0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Antibiotic Therapy in the Management of Hepatic Coma

BERNHARD B. FAST, M.D.; STANLEY J. WOLFE, M.D.; JAMES M. STORMONT, M.D.; CHARLES S. DAVIDSON, M.D.
AMA Arch Intern Med. 1958;101(2):467-475. doi:10.1001/archinte.1958.00260140299041.
Text Size: A A A
Published online

Hepatic coma is a metabolic disturbance occurring in some patients with liver disease which manifests itself as a "disorder of consciousness." The clinical features of the syndrome have been defined by Adams and Foley,1 providing criteria for diagnosis and a background for the investigation of its pathogenesis. The relationship between this disorder and toxic nitrogenous substances is generally recognized.2 These toxic substances, including ammonia, are believed to be a product of bacterial enzymatic action within the intestine.3 Antibacterial agents effective against intestinal organisms have been reported to improve prognosis in hepatic coma. 4,5,7 Assessment of results is complicated by the simultaneous utilization of a number of therapeutic measures and by the varied prognosis of the syndrome. Studies such as that reported by Fisher and Faloon 6 of patients with episodic stupor, whether spontaneous or following portacaval anastomosis, allow more controlled observations related to isolated therapeutic efforts. We with

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();