lactulose / Generic mfg. 
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  • ||||||||||  lactulose / Generic mfg., Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, L-ornithine-L-aspartate / Generic mfg.
    Review, Journal:  Hepatic encephalopathy: risk identification and prophylaxis approaches. (Pubmed Central) -  Mar 7, 2025   
    However, novel approaches like L-ornithine L-aspartate, albumin infusions, and antioxidants like resveratrol show promise in further improving outcomes by addressing underlying pathophysiological mechanisms, including systemic inflammation and gut dysbiosis...The future of HE management lies in personalized medicine, targeting specific inflammatory and metabolic pathways, with the potential integration of genetic manipulation. Continued research is essential to refine these strategies, ultimately aiming to improve the prognosis and quality of life for cirrhotic patients at risk of HE.
  • ||||||||||  lactulose / Generic mfg.
    Journal:  Synbiotic combination of fructooligosaccharides and probiotics ameliorates the metabolic dysfunction-associated steatotic liver disease. (Pubmed Central) -  Mar 6, 2025   
    Here, we have explored and evaluated multiple synbiotic combinations incorporating three distinctive prebiotics, lactitol, lactulose and fructooligosaccharides...These findings are critical in suggesting that synbiotic treatments are capable of restraining western diet-induced metabolic dysfunction in the liver. Additionally, this study demonstrated that adding probiotic strains amplified the effectiveness of fructooligosaccharides but not all prebiotics.
  • ||||||||||  AlbuRx (human albumin) / CSL Behring, Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
    Trial initiation date:  Human Albumin Infusion in Liver Cirrhosis and Overt Hepatic Encephalopathy (HACHE) (clinicaltrials.gov) -  Mar 4, 2025   
    P=N/A,  N=174, Not yet recruiting, 
    Additionally, this study demonstrated that adding probiotic strains amplified the effectiveness of fructooligosaccharides but not all prebiotics. Initiation date: Oct 2024 --> May 2025
  • ||||||||||  lactulose / Generic mfg.
    Journal:  Performance, nutrient digestibilities, and metabolic profiles of Holstein calves fed whole milk or milk replacer at two feeding levels. (Pubmed Central) -  Mar 3, 2025   
    From a single oral dose of indigestible markers (Cr-EDTA, lactulose, and d-mannitol), calves fed a high milk allowance showed greater urinary recovery of all markers after 6 h of collection, but not after 24 h. Calves fed a high milk allowance had a higher proportion of days with lower fecal scores during the preweaning phase...Higher milk allowance increased growth performance and had no adverse effects on starter feed intake or nutrient digestibility in the post-weaning phase. The multiple effects described for milk source and level of supply were overall independent, presenting no relevant interactions.
  • ||||||||||  lactulose / Generic mfg., Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, L-ornithine-L-aspartate / Generic mfg.
    Journal:  Unusual Presentation of Confusion: Hyperammonaemic Hepatic Encephalopathy Due to Intrahepatic Portosystemic Venous Shunt. (Pubmed Central) -  Feb 26, 2025   
    Intrahepatic portosystemic venous shunts should be considered in the differential diagnosis of patients presenting with confusion or other unexplained neurological symptoms, especially in the presence of liver dysfunction. Early diagnosis and appropriate management are crucial for favourable outcomes.
  • ||||||||||  lactulose / Generic mfg., Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
    Journal:  Drug Utilization of Rifaximin-? in Patients with Hepatic Encephalopathy: Evidence from Real Clinical Practice in Italy. (Pubmed Central) -  Feb 26, 2025   
    Although rifaximin 550 mg is the only formulation with specific indication and reimbursability to prevent HE relapses in Italy, rifaximin 200 mg is more largely used. The need to improve rifaximin prescribing choices is supported by higher persistence, lower switching rates, and average doses aligned to recommendations in patients treated with rifaximin 550 mg.
  • ||||||||||  lactulose / Generic mfg.
    Clinical, Clinical protocol, Journal:  LIVE-SMART: A sequential, multiple assignment randomized trial to reduce falls in cirrhosis. (Pubmed Central) -  Feb 19, 2025   
    We are performing a clinical trial to determine whether lactulose, TeleTai-Chi, or their combination will reduce falls in HE and improve health-related quality of life (HRQOL) among patients with cirrhosis...Our study has a central institutional review board with individual site IRB review. Dissemination includes the publication of study findings and patient-focused educational webinars.
  • ||||||||||  VE303 / Vedanta Biosci
    Clinical, Journal:  Safety and efficacy of a defined bacterial consortium, VE303, to treat HE. (Pubmed Central) -  Feb 19, 2025   
    P2
    Dissemination includes the publication of study findings and patient-focused educational webinars. VE303 was well tolerated in patients with cirrhosis and a history of overt HE, leading to the engraftment of certain VE303 strains and a higher percentage of patients with improved PHES.
  • ||||||||||  lactulose / Generic mfg.
    Preclinical, Journal:  Pre-clinical enteropathy in healthy soft-coated wheaten terriers. (Pubmed Central) -  Feb 19, 2025   
    Further research is needed to refine diagnostic methods, explore novel treatment strategies, and better understand the specific characteristics of the Brazilian population. Healthy SCWT dogs had changes in several biomarkers used to identify preclinical IBD in humans.
  • ||||||||||  lactulose / Generic mfg., omeprazole / Generic mfg., metoclopramide / Generic mfg.
    Journal:  Exploring the protective effects of vasoactive intestinal peptides on dry eye disease in SARS-CoV-2 survivors. (Pubmed Central) -  Feb 17, 2025   
    Laxative use (lactulose and polyethylene glycol) correlated positively with dry eye disease (OR 1.939, p = 0.016; OR 2.094, p = 0.015, respectively)...Conversely, omeprazole showed an inverse correlation with dry eye disease (OR 0.332, p < 0.001)...Proton pump inhibitors may mitigate the risk of dry eye disease, contrasting with adverse effects linked to laxatives and metoclopramide. Vasoactive intestinal peptide (VIP), which links gut and lacrimal gland functions, is a strong candidate for the basis of the underlying pathophysiological mechanisms.
  • ||||||||||  lactulose / Generic mfg.
    Journal:  Loop engineering of cellobiose 2-epimerase from Dictyoglomus thermophilum for efficient synthesis of lactulose. (Pubmed Central) -  Feb 15, 2025   
    Moreover, molecular dynamics simulations showed that modifications of the flexible loop affected protonation, enhancing isomerization selectivity. This study underscores the precision and efficacy of our engineering approach in customizing DtCE's properties to meet specific needs, while concurrently establishing a technical foundation for industrial-scale biosynthetic production of lactulose.
  • ||||||||||  lactulose / Generic mfg.
    Clinical, Journal:  Efficacy of Tui Na in idiopathic constipation in children with cerebral palsy: a randomized controlled clinical trial. (Pubmed Central) -  Feb 7, 2025   
    The control group was treated with basic treatment and 12 sessions of lactulose oral solution, whereas the Tuina group received basic treatment and 12 sessions of infantile Tuina treatment...The results of this study suggest that Tuina, as a nonpharmacological therapy, may be helpful as an alternative treatment for constipation. More advanced research and large-sample studies should be conducted.
  • ||||||||||  Review, Journal:  TIPS and hepatic encephalopathy in patients with cirrhosis. (Pubmed Central) -  Feb 4, 2025   
    The results further suggest the potential of lactulose to improve this behavior. In elective situations, such as refractory (intractable ascites (intolerance to diuretics) or resistant ascites (i.e. despite optimal diuretic treatment (spironolactone 400
  • ||||||||||  lactulose / Generic mfg., Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
    Clinical, Retrospective data, Journal:  Efficacy and safety of rifaximin for the prophylaxis of hepatic encephalopathy: A meta-analysis. (Pubmed Central) -  Jan 31, 2025   
    In elective situations, such as refractory (intractable ascites (intolerance to diuretics) or resistant ascites (i.e. despite optimal diuretic treatment (spironolactone 400 Rifaximin is beneficial for primary and secondary prevention of HE, but it does not reduce mortality or increase the incidence of adverse events in patients with end-stage cirrhosis caused by virus or alcohol.
  • ||||||||||  lactulose / Generic mfg.
    Journal:  The administration route of indigestible gut permeability markers modulates urinary marker recovery in calves. (Pubmed Central) -  Jan 29, 2025   
    To evaluate gut permeability, indigestible markers (lactulose, d-mannitol, and chromium [Cr]-EDTA) were administered in 2 periods, on Tuesday and Thursday in the third week after arrival...This suggests that both ADM_R were equivalent in assessing the effects of dietary interventions on gut permeability. However, different ADM_R likely affected the trajectory and time spent by the markers in each segment of the gut.
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
    Trial completion date, Trial primary completion date:  PEARL: Prevention of Post-TIPS Hepatic Encephalopathy by Administration of Rifaximin and Lactulose (clinicaltrials.gov) -  Jan 28, 2025   
    P4,  N=238, Recruiting, 
    However, different ADM_R likely affected the trajectory and time spent by the markers in each segment of the gut. Trial completion date: Sep 2023 --> Dec 2026 | Trial primary completion date: Sep 2022 --> Sep 2026
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
    Microbial Cell-Free DNA Testing for the Identification of Mycoplasma Infection in Post-Lung Transplant Hyperammonemia Syndrome (Poster Hall) -  Jan 19, 2025 - Abstract #ISHLT2025ISHLT_1291;    
    Shortly after the return of microbial cell-free DNA testing, the anaerobic culture of the pleural fluid became positive for Mycoplasma hominis.Summary Hyperammonemia syndrome is a severe complication of lung transplant, and identification of a causative infection can help guide treatment. Microbial cell-free DNA testing may offer an additional non-invasive method for identifying Mycoplasma and Ureaplasma infection.
  • ||||||||||  lactulose / Generic mfg.
    Cardio-Gut Crosstalk: Linking Amyloidosis to SIBO (Poster Hall) -  Jan 19, 2025 - Abstract #ISHLT2025ISHLT_1040;    
    levels measured every 15 minutes...Cardiac biomarkers may help detect SIBO earlier in CA, supporting timely intervention. Further research is needed to explore the underlying mechanisms and impact of SIBO management on outcomes in CA.
  • ||||||||||  Simulect (basiliximab) / Novartis, Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
    When the Lungs Breathe Trouble: Ureaplasma Infection Causing Hyperammonemia Syndrome, Followed by HSV Pneumonitis, After Bilateral Lung Transplant (Poster Hall) -  Jan 19, 2025 - Abstract #ISHLT2025ISHLT_461;    
    He underwent bilateral lung transplant with induction on basiliximab and methylprednisolone 1 week later, and started on maintenance immunosuppression with corticosteroids, mycophenolate, and tacrolimus...He was initiated on dialysis, lactulose, and rifaximin for HALT, and doxycycline and azithromycin for empiric mollicute coverage; his ammonia subsequently down trended with these interventions...Prophylactic famciclovir was transitioned to acyclovir for fourteen days, with valacyclovir thereafter as alternative viral prophylaxis...Empiric testing of serum ammonia for the week after lung transplant may trigger concern for mollicute infection, which historically carries high mortality after lung transplantation. Meanwhile, while airway wall erythema due to reperfusion injury may be observed soon after transplantation, new sudden onset erythema in subsequent weeks should provoke investigation for infectious causes, particularly HSV pneumonitis.
  • ||||||||||  lactulose / Generic mfg.
    Clinical, Journal:  Lactulose Versus Naloxone for Opioid-Induced Constipation in Intensive Care. (Pubmed Central) -  Jan 13, 2025   
    Symptoms of withdrawal syndrome were experienced by 15 patients (39.5%) patients in the naloxone group. The evidence suggests that lactulose is a superior treatment choice because it does not carry the risk of withdrawal syndrome or treatment ineffectiveness.
  • ||||||||||  Linzess (linaclotide) / Ironwood Pharma, AbbVie, Goofice (elobixibat) / Ipsen, Amitiza (lubiprostone) / Takeda, Mallinckrodt
    Review, Journal:  Management of Chronic Constipation: A Comprehensive Review. (Pubmed Central) -  Jan 6, 2025   
    In Japan, polyethylene glycol and lactulose can now be administered under insurance coverage...The temporary use of stimulant laxatives, suppositories, enemas, and digital evacuation is also recommended. The usefulness of biofeedback is yet to be determined.
  • ||||||||||  lactulose / Generic mfg.
    Journal:  Gastrointestinal permeability and kidney injury risk during hyperthermia in young and older adults. (Pubmed Central) -  Jan 3, 2025   
    Gastrointestinal permeability was assessed using a multi-sugar drink test containing lactulose, sucrose and rhamnose...Furthermore, our data indicate that older adults might be more at risk for increases in gastroduodenal permeability, as evidenced by the larger increases in sucrose excretion in response to heat stress. Finally, our findings show that heat stress impairs kidney function and elevates markers of kidney injury; however, these responses are not modulated by age.
  • ||||||||||  lactulose / Generic mfg.
    Journal:  Association of bacterial overgrowth in the small intestine with cortical thickness and functional connectivity in Parkinson's disease involving mild cognitive impairment. (Pubmed Central) -  Dec 27, 2024   
    This study explored potential associations of bacterial overgrowth in the small intestine, as detected based on levels of hydrogen and methane in breath after lactulose consumption, with cortical thickness and resting-state functional connectivity in different brain regions...Our results suggest that bacterial overgrowth in the small intestine may contribute to cortical thinning and alterations in resting-state functional connectivity in PD involving mild cognitive impairment. These insights support and deepen previous observations implicating the gut-brain axis in the neurological disorder.