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319 results on '"Rose, Christopher F."'

8. Assessment of the spectrum of hepatic encephalopathy: A multicenter study

Author

Reuter, Bradley, Walter, Kara, Bissonnette, Julien, Leise, Michael D, Lai, Jennifer, Tandon, Puneeta, Kamath, Patrick S, Biggins, Scott W, Rose, Christopher F, Wade, James B, and Bajaj, Jasmohan S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Digestive Diseases, Ammonia, Biomarkers, Canada, Clinical Competence, Cognition, Diet, Protein-Restricted, Education, Medical, Graduate, Gastroenterologists, Gastroenterology, Health Care Surveys, Hepatic Encephalopathy, Humans, Liver Function Tests, Neuropsychological Tests, Nurse Practitioners, Patient Simulation, Physician Assistants, Practice Patterns, Nurses', Practice Patterns, Physicians', Predictive Value of Tests, Rifamycins, Rifaximin, Risk Factors, Severity of Illness Index, United States, Video Recording, Surgery, Clinical sciences
Abstract

Hepatic encephalopathy (HE) is a major cause of morbidity in cirrhosis. However, its severity assessment is often subjective, which needs to be studied systematically. The aim was to determine how accurately trainee and nontrainee practitioners grade and manage HE patients throughout its severity. We performed a survey study using standardized simulated patient videos at 4 US and 3 Canadian centers. Participants were trainees (gastroenterology/hepatology fellows) and nontrainees (faculty, nurse practitioners, physician assistants). We determined the accuracy of HE severity identification and management options between grades 2. Serum ammonia levels were ordered in almost a third of grade ≥2 patients. For trainees and nontrainees, HE grades were identified similarly between groups. Trainees were less likely to order serum ammonia and low-protein diets, more likely to order rifaximin, and more likely to perform a more thorough workup for precipitating factors compared with nontrainee respondents. There was excellent concordance in the classification of grade ≥2 HE between nontrainees versus trainees, but lower grades showed discordance. Important differences were seen regarding blood ammonia, specialized testing, and nutritional management between trainees and nontrainees. These results have important implications at the patient level, interpreting multicenter clinical trials, and in the education of practitioners. Liver Transplantation 24 587-594 2018 AASLD.

Published
2018

10. A novel microRNA-based prognostic model outperforms standard prognostic models in patients with acetaminophen-induced acute liver failure

Author

Lee, W.M., Larson, Anne M., Liou, Iris, Fix, Oren, Schilsky, Michael, McCashland, Timothy, Hay, J. Eileen, Murray, Natalie, Shaikh, A. Obaid S., Blei, Andres, Ganger, Daniel, Zaman, Atif, Han, Steven H.B., Fontana, Robert, McGuire, Brendan, Chung, Raymond T., Smith, Alastair, Brown, Robert, Crippin, Jeffrey, Harrison, Edwin, Reuben, Adrian, Munoz, Santiago, Reddy, Rajender, Stravitz, R. Todd, Rossaro, Lorenzo, Satyanarayana, Raj, Hassanein, Tarek, Karvellas, Constantine J., Olson, Jodi, Subramanian, Ram, Hanje, James, Hameed, Bilal, Lalani, Ezmina, Pezzia, Carla, Sanders, Corron, Attar, Nahid, Hynan, Linda S., Durkalski, Valerie, Zhao, Wenle, Speiser, Jaime, Dillon, Catherine, Battenhouse, Holly, Gottfried, Michelle, Tavabie, Oliver D., Salehi, Siamak, Speiser, Jaime L., Rose, Christopher F., Menon, Krishna, Prachalias, Andreas, Heneghan, Michael A., Agarwal, Kosh, Lee, William M., McPhail, Mark J.W., and Aluvihare, Varuna R.

Published
2021
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15. Implication of Hypotension in the Pathogenesis of Cognitive Impairment and Brain Injury in Chronic Liver Disease.

Author

L'Écuyer, Sydnée, Charbonney, Emmanuel, Carrier, François Martin, and Rose, Christopher F.

Subjects
LIVER diseases, BRAIN injuries, VENOUS pressure, CHRONIC diseases, COGNITION disorders, HYPOTENSION
Abstract

The incidence of chronic liver disease is on the rise. One of the primary causes of hospital admissions for patients with cirrhosis is hepatic encephalopathy (HE), a debilitating neurological complication. HE is defined as a reversible syndrome, yet there is growing evidence stating that, under certain conditions, HE is associated with permanent neuronal injury and irreversibility. The pathophysiology of HE primarily implicates a strong role for hyperammonemia, but it is believed other pathogenic factors are involved. The fibrotic scarring of the liver during the progression of chronic liver disease (cirrhosis) consequently leads to increased hepatic resistance and circulatory anomalies characterized by portal hypertension, hyperdynamic circulatory state and systemic hypotension. The possible repercussions of these circulatory anomalies on brain perfusion, including impaired cerebral blood flow (CBF) autoregulation, could be implicated in the development of HE and/or permanent brain injury. Furthermore, hypotensive insults incurring during gastrointestinal bleed, infection, or liver transplantation may also trigger or exacerbate brain dysfunction and cell damage. This review will focus on the role of hypotension in the onset of HE as well as in the occurrence of neuronal cell loss in cirrhosis. [ABSTRACT FROM AUTHOR]

Published
2024
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25. P42 Semaglutide Reduces Cognitive Dysfunction in Experimental Non-Alcoholic Steatohepatitis Through Anti-Inflammatory and Neuroprotective Effects

Author

Kjærgaard, Kristoffer, primary, Daugaard Mikkelsen, Anne Catrine, additional, Bay-Richter, Cecilie, additional, Landau, Anne M., additional, Eriksen, Peter Lykke, additional, Elfving, Betina, additional, Tamnaloo, Farzaneh, additional, Yeoman, Jeppe Remme, additional, Dutoit-Hamilton, Stephen, additional, Rose, Christopher F, additional, Vilstrup, Hendrik, additional, Mookerjee, Rajeshwar Prosad, additional, and Thomsen, Karen Louise, additional

Published
2023
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33. Lessons on brain edema in HE: from cellular to animal models and clinical studies

Author

Pierzchala, Katarzyna, Hadjihambi, Anna, Mosso, Jessie, Jalan, Rajiv, Rose, Christopher F. F., Cudalbu, Cristina, Pierzchala, Katarzyna, Hadjihambi, Anna, Mosso, Jessie, Jalan, Rajiv, Rose, Christopher F. F., and Cudalbu, Cristina

Abstract

Brain edema is considered as a common feature associated with hepatic encephalopathy (HE). However, its central role as cause or consequence of HE and its implication in the development of the neurological alterations linked to HE are still under debate. It is now well accepted that type A and type C HE are biologically and clinically different, leading to different manifestations of brain edema. As a result, the findings on brain edema/swelling in type C HE are variable and sometimes controversial. In the light of the changing natural history of liver disease, better description of the clinical trajectory of cirrhosis and understanding of molecular mechanisms of HE, and the role of brain edema as a central component in the pathogenesis of HE is revisited in the current review. Furthermore, this review highlights the main techniques to measure brain edema and their advantages/disadvantages together with an in-depth description of the main ex-vivo/in-vivo findings using cell cultures, animal models and humans with HE. These findings are instrumental in elucidating the role of brain edema in HE and also in designing new multimodal studies by performing in-vivo combined with ex-vivo experiments for a better characterization of brain edema longitudinally and of its role in HE, especially in type C HE where water content changes are small.

Published
2023
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