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document
Long-term oral branched-chain amino acid treatment in chronic hepatic encephalopathy . A randomized double-blind casein-controlled trial . The Italian Multicenter Study Group . In a double blind randomized study , branched-chain amino acids and placebo ( casein ) were compared as a treatment for chronic hepatic encephalopathy in cirrhosis . After a 15-day run-in period with controlled diet ( 45-65 g protein ) , the patients were administered , in addition to their diet , branched-chain amino acids ( 0.24 g/kg , 30 patients ) or an equinitrogenous amount of casein ( 34 patients ) . One patient on branched-chain amino acids and two on casein were lost to the study . After 3 months , the index of portal-systemic encephalopathy significantly improved in patients on active treatment ( from 40 [ S.D . 14 ] % to 21 [ 17 ] ) , but was not in subjects receiving casein ( from 37 [ 13 ] % to 36 [ 12 ] ) . Two or more parameters of the index improved in 24 patients treated with amino acids ( 80 % ; confidence limits , 61-92 % ) , and only in 12 receiving casein ( 35 % ; confidence limits , 20-54 % ; p less than 0.001 ) . Patients who did not improve were given an alternative treatment for 3 more months . Casein-treated patients given branched-chain amino acids rapidly improved . The changes in neuropsychologic function were associated with an improvement in semiquantitative nitrogen balance , which became consistently positive in amino acid-treated subjects ; there was also a mild improvement in nutritional parameters and in liver function tests . The supplementation of oral branched-chain amino acids to the diet is superior to casein as a treatment for providing adequate nitrogen supply and improving the mental state of cirrhotic patients with chronic encephalopathy .
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Intervention_Pharmacological
oral branched-chain amino acid
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Intervention_Pharmacological
branched-chain amino acids
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Intervention_Control
placebo ( casein )
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Intervention_Pharmacological
branched-chain amino acids
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Intervention_Control
equinitrogenous amount of casein
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Intervention_Pharmacological
active treatment
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Intervention_Pharmacological
casein
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Intervention_Pharmacological
amino acids
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Intervention_Pharmacological
casein
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Intervention_Pharmacological
alternative treatment
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Intervention_Pharmacological
amino acids
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Intervention_Pharmacological
amino acid-treated
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Intervention_Pharmacological
oral branched-chain amino acids
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Intervention_Pharmacological
casein
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Outcome_Physical
improved .
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Participant_Condition
chronic hepatic encephalopathy
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Participant_Condition
chronic hepatic encephalopathy
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Participant_Condition
cirrhosis
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Participant_Sample-size
cirrhotic patients
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Participant_Condition
chronic encephalopathy