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Comparison between neomycin and lactulose in 173 patients with hepatic encephalopathy

A randomized clinical study

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Abstract

A randomized study was performed in order to compare the course of hepatic encephalopathy in patients treated with neomycin plus magnesium sulfate or with lactulose. Admission criteria were: morphological diagnosis of cirrhosis and absence of comorbidity, of contraindications to drugs, or of previous treatments which could influence the outcome. The treatment groups were similar in terms of clinical characteristics, fatalities, recovery rate from grade 1 encephalopathy, and disappearance rate of neuropsychiatric signs. Transitions from severe to grade 1 or 0 encephalopathy showed a 0.17 (NS) difference in favor of neomycin. Early therapy and evidence of precipitating factors showed a favorable prognostic significance. Ascites, hyperbilirubinemia, poor nutritional state, and hypoprothrombinemia showed bad prognostic significance. This is the first large-scale investigation on hepatic encephalopathy. It demonstrated a similar effectiveness of the two drugs in grade 1 encephalopathy and provides a basis for drug selection in the current management of the syndrome.

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Authors and Affiliations

  1. Department of Gastroenterology of Ancona, Firenze

    Francesco Orlandi MD, Umberto Freddara MD, Maria Teresa Candelaresi MD, Antonio Morettini MD, Gino R. Corazza MD, Aurelio Di Simone MD, Giorgio Dobrilla MD & Giorgio Cavallini MD

  2. Department of Gastroenterology of Ancona, Balzano

    Francesco Orlandi MD, Umberto Freddara MD, Maria Teresa Candelaresi MD, Antonio Morettini MD, Gino R. Corazza MD, Aurelio Di Simone MD, Giorgio Dobrilla MD & Giorgio Cavallini MD

  3. Department of Gastroenterology of Ancona, Istituto di Patologia Medica of Chieti, Chieti, Italy

    Francesco Orlandi MD, Umberto Freddara MD, Maria Teresa Candelaresi MD, Antonio Morettini MD, Gino R. Corazza MD, Aurelio Di Simone MD, Giorgio Dobrilla MD & Giorgio Cavallini MD

  4. Istituto di Clinica Medica, 1st School of Medicine, Napoli

    Francesco Orlandi MD, Umberto Freddara MD, Maria Teresa Candelaresi MD, Antonio Morettini MD, Gino R. Corazza MD, Aurelio Di Simone MD, Giorgio Dobrilla MD & Giorgio Cavallini MD

  5. Istituto di Clinica Medica of Verona, Verona, Italy

    Francesco Orlandi MD, Umberto Freddara MD, Maria Teresa Candelaresi MD, Antonio Morettini MD, Gino R. Corazza MD, Aurelio Di Simone MD, Giorgio Dobrilla MD & Giorgio Cavallini MD

Authors
  1. Francesco Orlandi MD
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  2. Umberto Freddara MD
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  3. Maria Teresa Candelaresi MD
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  4. Antonio Morettini MD
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  5. Gino R. Corazza MD
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  6. Aurelio Di Simone MD
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  7. Giorgio Dobrilla MD
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  8. Giorgio Cavallini MD
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Additional information

A number of coinvestigators in this study are listed alphabetically: L. Bartoletti, M. Bernardi, L. Capurso, A. De Cecco, G. Chibbaro, R. Galeazzi, S. Gentile, M. M. Koch, I. Lorenzini, M. Rainisio. G. Riegler.

This study was supported in part by a research grant, 286. 1975, Digestive Disease, University of Ancona, from Ministero Pubblica Istruzione, Roma.

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Orlandi, F., Freddara, U., Candelaresi, M.T. et al. Comparison between neomycin and lactulose in 173 patients with hepatic encephalopathy. Digest Dis Sci 26, 498–506 (1981). https://doi.org/10.1007/BF01308097

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  • DOI: https://doi.org/10.1007/BF01308097

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