Hepatic encephalopathy treatment may benefit people with hepatic encephalopathy. LOLA lowers ammonia levels by increasing the generation of urea through the urea cycle, a metabolic pathway that removes ammonia by turning it into the neutral substance urea. LOLA may be combined with lactulose and/or rifaximin if these alone are ineffective at controlling symptoms. In those with cirrhosis, the risk of developing hepatic encephalopathy is 20% per year, and at any time about 30–45% of people with cirrhosis exhibit evidence of overt encephalopathy. The prevalence of minimal hepatic encephalopathy detectable on formal neuropsychological testing is 60–80%; this increases the likelihood of developing overt
Scotch (adjective) ma Scotch blue bell." Scotch (adjective) Scotch is an adjective meaning "of Scotland". The modern usage in Scotland is Scottish or Scots, and the word "Scotch" is only applied to specific products, mostly food or drink, such as Scotch whisky, Scotch pie, Scotch broth, and Scotch eggs. "Scotch" applied to people is widely considered pejorative in Scotland, reflecting old Anglo-Scottish antagonisms, but it is still occasionally used in England and Ireland, though the usage is considered old-fashioned. The verb "to scotch" is unrelated to the adjective. It derives from Anglo-French "escocher" meaning "to notch, nick", from "coche", "a notch, groove",