Hepatic encephalopathy Hepatic encephalopathy Hepatic encephalopathy (HE) is an altered level of consciousness as a result of liver failure. Onset may be gradual or sudden. Other symptoms may include movement problems, changes in mood, or changes in personality. In the advanced stages it can result in a coma. Hepatic encephalopathy can occur in those with acute or chronic liver disease. Episodes can be triggered by infections, GI bleeding, constipation, electrolyte problems, or certain medications. The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver. The diagnosis is typically made
Scotch (adjective) 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", extended in English to