- |||||||||| lactulose / Generic mfg.
[VIRTUAL] Sleeping Beauty: Hypersomnolence and Hyperammonemia in a Patient with Multiple Myeloma () - Oct 17, 2021 - Abstract #KIDNEYWEEK2021KIDNEY_WEEK_2942;
The patient was given oral lactulose for several days without improvement...However, hyperammonemia is a poor prognosticator in patients with multiple myeloma. Hyperammonemia should be included in the differential diagnosis of metabolic encephalopathy in patients with multiple myeloma.
- |||||||||| lactulose / Generic mfg.
Clinical, Journal: Evaluation of fecal microbiota transplantation in Parkinson's disease patients with constipation. (Pubmed Central) - Oct 16, 2021
Through the lactulose H2 breath test, the intestinal bacterial overgrowth (SIBO) in PD patients returned to normal...Our study profiles specific characteristics and microbial dysbiosis in the gut of PD patients. FMT might be a therapeutic potential for reconstructing the gut microbiota of PD patients and improving their motor and non-motor symptoms.
- |||||||||| elobixibat (A3309) / Albireo, Ajinomoto, Ferring, Resolor (prucalopride) / J&J, Takeda, Amitiza (lubiprostone) / Takeda, Mallinckrodt
Clinical, Review, Journal: Medical Management of Constipation in Elderly Patients: Systematic Review. (Pubmed Central) - Oct 14, 2021
Psyllium, calcium polycarbophil, lactulose syrup, lactitol, polyethylene glycol, magnesium hydroxide, stimulant laxative with or without fiber, and other medications were more effective than placebo in elderly constipation patients in short-term...However, the quality of included studies was not high and most of studies was conducted in a small number of patients. Among these laxatives, polyethylene glycol seems to be safe and effective in long-term use of about 6 months in elderly patients.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, Cytovene (ganciclovir) / Roche
[VIRTUAL] HYPERAMMONEMIA SYNDROME AFTER LUNG TRANSPLANTATION: A CALL FOR BROADENING OF THE PERI-OPERATIVE ANTIMICROBIAL COVERAGE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2457;
Furthermore, she developed generalized tonic clonic seizures on POD 17 requiring initiation of levetiracetam and lacosamide...Patient was transitioned to dual therapy treatment with azithromycin and levofloxacin given the severity of illness and risk of resistance... We, therefore, recommend including antibiotics with efficacy against atypical infections in the post-operative period among all LT patients.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
[VIRTUAL] A RARE AND FATAL CASE OF ACUTE FULMINANT LIVER FAILURE INDUCED BY COVID-19 INFECTION () - Oct 13, 2021 - Abstract #CHEST2021CHEST_1367;
Understanding SARS-CoV-2's effects on a hepatocellular level may allow for anticipatory monitoring and prevention of liver damage from this virus. For those more severely affected, better treatments would help avoid the difficult course of emergency liver transplantation and resultant need for lifelong immunosuppression.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
[VIRTUAL] COMBINATION THERAPY WITH N-ACETYLCYSTEINE AND 4-METHYLPYRAZOLE FOR ACETAMINOPHEN OVERDOSE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_687;
Patient was treated with aggressive fluid resuscitation for pancreatitis; NAC and 4-MP for acetaminophen toxicity; lactulose and rifaximin for hepatic encephalopathy; vitamin K for coagulopathy; and albumin, octreotide, and midodrine for hepatorenal syndrome. In patients presenting with APAP overdose, combination therapy with NAC and 4-MP may provide complementary protective effects through targeting of different therapeutic pathways.
- |||||||||| lactulose / Generic mfg.
[VIRTUAL] AIR EMBOLISM FROM ENEMA RESULTING IN STROKE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_575;
Pneumatosis intestinalis is an exceedingly rare complication of enema. Being aware of this possibility can provide early recognition and intervention, leading to better outcomes for future patients.
- |||||||||| lactulose / Generic mfg., fluconazole oral / Generic mfg., meropenem / Generic mfg.
[VIRTUAL] TAKOTSUBO CARDIOMYOPATHY TRIGGERED BY CORONAVIRUS NL63 IN A COVID-19 PANDEMIC () - Oct 13, 2021 - Abstract #CHEST2021CHEST_484;
CRP was elevated at 2.28 that trended down on Meropenem as prior sputum cultures grew Pseudomonas, Serratia and E. Coli...Subsequently, Cryptococcus Neoformans was isolated in the CSF and Amphotericin B was added to an increased dose of fluconazole.As he showed signs of volume overload and increased oxygen demands he was treated with loop diuretics, ACE inhibitors, and beta blockers.He was transferred for a TEE to a tertiary care facility and was treated for 42 days with Amphotericin B, Diflucan and Lactulose for hyperammonemia... The presence of a viral respiratory infection due to Coronavirus NL63 presumptively triggered stress induced cardiomyopathy which responded with supportive care during a Covid-19 pandemic in a immunosuppressed patient without evidence of SARS CoV2.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
[VIRTUAL] POST-GASTRIC BYPASS HYPERAMMONEMIC ENCEPHALOPATHY: A RARE AND POTENTIALLY FATAL CAUSE OF ENCEPHALOPATHY IN THE ICU () - Oct 13, 2021 - Abstract #CHEST2021CHEST_415;
The presence of a viral respiratory infection due to Coronavirus NL63 presumptively triggered stress induced cardiomyopathy which responded with supportive care during a Covid-19 pandemic in a immunosuppressed patient without evidence of SARS CoV2. It is important to consider hyperammonemia related to bypass as a potential etiology for neurologic changes in patients with prior bypass, especially in the ICU setting where multiple etiologies can cause encephalopathy and hyperammonemia.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Journal, HEOR: Budget impact of optimizing rifaximin-α use for the prevention of recurrent hepatic encephalopathy in The Netherlands. (Pubmed Central) - Oct 12, 2021
Next to a clinical perspective, also from an economic perspective, wider prescription of rifaximin-α adhering to guidelines could be beneficial to reduce costs from a hospital perspective. From a healthcare payer's perspective, costs increase with addition of rifaximin-α due to relative better survival causing relatively higher drug and liver transplantation-related costs.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Journal: Microbiota changes and Intestinal Microbiota Transplantation in Liver Diseases and Cirrhosis. (Pubmed Central) - Oct 8, 2021
However, the role of fecal or intestinal microbiota transplantation is being increasingly recognized. The challenges, opportunities and the road ahead for the appropriate and safe use of intestinal microbiota transplantation in liver disease are reviewed, which opens up an exciting field of investigation and therapy in cirrhosis.
- |||||||||| lactulose / Generic mfg.
Clinical, Journal: Small intestinal bacterial overgrowth among patients with celiac disease unresponsive to a gluten free diet. (Pubmed Central) - Oct 8, 2021
The challenges, opportunities and the road ahead for the appropriate and safe use of intestinal microbiota transplantation in liver disease are reviewed, which opens up an exciting field of investigation and therapy in cirrhosis. The prevalence of SIBO was 31% in unresponsive patients with CeD according to LHBT and 15% in the quantitative culture of the jejunal aspirate, which is comparable with the published Western literature.
- |||||||||| lactulose / Generic mfg.
Journal: Enzymatic production of lactulose by fed-batch and repeated fed-batch reactor. (Pubmed Central) - Oct 8, 2021
The operation by repeated fed batch increases the efficiency of use of the biocatalysts (E) and the accumulated productivity compared to batch and fed batch operation with the same biocatalyst. E obtained was 4.13 g∙mg, 10.6 times higher than in fed-batch.
- |||||||||| Onureg (azacitidine oral) / BMS
Gastrointestinal events and management strategies for patients with acute myeloid leukemia (AML) in first remission receiving oral azacitidine (Oral-AZA) in the randomized, placebo-controlled, phase 3 QUAZAR AML-001 maintenance trial () - Oct 7, 2021 - Abstract #DGHO2021DGHO_969;
Median age at baseline was 68 years (range 55-86), 202 pts (86%) had intermediate-risk cytogenetics, 185 (78%) achieved CR after induction, and 184 (78%) received ≥1 consolidation course before study entry. Nausea, vomiting, and diarrhea were reported in 65%, 60%, and 50%of pts, respectively, treated with Oral-AZA.
- |||||||||| lactulose / Generic mfg.
Journal: Microbiome and Metabolic Changes of Milk in Response to Dietary Supplementation With Bamboo Leaf Extract in Dairy Cows. (Pubmed Central) - Oct 2, 2021
There were 64 different types of metabolites significantly upregulated, namely, glycerophospholipids and fatty acyls, and 15 significantly downregulated metabolites, such as moracetin, sphinganine, and lactulose in the AOB group...Several typical metabolites were highly correlated with specific ruminal bacteria, demonstrating a functional correlation between the milk microbiome and the associated metabolites. These insights into the complex mechanism and corresponding biological responses highlight the potential function of AOB, warranting further investigation into the regulatory role of specific pathways in the metabolism.
- |||||||||| lactulose / Generic mfg.
An unusual presentation of acute confusion state- Manganese Madness (Encephalopathy) () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_4505;
Patient was started on fluids, antibiotics, lactulose enema, thiamine, and anti-hyperkalemia measures...Treatment includes removal of the patient from the source exposure, Chelation therapy using CaNa2EDTA (EDTA) and Para-amino salicylic Acid (PAS) Older patients often develop more significant toxicity than younger patients and the prognosis is more related to morbidity than mortality. ADDITIONAL INFORMATION: In summary, diagnosis requires a high clinical suspicion, recognition of the risk factors, early usage of MRI and a team-based approach.
- |||||||||| lactulose / Generic mfg.
An unusual presentation of acute confusion state- Manganese Madness (Encephalopathy) () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_4504;
Patient was started on fluids, antibiotics, lactulose enema, thiamine, and anti-hyperkalemia measures...Treatment includes removal of the patient from the source exposure, Chelation therapy using CaNa2EDTA (EDTA) and Para-amino salicylic Acid (PAS) Older patients often develop more significant toxicity than younger patients and the prognosis is more related to morbidity than mortality. ADDITIONAL INFORMATION: In summary, diagnosis requires a high clinical suspicion, recognition of the risk factors, early usage of MRI and a team-based approach.
- |||||||||| lactulose / Generic mfg.
An unusual presentation of acute confusion state- Manganese Madness (Encephalopathy) () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_4503;
Patient was started on fluids, antibiotics, lactulose enema, thiamine, and anti-hyperkalemia measures...Treatment includes removal of the patient from the source exposure, Chelation therapy using CaNa2EDTA (EDTA) and Para-amino salicylic Acid (PAS) Older patients often develop more significant toxicity than younger patients and the prognosis is more related to morbidity than mortality. ADDITIONAL INFORMATION: In summary, diagnosis requires a high clinical suspicion, recognition of the risk factors, early usage of MRI and a team-based approach.
- |||||||||| lactulose / Generic mfg.
An unusual presentation of acute confusion state- Manganese Madness (Encephalopathy) () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_4502;
Patient was started on fluids, antibiotics, lactulose enema, thiamine, and anti-hyperkalemia measures...Treatment includes removal of the patient from the source exposure, Chelation therapy using CaNa2EDTA (EDTA) and Para-amino salicylic Acid (PAS) Older patients often develop more significant toxicity than younger patients and the prognosis is more related to morbidity than mortality. ADDITIONAL INFORMATION: In summary, diagnosis requires a high clinical suspicion, recognition of the risk factors, early usage of MRI and a team-based approach.
- |||||||||| lactulose / Generic mfg.
Journal: Identifying areas of improvement in nursing knowledge regarding hepatic encephalopathy management. (Pubmed Central) - Sep 28, 2021
We also found that 20% of the nurses had difficulty answering questions regarding titration of lactulose to bowel movements...With this simple survey, we identified important knowledge gaps among experienced nurses at our institution. We believe that by improving knowledge through focused lectures, we can improve patient care and reduce the length of hospitalizations in patients with HE.
- |||||||||| lactulose / Generic mfg.
Trial completion, Trial completion date, Trial primary completion date: Intestinal Permeability in Preterm Infants (clinicaltrials.gov) - Sep 28, 2021
P1, N=214, Completed,
We believe that by improving knowledge through focused lectures, we can improve patient care and reduce the length of hospitalizations in patients with HE. Recruiting --> Completed | Trial completion date: Jun 2021 --> Aug 2021 | Trial primary completion date: Jun 2021 --> Aug 2021
- |||||||||| lactulose / Generic mfg.
Journal: Synthesis of oligosaccharides with prebiotic potential by crude enzyme preparation from Bifidobacterium. (Pubmed Central) - Sep 26, 2021
Additionally, it also has transglycosylation activities on lactose, lactulose, maltose and sucrose substrates...Among newly synthetized oligosaccharides, the fraction namely OS4 was utilized by probiotic bifidobacteria only. In conclusion, new types of galacto- and glucooligosaccharides with high prebiotic potentials were synthetized by the crude enzyme from probiotic Bifidobacterium strains.
- |||||||||| lactulose / Generic mfg., sodium phenylbutyrate / Generic mfg.
Clinical, Journal: Differences in faecal microbiome composition between adult patients with UCD and PKU and healthy control subjects. (Pubmed Central) - Sep 18, 2021
The differences in the microbiome composition of UCD patients compared to healthy controls were in part related to lactulose use...We propose as a first next step, to study the impact of these faecal microbiome alterations on metabolic stability. The faecal microbiome of UCD patients was less diverse compared to PKU patients and even more compared to healthy controls.
- |||||||||| lactulose / Generic mfg.
Biomarker, Clinical, Journal: Biomarkers for assessment of intestinal permeability in clinical practice. (Pubmed Central) - Sep 16, 2021
The faecal microbiome of UCD patients was less diverse compared to PKU patients and even more compared to healthy controls. Our data suggest plasma LBP as a promising biomarker for intestinal permeability in adults and fecal zonulin as a potential biomarker in overweight and obese individuals.
- |||||||||| lactulose / Generic mfg.
Trial completion date, Trial primary completion date: Oral Administration of MB-102 Versus Dual Sugar Testing for Gut Permeability (clinicaltrials.gov) - Sep 9, 2021
P1, N=20, Recruiting,
These findings may guide recommendations on primary prophylaxis for OHE in patients with liver cirrhosis that may help reduce the occurrence of first episode of overt HE, and thereby prevent subsequent cognitive impairment in these patients. Trial completion date: Apr 2021 --> Dec 2021 | Trial primary completion date: Apr 2021 --> Dec 2021
- |||||||||| ceftriaxone / Generic mfg.
A Rare Predictor of Mortality: Black Esophagus (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_2809;
IV Octreotide, IV Ceftriaxone, and PPI were started and he underwent EGD which showed black circumferential mucosa at 23 cm to the GE junction at 41 cm, no visible esophageal varices...Lactulose was started...70% of patients present with hematemesis.Treatment is focused on supportive care and addressing coexisting comorbidities. Although mortality is high (32%), it is not necessarily AEN that is the cause of mortality but rather the patient's comorbidities and underlying conditions.Figure: Black esophagus
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Small Intestinal Bacterial Overgrowth After COVID-19 Infection (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_2746;
SIBO is typically evaluated with breath testing which relies on modification of a substrate such as lactulose by bacteria...The patient was prescribed Rifaximin with reported improvement in her symptoms...A suggested hypothesis is that of SARS-CoV-2 leading to alteration of gut microbiota resulting in ‘gut dysbiosis’ which can result in excessive and altered bacterial overgrowth. Further research on SARS-CoV-2 and gut microbiota is needed to better understand the GI manifestation of the infection.
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