional therapy for persistent cognitive impairment after resolution of overt hepatic encephalopathy in patients with cirrhosis: A double-blind randomized controlled trial. ( Bara, S; Dalal, A; Kumar, A; Mahajan, B; Maharshi, S; Sachdeva, S; Sharma, A; Sharma, BC; Sonika, U; Srivastava, S, 2023)
" AXA1665 was safe and well tolerated."	2.94	Safety, Tolerability, and Physiological Effects of AXA1665, a Novel Composition of Amino Acids, in Subjects With Child-Pugh A and B Cirrhosis. ( Afeyan, R; Carroll, S; Chakravarthy, MV; Comb, WC; Confer, S; Hamill, M; Neutel, J; Rebello, S; Sanyal, AJ; Tatsuta, N; Tramontin, T; Zhao, P, 2020)
"There is no study on the prevention of recurrence of encephalopathy with L-ornithine L-aspartate (LOLA)."	2.87	Secondary prophylaxis of hepatic encephalopathy in cirrhosis of liver: a double-blind randomized controlled trial of L-ornithine L-aspartate versus placebo. ( Dahale, AS; Sachdeva, S; Sharma, BC; Srivastava, S; Varakanahalli, S, 2018)
"pylori eradication in the treatment of hepatic encephalopathy in patients with LC is unlikely to occur."	2.82	Prevalence of Helicobacter pylori Infection in Patients with Minimal Hepatic Encephalopathy. ( Malfertheiner, P; Reisener, N; Schulz, C; Schütte, K; Voss, J, 2016)
"Minimal hepatic encephalopathy (MHE) represents the mildest form of hepatic encephalopathy (HE), with abnormal neuropsychologic findings."	2.78	Serum endotoxin, inflammatory mediators, and magnetic resonance spectroscopy before and after treatment in patients with minimal hepatic encephalopathy. ( Jain, L; Puri, SK; Sarin, S; Sharma, BC; Sharma, P; Srivastava, S, 2013)
"minimal hepatic encephalopathy with malnutrition can be given a diet of 35-40 cal/kgBW and 1."	2.76	The effect of L-ornithine L-aspartate and branch chain amino acids on encephalopathy and nutritional status in liver cirrhosis with malnutrition. ( Hasan, I; Ndraha, S; Simadibrata, M, 2011)
"pylori infection in causation of minimal hepatic encephalopathy (MHE) has not been well studied."	2.76	Role of Helicobacter pylori infection in the pathogenesis of minimal hepatic encephalopathy and effect of its eradication. ( Agrawal, A; Chandra, M; Gupta, A; Koowar, S, 2011)
"Minimal hepatic encephalopathy (HE) is associated with poorer quality of life and increased work disability."	2.73	Value of the apparent diffusion coefficient for quantification of low-grade hepatic encephalopathy. ( Fujita, N; Iwasa, M; Kaito, M; Kobayashi, Y; Maeda, M; Sugimoto, R; Takeda, K; Takei, Y; Tanaka, H; Urawa, N, 2008)
"Hyperammonemia is a feature of liver failure, which is associated with increased risk of infection."	2.73	Ammonia impairs neutrophil phagocytic function in liver disease. ( Davies, NA; Hodges, SJ; Jalan, R; Pitsillides, AA; Shawcross, DL; Stadlbauer, V; Wheeler-Jones, C; Wright, GA, 2008)
"Minimal hepatic encephalopathy (MHE) is common in cirrhosis but its pathophysiologic basis remains undefined."	2.73	Role of ammonia and inflammation in minimal hepatic encephalopathy. ( Jalan, R; Olde Damink, SW; Shawcross, DL; Wright, G, 2007)
"Minimal hepatic encephalopathy was diagnosed with the Trail Making Test (TMT), Symbol Digit Modalities Test (SDMT) and Auditory Verbal Learning Test (AVL) and cognitive function with the Mini Mental State Examination (MMSE)."	2.73	Acetyl-L-carnitine treatment in minimal hepatic encephalopathy. ( Cammalleri, L; Cristaldi, E; Gargante, MP; Malaguarnera, M; Pennisi, G; Rampello, L; Risino, C; Vacante, M, 2008)
"The pathogenesis of hepatic encephalopathy (HE) is controversial."	2.72	Amino acid challenge in patients with cirrhosis and control subjects: ammonia, plasma amino acid and EEG changes. ( Al Mardini, H; Douglass, A; Record, C, 2006)
"L: -Acetylcarnitine (LAC) is a physiologically active substance that improves both the energetic and the neurotransmission profiles."	2.72	Effects of L-acetylcarnitine on cirrhotic patients with hepatic coma: randomized double-blind, placebo-controlled trial. ( Astuto, M; Lo Giudice, E; Malaguarnera, M; Pistone, G; Raffaele, R; Rampello, L; Vecchio, I, 2006)
"Hepatic encephalopathy is a frequent complication of cirrhosis."	2.71	Oral tryptophan challenge studies in cirrhotic patients: no evidence of neuropsychiatric changes. ( Al Mardini, H; Douglass, A; Record, CO, 2003)
"Minimal hepatic encephalopathy (MHE) is an important disorder that may seriously impair daily functioning and quality of life in patients with cirrhosis."	2.71	Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. ( Bengmark, S; Duan, ZP; Ha, DK; Kurtovic, J; Liu, Q; Riordan, SM, 2004)
"Patients with liver cirrhosis have varying degrees of imbalance of the intestinal flora and probiotics can improve some of the symptoms of gastrointestinal dysfunction in these patients."	2.71	Intestinal microflora in patients with liver cirrhosis. ( Lu, Z; Wang, HJ; Xu, SZ; Zhao, HY, 2004)
" The patients were treated for 15 consecutive days with rifaximin, an antibiotic which is not absorbed by the intestinal wall, at a dosage of 1200 mg/day in association with sufficient lactulose to induce 2 or 3 evacuations per day."	2.68	Rifaximin in the treatment of chronic hepatic encephalopathy. ( Ferrieri, A; Massimetti, A; Puxeddu, A; Quartini, M, 1995)
"When propranolol was administered to patients with alcoholic cirrhosis and marginal liver function, as reflected by ammonia levels above 60 microM, it caused a significant increase in ammonia levels in arterialized-venous and arterial, but not in venous, blood (p less than 0."	2.66	Venous, arterial, and arterialized-venous blood ammonia levels and their relationship to hepatic encephalopathy after propranolol. ( Lieber, CS; Snady, H, 1988)
" In addition, branched chain amino acids or casein in a dosage of 0."	2.66	[Branched-chain amino acids in the treatment of latent porto-systemic encephalopathy. A placebo-controlled double-blind cross-over study]. ( Egberts, EH; Hamster, W; Jürgens, P; Schomerus, H, 1986)
"Acute hepatic encephalopathy in 70 cirrhotic patients was monitored during parenteral administration of amino acids between January 1979 and January 1984."	2.66	Treatment of acute hepatic encephalopathy in cirrhotics with a branched-chain amino acids enriched versus a conventional amino acids mixture. A controlled study of 70 patients. ( Aubin, JP; Bauret, P; Bellet-Herman, H; Bories, P; Michel, H; Pomier-Layrargues, G, 1985)
"Sarcopenia was positively associated with the presence of HE (OR 2."	2.61	Is sarcopenia associated with hepatic encephalopathy in liver cirrhosis? A systematic review and meta-analysis. ( Chang, KV; Chen, JD; Han, DS; Huang, KC; Lin, HY; Wu, WT, 2019)
"Hepatic encephalopathy is a common and devastating neuropsychiatric complication of acute liver failure or chronic liver disease."	2.61	Acetyl-L-carnitine for patients with hepatic encephalopathy. ( Arevalo-Rodriguez, I; Gluud, C; Martí-Amarista, CE; Martí-Carvajal, AJ, 2019)
"Neuropathology of hepatic encephalopathy (HE) in cirrhosis is primarily astroglial in nature characterized by Alzheimer type 2 astrocytosis together with activation of microglia indicative of neuroinflammation."	2.61	Hepatic Encephalopathy in Cirrhosis: Pathology and Pathophysiology. ( Butterworth, RF, 2019)
"Hepatic encephalopathy is one of the most debilitating clinical manifestations of cirrhosis and associated with increased morbidity and mortality."	2.61	Updates on the pathophysiology and therapeutic targets for hepatic encephalopathy. ( Alsahhar, JS; Rahimi, RS, 2019)
"Minimal hepatic encephalopathy (MHE) is an early and reversible form of hepatic encephalopathy."	2.58	Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis. ( Cao, HC; Cao, Q; Chen, P; Deng, M; Li, LJ; Yang, SG; Yu, CB, 2018)
"Minimal hepatic encephalopathy (mHE) is common among patients with cirrhotic liver disease and causes significant morbidity and mortality."	2.52	Diagnosis and Treatment of Low-Grade Hepatic Encephalopathy. ( Direkze, S; Jalan, R, 2015)
"Neurologic examination showed spastic paraparesis without other neurological disorders."	2.50	Hepatic myelopathy with spastic paraparesis: report of two cases and review of the literature. ( Ben Amor, S; Benammou, S; Harzallah, MS; Saied, MZ, 2014)
"Hepatic encephalopathy is a neuropsychiatric complication of liver cirrhosis the symptoms of which may vary from imperceptible to severe, invaliding, and even lethal."	2.50	Concise review of current concepts on nomenclature and pathophysiology of hepatic encephalopathy. ( Liakina, V; Savlan, I; Valantinas, J, 2014)
"Recently, inflammation has also been identified as a contributor to HE."	2.50	Pathophysiology, diagnosis, and management of hepatic encephalopathy. ( Lu, L; Patel, A; Sheasgreen, C, 2014)
"We review PET- and MR studies on hepatic encephalopathy (HE) metabolism in human subjects from the point of views of methods, methodological assumptions and use in studies of cirrhotic patients with clinically overt HE, cirrhotic patients with minimal HE, cirrhotic patients with no history of HE and healthy subjects."	2.49	Brain metabolism in patients with hepatic encephalopathy studied by PET and MR. ( Keiding, S; Pavese, N, 2013)
"Patients with liver cirrhosis frequently lack sufficient BCAAs and therefore suffer from various metabolic disorders."	2.49	Effects of oral branched-chain amino acids on hepatic encephalopathy and outcome in patients with liver cirrhosis. ( Kawaguchi, T; Sata, M; Taniguchi, E, 2013)
" We, therefore, speculate that the beneficial effect of long term intake of BCAA on HE demonstrated in clinical studies may be related to an improved muscle mass and nutritional status rather than to an ammonia lowering effect of BCAA themselves."	2.49	Branched-chain amino acids and muscle ammonia detoxification in cirrhosis. ( Aagaard, NK; Dam, G; Ott, P; Vilstrup, H, 2013)
"Hepatic encephalopathy is a medical phenomenon that is described as a neuropsychiatric manifestation of chronic or acute liver disease that is characterized by psychomotor, intellectual and cognitive abnormalities with emotional/affective and behavioral disturbances."	2.49	Current pathogenetic aspects of hepatic encephalopathy and noncirrhotic hyperammonemic encephalopathy. ( Cichoż-Lach, H; Michalak, A, 2013)
"Hepatic encephalopathy is a clinical diagnosis, and several scoring systems have been used to determine the severity of hepatic encephalopathy."	2.46	Clinical management of hepatic encephalopathy. ( Schiano, TD, 2010)
"Hepatic encephalopathy is characterized by neuropsychiatric abnormalities in patients with liver failure."	2.45	Hepatic encephalopathy: pathophysiology and emerging therapies. ( Shaikh, OS; Sundaram, V, 2009)
"The currently accepted regimens to treat hepatic encephalopathy such as lactulose and protein restricted diets need further clinical trials and therefore placebo controlled clinical trials in hepatic encephalopathy are justified."	2.44	Management of hepatic encephalopathy in patients with cirrhosis. ( Jalan, R; Wright, G, 2007)
"The aetiology of hepatic encephalopathy has not been conclusively established, but it is widely agreed that ammonia derived primarily from enteric bacterial flora plays a central role."	2.44	Review article: bacterial flora and pathogenesis in hepatic encephalopathy. ( Williams, R, 2007)
"Hepatic encephalopathy is a severe complication of cirrhosis that is related to the effects of ammonia."	2.44	Hepatic encephalopathy. ( Córdoba, J; Mínguez, B, 2008)
"Distinct syndromes are identified in acute liver failure and cirrhosis."	2.42	The molecular pathogenesis of hepatic encephalopathy. ( Davies, N; Jalan, R; Shawcross, D, 2003)
"Comparison of HE in acute liver failure (ALF) with that of cirrhosis allows recognition of important differences and similarities."	2.42	Pathogenesis of hepatic encephalopathy in acute liver failure. ( Blei, AT; Cahill, ME; Chung, C; Vaquero, J, 2003)
"Hepatic encephalopathy has been linked to H."	2.42	Helicobacter pylori and hepatic encephalopathy. ( Chawla, YK; Dhiman, RK; Duseja, A; Sachdev, A, 2003)
"The treatment of hepatic encephalopathy is predominantly an empirical approach because the process pathogenesis of this syndrome is uncertain."	2.39	Treatment of hepatic encephalopathy in patients with cirrhosis of the liver. ( Ferenci, P, 1996)
"Hepatic encephalopathy is a neuropsyquiatric syndrome associated to multifactorial metabolic disruptions."	2.38	[Pathogenesis of portal systemic encephalopathy]. ( Barragán, RF; García Compeán, D; Valadez Castillo, R, 1990)
"The definition of hepatic coma has been used for the most severe course of hepatic insufficiency, independent from the pathogenesis."	2.36	[On the neuro-psychiatric symptomatology of the so-called "hepatic coma" (author's transl)]. ( Binder, H, 1981)
"Serum ammonia testing in hepatic encephalopathy (HE) has been long debated in the field of hepatology."	1.91	The Ongoing Debate of Serum Ammonia Levels in Cirrhosis: the Good, the Bad, and the Ugly. ( Deutsch-Link, S; Moon, AM, 2023)
"Objective Rifaximin is used to treat hepatic encephalopathy."	1.91	Add-on Therapeutic Effects of Rifaximin on Treatment-resistant Hepatic Encephalopathy. ( Hayakawa, Y; Higuchi, M; Inada, K; Ishido, S; Izumi, N; Kakegawa, T; Kaneko, S; Kirino, S; Kurosaki, M; Maeyashiki, C; Matsumoto, H; Nakanishi, H; Nobusawa, T; Okamoto, R; Takahashi, Y; Takaura, K; Tamaki, N; Tanaka, S; Tanaka, Y; Tsuchiya, K; Yamashita, K; Yasui, Y, 2023)
"Hepatic encephalopathy is a confusional state associated with cirrhosis."	1.91	Serum ammonia does not guide management and is overutilised in patients with cirrhosis in hospital settings. ( Al-Ani, A; Hannah, N; Hebbard, G; Kansal, A; Sood, S; Vasic, D, 2023)
"The prevalence of minimal hepatic encephalopathy (MHE), in particular in different subgroups, remains unknown."	1.91	Prevalence of Minimal Hepatic Encephalopathy in Patients With Liver Cirrhosis: A Multicenter Study. ( Bloom, PP; Danneberg, S; Ehrenbauer, AF; Gabriel, M; Gairing, SJ; Galle, PR; Gioia, S; Labenz, C; Labenz, J; Lauridsen, MM; Lok, AS; Mangini, C; Marquardt, JU; Montagnese, S; Nardelli, S; Nielsen, EJ; Ripoll, C; Sultanik, P; Thabut, D; Weissenborn, K; Zarantonello, L; Zipprich, A, 2023)
"Psychometric hepatic encephalopathy score (PHES) <-4 or critical flicker frequency (CFF) <39 was considered abnormal."	1.91	Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis. ( Ampuero, J; Balcar, L; Ballester, MP; Carbonell-Asins, JA; Escudero, MD; Fiorillo, A; Jalan, R; Kerbert, AJC; Mandorfer, M; Montoliu, C; Reiberger, T; Romero-Gómez, M; Shawcross, DL; Thomsen, KL; Tranah, TH, 2023)
"Hyperlipidemia and oxidative stress with elevated oxidized low-density lipoprotein (ox-LDL) exacerbate hepatic inflammation and fibrosis."	1.72	Effects of PCSK-9 Inhibition by Alirocumab Treatments on Biliary Cirrhotic Rats. ( Chang, CC; Chuang, CL; Hou, MC; Hsu, SJ; Huang, HC; Lee, FY, 2022)
"Results: An improved rate of overt hepatic encephalopathy (HE) of 82."	1.72	Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites. ( Fukuda, H; Fukunaga, A; Higashi, M; Higashi, T; Hirai, F; Miyayama, T; Sakisaka, S; Shakado, S; Shibata, K; Takata, K; Tanaka, T; Tsuchiya, N; Uchida, Y; Umeda, K; Yamauchi, R; Yokoyama, K, 2022)
"The pathophysiology of hepatic encephalopathy (HE) is incompletely understood."	1.72	Elevation of Autoantibodies to Cerebral Proteins in Hepatic Encephalopathy: Another Pathogenic Factor? ( Falalyeyeva, TM; Manzhalii, EG; Moyseyenko, VO; Stremmel, W; Weiskirchen, R, 2022)
"We evaluated the dynamics of hepatic encephalopathy (HE) and ammonia estimation in acute-on-chronic liver failure (ACLF) patients due to a paucity of evidence."	1.62	Dynamic assessments of hepatic encephalopathy and ammonia levels predict mortality in acute-on-chronic liver failure. ( Al Mahtab, M; Arora, A; Butt, AS; Choudhury, A; Devarbhavi, H; Dhiman, RK; Dokmeci, AK; Duseja, A; Eapen, CE; Ghazinyan, H; Goel, A; Goyal, O; Hamid, SS; Hu, J; Jafri, W; Kim, DJ; Kulkarni, A; Kumar, A; Kumar, R; Lau, GK; Lee, GH; Lesmana, LA; Midha, V; Ning, Q; Payawal, DA; Prasad, VGM; Rao, PN; Sahu, M; Sarin, SK; Shah, S; Shaojie, X; Shresta, A; Shukla, A; Singh, A; Singh, V; Sollano, J; Sood, A; Tan, SS; Taneja, S; Tao, H; Treeprasertsuk, S; Verma, N; Yuemin, N; Zhongping, D, 2021)
"Ammonia levels are used to assess hepatic encephalopathy, but their levels are highly variable in clinical practice."	1.56	Variability and Lability of Ammonia Levels in Healthy Volunteers and Patients With Cirrhosis: Implications for Trial Design and Clinical Practice. ( Anderson, C; Bajaj, JS; Blankstein, L; Bloom, PP; Brennan, AM; Chung, RT; Denney, WS; Gavis, EA; Hassanein, TI; Kayali, Z; Lawitz, E; Lee, WM; Muthukumar, AR; Padilla-Martinez, M; Puurunen, MK; Rockey, DC; Sasso, R, 2020)
"Hepatic encephalopathy is a clinical diagnosis."	1.56	Low-Value Levels: Ammonia Testing Does Not Improve the Outcomes of Overt Hepatic Encephalopathy. ( Rahimi, RS; Tapper, EB, 2020)
"The current therapies for hepatic encephalopathy (HE) are not completely effective in all patients, probably due to the physiopathological heterogeneity and the different conditions underlying the bout of HE."	1.56	Oral glutamine challenge is a marker of altered ammonia metabolism and predicts the risk of hepatic encephalopathy. ( Ampuero, J; Camacho, I; Gil, A; Millán, R; Rico, MC; Romero-Gómez, M; Viloria, MDM, 2020)
"Sarcopenia has a negative impact on the prognosis of patients with liver cirrhosis (LC)."	1.56	Skeletal muscle volume loss among liver cirrhosis patients receiving levocarnitine predicts poor prognosis. ( Abe, K; Fujita, M; Hayashi, M; Ohira, H; Takahashi, A, 2020)
"Conclusion Rifaximin administration for hepatic encephalopathy improved the CONUT and ALBI scores."	1.56	Changes in the Body Composition and Nutritional Status after Long-term Rifaximin Therapy for Hyperammonemia in Japanese Patients with Hepatic Encephalopathy. ( Azumi, M; Endo, S; Honma, T; Imai, M; Ishikawa, T; Iwanaga, A; Nozawa, Y; Sano, T; Yoshida, T, 2020)
"In nonalcoholic fatty liver disease (NAFLD), fibrosis is the most important factor contributing to NAFLD-associated morbidity and mortality."	1.56	Ammonia Scavenging Prevents Progression of Fibrosis in Experimental Nonalcoholic Fatty Liver Disease. ( Andreola, F; Davies, N; De Chiara, F; Gracia-Sancho, J; Habtesion, A; Hall, A; Jalan, R; Jones, H; Leslie, J; Manicardi, N; Mann, J; Mookerjee, RP; Oakley, F; Paish, HL; Reed, LH; Rombouts, K; Thomsen, KL; Watson, AA, 2020)
"Minimal hepatic encephalopathy (MHE) is a subclinical complication of liver cirrhosis with a relevant social impact."	1.51	Minimal Hepatic Encephalopathy is Associated with Increased Cerebral Vascular Resistance. A Transcranial Doppler Ultrasound Study. ( Ainora, ME; Caracciolo, G; Funaro, B; Garcovich, M; Gasbarrini, A; Lupascu, A; Nesci, A; Pompili, M; Ponziani, FR; Quadarella, A; Riccardi, L; Zocco, MA, 2019)
"Psychometric Hepatic Encephalopathy Score (PHES) and ammonia improved significantly in the patients with amelioration in SMI >10% (n = 16) and not in those without (n = 11) (PHES: -1."	1.51	The modification of quantity and quality of muscle mass improves the cognitive impairment after TIPS. ( Gioia, S; Lattanzi, B; Merli, M; Nardelli, S; Pitocchi, F; Ridola, L; Riggio, O, 2019)
"Minimal hepatic encephalopathy is associated with an increased risk of mortality in patients with liver cirrhosis, independent of hepatocellular carcinoma stage or Child-Pugh score."	1.51	Prognostic significance of minimal hepatic encephalopathy in patients with liver cirrhosis in Japan: A propensity score-matching analysis. ( Hanai, T; Imai, K; Moriwaki, H; Shimizu, M; Shiraki, M; Suetsugu, A; Takai, K; Watanabe, S, 2019)
"Acute hepatic encephalopathy has significant morbidity and mortality in liver transplant recipients unless it is promptly treated."	1.48	Brain MRI findings in acute hepatic encephalopathy in liver transplant recipients. ( Chen, SQ; Guo, RM; Guo, Y; Jiao, J; Li, QL; Wang, J; Zhang, Y; Zhong, LR, 2018)
"Hepatic encephalopathy was defined by either a hepatic encephalopathy-related hospitalization and/or taking ammonia-lowering treatment (i."	1.48	Myosteatosis and sarcopenia are associated with hepatic encephalopathy in patients with cirrhosis. ( Bhanji, RA; Duarte-Rojo, A; Ebadi, M; Ghosh, S; Moctezuma-Velazquez, C; Montano-Loza, AJ; Rose, C, 2018)
"Hepatic encephalopathy is a major complication in patients with advanced cirrhosis and is associated with poor prognosis."	1.48	L-Carnitine for the Treatment of Overt Hepatic Encephalopathy in Patients with Advanced Liver Cirrhosis. ( Futsukaichi, Y; Kobayashi, S; Minemura, M; Sugiyama, T; Tajiri, K; Takahara, T; Yasumura, S, 2018)
"The indication for BRTO was gastric varices in 40 cases and hepatic encephalopathy in eight cases."	1.46	Plasma Glucose Level Is Predictive of Serum Ammonia Level After Retrograde Occlusion of Portosystemic Shunts. ( Aibe, Y; Ishikawa, T; Iwamoto, T; Matsuda, T; Sakaida, I; Takami, T, 2017)
"The major obstacle for the development of targeted therapies is the lack of pharmacodynamic (PD) biomarkers to provide an early readout of biological activities."	1.46	Metabolomics combined with pattern recognition and bioinformatics analysis methods for the development of pharmacodynamic biomarkers on liver fibrosis. ( Fang, J; Qiu, M; Wang, L; Wang, Y; Zhang, Y, 2017)
"Stage of esophageal varices and endoscopic inflammatory lesions in the stomach were evaluated, depending on the presence of H."	1.46	Helicobacter pylori infection among patients with liver cirrhosis. ( Flisiak, R; Kalinowska, A; Pogorzelska, J; Łapińska, M; Łapiński, TW, 2017)
"Sarcopenia is recognized as a condition related to quality of life and prognosis in patients with chronic liver disease, although no useful strategy for improving muscle volume and strength has been established."	1.46	Efficacy of branched-chain amino acid supplementation and walking exercise for preventing sarcopenia in patients with liver cirrhosis. ( Abe, M; Aibiki, T; Hiasa, Y; Hiraoka, A; Hirooka, M; Iwasaki, R; Izumoto, H; Kaneto, M; Kiguchi, D; Kishida, M; Kitahata, S; Kohgami, S; Matsuura, B; Michitaka, K; Miyamoto, Y; Miyata, H; Mori, K; Ninomiya, T; Okudaira, T; Suga, Y; Tokumoto, Y; Tomida, H; Tsubouchi, E; Ueki, H; Yamago, H, 2017)
"Minimal hepatic encephalopathy is associated with poor prognosis and mortality in patients with cirrhosis."	1.46	Lactulose reduces bacterial DNA translocation, which worsens neurocognitive shape in cirrhotic patients with minimal hepatic encephalopathy. ( Ampuero, J; Bellot, P; Figueruela, B; Francés, R; Gallego-Durán, R; González-Navajas, JM; Martínez-Moreno, B; Moratalla, A; Roger, M; Romero-Gómez, M; Such, J; Zapater, P, 2017)
"The pathogenesis of hepatic encephalopathy (HE) in cirrhosis is multifactorial and ammonia is thought to play a key role."	1.46	Ammonia mediates cortical hemichannel dysfunction in rodent models of chronic liver disease. ( Davies, N; De Chiara, F; Gourine, AV; Habtetion, A; Hadjihambi, A; Hosford, PS; Jalan, R; Karagiannis, A, 2017)
"MHE was diagnosed with psychometric hepatic encephalopathy score (PHES) ≤ -5."	1.46	Sleep disturbances in patients of liver cirrhosis with minimal hepatic encephalopathy before and after lactulose therapy. ( Puri, V; Sachdeva, S; Sharma, BC; Singh, J; Srivastava, S, 2017)
"Hyperammonemia is a consistent abnormality in cirrhosis that results in impaired skeletal muscle protein synthesis and breakdown (proteostasis)."	1.46	Ammonia lowering reverses sarcopenia of cirrhosis by restoring skeletal muscle proteostasis. ( Dasarathy, S; Davuluri, G; Deutz, NEP; Engelen, MPKJ; Kumar, A; Prayson, R; Silva, RNE; Ten Have, GAM, 2017)
"Portal hypertension affects portal-systemic shunt which leads to hepatic encephalopathy that the vascular modulation might influence severity of hepatic encephalopathy."	1.46	Effects of raloxifene on portal hypertension and hepatic encephalopathy in cirrhotic rats. ( Chang, CC; Chang, T; Chuang, CL; Hsin, IF; Hsu, SJ; Huang, HC; Lee, FY; Lee, SD; Lee, WS, 2017)
"EASL/AASLD hepatic encephalopathy (HE) guidelines proposed the alternative use of the term 'Covert HE' combining minimal HE (mHE) and Grade 1 HE into a single entity."	1.43	Clinical and Pathophysiological Characteristics of Cirrhotic Patients with Grade 1 and Minimal Hepatic Encephalopathy. ( Jalan, R; Macnaughtan, J; Mookerjee, RP; Thomsen, KL; Tritto, G, 2016)
"She was diagnosed with liver cirrhosis as a result of autoimmune hepatitis, combined with Sjögren's syndrome."	1.43	Gradual improvement of hyperammonemic hepatic encephalopathy after the extirpation of a large uterine leiomyoma in a woman with constipation and liver cirrhosis resulting from autoimmune hepatitis. ( Himeno, R; Kunitomo, K; Matsumoto, S; Ohkuchi, A; Sakamoto, T; Wada, M, 2016)
"Bumetanide was administered intraperitoneally in the course of the ammonia treatment."	1.43	Bumetanide increases manganese accumulation in the brain of rats with liver damage. ( Castro-Chávez, A; Florian-Soto, C; Heras-Romero, Y; Montes, S; Ríos, C; Rivera-Mancía, S, 2016)
"Umbilical hernia is a common abdominal complication in cirrhotic patients with ascites."	1.43	Association of umbilical hernia with volume of ascites in liver cirrhosis: a retrospective observational study. ( Dai, J; Deng, H; Guo, X; Hou, F; Li, J; Ning, Z; Peng, Y; Qi, X; Wang, R; Zhao, J, 2016)
"Spironolactone is an aldosterone receptor antagonist used to control fluid overload in cirrhotic patients although recent studies suggest that it also inhibits angiogenesis."	1.42	The Impact of Spironolactone on the Severity of Portal-Systemic Collaterals and Hepatic Encephalopathy in Cirrhotic Rats. ( Chang, CC; Ho, HL; Hsin, IF; Hsu, SJ; Huang, HC; Huo, TI; Lee, FY; Lee, SD; Lin, HC; Wang, SS, 2015)
"We included 80 patients with liver cirrhosis (58 men) and 20 healthy controls (11 men)."	1.40	Doppler assessment of splanchnic arterial flow in patients with liver cirrhosis: correlation with ammonia plasma levels and MELD score. ( Dimitrijevic, S; Glišić, TM; Jurišić, V; Perišić, MD, 2014)
"Thirty-seven patients with SRS due to liver cirrhosis were included in this study."	1.40	Relationships between splenorenal shunt/portal vein diameter ratio and systemic hemodynamics in patients with liver cirrhosis. ( Chikamori, F; Kuniyoshi, N; Okamoto, H, 2014)
"A total of 135 patients with liver cirrhosis and HE had serum ammonia levels measured on admission."	1.40	Ammonia levels and the severity of hepatic encephalopathy. ( Khokhar, N; Qureshi, MO; Shafqat, F, 2014)
"The data on the positive experience with hepatic encephalopathy in patients with cirrhosis liver L-ornithine-L-aspartate (drug larnamyn), the effectiveness of which is provided by its components (amino acids, ornithine and aspartate) which improve metabolism, ammonia detoxification mechanism, production of energy in the Krebs cycle, promote restoration of the cell membrane, and carried out anti-inflammatory and detoxicative effect."	1.40	[Pathogenesis, diagnosis and treatment of hepatic encephalopathies in patients with liver cirrhosis]. ( Manzhaliĭ, EH; Moĭseienko, VO; Nykula, TD; Solonovych, OS, 2014)
"Furthermore, the severity of liver cirrhosis, determined by Child-Pugh scores, correlated with serum IL-6 levels (r=0."	1.39	Correlation between interleukin-6 and ammonia in patients with overt hepatic encephalopathy due to cirrhosis. ( Cao, WK; Dai, CY; Li, L; Liang, SR; Luo, M; Yang, EN, 2013)
"We analyzed the presence of mild cognitive impairment (CI) by using the PHES battery of psychometric tests and measured the levels of ammonia and of the inflammatory cytokines IL-6 and IL-18 in blood of patients with different types of liver or dermatological diseases resulting in different grades of hyperammonemia and/or inflammation."	1.38	Contribution of hyperammonemia and inflammatory factors to cognitive impairment in minimal hepatic encephalopathy. ( Cassinello, N; Civera, M; Felipo, V; Garcia-Torres, ML; Jordá, E; Martinez-Valls, J; Molina, I; Montesinos, E; Montoliu, C; Olmo, JA; Ortega, J; Serra, MA; Urios, A; Wassel, A, 2012)
"Chronic hepatic encephalopathy is a characteristically reversible neuropsychiatric disorder that occurs mainly in patients with liver cirrhosis."	1.38	Regional reduction in gray and white matter volume in brains of cirrhotic patients: voxel-based analysis of MRI. ( Adachi, Y; Fujita, N; Gabazza, EC; Iwasa, M; Kobayashi, Y; Kuroda, M; Matsuda, H; Mifuji-Moroka, R; Moroka, H; Takei, Y, 2012)
"Although the Psychometric Hepatic Encephalopathy Score (PHES) for the diagnosis of minimal hepatic encephalopathy (MHE) has been validated in several countries, further validation is required for its use in different populations."	1.38	Psychometric hepatic encephalopathy score for the detection of minimal hepatic encephalopathy in Korean patients with liver cirrhosis. ( An, H; Jung, JY; Keum, B; Kim, CD; Kim, CH; Kim, JD; Lee, HS; Ryu, HS; Seo, YS; Um, SH; Yim, HJ; Yim, SY, 2012)
"Hyperammonemia is considered to be the main cause of decreased levels of the branched-chain amino acids (BCAA), valine, leucine, and isoleucine, in liver cirrhosis."	1.37	Acute hyperammonemia activates branched-chain amino acid catabolism and decreases their extracellular concentrations: different sensitivity of red and white muscle. ( Holecek, M; Kandar, R; Kovarik, M; Sispera, L, 2011)
"The diagnosis of hepatic encephalopathy (HE) relies on clinical, neurophysiological, psychometric and laboratory variables."	1.37	Different biochemical correlates for different neuropsychiatric abnormalities in patients with cirrhosis. ( Amodio, P; Angeli, P; Biancardi, A; Carlà, V; Carraro, P; Gatta, A; Mannaioni, G; Montagnese, S; Moroni, F; Schiff, S; Tono, N, 2011)
"However, HE in patients with liver cirrhosis is not associated with an up-regulation of inflammatory cytokines in cerebral cortex, despite microglia activation."	1.37	Microglia activation in hepatic encephalopathy in rats and humans. ( Bidmon, HJ; Görg, B; Häussinger, D; Keitel, V; Schrör, K; Zemtsova, I, 2011)
"In addition, the psychometric hepatic encephalopathy score (PHES), continues reaction time, and biochemical profile were assessed."	1.37	Spectral and dynamic electroencephalogram abnormalities are correlated to psychometric test performance in hepatic encephalopathy. ( Blauenfeldt, RA; Drewes, A; Graversen, C; Hansen, JB; Hansen, TM; Olesen, SS; Steimle, K, 2011)
"156 patients with cirrhosis (74 with hepatic encephalopathy and 82 without) were enrolled, and underwent clinical examination and blood testing."	1.37	Partial pressure of NH₃ in cirrhotic patients with and without hepatic encephalopathy. ( Gao, B; He, Y; Li, G; Luo, T; Song, H; Xu, J, 2011)
"Hepatic encephalopathy is liver-kidney-intestine-brain syndrome."	1.36	[Analysis of the relationship between hepatorenal syndrome and plasma ammonia]. ( He, Y; Li, GX; Xia, Y, 2010)
"Management of hepatic encephalopathy includes the eviction of the precipitating factor and prevention of recurrence."	1.36	[Hepatic encephalopathy in patients with cirrhosis: new aspects and practical recommendations]. ( Ditisheim, S; Spahr, L, 2010)
"Abdominal computed tomography showed liver cirrhosis and thrombus in the right branch of the portal vein."	1.35	Portal vein thrombosis in a patient with hepatitis C virus-related cirrhosis complicated with antiphospholipid syndrome. ( Kida, Y; Maeshima, E; Yamada, Y, 2009)
"Ataxia has been suggested in the literature to be a symptom of hepatic encephalopathy (HE), but so far has not been objectively quantified."	1.35	Postural control in patients with liver cirrhosis: a posturographic study. ( Fialka-Moser, V; Gangl, A; Mittermaier, C; Peck-Radosavljevic, M; Schmid, M; Voller, B, 2009)
"Minimal hepatic encephalopathy (MHE) impairs health-related quality of life and predicts overt hepatic encephalopathy (HE) in cirrhotic patients."	1.35	Predictors of nonresponse to lactulose for minimal hepatic encephalopathy in patients with cirrhosis. ( Sarin, SK; Sharma, BC; Sharma, P, 2009)
"Minimal hepatic encephalopathy (MHE) is associated with poorer quality of life and increased work disability."	1.34	Critical flicker frequency: diagnostic tool for minimal hepatic encephalopathy. ( Puri, V; Sarin, SK; Sharma, BC; Sharma, P, 2007)
"Hepatic encephalopathy is considered to be mainly caused by increased ammonia metabolism of the brain."	1.34	Correlations between magnetic resonance spectroscopy alterations and cerebral ammonia and glucose metabolism in cirrhotic patients with and without hepatic encephalopathy. ( Ahl, B; Burchert, W; Fischer-Wasels, D; Hecker, H; Köstler, H; van den Hoff, J; Weissenborn, K, 2007)
"Studies on animal models of hepatic encephalopathy (HE) suggest that poor nutritional status may facilitate the development of HE."	1.34	Malnutrition and diabetes mellitus are related to hepatic encephalopathy in patients with liver cirrhosis. ( Bengtsson, M; Björnsson, E; Henfridsson, P; Hugosson, I; Jalan, R; Kalaitzakis, E; Olsson, R, 2007)
"6 patients with liver cirrhosis were included in this pilot study."	1.33	[Detection of subclinical and overt hepatic encephalopathy and treatment control after L-ornithine-L-aspartate medication by magnetic resonance spectroscopy ((1)H-MRS)]. ( Gregor, M; Hass, HG; Hösl, F; Kaiser, S; Nägele, T; Seeger, U, 2005)
"Cirrhotic patients without overt hepatic encephalopathy may have cerebral function alterations called minimal hepatic encephalopathy (MHE)."	1.33	Neuropsychological and neurophysiological evaluation in cirrhotic patients with minimal hepatic encephalopathy undergoing liver transplantation. ( Amodio, P; Bassanello, M; Burra, P; Canova, D; D'Aloiso, MC; Del Piccolo, F; Fagiuoli, S; Masier, A; Senzolo, M; Zanus, G, 2005)
"The status epilepticus was resolved after antiepileptic therapy (phenytoin sodium) and treatment for hepatic encephalopathy (Branched chain amino acids)."	1.33	Hepatic encephalopathy with status epileptics: a case report. ( Hamagami, H; Ichinose, M; Kida, Y; Tanaka, H; Tsuji, T; Ueda, H, 2006)
"Subclinical hepatic encephalopathy (SHE) were detected 55 in 47."	1.33	[The effects of Helicobacter pylori infection on hyperammonaemia and hepatic encephalopathy in cirrhotic patients]. ( Cai, JT; Chen, T; Lü, B; Si, JM; Wang, LJ, 2006)
"The correlation with the severity of hepatic encephalopathy was similar for venous (r=0."	1.32	Role of determination of partial pressure of ammonia in cirrhotic patients with and without hepatic encephalopathy. ( Attili, AF; Efrati, C; Masini, A; Merli, M; Nicolao, F; Riggio, O, 2003)
"Hyperammonemia was induced by oral administration of an amino-acid (aa) solution mimicking hemoglobin composition."	1.32	Systemic inflammatory response exacerbates the neuropsychological effects of induced hyperammonemia in cirrhosis. ( Davies, NA; Jalan, R; Shawcross, DL; Williams, R, 2004)
"In addition, the prevalence of hypochlorhydria (defined as pH>4) was significantly greater in cirrhosis patients (45 vs."	1.32	[Gastric pH and Helicobacter pylori infection in patients with liver cirrhosis]. ( Choi, WC; Han, TH; Kim, KY; Kim, SJ; Lee, JH; Nam, YJ; Shin, WC, 2004)
"We examined 35 patients with liver cirrhosis and the results revealed a significant increase for the plasma activities of total Hex and its isoenzymes Hex A and Hex B (p < 0."	1.31	Relationship between plasma ammonia concentration and beta-N-acetylhexosaminidase isoenzyme activities in liver cirrhosis. ( Casal, JA; Pérez, LF; Rojas, P; Tutor, JC, 2000)
"To mimic episodic hepatic encephalopathy after gastrointestinal bleeding under controlled conditions, cirrhotic patients were challenged with an amino acid mixture of comparable composition to haemoglobin."	1.31	Amino acid challenge in patients with cirrhosis: a model for the assessment of treatments for hepatic encephalopathy. ( Al Mardini, H; Douglass, A; Record, C, 2001)
"A large portal-systemic shunt including gastric varices also causes severe encephalopathy in some cirrhotic patients."	1.31	Therapeutic effect of balloon-occluded retrograde transvenous obliteration on portal-systemic encephalopathy in patients with liver cirrhosis. ( Kato, T; Moriwaki, H; Nishigaki, Y; Sugihara, J; Tomita, E; Uematsu, T, 2001)
"Non-alcoholic cirrhotics without overt hepatic encephalopathy (n=24) underwent (1)H-MR of the brain and neuropsychological tests."	1.31	The development of low-grade cerebral edema in cirrhosis is supported by the evolution of (1)H-magnetic resonance abnormalities after liver transplantation. ( Alonso, J; Castells, L; Córdoba, J; Esteban, R; Guardia, J; Jacas, C; Kulisewsky, J; Margarit, C; Rovira, A; Sanpedro, F; Vargas, V, 2001)
"To study whether liver cirrhosis associated with Helicobacter pylori (H."	1.31	Changes in serum ammonia concentration in cirrhotic patients with Helicobacter pylori infection. ( Cao, Q; Fang, L; Gao, M; Qian, G; Si, J; Wang, Y, 2000)
"Latent or sub-clinical hepatic encephalopathy is a recognized complication of cirrhosis and is thought to represent one end of the spectrum of neuropsychiatric impairment, which occurrs as a result of portal-systemic shunting."	1.30	Oral glutamine challenge in cirrhotics pre- and post-liver transplantation: a psychometric and analyzed EEG study. ( Al-Mardini, H; Oppong, KN; Record, CO; Thick, M, 1997)
"pylori infection is associated with hepatic encephalopathy, especially in younger patients with decompensated liver disease."	1.30	Analysis of risk factors for chronic hepatic encephalopathy: the role of Helicobacter pylori infection. ( Dasani, BM; Lieber, CS; Sigal, SH, 1998)
"A prospective study of hepatic encephalopathy (HE) including neuropsychiatric and psychometric evaluation, electroencephalography, and determination of arterial ammonia levels was performed in 55 cirrhotic patients treated consecutively by transjugular intrahepatic portosystemic shunt (TIPS)."	1.30	Portosystemic hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: clinical, laboratory, psychometric, and electroencephalographic investigations. ( Figulla, HR; Hartmann, H; Münke, H; Nolte, W; Ramadori, G; Schindler, C; Unterberg, K; Werner, G; Wiltfang, J; Zumhasch, U, 1998)
"pylori) infection as a cause of hepatic encephalopathy is still debated."	1.30	Helicobacter pylori infection, plasma ammonia levels, and psychometric testing in cirrhotic patients. ( Attili, AF; Hassan, C; Meddi, P; Rinaldi, V; Winn, S; Zullo, A, 1999)
"HE in the presence of liver cirrhosis and/or portal-systemic shunting has been termed portal-systemic encephalopathy (PSE)."	1.30	Sleep disorders and portal-systemic encephalopathy following transjugular intrahepatic portosystemic stent shunt in patients with liver cirrhosis. Relation to plasma tryptophan. ( Bahn, E; Hajak, G; Nolte, W; Pilz, J; Ramadori, G; Rüther, E; von Heppe, J; Wiltfang, J, 1999)
"An unusual case of acute cerebral edema as part of the syndrome of portal systemic encephalopathy in an individual with established chronic liver disease is reported."	1.29	Acute cerebral edema as part of the syndrome of hepatic encephalopathy in an individual with chronic liver disease: a case report. ( Jabbour, N; Karavias, D; Van Thiel, DH, 1994)
"Chronic hepatic encephalopathy is highly responsive to changes in diet, to antibiotic therapy and to ingestion of nondigestible disaccharides."	1.29	Gastrointestinal transit in cirrhotic patients: effect of hepatic encephalopathy and its treatment. ( Chien, MC; Fagiuoli, S; Gavaler, JS; Van Thiel, DH; Wright, HI, 1994)
"In patients with liver cirrhosis the fasting plasma alpha-amino nitrogen concentration is high as the rule, due to reduced clearance of total alpha-amino nitrogen."	1.28	[Amino acid metabolism in liver cirrhosis]. ( Takao, T; Ukida, M, 1992)
"We report a case of progressive spastic paraparesis in a 45-year-old man with total portal-systemic shunting, which developed spontaneously due to congenital hepatic fibrosis."	1.28	Spastic paraparesis associated with portal-systemic venous shunting due to congenital hepatic fibrosis. ( Demirci, M; Elibol, B; Gedikoğlu, G; Saribaş, O; Tan, E, 1992)
"A 56 year-old-male liver cirrhosis patient was admitted because of hepatic encephalopathy with hyperammonemia."	1.28	[Positron emission tomography (PET) before and after treatment of hyperammonemia in a patient with decompensated liver cirrhosis]. ( Fujishima, M; Ichiya, Y; Ikeda, K; Kawatoko, T; Murai, K; Nomiyama, K; Sadoshima, S; Tsuji, H, 1991)
"We conclude that liver cirrhosis is characterized by an abnormal branched-chain amino acid response to protein ingestion, which matches the well-known intolerance to oral glucose."	1.27	Plasma amino acid response to protein ingestion in patients with liver cirrhosis. ( Bianchi, G; Bua, V; Dondi, C; Forlani, G; Marchesini, G; Melli, A; Pisi, E; Vannini, P; Zoli, M, 1983)
"Sex and etiology of liver cirrhosis did not affect the test results."	1.27	Quantitative psychometric testing and subclinical hepatic encephalopathy--comparative study between encephalopathic and non-encephalopathic patients with liver cirrhosis. ( Shiota, T, 1984)
"Conversely, the low frequency of encephalopathy after the distal splenorenal shunt (DSRS) may be due to preservation of both hepatic portal perfusion and mesenteric venous hypertension."	1.27	Portal hemodynamics, intestinal absorption, and postshunt encephalopathy. ( Rikkers, LF, 1983)
"Therefore, in liver cirrhosis a quotient derived from decreased PT and increased serum creatinine has a good prognostic value."	1.27	The role of protein metabolism in 204 liver cirrhotics with and without hepatic encephalopathy. I. Clinical and general biochemical findings. ( Kalk, JF; Koussouris, P; Motschenbacher, MT; Müting, D; Rausche, A, 1986)
" Rifaximin proved to be active on both aerobic and anaerobic bacteria and is thus effective, even at the dosage used, in the treatment of HE."	1.27	A non-absorbable rifamycin for treatment of hepatic encephalopathy. ( Celle, G; De Leo, C; Eftimiadi, C; Rovida, S; Schito, GC; Sukkar, GS; Testa, R, 1985)
"In 24 Patients therapy for hepatic encephalopathy was limited to infusion of the branched-chain enriched amino acid solution only, with wake-up in 66% of this group."	1.26	Infusion of branched-chain enriched amino acid solution in patients with hepatic encephalopathy. ( Atamian, S; Bradford, RR; Dienstag, J; Fischer, JE; Freund, H; Holroyde, J; Lehrich, J; Rosen, H; Slemmer, E; Yoshimura, N, 1982)
" From these results, oral administration of polymyxin B is concluded to be useful in the treatment of hyperammonemia and endotoxemia in liver cirrhosis, as a poorly absorbed antibiotic and as an antiendotoxin agent."	1.26	Enteric coated polymyxin B in the treatment of hyperammonemia and endotoxemia in liver cirrhosis. ( Adachi, M; Adachi, Y; Enomoto, M; Hashimoto, T; Inoue, H; Nagamine, Y; Nanno, T; Suwa, M; Yamamoto, T, 1982)
"It is proposed that hyperammonaemia in liver cirrhosis or after portacaval shunt contributes to plasma neutral aminoacid imbalance and to increased activity of the blood-brain neutral amino-acid transport system."	1.26	Hyperammonaemia, plasma aminoacid imbalance, and blood-brain aminoacid transport: a unified theory of portal-systemic encephalopathy. ( Fischer, JE; James, JH; Jeppsson, B; Ziparo, V, 1979)
"Because hepatic encephalopathy is mainly produced by toxic intestinal protein metabolites no protein should be adminstered at the beginining of the disease."	1.26	[Therapy of hepatic insufficiency]. ( Müting, D, 1977)
"Dopa, shows that the signs of hepatic encephalopathy are not directly related to the reduction in energy metabolism and that this metabolic disorder does not depend on a blocking of the dopaminergic synopses."	1.26	[Hepatic encephalopathies; hemodynamic and metabolic study of the influence of ammonia and levodopa]. ( Baldy-Moulinier, M; Bories, P; Michel, H; Passouant, P, 1977)
"3."	1.25	Exchange transfusion in hepatic coma: factors affecting results, with long-term follow-up data. ( Darin, JC; Hussey, CV; Lewis, JD; Varma, RR, 1975)
"In two groups of patients with liver cirrhosis and normal EEG (Group A) and with pathological EEG (Group B) it was possible to demonstrate a correlation between the severity grade of the EEG changes, the livertypical deviations of serum chemistry and alterations in cerebral oxidative metabolism."	1.25	Comparative studies of the electroencephalogram and the cerebral oxidative metabolism in patients with liver cirrhosis. ( Hoyer, S; Kommerell, B; Lanzinger, G; Papenberg, J, 1975)
"Patients with hepatic encephalopathy had significantly elevated levels which usually fell to zero following therapy."	1.24	THE METABOLISM OF THE VOLATILE AMINES: VII. THE CLINICAL SIGNIFICANCE OF TWO COMPONENTS OF THE BLOOD AMMONIA LEVEL. ( TOBE, BA, 1964)

Research

Studies (722)

Authors

Clinical Trials (21)

Trial Overview

Trial Outcomes

Change in Ammonia

Timeframe	Studies, this research(%)	All Research%
pre-1990	374 (51.80)	18.7374
1990's	67 (9.28)	18.2507
2000's	76 (10.53)	29.6817
2010's	142 (19.67)	24.3611
2020's	63 (8.73)	2.80

Authors	Studies
Gioia, S	3
Ridola, L	4
Cristofaro, L	1
Merli, M	10
Faccioli, J	1
Riggio, O	12
Nardelli, S	3
Jain, A	1
Sharma, BC	10
Mahajan, B	2
Srivastava, S	8
Kumar, A	4
Sachdeva, S	5
Sonika, U	2
Dalal, A	2
Deutsch-Link, S	2
Moon, AM	2
Jiang, Y	1
Barritt, AS	1
Tapper, EB	5
Yukawa-Muto, Y	1
Kamiya, T	1
Fujii, H	1
Mori, H	1
Toyoda, A	1
Sato, I	1
Konishi, Y	1
Hirayama, A	1
Hara, E	1
Fukuda, S	1
Kawada, N	1
Ohtani, N	1
Kroupina, K	1
Bémeur, C	1
Rose, CF	4
Huang, HC	3
Hsu, SJ	3
Chang, CC	3
Chuang, CL	2
Hou, MC	2
Lee, FY	4
Tranah, TH	5
Ballester, MP	6
Carbonell-Asins, JA	6
Ampuero, J	5
Alexandrino, G	1
Caracostea, A	1
Sánchez-Torrijos, Y	1
Thomsen, KL	5
Kerbert, AJC	2
Capilla-Lozano, M	1
Romero-Gómez, M	6
Escudero-García, D	2
Montoliu, C	6
Jalan, R	29
Shawcross, DL	13
Fallahzadeh, MA	1
Rahimi, RS	4
Yang, R	2
Xu, Y	2
Hou, W	1
Wang, L	6
Xiao, S	1
Li, C	3
Shao, H	2
Fei, X	1
Wang, Z	3
Hayakawa, Y	1
Tamaki, N	1
Nakanishi, H	1
Kurosaki, M	1
Tanaka, Y	1
Inada, K	1
Ishido, S	1
Kirino, S	1
Yamashita, K	1
Nobusawa, T	1
Matsumoto, H	1
Kakegawa, T	1
Higuchi, M	1
Takaura, K	1
Tanaka, S	1
Maeyashiki, C	1
Kaneko, S	1
Yasui, Y	1
Takahashi, Y	2
Tsuchiya, K	1
Okamoto, R	1
Izumi, N	1
Mukund, A	1
Choudhury, SP	1
Tripathy, TP	1
Ananthashayana, VH	1
Jagdish, RK	2
Arora, V	1
Singh, SP	1
Mishra, AK	1
Sarin, SK	6
Mallet, M	3
Desplats, V	1
Bouzbib, C	1
Sultanik, P	2
Alioua, I	1
Rudler, M	3
Weiss, N	4
Thabut, D	6
Yokoyama, K	1
Fukuda, H	1
Yamauchi, R	1
Higashi, M	1
Miyayama, T	1
Higashi, T	4
Uchida, Y	1
Shibata, K	1
Tsuchiya, N	1
Fukunaga, A	1
Umeda, K	1
Takata, K	1
Tanaka, T	1
Shakado, S	1
Sakisaka, S	1
Hirai, F	1
Kann, AE	1
Ba-Ali, S	1
Seidelin, JB	1
Larsen, FS	1
Hamann, S	1
Bjerring, PN	1
Elfeki, MA	1
Singal, AK	1
Wu, B	1
Feng, J	3
Guo, J	1
Wang, J	8
Xiu, G	1
Xu, J	5
Ning, K	1
Ling, B	1
Fu, Q	1
Mikkelsen, ACD	1
Vilstrup, H	6
Aagaard, NK	2
Huang, L	3
Yu, Q	2
Peng, H	1
Zhen, Z	1
Hannah, N	1
Vasic, D	1
Kansal, A	1
Al-Ani, A	1
Hebbard, G	1
Sood, S	1
Gairing, SJ	1
Mangini, C	1
Zarantonello, L	2
Nielsen, EJ	1
Danneberg, S	1
Gabriel, M	1
Ehrenbauer, AF	1
Bloom, PP	2
Ripoll, C	3
Galle, PR	1
Labenz, J	1
Zipprich, A	3
Lok, AS	1
Weissenborn, K	6
Marquardt, JU	1
Lauridsen, MM	1
Montagnese, S	3
Labenz, C	1
Eriksen, PL	1
Djernes, L	1
Ott, P	5
Wang, X	5
Zhang, M	2
Xiao, J	1
Zhang, W	2
Wang, Y	11
Zhang, S	3
Zou, X	1
Zhuge, Y	1
Zhang, F	1
Shi, J	3
Li, F	1
Amodio, P	5
Greinert, R	2
Reuken, P	1
Reichert, MC	1
Weber, SN	1
Hupfer, Y	1
Staltner, R	1
Meier Clinien, M	1
Lammert, F	1
Bruns, T	1
Balcar, L	2
Fiorillo, A	1
Escudero, MD	1
Mandorfer, M	1
Reiberger, T	2
Zhu, R	1
Liu, L	2
Zhang, G	3
Dong, J	2
Ren, Z	1
Li, Z	3
Maharshi, S	2
Sharma, A	1
Bara, S	1
Cardoso, FS	2
Kim, M	2
Pereira, R	2
Bagulho, L	2
Fidalgo, P	2
Pawlowski, A	2
Wunderink, R	2
Germano, N	2
Bagshaw, SM	2
Abraldes, JG	2
Karvellas, CJ	2
Bajaj, JS	2
Dong, JJ	1
Zhang, QY	1
Cai, YJ	1
Benítez, C	1
Muñoz, A	1
Poniachik, J	1
Ramírez, F	1
Muñoz, C	1
Cermenati, T	1
Martínez, N	1
Díaz, P	1
Meneses, L	1
Chung, RT	1
Hassanein, TI	1
Padilla-Martinez, M	1
Kayali, Z	1
Rockey, DC	4
Sasso, R	1
Muthukumar, AR	1
Lee, WM	1
Denney, WS	1
Gavis, EA	1
Anderson, C	1
Blankstein, L	1
Brennan, AM	1
Puurunen, MK	1
Lawitz, E	1
Senzolo, M	2
Formentin, C	1
Orlando, C	1
Beltrame, R	1
Vuerich, A	1
Angeli, P	2
Burra, P	2
Ponziani, FR	2
Funaro, B	1
Lupascu, A	1
Ainora, ME	1
Garcovich, M	2
Caracciolo, G	1
Quadarella, A	1
Nesci, A	1
Riccardi, L	1
Gasbarrini, A	3
Pompili, M	1
Zocco, MA	2
Haj, M	1
Gil, A	1
Viloria, MDM	1
Rico, MC	1
Millán, R	1
Camacho, I	2
Katayama, K	1
Toma, L	1
Stanciu, AM	1
Zgura, A	1
Bacalbasa, N	1
Diaconu, C	1
Iliescu, L	1
Darweesh, SK	1
Elsabaawy, MA	1
Eltahawy, MA	1
Ghanem, HS	1
Abdel-Razek, W	1
Jaffe, A	1
Lim, JK	1
Jakab, SS	1
Dellatore, P	1
Cheung, M	1
Mahpour, NY	1
Tawadros, A	1
Rustgi, VK	1
Rosenblatt, R	1
Yeh, J	1
Gaglio, PJ	1
Halim, AA	1
Alsayed, B	1
Embarak, S	1
Yaseen, T	1
Dabbous, S	1
Fontaine, O	1
Dueluzeau, R	1
Raibaud, P	1
Chabanet, C	1
Popoff, MR	1
Badoual, J	1
Gabilan, JC	1
Andremont, A	1
Gómez, L	1
Andrés, S	1
Sánchez, J	1
Alonso, JM	1
Rey, J	1
López, F	1
Jiménez, A	1
Yan, Z	1
Zhou, L	2
Zhao, Y	3
Hu, K	1
Liu, H	5
Wang, H	3
Guo, Z	1
Song, Y	1
Huang, H	4
Owen, TW	1
Al-Kaysi, RO	1
Bardeen, CJ	1
Cheng, Q	1
Wu, S	1
Cheng, T	1
Zhou, X	1
Wang, B	5
Zhang, Q	4
Wu, X	2
Yao, Y	3
Ochiai, T	1
Ishiguro, H	2
Nakano, R	2
Kubota, Y	2
Hara, M	1
Sunada, K	1
Hashimoto, K	1
Kajioka, J	1
Fujishima, A	1
Jiao, J	4
Gai, QY	3
Wang, W	2
Zang, YP	2
Niu, LL	2
Fu, YJ	3
Yao, LP	1
Qin, QP	1
Wang, ZY	1
Liu, J	4
Aleksic Sabo, V	1
Knezevic, P	1
Borges-Argáez, R	1
Chan-Balan, R	1
Cetina-Montejo, L	1
Ayora-Talavera, G	1
Sansores-Peraza, P	1
Gómez-Carballo, J	1
Cáceres-Farfán, M	1
Jang, J	1
Akin, D	1
Bashir, R	1
Yu, Z	1
Zhu, J	2
Jiang, H	1
He, C	2
Xiao, Z	1
Sun, Q	1
Han, D	1
Lei, H	1
Zhao, K	2
Zhu, L	1
Li, X	4
Fu, H	2
Wilson, BK	1
Step, DL	1
Maxwell, CL	1
Gifford, CA	1
Richards, CJ	1
Krehbiel, CR	1
Warner, JM	1
Doerr, AJ	1
Erickson, GE	1
Guretzky, JA	1
Rasby, RJ	1
Watson, AK	1
Klopfenstein, TJ	1
Sun, Y	4
Liu, Z	3
Pham, TD	1
Lee, BK	1
Yang, FC	1
Wu, KH	1
Lin, WP	1
Hu, MK	1
Lin, L	3
Shao, J	1
Sun, M	1
Xu, G	1
Zhang, X	7
Xu, N	1
Wang, R	2
Liu, S	1
He, H	1
Dong, X	2
Yang, M	2
Yang, Q	1
Duan, S	1
Yu, Y	2
Han, J	2
Zhang, C	4
Chen, L	2
Yang, X	1
Li, W	3
Wang, T	2
Campbell, DA	1
Gao, K	1
Zager, RA	1
Johnson, ACM	1
Guillem, A	1
Keyser, J	1
Singh, B	1
Steubl, D	1
Schneider, MP	1
Meiselbach, H	1
Nadal, J	1
Schmid, MC	1
Saritas, T	1
Krane, V	1
Sommerer, C	1
Baid-Agrawal, S	1
Voelkl, J	1
Kotsis, F	1
Köttgen, A	1
Eckardt, KU	1
Scherberich, JE	1
Li, H	5
Yao, L	2
Sun, L	3
Zhu, Z	1
Naren, N	1
Zhang, XX	2
Gentile, GL	1
Rupert, AS	1
Carrasco, LI	1
Garcia, EM	1
Kumar, NG	1
Walsh, SW	1
Jefferson, KK	1
Guest, RL	1
Samé Guerra, D	1
Wissler, M	1
Grimm, J	1
Silhavy, TJ	1
Lee, JH	4
Yoo, JS	1
Kim, Y	1
Kim, JS	2
Lee, EJ	1
Roe, JH	1
Delorme, M	1
Bouchard, PA	1
Simon, M	1
Simard, S	1
Lellouche, F	1
D'Urzo, KA	1
Mok, F	1
D'Urzo, AD	1
Koneru, B	1
Lopez, G	1
Farooqi, A	1
Conkrite, KL	1
Nguyen, TH	1
Macha, SJ	1
Modi, A	1
Rokita, JL	1
Urias, E	1
Hindle, A	1
Davidson, H	1
Mccoy, K	1
Nance, J	1
Yazdani, V	1
Irwin, MS	1
Yang, S	1
Wheeler, DA	1
Maris, JM	1
Diskin, SJ	1
Reynolds, CP	1
Abhilash, L	1
Kalliyil, A	1
Sheeba, V	1
Hartley, AM	2
Meunier, B	2
Pinotsis, N	1
Maréchal, A	2
Xu, JY	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
Influence of Shunt Occlusion on Organ Functions in Hyperammonemic Patients With Cirrhosis Having Porto-systemic Shunt. A Randomized Controlled Trial.[NCT03293459]		40 participants (Actual)	Interventional	2017-07-03	Completed
[NCT04771104]		9 participants (Actual)	Interventional	2017-01-01	Completed
The Importance of Bilirubin Molecular Species in Patients With Liver Cirrhosis Who Develop Hepatic Encephalopathy and Patients With Acute-on-chronic Liver Failure[NCT05566548]		50 participants (Anticipated)	Observational	2022-08-01	Recruiting
Expanding the Therapeutic Landscape of Post-TIPS Hepatic Encephalopathy[NCT05346029]		140 participants (Anticipated)	Interventional	2022-01-01	Recruiting
A Multicenter, Prospective, Randomized Controlled Study to Explore the Efficacy and Safety of Fecal Microbiota Transplantation With Different Bacterial Doses in the Treatment of Recurrent Hepatic Encephalopathy[NCT05669651]		100 participants (Anticipated)	Interventional	2022-12-01	Active, not recruiting
Serum Endotoxins, Inflammatory Mediators and MR Spectroscopy Before and After Treatment in Minimal Hepatic Encephalopathy[NCT01446523]		60 participants (Actual)	Interventional	2011-10-31	Completed
Plasma Free Amino Acids in Patients With Hepatic Encephalopathy and Its Impact on Disease Outcomes.[NCT03306498]		100 participants (Anticipated)	Observational	2017-12-15	Not yet recruiting
Efficacy of Intravenous 'L-ornithine L-aspartate' in Reversal of Overt Acute Hepatic Encephalopathy in Patients With Liver Cirrhosis: a Prospective, Randomized, Double-blind, Placebo Controlled Trial[NCT01722578]	Phase 4	200 participants (Actual)	Interventional	2013-12-31	Completed
A Phase 2a Study to Evaluate the Safety and Tolerability of OCR-002 (Ornithine Phenylacetate) in the Treatment of Patients With Acute Liver Failure/Severe Acute Liver Injury[NCT01548690]	Phase 2	47 participants (Actual)	Interventional	2012-06-30	Completed
A Nutritional Approach to Minimal Hepatic Encephalopathy[NCT01083446]		60 participants (Anticipated)	Interventional	2008-07-31	Recruiting
Intravenous Branched-chain Amino Acids for Overt Hepatic Encephalopathy in Patients With Acute on Chronic Liver Failure - A Multi-centric Double-blind Randomized Controlled Trial[NCT05700695]	Phase 1	246 participants (Anticipated)	Interventional	2023-01-17	Recruiting
Efficacy of Lactulose Plus Intravenous Branched Chain Amino Acids Versus Lactulose Alone in Patients of Acute on Chronic Liver Failure With Overt Hepatic Encephalopathy: A Prospective Randomized Clinical Trial[NCT04238416]	Phase 1	70 participants (Actual)	Interventional	2019-11-01	Completed
Glutamine Challenge as Predictor of Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt (TIPS)[NCT02026609]		3 participants (Actual)	Observational	2013-05-31	Terminated (stopped due to Lack of patient accrual)
Effect of Polyethylene Glycol Versus Lactulose on Hepatic Encephalopathy in Patients With Liver Cirrhosis; a Randomized Clinical Trial (PEGHE Trial)[NCT04436601]	Phase 4	102 participants (Anticipated)	Interventional	2020-03-09	Recruiting
Probiotics for the Prevention of Major Complications of Cirrhosis[NCT00312910]		50 participants (Anticipated)	Interventional	2005-04-30	Completed
Probiotics in Patients With Primary Sclerosing Cholangitis and Inflammatory Bowel Disease- a Randomized Placebo-Controlled Cross-Over Trial[NCT00161148]	Phase 3	12 participants	Interventional	2005-01-31	Recruiting
[NCT00678613]	Phase 2/Phase 3	250 participants (Anticipated)	Interventional	2007-07-31	Recruiting
Evaluation of the Therapeutic Effect of Rifaximin on Covert Hepatic Encephalopathy With Underlying Small Intestinal Bacterial Overgrowth and Gastrointestinal Dysmotility in Liver Cirrhosis Patients[NCT04244877]	Phase 3	0 participants (Actual)	Interventional	2021-09-15	Withdrawn (stopped due to Study was unable to recruit participants..)
Acetyl-L-Carnitine Reduces Depression and Improves Quality of Life in Patients With Minimal Hepatic Encephalopathy[NCT01223729]		67 participants	Interventional	2002-04-30	Completed
Therapeutic Efficacy of L-Ornithine L-Aspartate Infusion in Patients With Acute Liver Failure: A Double- Blind, Randomized, Placebo- Controlled Study[NCT00470314]	Phase 2	150 participants (Actual)	Interventional	2005-01-31	Active, not recruiting
The Effectiveness of L-ornithine-L-aspartate on Plasma Ammonia in Cirrhotic Patients After TIPS Procedure: a Prospective, Randomized, Controlled, Open-label Clinical Trial[NCT01440829]	Phase 2/Phase 3	40 participants (Actual)	Interventional	2011-12-31	Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

To evaluate the effect of OCR-002 on ammonia levels in patients with acute liver failure/severe acute liver injury (NCT01548690)
Timeframe: Baseline and 72 Hours

Measurement of OCR-002 Plasma Concentration

Intervention	Percent Change (Mean)
Maximum Dose Level 3.33 g/24h	41.2
Maximum Dose Level 6.65 g/24h	16.6
Maximum Dose Level 10 g/24h	41.8
Maximum Dose Level 20g/24h	38.4

To evaluate the steady state pharmacokinetic and pharmacodynamic profile of OCR-002 in patients with impaired and intact renal function using urinary phenylacetylglutamine (PAGN) as a surrogate marker (NCT01548690)
Timeframe: 24 Hours after last infusion

Neurological Function Measured by the Orientation Log (O-log)

Intervention	micrograms per millileter (Mean)
Maximum Dose Level 3.33 g/24h	65.6
Maximum Dose Level 6.65 g/24h	32.2
Maximum Dose Level 10 g/24h	33.4
Maximum Dose Level 20g/24h	104.9

The orientation log focuses on orientation to place, time, and circumstance. There are 10 items on the orientation log, which are scored 0-3. A spontaneous correct response is awarded 3 points. A spontaneous response that is lacking or incorrect, but a correct response is provided following a logical cue is awarded 2 points. A score of 1 is given if spontaneous and cued responses are lacking or incorrect, but a correct response is provided in a recognition format. A score of 0 is given if the spontaneous, cued, or recognition format does not generate a correct answer. Scores from the 10 items are summed and the final score ranges from 0 to 30. (NCT01548690)
Timeframe: 30 Days

Neurological Function Measured by the West Haven Criteria (WHC) for Hepatic Encephalopathy

Intervention	units on a scale (Mean)
Maximum Dose Level 3.33 g/24h	23.8
Maximum Dose Level 6.65 g/24h	24.0
Maximum Dose Level 10 g/24h	24.0
Maximum Dose Level 20g/24h	24.0

The West Haven Criteria (WHC) for Hepatic Encephalopathy measures the severity of encephalopathy and patient's level of consciousness. The scale ranges from 0 to 4; a minimum score of 0 represents a better outcome, and a maximum total score of 4 represents a worse outcome. A score of 0 corresponds to normal consciousness and behavior and normal neurological examination. A score of 1 corresponds to mild lack of awareness, shortened attention span, and impaired addition or subtraction; mild asterixis or tremor. A score of 2 corresponds to lethargy, disorientated or inappropriate behavior, obvious asterixis; slurred speech. A score of 3 corresponds to somnolent but arousable, gross disorientation or bizarre behavior, muscle rigidity and clonus; hyperreflexia. A score of 4 corresponds to coma and decerebrate posturing. (NCT01548690)
Timeframe: 120 hours from start of infusion

Number of Participants That do Not Tolerate the Administered Dose and Had Grade 3 or 4 Treatment Emergent Adverse Events as a Measure of Safety and Tolerability

Intervention	units on a scale (Mean)
Maximum Dose Level 3.33 g/24h	2.4
Maximum Dose Level 6.65 g/24h	3.2
Maximum Dose Level 10 g/24h	1.6
Maximum Dose Level 20g/24h	1.8

To evaluate the safety and tolerability of OCR-002 in patients with acute liver failure/severe acute liver injury (NCT01548690)
Timeframe: 30 Days

Article	Year
Serum Ammonia in Cirrhosis: Clinical Impact of Hyperammonemia, Utility of Testing, and National Testing Trends. Clinical therapeutics, 2022, Volume: 44, Issue:3 Topics: Adult; Ammonia; Hepatic Encephalopathy; Humans; Hyperammonemia; Liver Cirrhosis; Sarcopenia	2022
Amino acids, ammonia, and hepatic encephalopathy. Analytical biochemistry, 2022, 07-15, Volume: 649 Topics: Amino Acids; Ammonia; Dietary Proteins; Hepatic Encephalopathy; Humans; Liver Cirrhosis	2022
Hepatic Encephalopathy: Current and Emerging Treatment Modalities. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022, Volume: 20, Issue:8S Topics: Ammonia; Hepatic Encephalopathy; Humans; Liver Cirrhosis	2022
Blood ammonia in patients with chronic liver diseases: A better defined role in clinical practice. Analytical biochemistry, 2022, 11-15, Volume: 657 Topics: Ammonia; Brain; Diagnosis, Differential; Hepatic Encephalopathy; Humans; Liver Cirrhosis	2022
Alterations of gut microbiome and effects of probiotic therapy in patients with liver cirrhosis: A systematic review and meta-analysis. Medicine, 2022, Dec-23, Volume: 101, Issue:51 Topics: Ammonia; Bifidobacterium; Gastrointestinal Microbiome; Hepatic Encephalopathy; Humans; Lactobacillus	2022
Zinc and protein metabolism in chronic liver diseases. Nutrition research (New York, N.Y.), 2020, Volume: 74 Topics: Amino Acids, Branched-Chain; Ammonia; Chronic Disease; Dietary Supplements; Humans; Hyperammonemia;	2020
Pathophysiology of Hepatic Encephalopathy. Clinics in liver disease, 2020, Volume: 24, Issue:2 Topics: Ammonia; Animals; Astrocytes; Diabetes Complications; gamma-Aminobutyric Acid; Gastrointestinal Micr	2020
Clinical Manifestations of Hepatic Encephalopathy. Clinics in liver disease, 2020, Volume: 24, Issue:2 Topics: Ammonia; Cognition Disorders; Dyskinesias; Hepatic Encephalopathy; Humans; Lethargy; Liver Cirrhosis	2020
Long-Term Management: Modern Measures to Prevent Readmission in Patients with Hepatic Encephalopathy. Clinics in liver disease, 2020, Volume: 24, Issue:2 Topics: Ammonia; Disease Progression; Gastrointestinal Agents; Hepatic Encephalopathy; Humans; Liver Cirrhos	2020
The Egyptian journal of chest diseases and tuberculosis, 2016, Volume: 65, Issue:1 Topics: A549 Cells; Acetylmuramyl-Alanyl-Isoglutamine; Acinetobacter baumannii; Acute Lung Injury; Adaptor P	2016
Skeletal Muscle and the Effects of Ammonia Toxicity in Fish, Mammalian, and Avian Species: A Comparative Review Based on Molecular Research. International journal of molecular sciences, 2020, Jun-30, Volume: 21, Issue:13 Topics: Ammonia; Animals; Birds; Fishes; Hyperammonemia; Liver Cirrhosis; Mammals; Muscle Development; Muscl	2020
Ammonia Removal by Metabolic Scavengers for the Prevention and Treatment of Hepatic Encephalopathy in Cirrhosis. Drugs in R&D, 2021, Volume: 21, Issue:2 Topics: Ammonia; Hepatic Encephalopathy; Humans; Hyperammonemia; Liver Cirrhosis	2021
Branched-chain amino acid supplementation in treatment of liver cirrhosis: Updated views on how to attenuate their harmful effects on cataplerosis and ammonia formation. Nutrition (Burbank, Los Angeles County, Calif.), 2017, Volume: 41 Topics: Amino Acids, Branched-Chain; Ammonia; Dietary Supplements; Humans; Ketoglutaric Acids; Liver Cirrhos	2017
Hepatic encephalopathy: a critical current review. Hepatology international, 2018, Volume: 12, Issue:Suppl 1 Topics: Albumins; Ammonia; Anti-Bacterial Agents; Bile Acids and Salts; Brain; Brain Edema; Cognitive Dysfun	2018
Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis. Hepatobiliary & pancreatic diseases international : HBPD INT, 2018, Volume: 17, Issue:1 Topics: Adult; Aged; Ammonia; Biomarkers; Chi-Square Distribution; Disease Progression; Endotoxins; Female;	2018
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Is sarcopenia associated with hepatic encephalopathy in liver cirrhosis? A systematic review and meta-analysis. Journal of the Formosan Medical Association = Taiwan yi zhi, 2019, Volume: 118, Issue:4 Topics: Ammonia; Hepatic Encephalopathy; Humans; Liver; Liver Cirrhosis; Muscle, Skeletal; Sarcopenia	2019
[Helicobacter pylori and hepatic encephalopathy]. Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology, 2018, Jul-20, Volume: 26, Issue:7 Topics: Ammonia; Helicobacter Infections; Helicobacter pylori; Hepatic Encephalopathy; Humans; Liver Cirrhos	2018
Acetyl-L-carnitine for patients with hepatic encephalopathy. The Cochrane database of systematic reviews, 2019, 01-05, Volume: 1 Topics: Acetylcarnitine; Ammonia; Chelating Agents; Fatigue; Female; Hepatic Encephalopathy; Humans; Liver C	2019
Hepatic Encephalopathy in Cirrhosis: Pathology and Pathophysiology. Drugs, 2019, Volume: 79, Issue:Suppl 1 Topics: Ammonia; Basal Ganglia; Cerebellum; gamma-Aminobutyric Acid; Hepatic Encephalopathy; Humans; Inflamm	2019
Pharmacokinetic and Pharmacodynamic Properties of L-Ornithine L-Aspartate (LOLA) in Hepatic Encephalopathy. Drugs, 2019, Volume: 79, Issue:Suppl 1 Topics: Ammonia; Animals; Brain; Dipeptides; Glutamic Acid; Glutamine; Hepatic Encephalopathy; Humans; Liver	2019
L-Ornithine L-Aspartate (LOLA) for Hepatic Encephalopathy in Cirrhosis: Results of Randomized Controlled Trials and Meta-Analyses. Drugs, 2019, Volume: 79, Issue:Suppl 1 Topics: Ammonia; Dipeptides; Hepatic Encephalopathy; Humans; Liver; Liver Cirrhosis; Meta-Analysis as Topic;	2019
Updates on the pathophysiology and therapeutic targets for hepatic encephalopathy. Current opinion in gastroenterology, 2019, Volume: 35, Issue:3 Topics: Amino Acids, Aromatic; Amino Acids, Branched-Chain; Ammonia; Dipeptides; Fecal Microbiota Transplant	2019
Sarcopenia: Ammonia metabolism and hepatic encephalopathy. Clinical and molecular hepatology, 2019, Volume: 25, Issue:3 Topics: Ammonia; Exercise Therapy; Follistatin; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Muscle Prot	2019
l-ornithine-l-aspartate for hepatic encephalopathy in patients with cirrhosis: a meta-analysis of randomized controlled trials. Journal of gastroenterology and hepatology, 2013, Volume: 28, Issue:5 Topics: Ammonia; Dipeptides; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Randomized Controlled Trials a	2013
Inflammation and hepatic encephalopathy. Archives of biochemistry and biophysics, 2013, Aug-15, Volume: 536, Issue:2 Topics: Ammonia; Animals; Brain; Endotoxemia; Gastrointestinal Tract; Hepatic Encephalopathy; Humans; Inflam	2013
Association of Helicobacter pylori with elevated blood ammonia levels in cirrhotic patients: a meta-analysis. Yonsei medical journal, 2013, Volume: 54, Issue:4 Topics: Ammonia; Asian People; Helicobacter Infections; Helicobacter pylori; Humans; Liver Cirrhosis; Public	2013
Brain metabolism in patients with hepatic encephalopathy studied by PET and MR. Archives of biochemistry and biophysics, 2013, Aug-15, Volume: 536, Issue:2 Topics: Ammonia; Brain; Brain Edema; Hepatic Encephalopathy; Humans; Liver; Liver Cirrhosis; Magnetic Resona	2013
Hepatic myelopathy with spastic paraparesis: report of two cases and review of the literature. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2014, Volume: 23 Suppl 2 Topics: Adult; Ammonia; Esophageal and Gastric Varices; Hepatitis B, Chronic; Humans; Liver Cirrhosis; Magne	2014
Branched-chain amino acids and ammonia metabolism in liver disease: therapeutic implications. Nutrition (Burbank, Los Angeles County, Calif.), 2013, Volume: 29, Issue:10 Topics: Amino Acids, Branched-Chain; Ammonia; Animals; Disease Models, Animal; Glutamine; Hepatic Encephalop	2013
Association of Helicobacter pylori infection with hepatic encephalopathy risk: a systematic review. Clinics and research in hepatology and gastroenterology, 2013, Volume: 37, Issue:6 Topics: Ammonia; Helicobacter Infections; Helicobacter pylori; Hepatic Encephalopathy; Humans; Liver Cirrhos	2013
Contributions of microdialysis to new alternative therapeutics for hepatic encephalopathy. International journal of molecular sciences, 2013, Aug-05, Volume: 14, Issue:8 Topics: Ammonia; Animals; Hepatic Encephalopathy; Humans; Hyperammonemia; Liver; Liver Cirrhosis; Microdialy	2013
Effects of oral branched-chain amino acids on hepatic encephalopathy and outcome in patients with liver cirrhosis. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2013, Volume: 28, Issue:5 Topics: Administration, Oral; Amino Acids; Amino Acids, Branched-Chain; Ammonia; Dietary Supplements; Hepati	2013
Concise review of current concepts on nomenclature and pathophysiology of hepatic encephalopathy. Medicina (Kaunas, Lithuania), 2014, Volume: 50, Issue:2 Topics: Ammonia; Cognition; gamma-Aminobutyric Acid; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Mangan	2014
Ammonia and amino acid profiles in liver cirrhosis: effects of variables leading to hepatic encephalopathy. Nutrition (Burbank, Los Angeles County, Calif.), 2015, Volume: 31, Issue:1 Topics: Amino Acids, Aromatic; Amino Acids, Branched-Chain; Ammonia; Brain; Dietary Proteins; Glutamine; Hep	2015
Pathophysiology, diagnosis, and management of hepatic encephalopathy. Inflammopharmacology, 2014, Volume: 22, Issue:6 Topics: Ammonia; Anti-Bacterial Agents; Anti-Inflammatory Agents; Hepatic Encephalopathy; Humans; Inflammati	2014
Diagnosis and Treatment of Low-Grade Hepatic Encephalopathy. Digestive diseases (Basel, Switzerland), 2015, Volume: 33, Issue:4 Topics: Accidental Falls; Ammonia; Carnitine; Cognition Disorders; Electroencephalography; Gastrointestinal	2015
The Role of Sarcopenia and Frailty in Hepatic Encephalopathy Management. Clinics in liver disease, 2015, Volume: 19, Issue:3 Topics: Ammonia; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Liver Transplantation; Sarcopenia	2015
Pathogenesis of hepatic encephalopathy in cirrhosis: the concept of synergism revisited. Metabolic brain disease, 2016, Volume: 31, Issue:6 Topics: Ammonia; Animals; Antioxidants; Energy Metabolism; Glutamate-Ammonia Ligase; Hepatic Encephalopathy;	2016
Hepatic Encephalopathy: Pharmacological Therapies Targeting Ammonia. Seminars in liver disease, 2016, Volume: 36, Issue:1 Topics: Ammonia; Animals; Chelating Agents; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Liver, Artifici	2016
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An update on the use of benzoate, phenylacetate and phenylbutyrate ammonia scavengers for interrogating and modifying liver nitrogen metabolism and its implications in urea cycle disorders and liver disease. Expert opinion on drug metabolism & toxicology, 2017, Volume: 13, Issue:4 Topics: Ammonia; Animals; Benzoates; Drug Design; Glutamine; Humans; Liver Cirrhosis; Liver Diseases; Liver	2017
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Article	Year
L-ornithine L-aspartate in acute treatment of severe hepatic encephalopathy: A double-blind randomized controlled trial. Hepatology (Baltimore, Md.), 2022, Volume: 75, Issue:5 Topics: Ammonia; Aspartic Acid; Hepatic Encephalopathy; Humans; Lactulose; Liver Cirrhosis; Ornithine; Rifax	2022
Influence of shunt occlusion on liver volume and functions in hyperammonemic cirrhosis patients having large porto-systemic shunts: a randomized control trial. Hepatology international, 2023, Volume: 17, Issue:1 Topics: Ammonia; Balloon Occlusion; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Treatment Outcome	2023
The effect of induced hyperammonaemia on sleep and melanopsin-mediated pupillary light response in patients with liver cirrhosis: A single-blinded randomized crossover trial. PloS one, 2022, Volume: 17, Issue:9 Topics: Amino Acids; Ammonia; Circadian Rhythm; Cross-Over Studies; Glucose; Humans; Hyperammonemia; Liver C	2022
Clearance and production of ammonia quantified in humans by constant ammonia infusion - the effects of cirrhosis and ammonia-targeting treatments. Journal of hepatology, 2023, Volume: 79, Issue:2 Topics: Ammonia; Hepatic Encephalopathy; Humans; Hyperammonemia; Lactulose; Liver Cirrhosis; Male; Phenylbut	2023
Clinical study of probiotics combined with lactulose for minimal hepatic encephalopathy treatment. European journal of gastroenterology & hepatology, 2023, 07-01, Volume: 35, Issue:7 Topics: Ammonia; Glycation End Products, Advanced; Hepatic Encephalopathy; Humans; Lactulose; Liver Cirrhosi	2023
Nutritional therapy for persistent cognitive impairment after resolution of overt hepatic encephalopathy in patients with cirrhosis: A double-blind randomized controlled trial. Journal of gastroenterology and hepatology, 2023, Volume: 38, Issue:11 Topics: Adult; Ammonia; Cognitive Dysfunction; Endotoxins; Hepatic Encephalopathy; Humans; Liver Cirrhosis;	2023
The Egyptian journal of chest diseases and tuberculosis, 2016, Volume: 65, Issue:1 Topics: A549 Cells; Acetylmuramyl-Alanyl-Isoglutamine; Acinetobacter baumannii; Acute Lung Injury; Adaptor P	2016
Safety, Tolerability, and Physiological Effects of AXA1665, a Novel Composition of Amino Acids, in Subjects With Child-Pugh A and B Cirrhosis. Clinical and translational gastroenterology, 2020, Volume: 11, Issue:8 Topics: Adult; Aged; Amino Acids, Branched-Chain; Ammonia; Cross-Over Studies; Drugs, Investigational; Femal	2020
Secondary prophylaxis of hepatic encephalopathy in cirrhosis of liver: a double-blind randomized controlled trial of L-ornithine L-aspartate versus placebo. European journal of gastroenterology & hepatology, 2018, Volume: 30, Issue:8 Topics: Adult; Ammonia; Biomarkers; Chi-Square Distribution; Dipeptides; Double-Blind Method; Female; Flicke	2018
Role of probiotics in the treatment of minimal hepatic encephalopathy in patients with HBV-induced liver cirrhosis. The Journal of international medical research, 2018, Volume: 46, Issue:9 Topics: Adult; Ammonia; China; Cognition Disorders; Female; Gastrointestinal Microbiome; Hepatic Encephalopa	2018
Rifaximin versus metronidazole in management of acute episode of hepatic encephalopathy: An open labeled randomized clinical trial. Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology, 2018, Volume: 19, Issue:2 Topics: Acute Disease; Adult; Ammonia; Anti-Infective Agents; Female; Hepatic Encephalopathy; Humans; Length	2018
Serum endotoxin, inflammatory mediators, and magnetic resonance spectroscopy before and after treatment in patients with minimal hepatic encephalopathy. Journal of gastroenterology and hepatology, 2013, Volume: 28, Issue:7 Topics: Adolescent; Adult; Aged; Ammonia; Biomarkers; Endotoxins; Female; Gastrointestinal Agents; Hepatic E	2013
Lactulose is highly potential in prophylaxis of hepatic encephalopathy in patients with cirrhosis and upper gastrointestinal bleeding: results of a controlled randomized trial. Digestion, 2013, Volume: 87, Issue:2 Topics: Adult; Aged; Ammonia; Female; Gastrointestinal Hemorrhage; Hepatic Encephalopathy; Humans; Lactulose	2013
Fasting Blood Ammonia Predicts Risk and Frequency of Hepatic Encephalopathy Episodes in Patients With Cirrhosis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2016, Volume: 14, Issue:6 Topics: Ammonia; Double-Blind Method; Fasting; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Models, Stat	2016
Prevalence of Helicobacter pylori Infection in Patients with Minimal Hepatic Encephalopathy. Journal of gastrointestinal and liver diseases : JGLD, 2016, Volume: 25, Issue:2 Topics: Aged; Ammonia; Biomarkers; Female; Germany; Helicobacter Infections; Helicobacter pylori; Hepatic En	2016
Value of the apparent diffusion coefficient for quantification of low-grade hepatic encephalopathy. The American journal of gastroenterology, 2008, Volume: 103, Issue:6 Topics: Aged; Ammonia; Brain; Cohort Studies; Diffusion Magnetic Resonance Imaging; Female; Hepatic Encephal	2008
Ammonia impairs neutrophil phagocytic function in liver disease. Hepatology (Baltimore, Md.), 2008, Volume: 48, Issue:4 Topics: Amino Acids; Ammonia; Animals; Cell Survival; Cells, Cultured; Disease Models, Animal; Double-Blind	2008
L-ornithine-L-aspartate infusion efficacy in hepatic encephalopathy. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2008, Volume: 18, Issue:11 Topics: Adult; Aged; Ammonia; Cognition; Dipeptides; Female; Health Status Indicators; Hepatic Encephalopath	2008
A snack enriched with oral branched-chain amino acids prevents a fall in albumin in patients with liver cirrhosis undergoing chemoembolization for hepatocellular carcinoma. Nutrition research (New York, N.Y.), 2009, Volume: 29, Issue:2 Topics: Aged; Amino Acids, Branched-Chain; Ammonia; Blood Proteins; Carcinoma, Hepatocellular; Chemoemboliza	2009
Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study. European journal of gastroenterology & hepatology, 2009, Volume: 21, Issue:7 Topics: Acetylcarnitine; Amino Acids, Branched-Chain; Ammonia; Double-Blind Method; Electroencephalography;	2009
Probiotics for patients with compensated liver cirrhosis: a double-blind placebo-controlled study. Nutrition (Burbank, Los Angeles County, Calif.), 2011, Volume: 27, Issue:2 Topics: Aged; Ammonia; Bacterial Infections; Double-Blind Method; Female; Follow-Up Studies; Humans; Hyperte	2011
A double-blind, randomized, placebo-controlled trial of intravenous L-ornithine-L-aspartate on postural control in patients with cirrhosis. Liver international : official journal of the International Association for the Study of the Liver, 2010, Volume: 30, Issue:4 Topics: Aged; Ammonia; Biopsy, Needle; Dipeptides; Dose-Response Relationship, Drug; Double-Blind Method; Dr	2010
The effect of L-ornithine L-aspartate and branch chain amino acids on encephalopathy and nutritional status in liver cirrhosis with malnutrition. Acta medica Indonesiana, 2011, Volume: 43, Issue:1 Topics: Adult; Aged; Albumins; Amino Acids, Branched-Chain; Ammonia; Dietary Proteins; Dipeptides; Double-Bl	2011
Role of Helicobacter pylori infection in the pathogenesis of minimal hepatic encephalopathy and effect of its eradication. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2011, Volume: 30, Issue:1 Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Ammonia; Anti-Bacterial Agents; Clarithromycin; Drug	2011
Overnight glucose infusion suppresses renal ammoniagenesis and reduces hyperammonaemia induced by a simulated bleed in cirrhotic patients. Alimentary pharmacology & therapeutics, 2012, Volume: 35, Issue:8 Topics: Aged; Amino Acids; Ammonia; Cross-Over Studies; Fasting; Female; Gastrointestinal Hemorrhage; Glucag	2012
Secondary prophylaxis of hepatic encephalopathy in cirrhosis: an open-label, randomized controlled trial of lactulose, probiotics, and no therapy. The American journal of gastroenterology, 2012, Volume: 107, Issue:7 Topics: Adolescent; Adult; Aged; Ammonia; Analysis of Variance; Chi-Square Distribution; Female; Gastrointes	2012
Effect of blood ammonia elevation following oral glutamine load on the psychometric performance of cirrhotic patients. Metabolic brain disease, 2003, Volume: 18, Issue:1 Topics: Administration, Oral; Adult; Aged; Ammonia; Female; Glutamine; Humans; Liver Cirrhosis; Male; Middle	2003
Oral tryptophan challenge studies in cirrhotic patients: no evidence of neuropsychiatric changes. Metabolic brain disease, 2003, Volume: 18, Issue:3 Topics: Aged; Ammonia; Electroencephalography; Female; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Male	2003
L-Carnitine in the treatment of mild or moderate hepatic encephalopathy. Digestive diseases (Basel, Switzerland), 2003, Volume: 21, Issue:3 Topics: Ammonia; Carnitine; Double-Blind Method; Female; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Ma	2003
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology (Baltimore, Md.), 2004, Volume: 39, Issue:5 Topics: Adult; Aged; Ammonia; Dietary Fiber; Endotoxins; Feces; Female; Fermentation; Hepatic Encephalopathy	2004
Low myo-inositol and high glutamine levels in brain are associated with neuropsychological deterioration after induced hyperammonemia. American journal of physiology. Gastrointestinal and liver physiology, 2004, Volume: 287, Issue:3 Topics: Adult; Aged; Amino Acids; Ammonia; Basal Ganglia; Brain Chemistry; Choline; Creatinine; Female; Glut	2004
Intestinal microflora in patients with liver cirrhosis. Chinese journal of digestive diseases, 2004, Volume: 5, Issue:2 Topics: Ammonia; Bifidobacterium; Endotoxins; Feces; Humans; Intestines; Liver Cirrhosis; Probiotics	2004
Improvement of hepatic encephalopathy using a modified high-calorie high-protein diet. Romanian journal of gastroenterology, 2005, Volume: 14, Issue:3 Topics: Adolescent; Adult; Aged; Ammonia; Dietary Proteins; Female; Hepatic Encephalopathy; Humans; Liver Ci	2005
Amino acid challenge in patients with cirrhosis and control subjects: ammonia, plasma amino acid and EEG changes. Metabolic brain disease, 2006, Volume: 21, Issue:1 Topics: Adult; Aged; Amino Acids; Ammonia; Electroencephalography; Female; Hepatic Encephalopathy; Humans; L	2006
Effects of L-acetylcarnitine on cirrhotic patients with hepatic coma: randomized double-blind, placebo-controlled trial. Digestive diseases and sciences, 2006, Volume: 51, Issue:12 Topics: Acetylcarnitine; Adult; Ammonia; Blood Urea Nitrogen; Double-Blind Method; Electroencephalography; F	2006
Role of ammonia and inflammation in minimal hepatic encephalopathy. Metabolic brain disease, 2007, Volume: 22, Issue:1 Topics: Adult; Aged; Amino Acids; Ammonia; Biomarkers; C-Reactive Protein; Female; Hepatic Encephalopathy; H	2007
Acetyl-L-carnitine treatment in minimal hepatic encephalopathy. Digestive diseases and sciences, 2008, Volume: 53, Issue:11 Topics: Acetylcarnitine; Adult; Ammonia; Bilirubin; Cognition; Double-Blind Method; Female; Hepatic Encephal	2008
Branched-chain amino acids vs lactulose in the treatment of hepatic coma: a controlled study. Digestive diseases and sciences, 1982, Volume: 27, Issue:10 Topics: Amino Acids; Amino Acids, Branched-Chain; Ammonia; Clinical Trials as Topic; Disaccharides; Glucose;	1982
Branched-chain amino acids vs lactulose in the treatment of hepatic coma: a controlled study. Digestive diseases and sciences, 1982, Volume: 27, Issue:10 Topics: Amino Acids; Amino Acids, Branched-Chain; Ammonia; Clinical Trials as Topic; Disaccharides; Glucose;	1982
Branched-chain amino acids vs lactulose in the treatment of hepatic coma: a controlled study. Digestive diseases and sciences, 1982, Volume: 27, Issue:10 Topics: Amino Acids; Amino Acids, Branched-Chain; Ammonia; Clinical Trials as Topic; Disaccharides; Glucose;	1982
Branched-chain amino acids vs lactulose in the treatment of hepatic coma: a controlled study. Digestive diseases and sciences, 1982, Volume: 27, Issue:10 Topics: Amino Acids; Amino Acids, Branched-Chain; Ammonia; Clinical Trials as Topic; Disaccharides; Glucose;	1982
Treatment of chronic portal--systemic encephalopathy with vegetable and animal protein diets. A controlled crossover study. Digestive diseases and sciences, 1982, Volume: 27, Issue:12 Topics: Adult; Ammonia; Animals; Chronic Disease; Clinical Trials as Topic; Diabetes Complications; Dietary	1982
Effect of pyridoxine-2-oxoglutarate administration in patients with advanced cirrhosis: control of ammonia pyruvate and lactate high plasma concentrations. Advances in experimental medicine and biology, 1982, Volume: 153 Topics: Amino Acids; Ammonia; Blood Glucose; Clinical Trials as Topic; Double-Blind Method; Humans; Lactates	1982
[Whole-gut irrigation with mannitol in cirrhotic patients with gastro-intestinal bleeding. Changes in blood ammonia and aminoacids levels (author's transl)]. La Nouvelle presse medicale, 1981, Jan-10, Volume: 10, Issue:1 Topics: Amino Acids; Ammonia; Brain Diseases; Gastric Lavage; Gastrointestinal Hemorrhage; Humans; Liver Cir	1981
Oral keto analogs of branched-chain amino acids in hyperammonemia in patients with cirrhosis of the liver. A double-blind crossover study. Digestion, 1982, Volume: 24, Issue:2 Topics: Administration, Oral; Adult; Aged; Amino Acids, Branched-Chain; Ammonia; Double-Blind Method; Electr	1982
Rifaximin in the treatment of chronic hepatic encephalopathy. Current medical research and opinion, 1995, Volume: 13, Issue:5 Topics: Adult; Aged; Aged, 80 and over; Ammonia; Analysis of Variance; Anti-Bacterial Agents; Chronic Diseas	1995
[The treatment of hepatic encephalopathy with Hepa-Mertz]. Terapevticheskii arkhiv, 1995, Volume: 67, Issue:6 Topics: Ammonia; Biomarkers; Chronic Disease; Dipeptides; Hepatic Encephalopathy; Humans; Liver Cirrhosis; P	1995
Effects of long-term administration of low-dose lactitol in patients with cirrhosis but without overt encephalopathy. Journal of hepatology, 1994, Volume: 21, Issue:6 Topics: Aged; Ammonia; Dose-Response Relationship, Drug; Electroencephalography; Female; Hepatic Encephalopa	1994
D-propoxyphene and norpropoxyphene kinetics after the oral administration of D-propoxyphene: a new approach to liver function? Journal of hepatology, 1994, Volume: 21, Issue:3 Topics: Administration, Oral; Adult; Aged; Amino Acids, Branched-Chain; Ammonia; Bile Acids and Salts; Dextr	1994
Effect of acute lactulose administration on serum acetate levels in cirrhosis. Clinical and investigative medicine. Medecine clinique et experimentale, 1994, Volume: 17, Issue:3 Topics: Acetates; Adult; Aged; Ammonia; Blood Glucose; Colon; Cross-Over Studies; Diet; Fatty Acids, Noneste	1994
Vegetable versus animal protein diet in cirrhotic patients with chronic encephalopathy. A randomized cross-over comparison. Journal of internal medicine, 1993, Volume: 233, Issue:5 Topics: Aged; Amino Acids; Ammonia; Blood Glucose; Chronic Disease; Dietary Proteins; Hepatic Encephalopathy	1993
Effects of ornithine aspartate on plasma ammonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. Journal of hepatology, 1993, Volume: 19, Issue:3 Topics: Adult; Amino Acids; Ammonia; Blood Glucose; Dipeptides; Double-Blind Method; Female; Humans; Insulin	1993
Effects of ornithine aspartate on plasma ammonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. Journal of hepatology, 1993, Volume: 19, Issue:3 Topics: Adult; Amino Acids; Ammonia; Blood Glucose; Dipeptides; Double-Blind Method; Female; Humans; Insulin	1993
Effects of ornithine aspartate on plasma ammonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. Journal of hepatology, 1993, Volume: 19, Issue:3 Topics: Adult; Amino Acids; Ammonia; Blood Glucose; Dipeptides; Double-Blind Method; Female; Humans; Insulin	1993
Effects of ornithine aspartate on plasma ammonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. Journal of hepatology, 1993, Volume: 19, Issue:3 Topics: Adult; Amino Acids; Ammonia; Blood Glucose; Dipeptides; Double-Blind Method; Female; Humans; Insulin	1993
Early and late changes in fasting and absorptive plasma amino acids and ammonia after distal splenorenal shunt in cirrhosis. Hepatology (Baltimore, Md.), 1994, Volume: 19, Issue:2 Topics: Adult; Aged; Amino Acids; Ammonia; Esophageal and Gastric Varices; Female; Follow-Up Studies; Glucag	1994
Long-term effects of Enterococcus faecium SF68 versus lactulose in the treatment of patients with cirrhosis and grade 1-2 hepatic encephalopathy. Journal of hepatology, 1995, Volume: 23, Issue:1 Topics: Adult; Aged; Ammonia; Dose-Response Relationship, Drug; Double-Blind Method; Enterococcus faecium; E	1995
Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology (Baltimore, Md.), 1997, Volume: 25, Issue:6 Topics: Adult; Aged; Ammonia; Dipeptides; Double-Blind Method; Female; Hepatic Encephalopathy; Humans; Infus	1997
Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology (Baltimore, Md.), 1997, Volume: 25, Issue:6 Topics: Adult; Aged; Ammonia; Dipeptides; Double-Blind Method; Female; Hepatic Encephalopathy; Humans; Infus	1997
Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology (Baltimore, Md.), 1997, Volume: 25, Issue:6 Topics: Adult; Aged; Ammonia; Dipeptides; Double-Blind Method; Female; Hepatic Encephalopathy; Humans; Infus	1997
Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology (Baltimore, Md.), 1997, Volume: 25, Issue:6 Topics: Adult; Aged; Ammonia; Dipeptides; Double-Blind Method; Female; Hepatic Encephalopathy; Humans; Infus	1997
Measurement of the expiratory ammonia concentration and its clinical significance. Metabolic brain disease, 1997, Volume: 12, Issue:2 Topics: Ammonia; Breath Tests; Female; Humans; Hydrogen-Ion Concentration; Liver Cirrhosis; Male; Middle Age	1997
Clinical efficacy of lactulose in cirrhotic patients with and without subclinical hepatic encephalopathy. Hepatology (Baltimore, Md.), 1997, Volume: 26, Issue:6 Topics: Administration, Oral; Adult; Aged; Ammonia; Cathartics; Female; Hepatic Encephalopathy; Humans; Lact	1997
Effect of treatment with acarbose and insulin in patients with non-insulin-dependent diabetes mellitus associated with non-alcoholic liver cirrhosis. Diabetes, obesity & metabolism, 2001, Volume: 3, Issue:1 Topics: Acarbose; Ammonia; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 2; Double-Blind Method; Fasting	2001
Treatment of chronic portal systemic encephalopathy with bromocriptine: a double-blind controlled trial. Gastroenterology, 1979, Volume: 76, Issue:6 Topics: Ammonia; Bromocriptine; Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Electroencep	1979
Ammonia and uric acid formation after rapid intravenous fructose administration to healthy subjects and patients with compensated cirrhosis of the liver. Nutrition and metabolism, 1975, Volume: 19, Issue:5-6 Topics: Adult; Ammonia; Clinical Trials as Topic; Female; Fructose; Humans; Injections, Intravenous; Liver;	1975
Crystalline lactulose in the therapy of hepatic cirrhosis. Evaluation of clinical and immunological parameters. Preliminary results. Arzneimittel-Forschung, 1992, Volume: 42, Issue:7 Topics: Adult; Aged; Ammonia; Bilirubin; Blood Bactericidal Activity; Crystallization; Female; Humans; Lactu	1992
Intensive enteral feeding in advanced cirrhosis: reversal of malnutrition without precipitation of hepatic encephalopathy. Archives of disease in childhood, 1992, Volume: 67, Issue:5 Topics: Amino Acids; Ammonia; Anthropometry; Child; Child, Preschool; Enteral Nutrition; Female; Hepatic Enc	1992
Rifaximin versus neomycin on hyperammoniemia in chronic portal systemic encephalopathy of cirrhotics. A double-blind, randomized trial. The Italian journal of gastroenterology, 1991, Volume: 23, Issue:4 Topics: Aged; Ammonia; Chronic Disease; Double-Blind Method; Female; Hepatic Encephalopathy; Humans; Liver C	1991
Effect of L-carnitine upon ammonia tolerance test in cirrhotic patients. Advances in experimental medicine and biology, 1990, Volume: 272 Topics: Aged; Ammonia; Carnitine; Female; Humans; Hypertension, Portal; Liver Cirrhosis; Male; Middle Aged;	1990
Role of gluconeogenesis from amino acids in determining fasting and absorptive levels of plasma ammonia in cirrhosis. The American journal of gastroenterology, 1988, Volume: 83, Issue:6 Topics: Adult; Aged; Amino Acids; Ammonia; Dietary Proteins; Fasting; Female; Glucagon; Gluconeogenesis; Hum	1988
Propranolol does not alter cerebral blood flow and functions in cirrhotic patients without previous hepatic encephalopathy. Hepatology (Baltimore, Md.), 1989, Volume: 9, Issue:3 Topics: Ammonia; Brain; Cerebrovascular Circulation; Exercise; Heart Rate; Humans; Liver Cirrhosis; Proprano	1989
Venous, arterial, and arterialized-venous blood ammonia levels and their relationship to hepatic encephalopathy after propranolol. The American journal of gastroenterology, 1988, Volume: 83, Issue:3 Topics: Ammonia; Arteries; Hepatic Encephalopathy; Humans; Hypertension, Portal; Liver Cirrhosis; Male; Prop	1988
[Branched-chain amino acids in the treatment of latent porto-systemic encephalopathy. A placebo-controlled double-blind cross-over study]. Zeitschrift fur Ernahrungswissenschaft, 1986, Volume: 25, Issue:1 Topics: Administration, Oral; Adult; Aged; Amino Acids, Branched-Chain; Ammonia; Caseins; Clinical Trials as	1986
Treatment of acute hepatic encephalopathy in cirrhotics with a branched-chain amino acids enriched versus a conventional amino acids mixture. A controlled study of 70 patients. Liver, 1985, Volume: 5, Issue:5 Topics: Acute Disease; Adult; Aged; Amino Acids; Amino Acids, Branched-Chain; Ammonia; Electroencephalograph	1985
Effect of clopamide and hydrochlorothiazide on plasma ammonia. Lancet (London, England), 1969, Sep-13, Volume: 2, Issue:7620 Topics: Aged; Amides; Ammonia; Clopamide; Diuretics; Female; Humans; Hydrochlorothiazide; Liver Cirrhosis; M	1969
[Acute liver failure]. La Nouvelle presse medicale, 1974, Mar-16, Volume: 3, Issue:11 Topics: Acute Disease; Adrenal Cortex Hormones; Ammonia; Biopsy, Needle; Blood Coagulation Disorders; Blood	1974
Complications of portacaval anastomosis. By-products of a controlled investigation. The American journal of gastroenterology, 1973, Volume: 59, Issue:3 Topics: Ammonia; Clinical Trials as Topic; Connecticut; Diabetes Mellitus; Gastric Juice; Hemosiderin; Hemos	1973
[Double blind study of lactulose in 8 patients with chronic hepatic encephalopathy after portocaval shunt]. Archives francaises des maladies de l'appareil digestif, 1973, Volume: 62, Issue:4 Topics: Adult; Aged; Ammonia; Brain Diseases; Chronic Disease; Clinical Trials as Topic; Disaccharides; Elec	1973
[Double blind study of lactulose in 8 patients with chronic hepatic encephalopathy after portocaval shunt]. Archives francaises des maladies de l'appareil digestif, 1973, Volume: 62, Issue:4 Topics: Adult; Aged; Ammonia; Brain Diseases; Chronic Disease; Clinical Trials as Topic; Disaccharides; Elec	1973
Blood ammonia levels in advanced cirrhosis during therapeutic elevation of the insulin:glucagon ratio. The New England journal of medicine, 1974, 07-25, Volume: 291, Issue:4 Topics: Administration, Oral; Ammonia; Diet Therapy; Dietary Proteins; Glucagon; Glucose; Humans; Insulin; I	1974
Lactulose in the treatment of chronic portal-systemic encephalopathy. A double-blind clinical trial. The New England journal of medicine, 1969, Aug-21, Volume: 281, Issue:8 Topics: Adult; Aged; Alcoholism; Ammonia; Brain Diseases; Chronic Disease; Clinical Trials as Topic; Colon;	1969
[On the therapy of liver diseases with ornithine aspartate]. Medizinische Klinik, 1969, Volume: 64, Issue:35 Topics: Acute Disease; Alanine Transaminase; Ammonia; Aspartic Acid; Bilirubin; Cholangitis; Chronic Disease	1969
Some observations on the effects of treatment with lactulose on patients with chronic hepatic encephalopathy. The Quarterly journal of medicine, 1970, Volume: 39, Issue:154 Topics: Adult; Aged; Ammonia; Brain Diseases; Disaccharides; Electroencephalography; Feces; Female; Hepatiti	1970
Lactulose treatment of hepatic encephalopathy in outpatients. Archives of surgery (Chicago, Ill. : 1960), 1971, Volume: 102, Issue:1 Topics: Adolescent; Aged; Alcoholism; Ambulatory Care; Ammonia; Brain Diseases; Colon; Diet Therapy; Dietary	1971

ammonium hydroxide and Cirrhosis, Liver