Hepatic encephalopathy An imbalance between aromatic amino acids (phenylalanine, tryptophan and tyrosine) and branched-chain amino acids (leucine, isoleucine and valine) has been described; this would lead to the generation of false neurotransmitters (such octopamine and 2-hydroxyphenethylamine). Dysregulation of the serotonin system, too, has been reported. Depletion of zinc and accumulation of manganese may play a role. Inflammation elsewhere in the body may precipitate encephalopathy through the action of cytokines and bacterial lipopolysaccharide on astrocytes. The diagnosis of hepatic encephalopathy can only be made in the presence of confirmed liver disease (types A and C) or a portosystemic shunt (type B), as its
Convention Relating to the Status of Refugees Cultural Rights, but no one has ever done so in regard to violations of the Convention. Nations may levy international sanctions against violators, but no nation has ever done this. At present, the only real consequences of violation are 1) public shaming in the press, and 2) verbal condemnation of the violator by the UN and by other nations. To date these have not proven to be significant deterrents. Convention Relating to the Status of Refugees The Convention Relating to the Status of Refugees, also known as the 1951 Refugee Convention, is a United Nations multilateral treaty that defines who