- |||||||||| lactulose / Generic mfg.
An Intriguing Case of Hyperammonemia Encountered in Intensive Care Unit (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area E) - Mar 15, 2020 - Abstract #ATS2020ATS_8145;
Lactulose was given through nasogastric tube 20 gm every 6 hours to maintain 3-4 loose stools/day...He had increased absorption of ammonia into the mesenteric blood supply due to very slow transit constipation that overwhelmed hepatic ammonia excretion.Persistent untreated encephalopathy increases risk of cerebral edema, herniation, hospital stay, morbidity, mortality and impacts cognitive and functional recovery. Thus, even in absence of liver disease intensivists must routinely check serum ammonia in acute encephalopathy of unclear etiology and perform work up for uncommon but treatable causes of hyperammonemia.
- |||||||||| metformin / Generic mfg.
Profound Shock from Metformin-Induced Lactic Acidosis in a Patient with End Stage Liver Disease and Hepatic Encephalopathy (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area E) - Mar 15, 2020 - Abstract #ATS2020ATS_8124;
In our patient with cirrhosis, MILA resulted from downstream consequences of hepatic encephalopathy, and caused profound shock that improved with rapid initiation of renal replacement therapy. In patients with risk factors for MILA presenting with acidosis and shock, early recognition of potential metformin toxicity, and prompt initiation of dialysis with continual circulatory support may improve outcomes.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA
Reversible Decerbrate Posturing Due to Hepatic Encephalopathy (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area E) - Mar 15, 2020 - Abstract #ATS2020ATS_8120;
In conclusion, hepatic encephalopathy is a rare but reversible cause of decerebrate posturing. Clinicians should be aware of this condition in patients presenting with HE progressing to coma since it might save unnecessary workup.
- |||||||||| lactulose / Generic mfg.
Somebody Call the Cop! (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area D) - Mar 15, 2020 - Abstract #ATS2020ATS_5157;
He initially had an ammonia level of 162 µmol/L and was treated with lactulose...Despite the sometimes elusive diagnosis, most patients with COP do quite well when adequately treated with cure rates as high as 80%. Spontaneous remission can occur in up to 50% of milder cases.
- |||||||||| lactulose / Generic mfg., Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA
Clinical: “Risk factors for nosocomial infections were admission infections, MELD>20, SIRS criteria, PPI, rifaximin, and lactulose use.” Not sure if PPI, lactulose and rifaximin are markers of HE, or whether these are independent factors we should rationalise during ward rounds (Twitter) - Mar 14, 2020
- |||||||||| lactulose / Generic mfg., Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA
Clinical: Nice study. Nosocomial infections have been associated with ⬆️mortality. this multicenter study from the US showed Age, alcohol, MELD,lactulose, AKI, ICU, and NI increased the risk of death, whereas rifaximin decreased the risk of death. https://t.co/WGwYqUHG7y @JasmohanBajaj (Twitter) - Mar 14, 2020
- |||||||||| lactulose / Generic mfg.
Preclinical, Journal: Effects of sialylated lactulose on the mouse intestinal microbiome using Illumina high-throughput sequencing. (Pubmed Central) - Mar 10, 2020
The results of the intestinal microbiota sample composition indicated that there were differences between the sialylated lactulose groups and the normal control group. Thus, sialylated lactulose could be used as a functional food component with potential therapeutic applications in manipulating intestinal microbiota to exert beneficial effects on the host's health.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA
NON-CIRRHOTIC HYPERAMMONEMIA SECONDARY TO EXTRAHEPATIC PORTOSYSTEMIC VENOUS SHUNT PRESENTING AS A CONGNITIVE DYSFUNCTION: A CASE REPORT AND LITERATURE REVIEW () - Mar 8, 2020 - Abstract #CDDW2020CDDW_262;
Also, we discuss the differential diagnoses of non-cirrhotic hyperammonemia and the pathophysiology, classification and diagnosis of spontaneous portosystemic shunts.Methods A retrospective chart review Results A 57-year-old woman with longstanding essential tremors on topiramate presented with a 30-month history of recurrent disabling episodes of unexplained “zoning out”...She is currently stable on lactulose and rifaximin with a drop in her ammonia level to 63uml/l, and an interventional radiological procedure is being considered...Any unexplained change in level of consciousness, cognition and/or behavior merits measurement of serum ammonia irrespective of clinical liver status. Funding Agencies None
- |||||||||| lactulose / Generic mfg.
Preclinical, Journal: Optimized germinated soybean/cornstarch extrudate and its in vitro fermentation with human inoculum. (Pubmed Central) - Mar 4, 2020
The optimised extrudate showed a 36% indigestible fraction and high fermentability with respect to that of the lactulose control...Acetic, propionic, and butyric acids were produced at a molar ratio of 62:27:11, while the highest SCFA concentrations were found 48 h after incubation. The RS of the optimised extruder was a viable substrate for in vitro colonic fermentation, suggesting that it is a good food source to produce SCFAs, which could exert an effect on the regulation of lipid and glucose metabolism.
- |||||||||| lactulose / Generic mfg.
Journal: Whey and Its Derivatives for Probiotics, Prebiotics, Synbiotics, and Functional Foods: a Critical Review. (Pubmed Central) - Mar 3, 2020
Particular interest is given to probiotic growth in the presence of whey derivatives such as lactulose, a lactose derivative, which is a highly sought-after prebiotic in functional feeding...The role of bioactive peptides from whey is also discussed in this study. Finally, the importance of an integrated valuation of whey is discussed with an emphasis on functional nutrition and the role of probiotics in the development of novel foods such as synbiotics.
- |||||||||| lactulose / Generic mfg.
Journal: Association of endotoxaemia & gut permeability with complications of acute pancreatitis: Secondary analysis of data. (Pubmed Central) - Feb 28, 2020
Gut permeability, assessed by lactulose/mannitol excretion in urine and endotoxin core antibodies type IgG and IgM (EndoCab IgG and IgM) were measured on days zero and seven (D0 and D7) of admission...There was no significant difference in serum IgG and IgM anti-endotoxin levels and LMR at baseline and at D7 among patients with organ failure, infection and mortality. Our findings showed that serum IgG and IgM anti-endotoxin titres and LMR at admission and at day 7 were not associated with organ failure, infection, and death of patients with AP.
- |||||||||| lactulose / Generic mfg.
Preclinical, Journal: The ameliorative effect of the Pyracantha fortuneana (Maxim.) H. L. Li extract on intestinal barrier dysfunction through modulating glycolipid digestion and gut microbiota in high fat diet-fed rats. (Pubmed Central) - Feb 28, 2020
Results showed that PFE intervention ameliorated HFD-induced intestinal barrier dysfunction by attenuating impaired structural integrity, reducing the elevated lactulose/mannitol ratio, and improving the mRNA and protein expression levels of tight junction proteins in HFD-fed rats...Several bacterial groups, which were linked with gut barrier integrity, were modulated after PFE administration, that is, Actinobacteria, Bacteroidaceae, Corynebacteriaceae, Lactobacillaceae, and S24-7 were elevated and the HFD-induced increase in Clostridia, Ruminococcaceae, Oscillospira, and Flexispira was restored. These data provide evidence for the ameliorative effect of the PFE on diet-induced intestinal barrier functional alternations in association with its capacity to modulate glycolipid digestion and gut microbiota in HFD-fed obese rats.
- |||||||||| lactulose / Generic mfg., SPX-106T / Spherix
Journal: One-pot synthesis of sweetening syrup from lactose. (Pubmed Central) - Feb 21, 2020
The one-pot synthesis, enzymatic hydrolysis and catalytic isomerization over 20%-MgO/SiO, converted 99.3% of lactose into a sweetening syrup made of glucose (30.48%), galactose (33.51%), fructose (16.92%), D-tagatose (10.54%), and lactulose (3.62%). The outcomes of this research present an opportunity for expanding the utilization of lactose.
- |||||||||| lactulose / Generic mfg.
Journal: Effects of early-life lactoferrin intervention on growth performance, small intestinal function and gut microbiota in suckling piglets. (Pubmed Central) - Feb 20, 2020
Urinary lactulose-mannitol ratios decreased in the LF group, whereas the gene and protein expressions of jejunal occludin increased in the LF group on day 8 and day 21, and higher gene and protein levels of ileal occludin were observed on day 8 (P < 0.05)...In the ileum, the abundance of Actinobacillus was decreased in the LF piglets on day 8 and day 21 (P < 0.05). The early-life LF intervention enhanced the growth performance and decreased diarrhoea incidence in the suckling piglets by promoting the development of intestinal function and changing the microbiota in the small intestine.
- |||||||||| lactulose / Generic mfg., Contepo (ZTI-01) / Nabriva
Clinical, Journal, Combination therapy: Efficacy of combined antibacterial-prebiotic therapy in combination with D-mannose in women with uncomplicated lower urinary tract infection (Pubmed Central) - Feb 13, 2020
The outcome of this study suggests that EA is a promising technique for the enhanced production of lactulose from lactose. The results of the study demonstrated the high efficacy and safety of complex therapy with Ecofomural containing fosfomycin and lactulose, in combination with long-term enrichment of the diet with D-mannose (Ecocystin) b in order to prolong the inter-relapse period of uncomplicated lower urinary tract infection.
- |||||||||| lactulose / Generic mfg.
Clinical, Journal: Diabetes does not increase infection risk or mortality following an infection in patients with cirrhosis and ascites. (Pubmed Central) - Feb 13, 2020
We used Cox regression to estimate the hazard ratio (HR) of any infection, adjusting for confounding by patient age, gender, MELD score, albumin, use of proton pump inhibitors and lactulose, cirrhosis aetiology, and severity of ascites...We showed that the risk of infections was the same in patients with cirrhosis, ascites and diabetes as in patients with cirrhosis and ascites alone. Thus, their combined effects do not exceed the effect of cirrhosis alone.
- |||||||||| lactulose / Generic mfg.
Resolution of covalently derivatized carbohydrate isomers with cyclic ion mobility-tandem mass spectrometry (Exhibit Hall A, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_8120;
A series of four monosaccharide standards (fructose, galactose, glucose, and mannose) and eight disaccharide standards (cellobiose, isomaltose, lactose, lactulose, maltose, melibiose, sucrose, and trehalose) were included in this study...cIM-MS/MS also provided increased structural information for the covalent derivatives in this study compared to IM-MS/MS. Tandem IM techniques analogous to MS/MS were used to further characterize these isomers.
- |||||||||| lactulose / Generic mfg.
Resolution of covalently derivatized carbohydrate isomers with cyclic ion mobility-tandem mass spectrometry (Exhibit Hall A, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_3842;
A series of four monosaccharide standards (fructose, galactose, glucose, and mannose) and eight disaccharide standards (cellobiose, isomaltose, lactose, lactulose, maltose, melibiose, sucrose, and trehalose) were included in this study...cIM-MS/MS also provided increased structural information for the covalent derivatives in this study compared to IM-MS/MS. Tandem IM techniques analogous to MS/MS were used to further characterize these isomers.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA
Rehabilitation following Valproic Acid-Induced Hyperammonemic Encephalopathy (VHE) in a patient with Intractable Epilepsy () - Feb 11, 2020 - Abstract #ISPRM2020ISPRM_1470;
Over his 14 day stay, comprehensive physical, occupational, and speech therapies lead to meaningful improvement in FIM scores (51 to 87). Conclusions : This case demonstrates the unique challenges of a patient with intractable epilepsy with a complex and carefully balanced medication regimen complicated by continued neurologic insult during his rehabilitation course.
- |||||||||| lactulose / Generic mfg.
Clinical, Journal: The Efficacy of Lactulose for the Treatment of Hyperammonemic Encephalopathy Due to Severe Heart Failure. (Pubmed Central) - Feb 6, 2020
Organ hypoperfusion or congestion by heart failure may lead to various organ dysfunctions, and liver and intestinal circulatory impairment might cause ammonia metabolic failure. Here, we report on the case of a patient with hyperammonemic encephalopathy that was secondary to heart failure, which was effectively treated by lactulose.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
Enrollment open, Trial initiation date: PEARL: Prevention of Post-TIPS Hepatic Encephalopathy by Administration of Rifaximin and Lactulose (clinicaltrials.gov) - Jan 30, 2020
P4, N=238, Recruiting,
Here, we report on the case of a patient with hyperammonemic encephalopathy that was secondary to heart failure, which was effectively treated by lactulose. Not yet recruiting --> Recruiting | Initiation date: Oct 2019 --> Jan 2020
- |||||||||| lactulose / Generic mfg.
PHYSIOLOGIC IN VIVO HOMEOSTASIS OF INTESTINAL PERMEABILITY IN TNF-α+/+ MICE. () - Jan 28, 2020 - Abstract #DDW2020DDW_2914;
Interestingly, the data may reflect resetting of physiologic intestinal homeostasis, as demonstrated from L/M ratio and S/L ratio. This suggests that upregulated TNF-α may play a role in increased intestinal permeability in PI-IBS-D patients and future therapies aimed at blocking TNF-α might provide new and promising therapies for PI-IBS-D patients
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