Intoxications and poisonings

Flumazenil versus placebo or no intervention for people with cirrhosis and hepatic encephalopathy

Abstract Background Hepatic encephalopathy is a common complication of cirrhosis which results in poor brain functioning. The spectrum of changes associated with hepatic encephalopathy ranges from the clinically ‘indiscernible’ or minimal hepatic encephalopathy to the clinically ‘obvious’ or overt hepatic encephalopathy. Flumazenil is a synthetic benzodiazepine antagonist with high affinity for the central benzodiazepine recognition […]

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Branched-chain amino acids for hepatic encephalopathy

Abstract Background Hepatic encephalopathy is a brain dysfunction with neurological and psychiatric changes associated with liver insufficiency or portal-systemic shunting. The severity ranges from minor symptoms to coma. A Cochrane systematic review including 11 randomised clinical trials on branched-chain amino acids (BCAA) versus control interventions has evaluated if BCAA may benefit people with hepatic encephalopathy. […]

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Probiotics for patients with hepatic encephalopathy

Abstract Background Hepatic encephalopathy is a disorder of brain function as a result of liver failure or portosystemic shunt or both. Both hepatic encephalopathy (clinically overt) and minimal hepatic encephalopathy (not clinically overt) significantly impair patient’s quality of life and daily functioning, and represent a significant burden on healthcare resources. Probiotics are live micro-organisms, which […]

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Dopamine agents for hepatic encephalopathy

Abstract Background Patients with hepatic encephalopathy may present with extrapyramidal symptoms and changes in basal ganglia. These changes are similar to those seen in patients with Parkinson’s disease. Dopamine agents (such as bromocriptine and levodopa, used for patients with Parkinson’s disease) have therefore been assessed as a potential treatment for patients with hepatic encephalopathy. Objectives […]

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Hyperbaric oxygen for carbon monoxide poisoning

Abstract Background Poisoning with carbon monoxide (CO) remains an important cause of accidental and intentional injury worldwide. Several unblinded non-randomized trials have suggested that the use of hyperbaric oxygen (HBO) prevents the development of neurological sequelae. This has led to the widespread use of HBO in the management of patients with carbon monoxide poisoning. Objectives […]

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Oximes for acute organophosphate pesticide poisoning

Abstract Background Acute organophosphorus pesticide poisoning causes tens of thousands of deaths each year across the developing world. Standard treatment involves administration of intravenous atropine and oxime to reactivate inhibited acetylcholinesterase. The clinical usefulness of oximes, such as pralidoxime and obidoxime, has been challenged over the past 20 years by physicians in many parts of […]

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Nonabsorbable disaccharides for hepatic encephalopathy

Abstract Background Nonabsorbable disaccharides (lactulose or lactitol) are considered the treatment of choice for hepatic encephalopathy. Objectives To assess the beneficial and harmful effects of nonabsorbable disaccharides for patients with hepatic encephalopathy. Search methods Trials were identified through The Cochrane Hepato-Biliary Group Controlled Trials Register (March 2003), The Cochrane Central Register of Controlled Trials (Issue […]

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