lactulose / Generic mfg. 
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  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
    [VIRTUAL] Hyperammonemia in Critically Ill Patients, and Interplay of Pathophysiologic and Iatrogenic Factors () -  Mar 14, 2021 - Abstract #ATS2021ATS_4170;    
    Case Report: 76-year-old male with history of follicular lymphoma treated with R-CHOP was admitted to ICU one month after his most recent chemotherapy with sepsis and ruptured urinary bladder requiring intubation...Subsequently valproate was substituted with levetiracetam due to concern for worsening hyperammonemia, but unfortunately, he progressed to status epilepticus and ammonia level continued to worsen...Lactulose and rifaximin provide palliative treatment, by increasing gastrointestinal elimination and reducing gastrointestinal production of ammonia respectively, while we treat the underlying cause. Severe hyperammonemia (>200 µmol/L) with signs of cerebral edema or seizures should prompt emergent nephrology consultation and initiation of hemodialysis.
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma, Avastin (bevacizumab) / Roche
    [VIRTUAL] When the Liver Goes Bad, Life Goes Sad- Severe Resistant Hepatic Encephalopathy Due to Fibrolamellar Hepatic Cancer () -  Mar 14, 2021 - Abstract #ATS2021ATS_364;    
    The patient was treated with Rifaximin and Lactulose for hyperammonemic encephalopathy. The patient also received a total of two cycles of immunotherapy with Atezolizumab/Bevacizumab...It is crucial to recognize HEA in young patients with no underlying disease as a complication of fHHC, as a prompt diagnosis can lead to a better outcome.
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
    [VIRTUAL] Hyperammonemia-Induced Encephalopathy: A Rare Devastating Complication of Bariatric Surgery () -  Mar 14, 2021 - Abstract #ATS2021ATS_149;    
    Laboratory findings include hyperammonemia, hypoalbuminemia, high glutamine and low zinc levels, in absence of cirrhosis. Management includes prevention of cerebral edema and seizures, reducing ammonia levels with lactulose or rifaximin, dietary protein restriction, decreasing the catabolic state by giving zinc, micronutrients, intravenous glucose, and amino acids.
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
    Clinical, Journal, HEOR:  Cost-Effectiveness of Rifaximin Treatment in Patients with Hepatic Encephalopathy. (Pubmed Central) -  Mar 9, 2021   
    The marked tendency for synthesizing this linkage indicates that under hydrolytic conditions, β-Gal-(1 → 3)-Gal- and β-Gal-(1 → 5)-Fru glycosidic bonds would be preferentially digested. The clinical benefit of rifaximin, combined with an acceptable economic profile, demonstrates the advantages of rifaximin maintenance therapy as an important option to consider for patients at risk of recurrent HE.
  • ||||||||||  lactulose / Generic mfg.
    Journal:  Goat milk protein digestibility in relation to intestinal function. (Pubmed Central) -  Mar 9, 2021   
    This trial was registered at clinicaltrials.gov as NCT03801317. The true ileal digestibility of goat milk protein in South Indian WRA with normal intestinal absorptive function and integrity was comparable to earlier estimates in healthy French adults.
  • ||||||||||  lactulose / Generic mfg.
    Enrollment open:  GI Effects of Iron in Healthy Volunteers (clinicaltrials.gov) -  Mar 4, 2021   
    P=N/A,  N=48, Recruiting, 
    The true ileal digestibility of goat milk protein in South Indian WRA with normal intestinal absorptive function and integrity was comparable to earlier estimates in healthy French adults. Not yet recruiting --> Recruiting
  • ||||||||||  lactulose / Generic mfg.
    Journal:  Lactulose and Melibiose Inhibit α-Synuclein Aggregation and Up-Regulate Autophagy to Reduce Neuronal Vulnerability. (Pubmed Central) -  Feb 25, 2021   
    Lactulose and melibiose further reduced α-synuclein aggregation and associated oxidative stress, as well as protected cells against α-synuclein-induced neurotoxicity by up-regulating autophagy and nuclear factor, erythroid 2 like 2 (NRF2) pathway in DAergic neurons derived from SH-SY5Y cells over-expressing α-synuclein. Our findings strongly indicate the potential of lactulose and melibiose for mitigating PD neurodegeneration, offering new drug candidates for PD treatment.
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
    [VIRTUAL] Outcomes in Patients > 70 Years-Old Undergoing TIPS Procedure: A single center 10-year retrospective review () -  Feb 24, 2021 - Abstract #SIR2021SIR_741;    
    Our findings strongly indicate the potential of lactulose and melibiose for mitigating PD neurodegeneration, offering new drug candidates for PD treatment. Patient age ≥ 70 years old at the time of TIPS procedure represents an independent risk factor for increased 30 and 90 day mortality regardless of MELD-Na score. No significant difference in the incidence of HE was identified between the older and younger cohorts. Although TIPS procedures can be safely performed in the elderly population, these patients should be followed closely and optimized prior to the procedure.
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
    [VIRTUAL] Recurrent hepatic encephalopathy: beyond infection and GI bleeding. () -  Feb 23, 2021 - Abstract #BWG2021BWG_228;    
    During a subsequent admission for HE levetiracetam was started because of epileptic activity on EEG...In cases refractory to treatment, assessment of a portosystemic shunt is recommended. Around 60 % of patients remain free of hepatic encephalopathy three months after embolization, and 49-55 % after 1-2 years.
  • ||||||||||  Journal:  Mapping the Transglycosylation Relevant Sites of Cold-Adapted β-d-Galactosidase from Arthrobacter sp. 32cB. (Pubmed Central) -  Feb 18, 2021   
    As a result, not only the galactose binding sites were mapped on the enzyme's surface but also the mode of lactulose, product of transglycosylation reaction, and binding within the enzyme's active site were determined and the glucopyranose binding site in the distal of active site was discovered. The latter two especially show structural details of transglycosylation, providing valuable information that may be used for engineering of ArthβDG or other analogous galactosidases belonging to GH2 family.
  • ||||||||||  lactulose / Generic mfg., azithromycin / Generic mfg.
    [VIRTUAL] A RAPIDLY GROWING MASS AND UNUSUAL GAS IN AN ORTHOTOPIC HEART TRANSPLANT PATIENT (eAbstract site) -  Feb 17, 2021 - Abstract #ACC2021ACC_3545;    
    Dialysis and lactulose therapy were successfully discontinued with normal ammonia levels and mental status. While no definitive source was ever isolated, infection with a urease-producing bacterium was deemed the most likely etiology, and he has remained well for 3 months after presentation.
  • ||||||||||  lactulose / Generic mfg.
    Clinical, Journal:  Acute kidney injury in hospitalized cirrhotic patients: Risk factors, type of kidney injury, and survival. (Pubmed Central) -  Feb 9, 2021   
    In 207 (65.7%) patients, diuretic/lactulose/nonsteroidal anti-inflammatory drugs use was noted, and infection was present in 190 (60.3%) patients...Use of AKI-precipitating medications was the most common cause of AKI, followed by bacterial infection. AKI patients had increased prevalence of acute-on-chronic liver failure and had prolonged hospitalization and lower survival both at 28 days and 90 days.
  • ||||||||||  Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
    Journal:  Fecal Microbiota Transplant in Cirrhosis Reduces Gut Microbial Antibiotic Resistance Genes: Analysis of Two Trials. (Pubmed Central) -  Feb 9, 2021   
    We aimed to study the effect of capsule and enema FMT on ARG abundance in fecal samples, which were collected during two published FMT trials in patients with cirrhosis on rifaximin, lactulose, and proton pump inhibitors...Compared to placebo, patients who were post-FMT had lower abundance of vancomycin (VanH), beta-lactamase (ACT), and rifamycin ARGs; the latter was associated with cognitive improvement...No changes were seen within the SOC group. Despite differences in routes of administration and preintervention antibiotics, we found that ARG abundance is largely reduced after FMT compared to pre-FMT baseline and non-FMT groups in decompensated cirrhosis.
  • ||||||||||  Farxiga (dapagliflozin) / Ono Pharma, AstraZeneca
    [VIRTUAL] Phosphoinositide 3-Kinase Inhibitor-Induced Hyperglycemia (On-Demand) -  Feb 2, 2021 - Abstract #ENDO2021ENDO_1092;    
    Dapagliflozin treatment quickly improved BG to <200 mg/dL, but she developed candida intertrigo so it was discontinued and insulin was started...Within days, she was admitted with encephalopathy and a UTI which improved with antibiotics and lactulose...Total daily insulin needs went from 18u, to 124u by day 5 of alpelisib...For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO 2021.
  • ||||||||||  dexamethasone / Generic mfg., spironolactone / Generic mfg., enoxaparin sodium / Generic mfg.
    [VIRTUAL] Type 4 Renal Tubular Acidosis (RTA) Induced by Spironolactone Use in Secondary Adrenal Insufficiency (On-Demand) -  Feb 2, 2021 - Abstract #ENDO2021ENDO_731;    
    She was successfully treated with oral lactulose for hepatic encephalopathy...Her hyperkalemia persisted (6.3-6.8 mmol/L), and she was started on oral patiromer...On day 8, endocrinology discontinued dexamethasone and enoxaparin, and started hydrocortisone 10 mg orally in AM and 5 mg in PM...The patient was discharged with hydrocortisone 10 mg daily, and spironolactone was permanently discontinued. Spironolactone use can result in type 4 RTA due to aldosterone resistance and mimic mineralocorticoid deficits characteristic of primary adrenal insufficiency.