scholarly journals Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 15 ◽  
Author(s):  
Óscar López-Franco ◽  
Jean-Pascal Morin ◽  
Albertina Cortés-Sol ◽  
Tania Molina-Jiménez ◽  
Diana I. Del Moral ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Liver Transplant ◽  
Cognitive Deficits ◽  
Metabolic Diseases ◽  
Meta Analysis ◽  
Mean Difference ◽  
Random Effects Models ◽  
Wide Range ◽  
History Of ◽  
Cirrhotic Patients

Hepatic encephalopathy (HE) is one of the most disabling metabolic diseases. It consists of a complication of liver disease through the action of neurotoxins, such as excessive production of ammonia from liver, resulting in impaired brain function. Its prevalence and incidence are not well known, although it has been established that up to 40% of cirrhotic patients may develop HE. Patients with HE episodes display a wide range of neurological disturbances, from subclinical alterations to coma. Recent evidence suggests that the resolution of hepatic encephalopathy does not fully restore cognitive functioning in cirrhotic patients. Therefore, the aim of this review was to evaluate the evidence supporting the presence of lingering cognitive deficits in patients with a history of HE compared to patients without HE history and how liver transplant affects such outcome in these patients. We performed two distinct meta-analysis of continuous outcomes. In both cases the results were pooled using random-effects models. Our results indicate that cirrhotic patients with a history of HE show clear cognitive deficits compared control cirrhotic patients (Std. Mean Difference (in SDs) = −0.72 [CI 95%: −0.94, −0.50]) and that these differences are not fully restored after liver transplant (Std. Mean Difference (in SDs) = −0.72 [CI 95%: −0.94, −0.50]).

scholarly journals Impact of Pretransplant Hepatic Encephalopathy on Liver Posttransplantation Outcomes

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Lewis W. Teperman
Keyword(s):  
Hepatic Encephalopathy ◽  
Liver Transplant ◽  
Cognitive Deficits ◽  
Management Strategy ◽  
Negative Impact ◽  
Neuromuscular Function ◽  
Therapeutic Strategies ◽  
Neurologic Complications ◽  
History Of ◽  
Pharmacologic Therapies

Patients with cirrhosis commonly experience hepatic encephalopathy (HE), a condition associated with alterations in behavior, cognitive function, consciousness, and neuromuscular function of varying severity. HE occurring before liver transplant can have a substantial negative impact on posttransplant outcomes, and preoperative history of HE may be a predictor of posttransplant neurologic complications. Even with resolution of previous episodes of overt or minimal HE, some patients continue to experience cognitive deficits after transplant. Because HE is one of the most frequent pretransplant complications, improving patient HE status before transplant may improve outcomes. Current pharmacologic therapies for HE, whether for the treatment of minimal or overt HE or for prevention of HE relapse, are primarily directed at reducing cerebral exposure to systemic levels of gut-derived toxins (e.g., ammonia). The current mainstays of HE therapy are nonabsorbable disaccharides and antibiotics. The various impacts of adverse effects (such as diarrhea, abdominal distention, and dehydration) on patient's health and nutritional status should be taken into consideration when deciding the most appropriate HE management strategy in patients awaiting liver transplant. This paper reviews the potential consequences of pretransplant HE on posttransplant outcomes and therapeutic strategies for the pretransplant management of HE.

scholarly journals Tolerability of statin-based management of patients with a history of statin-associated muscle symptoms: protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e052341
Author(s):  
Fanny Villoz ◽  
Christina Lyko ◽  
Cinzia Del Giovane ◽  
Nicolas Rodondi ◽  
Manuel R Blum
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Mean Difference ◽  
Control Group ◽  
Cochrane Central Register ◽  
Eligibility Criteria ◽  
Clinical Issue ◽  
Standard Data ◽  
Evaluation Approach ◽  
History Of

IntroductionStatin-associated muscle symptoms (SAMSs) are a major clinical issue in the primary and secondary prevention of cardiovascular events. Current guidelines advise various approaches mainly based on expert opinion. We will lead a systematic review and meta-analysis to explore the tolerability and acceptability and effectiveness of statin-based therapy management of patients with a history of SAMS. We aim to provide evidence on the tolerability and different strategies of statin-based management of patients with a history of SAMS.Methods and analysisWe will conduct a systematic review of randomised controlled trials (RCTs) and non-randomised studies with a control group. We will search in Data sources MEDLINE, EMBASE, Cochrane Central Register of Controlled Clinical Trials, Scopus, Clinicaltrials.gov and Proquest from inception until April 2021. Two independent reviewers will carry out the study selection based on eligibility criteria. We will extract data following a standard data collection form. The reviewers will use the Cochrane Collaboration’s tools and Newcastle-Ottawa Scale to appraise the study risk of bias. Our primary outcome will be tolerability and our secondary outcomes will be acceptability and effectiveness. We will conduct a qualitative analysis of all included studies. In addition, if sufficient and homogeneous data are available, we will conduct quantitative analysis. We will synthesise dichotomous data using OR with 95% CI and continuous outcomes by using mean difference or standardised mean difference (with 95% CI). We will determine heterogeneity visually with forest plots and quantitatively with I2 and Q-test. We will summarise the confidence in the quantitative estimate by using Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationAs a systematic review of literature without collection of new clinical data, there will be no requirement for ethical approval. We will disseminate findings through peer-reviewed publications.PROSPERO registration numberCRD42020202619.

scholarly journals Longitudinal studies of cognition in schizophrenia: Meta-analysis

2008 ◽  
Vol 192 (4) ◽  
pp. 248-257 ◽  
Author(s):  
Andrei Szöke ◽  
Anca Trandafir ◽  
Marie-Estelle Dupont ◽  
Alexandre Méary ◽  
Franck Schürhoff ◽  
...  
Keyword(s):  
Longitudinal Studies ◽  
Cognitive Deficits ◽  
Verbal Fluency ◽  
Meta Analysis ◽  
Cognitive Remediation ◽  
Cognitive Tasks ◽  
Longitudinal Course ◽  
Semantic Verbal Fluency ◽  
Wide Range ◽  
Available Information

BackgroundA wide range of cognitive deficits have been demonstrated in schizophrenia, but their longitudinal course remains unclear.AimsTo bring together all the available information from longitudinal studies of cognitive performance in people with schizophrenia.MethodWe carried out a meta-analysis of 53 studies. Unlike previous reviewers, we included all studies (regardless of the type of medication), analysed each variable separately and compared results with data from controls.ResultsParticipants with schizophrenia showed a significant improvement in most cognitive tasks. The available data for controls showed, with one exception (the Stroop test), a similar or greater improvement. Performance in semantic verbal fluency remained stable in both individuals with schizophrenia and controls.ConclusionsParticipants with schizophrenia displayed improvement in most cognitive tasks, but practice was more likely than cognitive remediation to account for most of the improvements observed. Semantic verbal fluency may be the best candidate cognitive endophenotype.

History of Hepatic Encephalopathy Is Associated With Symptoms of Depression in Liver Transplant Candidates

2017 ◽  
Vol 112 ◽  
pp. S567
Author(s):  
Alex N. Zimmet ◽  
George Stukenborg ◽  
Blake Niccum ◽  
Gold Adkins ◽  
Jennifer Wang ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Liver Transplant ◽  
Symptoms Of Depression ◽  
History Of ◽  
Transplant Candidates

Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis

2018 ◽  
Vol 17 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Qing Cao ◽  
Cheng-Bo Yu ◽  
Shi-Gui Yang ◽  
Hong-Cui Cao ◽  
Ping Chen ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Meta Analysis ◽  
Minimal Hepatic Encephalopathy ◽  
Probiotic Treatment ◽  
Cirrhotic Patients

scholarly journals Widespread Cognitive Deficits in Alcoholism Persistent Following Prolonged Abstinence: An Updated Meta-analysis of Studies That Used Standardised Neuropsychological Assessment Tools

2019 ◽  
Vol 35 (1) ◽  
pp. 31-45 ◽  
Author(s):  
Simon F Crowe ◽  
Davide M Cammisuli ◽  
Elizabeth K Stranks
Keyword(s):  
Cognitive Deficits ◽  
Neuropsychological Tests ◽  
Cognitive Deficit ◽  
Meta Analysis ◽  
Neuropsychological Test ◽  
Assessment Tools ◽  
Cross Sectional ◽  
Memory Functioning ◽  
Wide Range

Abstract Objective This study presents an updated meta-analysis replicating the study of (Stavro, K., Pelletier, J., & Potvin, S. (2013). Widespread and sustained cognitive deficits in alcoholism: A meta-analysis. Addiction Biology, 18, 203–213. doi:10.1111/j.1369-1600.2011.00418.x) regarding the cognitive functioning of alcoholics as a function of time abstinent. Methods A total of 34 studies (including a total of 2,786 participants) that met pre-determined inclusion and exclusion criteria were included in the analyses. The alcoholics were categorised into recently detoxified alcoholics (0–31 days sober), alcoholics 32–365 days sober and alcoholics >365 days sober consistent with the previous study. The current study employed more stringent control on the tests included in the analysis to include only those tasks described in contemporary neuropsychological test compendia. Forty-seven percent of the papers surveyed were not include in the previous meta-analysis. Results The results indicated that there was a diffuse and pervasive pattern of cognitive deficit among recently detoxified alcoholics and that these deficits, particularly with regard to memory functioning, persisted even in longer term abstinent alcoholics. This was inconsistent with the prior meta-analysis which contended that significant cognitive recovery was possible after as little as 1 year. Conclusion The persisting cognitive deficits were noted across a wide range of cognitive functions, supporting the notion of a diffuse rather than a specific compromise of cognition in alcoholism following discontinuation, as measured using standardised neuropsychological tests. Limitations on the finding included the fact that it was a cross-sectional rather than a longitudinal analysis, was subject to heterogeneity of method, had low representation of females in the samples, and had fewer studies of long-term sober samples.

Meta-analysis in Sociological Research: Power and Heterogeneity

2019 ◽  
pp. 004912411988247 ◽  
Author(s):  
Guangyu Tong ◽  
Guang Guo
Keyword(s):  
Random Effects ◽  
Science Studies ◽  
Meta Analysis ◽  
Sociological Research ◽  
Random Effects Models ◽  
Sociological Inquiry ◽  
Wide Range ◽  
Fixed And Random Effects ◽  
Study Heterogeneity ◽  
Analysis Models

Meta-analysis is a statistical method that combines quantitative findings from previous studies. It has been increasingly used to obtain more credible results in a wide range of scientific fields. Combining the results of relevant studies allows researchers to leverage study similarities while modeling potential sources of between-study heterogeneity. This article provides a review of the core methodologies of meta-analysis that we consider most relevant to sociological research. After developing the foundation of the fixed- and random-effects models of meta-analysis models, this article illustrates the utility of the method with regression coefficients reported from two sets of social science studies. We explain the various steps of the process including constructing the meta-sample from primary studies, estimating the fixed- and random-effects models, analyzing the source of heterogeneity across studies, and assessing publication bias. We conclude with a discussion of steps that could be taken to strengthen the development of meta-analysis in sociological research, which will eventually increase the credibility of sociological inquiry via a knowledge-cumulative process.

Structural and functional cerebral impairments in cirrhotic patients with a history of overt hepatic encephalopathy

2012 ◽  
Vol 81 (10) ◽  
pp. 2463-2469 ◽  
Author(s):  
Hua-Jun Chen ◽  
Xi-Qi Zhu ◽  
Hao Shu ◽  
Ming Yang ◽  
Yi Zhang ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Overt Hepatic Encephalopathy ◽  
History Of ◽  
Cirrhotic Patients
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