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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was done to determine whether the cognitive dysfunction often found in chronic alcoholics would be greater for alcoholics with Laennec's cirrhosis than for alcoholics without cirrhosis. It was hypothesized that cirrhotic alcoholics would score lower than non-cirrhotic alcoholics, who in turn would score lower than non-alcoholic, non-cirrhotic controls on (1) WAIS Verbal, Performance, and Full Scale IQ; (2) scaled score configuration; and (3) the Wechsler Deterioration Quotient. The WAIS was administered in a Veterans Administration Center to 60 Caucasian male patients aged 35-64 who had been assigned to one of the three groups (N = 20 per group). No differences were found among groups on age, education, or the Information and Vocabulary subtests (p greater than .05). Significant differences (p less than .05) were found on Verbal, Performance, and Full Scale IQ, the remaining nine subtests, and the Deterioration Quotient. A stepwise discriminate function analysis substantiated these differences. It was concluded that Laennec's cirrhosis is a physical condition that negatively affects intellectual functioning in alcoholics.
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PMID:WAIS functioning of cirrhotic and non-cirrhotic alcoholics. 83 23

A battery of computer-based psychological tests given to seven patients with chronic hepatic encephalopathy showed them to be intellectually impaired, particularly on speed-based measures, as compared with general hospital patients and with patients with cirrhosis but without clinical or electroencephalographic evidence of encephalopathy. Two of the seven patients in the latter group also showed evidence of cognitive impairment on some tests. The effects of levodopa were also evaluated by sequential assessment with these tests. Although there was some improvement in speed of performance on certain tasks and a suggestion of deterioration on other measures, there was little overall change. It is concluded that levodopa has an 'arousing' or antidepressant action and that its effect on intellectual functions is secondary to this alerting effect and is consequently dependent on the emotional and attentional status of the patient.
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PMID:Cognitive deficits associated with chronic hepatic encephalopathy and their response to levodopa. 118

Visual event-related P300 potentials, conventional visual evoked potentials, and psychometric tests were applied to patients with noncirrhotic chronic liver disease and to clinically nonencephalopathic and encephalopathic cirrhotics to compare their diagnostic efficacy in detecting early portosystemic encephalopathy (PSE). Sixty-four investigations were performed in 58 patients. The latencies of the P300 parameters were significantly longer in both the encephalopathic and nonencephalopathic cirrhotics than in the noncirrhotics, indicating distinctly abnormal cortical processing of visual stimuli in cirrhotic patients. The visual P300 potentials showed the highest sensitivity and specificity for grade I PSE. Abnormal P300 test results were also found in 78% of the clinically nonencephalopathic cirrhotics, while psychometric tests showed abnormalities in only 41%. The P300 latencies were similar in alcoholic and nonalcoholic cirrhotics. Significant inverse correlations were found between the P300 latencies and measures of quantitative liver function such as galactose-elimination capacity and aminopyrine breath test. It is concluded that visual event-related P300 potentials are a sensitive index of subclinical and grade I PSE. Furthermore, the degree of cognitive dysfunction detected by this method in patients with liver cirrhosis appears to be related to the reduction in hepatic metabolic capacity.
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PMID:Visual event-related P300 potentials in early portosystemic encephalopathy. 161 38

Neuropsychological testing was performed on: 10 right-handed patients who had had 1-4 right hemisphere transient ischaemic attacks (TIAs), 10 normal controls, 10 house painters with long-term exposure to organic solvents, and 10 patients with liver cirrhosis. The subjects in each group were matched for age and education. No TIA patient had significant internal carotid artery stenosis, and CT was normal except in one patient, although magnetic resonance imaging (MRI) performed 3 years after the testing was abnormal in 4/8 cases. No patient reported additional distinct TIAs during the period between neuropsychological testing and MRI. The TIA patients showed lateralized signs of spatial impairment, whereas the cirrhotics and also (but to a lesser degree) the house painters showed signs of diffuse cerebral dysfunction. The study shows that hemispheric TIAs in patients without significant internal carotid artery stenosis may result in persistent focal cognitive impairment. This can be demonstrated with sensitive neuropsychological instruments even when MRI is normal.
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PMID:Spatial impairment following right hemisphere transient ischaemic attacks in patients without carotid artery stenosis. 258 7

Auditory event-related potentials (ERPs) were studied in 28 patients with chronic liver cirrhosis and in 34 patients on regular hemodialysis treatment for chronic renal failure. Prolongation of P3 wave latency was the earliest and most evident sign of brain cognitive dysfunction in both groups. The changes of ERPs well corresponded to the stage of metabolic affliction when, in addition, N1 and N2 wave latencies were delayed in patients with more advanced liver cirrhosis. In the group of hemodialyzed patients, ERPs reflected the effects of an individual treatment procedure as well.
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PMID:Event-related potentials in evaluation of metabolic encephalopathies. 769 Sep 88

We investigated the association of non-insulin-dependent (Type 2) diabetes mellitus and depression symptoms in a representative community-dwelling elderly population independently of other conditions such as gender, age, status, disability, cognitive impairment and a number of chronic medical conditions such as chronic obstructive lung disease, degenerative joint disease, heart disease, cirrhosis of the liver, cholelithiasis, peptic ulcer and kidney stones. A total of 1339 elderly subjects living in southern Italy were randomly selected from electoral rolls and evaluated. All subjects were tested by the Geriatric Depression Scale to detect depression, the Mini-Mental State Examination to study cognitive function and the Activity Daily Living Index to evaluate disability. Non-insulin-dependent diabetes mellitus affected 14.7% of our sample. Depression was more prevalent in women over 75 years of age than in younger women (15.9 vs 8.1%, p < 0.001). In multiple linear regression analysis, diabetes mellitus was found to be significantly associated with depression independently of age, gender, loneliness, cognitive impairment, chronic obstructive lung disease, degenerative joint disease, heart diseases, cancer, kidney disease, cirrhosis of the liver and cholelithiasis. It is concluded that non-insulin-dependent diabetes mellitus is significantly associated with depression in the elderly, which may have clinical implications for the achievement of sufficient blood glucose control.
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PMID:Non-insulin-dependent diabetes mellitus is associated with a greater prevalence of depression in the elderly. The Osservatorio Geriatrico of Campania Region Group. 889 92

In the search for explanation of persistent cognitive impairment associated with alcohol dependence, the possible role of liver disease has aroused considerable interest. However, review of the relevant literature provides only ambiguous support for any general relationship between neuropsychological status and laboratory tests of liver function. We tested the general hypothesis, and also two specific hypotheses relating particular liver function parameters (gamma-glutamyl transferase and serum albumin) to mental ability in a sample of 54 recently detoxified alcohol-dependent people. Despite adequate design power, we failed to obtain evidence for general or specific correlations between mental ability and liver function. We conclude that the accumulated data do not provide direct support for the hypothesis that liver disease plays a part in the genesis of chronic alcohol-related brain impairment in clients without cirrhosis.
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PMID:Does liver dysfunction explain neuropsychological status in recently detoxified alcohol-dependent clients? 919 30

Sleep disturbance is a classic sign of hepatic encephalopathy. However, there are limited data regarding its prevalence in cirrhotic patients without overt hepatic encephalopathy. We assessed the characteristics of sleep in cirrhosis using a sleep questionnaire (n = 44) and actigraphy (n = 20). The results were compared with those of subjects with chronic renal failure and those of healthy controls. Presence of subclinical hepatic encephalopathy, chronotypology profile, and individual's affective state were also analyzed. The questionnaire indicated an elevated number of cirrhotic patients (47.7%) and patients with chronic renal failure (38.6%) who complained of unsatisfactory sleep compared with healthy controls (4.5%, P < .01). Actigraphy corroborated the deterioration of sleep parameters in cirrhotic patients with unsatisfactory sleep. The sleep disturbance in cirrhosis was not associated with clinical parameters nor with cognitive impairment. Cirrhotic subjects and patients with chronic renal failure with unsatisfactory sleep showed higher scores for depression and anxiety, raising the possibility that the effects of chronic disease may underlie the pathogenesis of sleep disturbance. However, in contrast to chronic renal failure, unsatisfactory sleep in cirrhosis was associated with delayed bedtime, delayed wake-up time, and evening chronotypology. In conclusion, a sleep disturbance is frequent in cirrhotic patients without hepatic encephalopathy and may be related to abnormalities of the circadian timekeeping system.
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PMID:High prevalence of sleep disturbance in cirrhosis. 946 28

Cognitive impairment is common in patients with advanced liver disease. It has been suggested that patients with alcoholic liver disease (ALD) have more impaired cognition than nonalcoholics. The objective of this study was to characterize any differences in cognitive functions between alcoholic cirrhotic patients and non-alcoholic cirrhotic patients of similar age, education, and severity of liver disease. We assessed cognitive functions in 117 patients with alcoholic cirrhosis and 163 patients with nonalcoholic cirrhosis using a brief battery of neuropsychological tests. In addition, all patients had standard psychiatric examinations to assess the effect of the disease severity, alcoholism, anxiety, and depression on the test scores. The study showed a higher proportion of patients with cognitive impairment in the alcoholic group. Alcoholics performed poorly in tests of memory and motor speed compared with nonalcoholics, despite similar premorbid IQ and education. Because patients with alcoholic cirrhosis had more severe liver disease (Child-Pugh score 8.5 +/- 2.2 vs. 7.6 +/- 2.2, P =.03) than nonalcoholics, the results were reanalyzed after adjusting for the linear effects of Child-Pugh score on cognitive test scores. We also used two-way analysis of variance to examine the interaction between Child class and alcoholism. Finally, the test scores were compared within each Child class. These analyses revealed no primary or interaction effect of alcoholism and confirmed that the differences in the test scores observed in alcoholics reflect the greater severity of their liver disease. The severity of cognitive impairment is similar in both alcoholic and non-alcoholic cirrhotic patients when adjusted for the severity of liver disease.
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PMID:Cognitive impairment in alcoholic and nonalcoholic cirrhotic patients. 1057 12

The presence of cognitive impairment in end-stage liver disease is well recognized, as are patient reports of an impoverished quality of life. The aim of this study is to systematically evaluate the effect of orthotopic liver transplantation (OLT) on these factors. Thirty-two adult patients activated for OLT participated in the study. Assessments were made on activation and at 1, 3, and 9 months post-OLT, with 24 transplant recipients available for reassessment at 9 months. Two control groups (10 patients with nonalcoholic cirrhosis and 10 healthy volunteers) also completed the test protocol at four 2-month intervals. The test battery included the Austin Quality-of-Life Scale, Weschler Adult Intelligence Scale-Revised, Benton's Controlled Oral Word Test, and the Complex Figure of Rey. The OLT group showed significant improvement in cognitive performance and their reported quality of life. These changes were evident by 3 month post-OLT and remained stable at subsequent testing. The control groups typically remained stable over test occasions. Clearly, OLT extends life and, most importantly, improves patients' quality of life and their cognitive functioning.
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PMID:Quality of life and cognitive function of liver transplant patients: a prospective study. 1098 64


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