- |||||||||| lactulose / Generic mfg.
Clinical, Journal: Impact of Extensively Hydrolyzed Infant Formula on Circulating Lipids During Early Life. (Pubmed Central) - Jun 11, 2022
P=N/A
Child's growth (weight and length) and intestinal functional markers, including lactulose mannitol (LM) ratio, fecal calprotectin, and fecal beta-defensin, were also measured at given time points...Our study suggests that HF intervention changes the circulating lipidome, including those lipids previously found to be associated with progression to islet autoimmunity or overt T1D. [Clinicaltrials.gov], identifier [NCT01735123].
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Trial completion, Trial completion date, Trial primary completion date: Oral Administration of MB-102 Versus Dual Sugar Testing for Gut Permeability (clinicaltrials.gov) - Jun 10, 2022
P1, N=22, Completed,
[Clinicaltrials.gov], identifier [NCT01735123]. Recruiting --> Completed | Trial completion date: Mar 2022 --> Oct 2021 | Trial primary completion date: Mar 2022 --> Oct 2021
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Review, Journal: Encephalopathy in Cirrhosis: Prevention and Management. (Pubmed Central) - Jun 10, 2022
Lactulose and rifaximin are approved treatment options for the treatment of HE. In patients who have localised neurological signs or are not improving with lactulose and rifaximin should be investigated for other causes of altered sensorium.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Clinical, Review, Journal: Hepatic Encephalopathy-Related Hospitalizations in Cirrhosis: Transition of Care and Closing the Revolving Door. (Pubmed Central) - Jun 9, 2022
Providers offering transitional care management may be reimbursed when establishing contact with patients within 2 days post-discharge and conducting an outpatient visit within 7 days or 14 days. Several approaches have been shown to improve outcomes broadly in patients post-discharge and may also be effective for improving outcomes specifically in patients hospitalized with cirrhosis and HE, thus closing the revolving door on rehospitalizations in this population.
- |||||||||| lactulose / Generic mfg.
Journal: First-Void Urine Microbiome in Women with Chlamydia trachomatis Infection. (Pubmed Central) - Jun 5, 2022
At discharge, 42% of patients did not have access to rifaximin regardless of being prescribed the medication, identifying that copay is a significant barrier in allowing patients to have access to rifaximin. These data can help elucidate the pathogenesis of chlamydial urogenital infections, as well as to set up innovative diagnostic and therapeutic approaches.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Biomarker, Clinical, Retrospective data, Review, Clinical Trial,Phase I, Clinical Trial,Phase II, Clinical Trial,Phase III, Journal: Refractory Hyperammonemic encephalopathy in Fibrolamellar hepatocellular carcinoma, a case report and literature review. (Pubmed Central) - Jun 4, 2022
There is a variable frequency of episodes reported in the literature. Most patients respond well to ammonia scavenger therapies rather than conventional HE management with lactulose or rifaxmin.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Review, Journal: Evidence-based approach to management of hepatic encephalopathy in adults. (Pubmed Central) - Jun 4, 2022
There are many therapeutic agents available for the management of HE, most of which are directed towards lowering the gut nitrogen load and thus the serum ammonia level. This review aims to provide an update on the conventional and emerging treatment options for HE.
- |||||||||| lactulose / Generic mfg.
Journal: Assessment of the state of the small intestine microbiota in children on a long-term dairy-free diet (Pubmed Central) - May 29, 2022
In all children, SIBO was determined using a hydrogen breath test with a load of lactulose using a digital analyzer of exhaled hydrogen...Conclusion. Thus, among children of primary school age who follow a long-term dairyfree diet, SIBO is significantly more often recorded relative to children who are on a traditional type of diet.
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Journal: Altered Intestinal Production of Volatile Fatty Acids in Dogs Triggered by Lactulose and Psyllium Treatment. (Pubmed Central) - May 29, 2022
Increased acetate and propionate concentrations were observed following the administration of both supplements; however, elevated n-butyrate production was found only after psyllium treatment, suggesting that the applied prebiotics may exert slightly different effects in the hindgut of dogs. These findings can be also of great importance regarding the treatment and management of patients suffering from intestinal disorders as well as hepatic encephalopathy due to portosystemic shunt.
- |||||||||| lactulose / Generic mfg.
Review, Journal: Saudi Experts Consensus on Diagnosis and Management of Pediatric Functional Constipation. (Pubmed Central) - May 26, 2022
This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days...In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
TIPS: Should a history of hepatic encephalopathy be a counter indication. (New York East Ballroom) - May 21, 2022 - Abstract #GEST2022GEST_372;
While a history of HE does not appear to be a predictor of HE development it does seem to correlate with hospital admissions. However, this data suggests a history of HE may not be sufficient reason to withhold TIPS placement.
- |||||||||| lactulose / Generic mfg.
Journal: Constipation in Children and Adolescents: Evaluation and Treatment. (Pubmed Central) - May 20, 2022
Second-line options include lactulose and enemas...Clinicians should acknowledge caregivers' specific challenges and the negative effects of constipation on the child's quality of life. Referral to a pediatric gastroenterologist is recommended when there is a concern for organic causes or constipation persists despite adequate therapy.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
POST-COVID ACUTE LIVER INJURY WITH PSEUDOMONAS MENDOCINA BACTERAEMIA IN A 6 YEAR OLD () - May 19, 2022 - Abstract #ESPID2022ESPID_1247;
His course was complicated by secondary hospital acquired Pseudomonas mendocina bacteremia which responded to meropenem. Onset of encephalopathy, IVIG and meropenem given 29/10/2021 5/11/2021 16/11/2021 Hemoglobin (g/dl) 9.2 Total Leukocyte Count (cells/cmm) 14,900 Differential Leukocyte Count (N/L/M/E) 83/3/2/0 Platelet Count (L/cmm) 6.43 L/cmm SGOT/SGPT (IU) 3464/1661 1934/1328 697/488 TB/DB (mg/dl) 6.4/5.9 15.1/13.4 Total Protein/Albumin (g/dl) 6.1/3.2 PT/INR 22.8/2.07 Ammonia (mcg/dl) 87 168 GGTP (IU/L) 172 LDH (U/L) 2022 Triglycerides (mg/dl) 111 Ferritin (mcg/L) 1320 CRP 54 11 ESR 65 50 IL-6 (0-7 pg/ml) 64 Blood Culture No growth P. mendocina Covid Antibodies (Spike Protein) 147 (positive) D-dimer (<0.5 mcg FEU/ml) 1.74 Fibrinogen (199—409 mg/dl) 229 Learning Points/ COVID-19 should be kept in mind in fulminant liver failure when other causes have been ruled out.
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Trial primary completion date: Validation of the Small Intestine Microbiome Aspiration (SIMBA) Capsule (clinicaltrials.gov) - May 19, 2022
P=N/A, N=30, Recruiting,
Onset of encephalopathy, IVIG and meropenem given 29/10/2021 5/11/2021 16/11/2021 Hemoglobin (g/dl) 9.2 Total Leukocyte Count (cells/cmm) 14,900 Differential Leukocyte Count (N/L/M/E) 83/3/2/0 Platelet Count (L/cmm) 6.43 L/cmm SGOT/SGPT (IU) 3464/1661 1934/1328 697/488 TB/DB (mg/dl) 6.4/5.9 15.1/13.4 Total Protein/Albumin (g/dl) 6.1/3.2 PT/INR 22.8/2.07 Ammonia (mcg/dl) 87 168 GGTP (IU/L) 172 LDH (U/L) 2022 Triglycerides (mg/dl) 111 Ferritin (mcg/L) 1320 CRP 54 11 ESR 65 50 IL-6 (0-7 pg/ml) 64 Blood Culture No growth P. mendocina Covid Antibodies (Spike Protein) 147 (positive) D-dimer (<0.5 mcg FEU/ml) 1.74 Fibrinogen (199—409 mg/dl) 229 Learning Points/ COVID-19 should be kept in mind in fulminant liver failure when other causes have been ruled out. Trial primary completion date: Aug 2022 --> May 2022
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Effectiveness of probiotics in the secondary prevention of hepatic encephalopathy among cirrhotic patients (Poster Area) - May 12, 2022 - Abstract #EASLILC2022EASL_ILC_1929;
SIBO is also present under pre-cirrhotic conditions, but its prevalence seems to correlate with liver disease irreversible derangement. In our cohort of cirrhotic patients, combination of lactulose and probiotics showed better response compared to lactulose alone in the long term secondary prevention of hepatic encephalopathy.
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Journal: Nutrition, defecation, and the lower gastrointestinal tract during critical illness. (Pubmed Central) - May 7, 2022
Whether constipation is an epiphenomenon or simply a reflection of greater severity of critical illness, at some point it may contribute to worsening morbidity in the ICU. A graded prophylactic bowel regimen should help reverse impairment of the gastrointestinal transit and aid in reducing its deleterious impact on the hospital course of the critically ill patient.
- |||||||||| lactulose / Generic mfg.
Clinical, Journal: Exposure to multiple mycotoxins, environmental enteric dysfunction and child growth: Results from the AflaCohort Study in Banke, Nepal. (Pubmed Central) - May 6, 2022
Using data from a birth cohort study, the objectives of this study were to (a) quantify exposure to multiple mycotoxins (serum aflatoxin [AFB ] and ochratoxin A [OTA], urinary fumonisin [UFB ] and deoxynivalenol [DON]), as well EED (lactulose:mannitol [L:M] ratio); (b) examine the potential combined effects of multiple mycotoxin exposure and EED on growth...These findings suggest that certain mycotoxins and EED may have independent impacts on different facets of growth and that aflatoxin dominates such impacts. Thus, programs reducing exposure to mycotoxin and EED through multi-sectoral nutrition-sensitive interventions have the potential to improve child growth.
- |||||||||| lactulose / Generic mfg., methotrexate / Generic mfg.
Increased intestinal permeability in patients with psoriatic arthritis classified as treatment failures during the 26-week FLORA trial (Poster View 7) - May 6, 2022 - Abstract #EULAR2022EULAR_2479;
P=N/A
In the FLORA trial, intestinal permeability evaluated by the L:M test did not differ significantly between donors and patients at baseline. Whether the higher intestinal permeability observed in patients classified as treatment failures compared to non-failures at week 26 can be attributed to differences in disease activity and/or the instigation of additional immunosuppression in the failure group during the trial needs further investigation.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Retrospective data, Review, Journal, Combination therapy: Combination therapy with rifaximin and lactulose in hepatic encephalopathy: A systematic review and meta-analysis. (Pubmed Central) - May 3, 2022
Moreover, the use of rifaximin plus lactulose was associated with a reduced risk of mortality as compared with lactulose alone (RR, 0.57; 95% CI, 0.41-0.80; P = 0.001). This study found that the use of rifaximin in combination with lactulose could provide additional benefits in terms of increased effective rate and decreased mortality than lactulose alone in patients with HE.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Clinical, Journal: An Electronic Decision Support Intervention Reduces Readmissions for Patients With Cirrhosis. (Pubmed Central) - Apr 27, 2022
Combination of LOLA with lactulose and rifaximin was more effective than only lactulose and rifaximin in improving grades of HE, recovery time from encephalopathy, with lower 28-day mortality. An interruptive alert in the electronic ordering system was associated with a lower risk of readmissions.
- |||||||||| lactulose / Generic mfg.
Trial completion date, Trial primary completion date: GI Effects of Iron in Healthy Volunteers (clinicaltrials.gov) - Apr 27, 2022
P=N/A, N=48, Recruiting,
An interruptive alert in the electronic ordering system was associated with a lower risk of readmissions. Trial completion date: Apr 2022 --> Sep 2022 | Trial primary completion date: Mar 2022 --> Aug 2022
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CHARACTERIZING IBS PATIENTS WHO ARE HYPERSENSITIVE TO A LACTULOSE NUTRIENT CHALLENGE TEST (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_6164;
This group of patients have a higher burden of symptoms in general, but also rectal hypersensitivity and higher hydrogen production. This test seems to be useful to explore pathophysiological mechanisms in IBS, and its potential to predict response to treatment, such as dietary interventions, should be explored.
- |||||||||| lactulose / Generic mfg.
MODERATE/HIGH AMOUNTS OF FODMAPS AGGRAVATE GASTROINTESTINAL SYMPTOMS IN PATIENTS WITH IRRITABLE BOWEL SYNDROME, BUT ONLY A SUBSET RESPONDS CLINICALLY TO THE LOW FODMAP DIET (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_6156;
The periods were separated by a wash-out period (≥14 days).Severity of IBS symptoms (IBS-SSS) and stool form (BSFS) were reported before and after the diet periods, and gut microbial fermentation was assessed using the lactulose nutrient challenge test (LeNeve et al...Conclusion Moderate/high amounts of FODMAPs aggravated GI symptoms in IBS patients, but only a subset of patients responded favorably to the low FODMAP diet, and no predictors of clinical response to this diet could be identified. Larger studies assessing predictors of response, potentially including longer treatment and challenge periods, are needed to identify the characteristics of IBS patients that respond favorably to the low FODMAP diet.
- |||||||||| lactulose / Generic mfg.
ENVIRONMENTAL FACTORS ASSOCIATED WITH RISK OF CROHN'S DISEASE DEVELOPMENT IN A PROSPECTIVE COHORT OF HEALTHY FIRST-DEGREE RELATIVES OF CD PATIENTS (20CD - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_5229;
As a secondary analysis, regression models were used to identify the relationship of exposures with biological factors associated with CD risk previously identified by our group i.e.: i) intestinal permeability using urinary fractional excretion of lactulose to mannitol ratio (LMR) with LMR≥0.025 defined as abnormal; ii) subclinical inflammation using fecal calprotectin (FCP) with FCP≥100µg/g, and iii) fecal microbiome composition and diversity using 16S rDNA sequencing...Conclusion sThis study shows that living with a dog and having a larger family in early life may be protective against the future development of CD. Additionally, exposure to dogs during early life is associated with normal gut permeability later in life, suggesting that the effect of living with a dog may be mediated through effects on gut barrier function.
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