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Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis

BACKGROUND AND AIM: Hepatic encephalopathy (HE) is a frequent complication of liver diseases. Systemic inflammation is key for HE pathogenesis. The main goal of the study was to investigate the role of psychometric tests, critical flicker frequency (CFF), and comparative evaluation of inflammatory i...

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Autores principales: Demirciler, Erkut, Danis, Nilay, Ergun, Pelin, Kose, Timur, Turan, Ilker, Gunsar, Fulya, Akarca, Ulus Salih, Ersoz, Galip, Karasu, Zeki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9951890/
https://www.ncbi.nlm.nih.gov/pubmed/36843898
http://dx.doi.org/10.14744/hf.2022.2022.0010
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author Demirciler, Erkut
Danis, Nilay
Ergun, Pelin
Kose, Timur
Turan, Ilker
Gunsar, Fulya
Akarca, Ulus Salih
Ersoz, Galip
Karasu, Zeki
author_facet Demirciler, Erkut
Danis, Nilay
Ergun, Pelin
Kose, Timur
Turan, Ilker
Gunsar, Fulya
Akarca, Ulus Salih
Ersoz, Galip
Karasu, Zeki
author_sort Demirciler, Erkut
collection PubMed
description BACKGROUND AND AIM: Hepatic encephalopathy (HE) is a frequent complication of liver diseases. Systemic inflammation is key for HE pathogenesis. The main goal of the study was to investigate the role of psychometric tests, critical flicker frequency (CFF), and comparative evaluation of inflammatory indicators for the diagnosis of covert HE (CHE). MATERIALS AND METHODS: The study was a prospective, nonrandomized, case–control study with a total of 76 cirrhotic patients and 30 healthy volunteers. The West Haven criteria were used to determine the occurrence of CHE in cirrhotic patients. Psychometric tests were applied to healthy and cirrhotic groups. CFF, venous ammonia, serum endotoxin, IL-6, IL-18, tumor necrosis factor alpha (TNF-α) levels, and hemogram parameters were evaluated for cirrhotic patients. RESULTS: CFF values and psychometric tests were found to accurately discriminate CHE positives from CHE negatives (p<0.05). When the control group was excluded, the digit symbol test and the number connection A test failed, unlike CFF and other psychometric tests. Using CFF, a 45 Hz cutoff value had 74% specificity and 75% sensitivity. Basal albumin levels (p=0.063), lymphocyte-to-monocyte ratio (LMR) (p=0.086), and neutrophil-to-lymphocyte ratio (p 0.052) were significant, albeit slightly, among CHE groups. Basal albumin levels had 50% sensitivity and 71% specificity when 2.8 g/dL was used as a cutoff value to determine CHE. CONCLUSION: Both psychometric tests and CFF can be useful in diagnosing CHE. Using cytokine and endotoxin levels seems to be inadequate to diagnose CHE. Using LMR and albumin levels instead of psychometric tests for diagnosing CHE can be promising.
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spelling pubmed-99518902023-02-25 Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis Demirciler, Erkut Danis, Nilay Ergun, Pelin Kose, Timur Turan, Ilker Gunsar, Fulya Akarca, Ulus Salih Ersoz, Galip Karasu, Zeki Hepatol Forum Research Article BACKGROUND AND AIM: Hepatic encephalopathy (HE) is a frequent complication of liver diseases. Systemic inflammation is key for HE pathogenesis. The main goal of the study was to investigate the role of psychometric tests, critical flicker frequency (CFF), and comparative evaluation of inflammatory indicators for the diagnosis of covert HE (CHE). MATERIALS AND METHODS: The study was a prospective, nonrandomized, case–control study with a total of 76 cirrhotic patients and 30 healthy volunteers. The West Haven criteria were used to determine the occurrence of CHE in cirrhotic patients. Psychometric tests were applied to healthy and cirrhotic groups. CFF, venous ammonia, serum endotoxin, IL-6, IL-18, tumor necrosis factor alpha (TNF-α) levels, and hemogram parameters were evaluated for cirrhotic patients. RESULTS: CFF values and psychometric tests were found to accurately discriminate CHE positives from CHE negatives (p<0.05). When the control group was excluded, the digit symbol test and the number connection A test failed, unlike CFF and other psychometric tests. Using CFF, a 45 Hz cutoff value had 74% specificity and 75% sensitivity. Basal albumin levels (p=0.063), lymphocyte-to-monocyte ratio (LMR) (p=0.086), and neutrophil-to-lymphocyte ratio (p 0.052) were significant, albeit slightly, among CHE groups. Basal albumin levels had 50% sensitivity and 71% specificity when 2.8 g/dL was used as a cutoff value to determine CHE. CONCLUSION: Both psychometric tests and CFF can be useful in diagnosing CHE. Using cytokine and endotoxin levels seems to be inadequate to diagnose CHE. Using LMR and albumin levels instead of psychometric tests for diagnosing CHE can be promising. Kare Publishing 2023-01-17 /pmc/articles/PMC9951890/ /pubmed/36843898 http://dx.doi.org/10.14744/hf.2022.2022.0010 Text en © Copyright 2023 by Hepatology Forum https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Research Article
Demirciler, Erkut
Danis, Nilay
Ergun, Pelin
Kose, Timur
Turan, Ilker
Gunsar, Fulya
Akarca, Ulus Salih
Ersoz, Galip
Karasu, Zeki
Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis
title Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis
title_full Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis
title_fullStr Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis
title_full_unstemmed Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis
title_short Psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis
title_sort psychometric tests, critical flicker frequency, and inflammatory indicators in covert hepatic encephalopathy diagnosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9951890/
https://www.ncbi.nlm.nih.gov/pubmed/36843898
http://dx.doi.org/10.14744/hf.2022.2022.0010
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