0000000000281643

AUTHOR

Raquel García-garcía

showing 5 related works from this author

The PHES battery does not detect all cirrhotic patients with early neurological deficits, which are different in different patients.

2017

Background and aims The psychometric hepatic encephalopathy score (PHES) is the “gold standard” for minimal hepatic encephalopathy (MHE) diagnosis. Some reports suggest that some cirrhotic patients “without” MHE according to PHES show neurological deficits and other reports that neurological alterations are not homogeneous in all cirrhotic patients. This work aimed to assess whether: 1) a relevant proportion of cirrhotic patients show neurological deficits not detected by PHES; 2) cirrhotic patients with mild neurological deficits are a homogeneous population or may be classified in sub-groups according to specific deficits. Methods Cirrhotic patients “without” (n = 56) or “with” MHE (n = 4…

Liver CirrhosisMalePathologyPediatricsCirrhosisPsychometricsSocial Scienceslcsh:MedicineNeuropsychological Tests0302 clinical medicineMedicine and Health SciencesPsychologyCluster AnalysisAttentionlcsh:ScienceHepatic encephalopathyCognitive Impairmenteducation.field_of_studyMultidisciplinaryCognitive NeurologyLiver DiseasesMiddle AgedNeurologyCirrhosisOncologyFemale030211 gastroenterology & hepatologyResearch Articlemedicine.medical_specialtyPsychometricsCognitive NeurosciencePopulationGastroenterology and HepatologyCarcinomas03 medical and health sciencesNeuropsychologyGastrointestinal TumorsmedicineHumanseducationNeuropsychological TestingAgedWorking memorybusiness.industryGold standardlcsh:RCognitive PsychologyCase-control studyBiology and Life SciencesCancers and NeoplasmsReproducibility of ResultsHepatocellular Carcinomamedicine.diseasePatient Outcome AssessmentCase-Control StudiesHepatic EncephalopathyStroop TestCognitive Sciencelcsh:QbusinessPsychomotor Performance030217 neurology & neurosurgeryNeuroscienceFollow-Up StudiesStroop effectPLoS ONE
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Minimal hepatic encephalopathy is associated with expansion and activation of CD4+CD28−, Th22 and Tfh and B lymphocytes

2017

AbstractPeripheral inflammation acts synergistically with hyperammonemia in inducing neurological alterations in cirrhotic patients with minimal hepatic encephalopathy (MHE). We hypothesized that appearance of MHE would be associated to some specific qualitative change in peripheral inflammation. The aim of this work was to characterize the changes in peripheral inflammation associated to appearance of MHE. We analyzed it by immunophenotyping and cytokine profile analysis, in cirrhotic patients without or with MHE and controls. The main alterations associated specifically with MHE are: 1) increased activation of all subtypes of CD4+ T-lymphocytes, with the increased expression of CD69; 2) i…

0301 basic medicinemedicine.medical_specialtyScienceInflammationArticleMonocytesImmunophenotyping03 medical and health sciencesImmune systemImmunophenotypingCD28 AntigensInternal medicinemedicineHumansCX3CL1Hepatic encephalopathyB-LymphocytesMultidisciplinarybusiness.industryCD69QRCD28HyperammonemiaT-Lymphocytes Helper-Inducermedicine.disease030104 developmental biologyEndocrinologyHepatic EncephalopathyImmunoglobulin GCD4 AntigensImmunologyMedicineCytokinesmedicine.symptombusinesshuman activitiesScientific Reports
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Cirrhotic patients with minimal hepatic encephalopathy have increased capacity to eliminate superoxide and peroxynitrite in lymphocytes, associated w…

2018

Patients with minimal hepatic encephalopathy (MHE) show increased oxidative stress in blood. We aimed to assess whether MHE patients show alterations in different types of blood cells in (a) basal reactive oxygen and nitrogen species levels; (b) capacity to metabolise these species. To assess the mechanisms involved in the altered capacity to metabolise these species we also analysed: (c) peroxynitrite formation and d) peroxynitrite reaction with biological molecules. Levels of reactive oxygen and nitrogen species were measured by flow cytometry in blood cell populations from cirrhotic patients with and without MHE and controls, under basal conditions and after adding generators of superoxi…

Liver CirrhosisMale0301 basic medicinemedicine.medical_specialtyFree radicalsmedicine.disease_causeBiochemistryNitric oxideBlood cell03 medical and health scienceschemistry.chemical_compound0302 clinical medicineSuperoxidesnitric oxidePeroxynitrous AcidInternal medicinemedicineHumansCognitive DysfunctionLymphocytesHepatic encephalopathycognitive impairmentnitrotyrosineSuperoxideNitrotyrosinePsychometric Hepatic Encephalopathy ScoreGeneral MedicinePlumbaginmedicine.disease030104 developmental biologymedicine.anatomical_structureEndocrinologychemistryHepatic EncephalopathyFemalehuman activities030217 neurology & neurosurgeryOxidative stressPeroxynitrite
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Hyperammonemia alters the mismatch negativity in the auditory evoked potential by altering functional connectivity and neurotransmission

2020

Minimal hepatic encephalopathy (MHE) is a neuropsychiatric syndrome produced by central nervous system dysfunction subsequent to liver disease. Hyperammonemia and inflammation act synergistically to alter neurotransmission, leading to the cognitive and motor alterations in MHE, which are reproduced in rat models of chronic hyperammonemia. Patients with MHE show altered functional connectivity in different neural networks and a reduced response in the cognitive potential mismatch negativity (MMN), which correlates with attention deficits. The mechanisms by which MMN is altered in MHE remain unknown. The objectives of this work are as follows: To assess if rats with chronic hyperammonemia rep…

0301 basic medicineMalehippocampusPopulationMismatch negativityNeurotransmissionStimulus (physiology)Auditory cortexBiochemistrySynaptic Transmissionbehavioral disciplines and activitiesmetabolic diseases03 medical and health sciencesCellular and Molecular Neuroscience0302 clinical medicineNeural PathwaysmedicineAnimalsHyperammonemiaEvoked potentialRats Wistareducationeducation.field_of_studybusiness.industryGlutamate receptorBrainHyperammonemiamedicine.diseaseencephalopathyRats030104 developmental biologyHepatic EncephalopathyEvoked Potentials AuditorybusinessNeuroscience030217 neurology & neurosurgerypsychological phenomena and processes
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Interplay between glutamatergic and GABAergic neurotransmission alterations in cognitive and motor impairment in minimal hepatic encephalopathy.

2015

The cognitive and motor alterations in hepatic encephalopathy (HE) are the final result of altered neurotransmission and communication between neurons in neuronal networks and circuits. Different neurotransmitter systems cooperate to modulate cognitive and motor function, with a main role for glutamatergic and GABAergic neurotransmission in different brain areas and neuronal circuits. There is an interplay between glutamatergic and GABAergic neurotransmission alterations in cognitive and motor impairment in HE. This interplay may occur: (a) in different brain areas involved in specific neuronal circuits; (b) in the same brain area through cross-modulation of glutamatergic and GABAergic neur…

CerebellumMinimal hepatic encephalopathyGlutamic AcidNeurotransmissionSynaptic TransmissionCellular and Molecular NeuroscienceGlutamatergicmedicineHyperammonemiaAnimalsHumansGlutamatergic neurotransmissionGABAergic neurotransmissionHepatic encephalopathygamma-Aminobutyric AcidHepatic encephalopathyGABAA receptorbusiness.industryGlutamate receptorHyperammonemiaCognitionCell Biologymedicine.diseaseMotor Skills Disordersmedicine.anatomical_structureHepatic EncephalopathyCognitive functionCognition DisordersbusinessNeuroscience
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