Chronic disease of the liver, characterized by fibrosis
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One out of four Americans has Fatty Liver Disease and Doesn't Even Know It. Are you one? with Phil George Series #3: NAFLD ( non alcoholic fatty liver disease) at least one out of 4 Americans have it and don't know they do until they have serious liver damage that can result in Cirrhosis or liver cancer + I can relate this to metabolic syndrome and excess carbs and as always I can explain “Mechanism or Action” or how you get this “silent Killer” Bio: Phil has spent most of his adult life educating and helping clients live a healthier, more fulfilling life. He is a clinical biochemist/certified personal trainer/health coach. As a biochemist, he was trained to understand “the mechanism of action” or what is causing the problem as opposed to just throwing medications at the illness. Many clients/listeners say that Phil makes complicated subjects much easier to understand. He was hired by a veteran's group and gave seminars throughout New England. Phil continues to give seminars to senior centers and other groups in New England. For the past two years Phil has been the host of a popular radio and TV show in Central Massachusetts, WellnessWave Radio,LLC. on WCRN in Boston, MA. Affiliations: Society of Metabolic Health Practitioners Nutrition Coalition Root Cause Practitioners Please feel free to email him at philgeorge@charter.net with any health/nutrition/exercise questions. https://www.wellnesswave.net/ Be sure to tune into his Radio Show “Wellness Wave Radio LLC” on Dreamvisions 7 Radio Network every Wednesday 11am/11pmET Learn more: https://dreamvisions7radio.com/wellness-wave-radio-llc/ Call In and Chat with Deborah during Live Show: 833-220-1200 or 319-527-2638 Learn more about Deborah here: www.lovebyintuition.com
Jacob has an amazing page on Instagram called feel_sober_good and that's exactly what he shares. In 2023 Jacob almost lost his life due to his alcohol intake. He was diagnosed with Cirrhosis of the liver. Here how he was able to battle through and how he is doing life now and showing others how to live their lives sober!!Support the show
This episode of Vitality Radio is part six in our ongoing listener Q&A series! Jared tackles two powerful topics you've been asking about: how to naturally support healthy liver function when dealing with non-alcoholic fatty liver, and how to spot misleading supplement marketing online. Learn the most common root causes of fatty liver, the subtle signs it may be affecting you, and key lifestyle, dietary, and supplement strategies that can help the liver perform its vital detoxification role. Then, Jared exposes a widespread online scam used to push questionable supplements and shows you how to protect yourself from hype-based marketing.Products:Assimil-8 Digestive EnzymesBack on TractLiverVitalityEndoCleanseAdditional Information:SCAM: https://yoursupplementreview.com/ (changes products, but always promoting Citruna)Visit the podcast website here: VitalityRadio.comYou can follow @vitalitynutritionbountiful and @vitalityradio on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.
In this episode Dr Emma Spencer discusses decompensated cirrhosis with Dr Michael Williams. This discussion includes the definition of a decompensation event, how to recognise these events on the medical take and the importance of doing so. They also discuss key steps in investigating causes of decompensations of cirrhosis and how to manage these unwell patients. Dr Michael Williams is a consultant hepatologist, working on the Scottish Liver Transplant Unit in Edinburgh. His clinical interests are liver transplantation and autoimmune liver disease. Dr Emma Spencer is an IMT3 doctor in the South East of Scotland and a member of the RCPE's Trainees & Members' Committee (T&MC). Recording date: 13 March 2025 -- Useful Links -- BSG/BASL Decomp Cirrhosis Care Bundle - https://www.bsg.org.uk/clinical-resource/bsg-basl-decompensated-cirrhosis-first-24-hours -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: cme@rcpe.ac.uk
Send us a textThis recording features audio versions of May 2025 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Recurrent Portal Hypertension after Liver Transplant: Impact on Survival and the Role of Transjugular Intrahepatic Portosystemic Shunt Creation in Management ReadNontarget Hemangioma Size Reduction after Bleomycin–Ethiodized Oil Embolization of Primary Hepatic Hemangioma ReadMR–Guided Microwave Ablation for Patients with Cirrhosis Complicated by Small Hepatocellular Carcinoma ReadEmbolotherapy for Pulmonary Arteriovenous Malformations in the Pediatric Population with Hereditary Hemorrhagic Telangiectasias—A Retrospective Case Series ReadEffects of Prophylactic Coil Embolization of Pelvic Arteries on Surgical Outcomes in Hemodynamically Stable Patients with Complex Acetabular Fractures ReadPercutaneous Ablation versus Radiotherapy for Pain Related to Bone and Soft Tissue Malignancies: A Multipayor Database Analysis of Outcomes ReadJVIR and SIR thank all those who helped record this episode. To sign up to help with future episodes, please contact our outreach coordinator at millennie.chen.jvir@gmail.com. Host:Sonya Choe, University of California Riverside School of MedicineAudio editor:Sonya Choe, University of California Riverside School of MedicineOutreach coordinator:Millennie Chen, University of California Riverside School of MedicineAbstract readers:Ahmed Alzubaidi, Wayne State University School of MedicineIpek Midillioglu, Western University of Health Sciences, College of Osteopathic MedicineNate Wright, Warren Alpert Medical School of Brown University Sanya Dhama, University of California Riverside School of MedicineTiffany Nakla, Touro University Nevada College of Osteopathic MedicineKalei Hering, Harvard Medical School SIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show
Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C. Hepatitis D, also known as “delta hepatitis,” is a liver infection caused by the hepatitis D virus (HDV). Hepatitis D only occurs in people who are also infected with the hepatitis B virus. Hepatitis D is spread when blood or other body fluids from a person infected with the virus enters the body of someone who is not infected. Hepatitis D can be an acute, short-term infection or become a long-term, chronic infection. Hepatitis D can cause severe symptoms and serious illness that can lead to life-long liver damage and even death. People can become infected with both hepatitis B and hepatitis D viruses at the same time (known as “coinfection”) or get hepatitis D after first being infected with the hepatitis B virus (known as “superinfection”). There is no vaccine to prevent hepatitis D. However, prevention of hepatitis B with hepatitis B vaccine also protects against future hepatitis D infection. Hepatitis E is a liver infection caused by the hepatitis E virus (HEV). HEV is found in the stool of an infected person. It is spread when someone unknowingly ingests the virus – even in microscopic amounts. In developing countries, people most often get hepatitis E from drinking water contaminated by feces from people who are infected with the virus. In the United States and other developed countries where hepatitis E is not common, people have gotten sick with hepatitis E after eating raw or undercooked pork, venison, wild boar meat, or shellfish. In the past, most cases in developed countries involved people who have recently traveled to countries where hepatitis E is common. Symptoms of hepatitis E can include fatigue, poor appetite, stomach pain, nausea, and jaundice. However, many people with hepatitis E, especially young children, have no symptoms. Except for the rare occurrence of chronic hepatitis E in people with compromised immune systems, most people recover fully from the disease without any complications. No vaccine for hepatitis E is currently available in the United States. (credits CDC)
This conversation is the opening segment of SurfingMASH's April discussion, in memory of Stephen A. Harrison, on drug development. In addition to co-hosts Jörn Schattenberg, Louise Campbell and Roger Green, panelists include hepatologists and key opinion leaders Sven Francque and Naim Alkhouri. This opening discussion focuses on exciting advances in one drug class (FGF-21s) and, more broadly, on exploring ways to treat cirrhosis. As Naim points out in his opening comment, these two issues— cirrhosis as a challenge and FGF-21s as a possible solution path —intersect in clear and exciting ways. He notes that the FGF-21 efruxifermin has been reported to have significant improvement in patients with cirrhosis, while the FGF-21 pegozafermin has shared positive results in a small cohort of patients. He also notes that a third FGF-21, efimosfermin alfa, has results in advanced non-cirrhotic MASH that suggest potential for similar efficacy in patients with cirrhosis, but this must be studied and confirmed in clinical trials. He mentions that resmetirom may also be showing signs of efficacy in some patients with cirrhosis. The entire package, he says, is a "game changer."Jörn notes that we are having parallel advances in treatment for advanced, non-cirrhotic patients. Sven concurs and comments that we are seeing effects that are not strictly related to metabolic disease. There is exceptional power that we can demonstrate one-level regression in sicker patients. The three agree that, at the same time, we are seeing cirrhosis trials that will lead to outcomes data; outcomes trials in non-cirrhotic medications may not be far away.Roger asks whether we are making progress in treating patients living with decompensated cirrhosis. Sven discusses what we are learning about treating portal hypertension, which is an important benefit unrelated to fibrosis regression. Simply improving portal hypertension will have an impact on endpoints. Naim points out that some ongoing trials include patients with cirrhosis, including survodutide and belapectin. Louise notes it will require "great P.R." to reverse some of the current perceptions about cirrhosis, but that this is "great." Naim states that even today, we have "a lot to offer" patients with portal hypertension or other symptoms of decompensation. As he concludes, he notes that this is underappreciated today.
00:00:00 - Surf's Up: Season 6 Episode 5Host Roger Green briefly describes this episode's three sections and introduces Roundtable guests. The Roundtable panel shares groundbreakers. 00:10:39 - Roundtable: A Deep Dive Into Drug Development, Part OneThe opening portion of this month's roundtable centers around two issues: exciting data for FGF-21s and, more generally, treating patients with cirrhosis. Naim Alkhouri sets the tone in his opening comments, which start by focusing on the exciting SYMMETRY data from efruxifermin and then hones in on FGF-21s and resmetirom in cirrhosis. The rest of the conversation features Jörh Schattenberg, Sven Francque and Naim discussing therapies in development for compensated and decompensating cirrhosis.00;24:44 - Newsmaker: Naga Chalasani on Real-World Experience Prescribing ResmetiromNaga joins Roger to discuss the paper Early Experience with resmetirom to treat Metabolic Dysfunction-Associated Steatohepatitis With Fibrosis in a Real-World Setting from his group at Indiana University, which his group authored and Hepatology Communications recently posted. The paper, based on IU Health's experience with its first 113 resmetirom patients, shares the group's practical experience developing processes to work closely with the specialty pharmacies dispensing resmetirom and, finally, concludes that a more engaged patient management strategy might reduce drug discontinuation to a level comparable with clinical trials. 00:47:21 - Expert: Scott Friedman on Gene Therapy, Diversity of Stellate Cell Types, Other Basic Liver ScienceScott and Roger cover a range of basis science topics in a fast-moving 19-minute discussion. It starts with Scott discussing the increasing acceptance that gene therapy is an acceptable way to treat a range of liver diseases, many of which are orphan or ultra-orphan but, in fact, include potential gene therapies for non-cirrhotic MASH and MASH cirrhosis. He notes that in addition to classic gene therapy, which introduces protective gene variants into the systems of patients with the risky variants, gene therapy is now looking to introduce FGF-21 into patients through genetic modification. From there, the conversation covers CAR-T therapy, the increasing ability to identify many different types of stellate cells and the idea that the most effective therapy for eary fibrosis, advanced fibrosis and cirrhosis might require fundamentally different kinds of interventions. The two final elements are the idea that what we now call "MASH" may be several diseases with different etiologies with similar manifestations and a passionate call for all of us to support maintaining NIH funding in whatever ways we can.01:06:45 - Business ReportAs Roger copes with his laryngitis, AI voices deliver an abbreviated business report
Many people confuse fatty liver disease with cirrhosis. In this podcast, Salinas Valley Health gastroenterologist Vikram Patel, MD, clarifies the distinctions between the two, revealing why early intervention in fatty liver disease is vital to avoid the irreversible consequences of cirrhosis.
How does acute kidney injury presentation and management differ globally for patients hospitalised with cirrhosis? We spoke to Salvatore Piano, corresponding author of the landmark International Club of Ascites GLOBAL AKI study, about new data on regional variations in severity, phenotype, treatment, and outcomes across 5 continents.Read the full article:https://www.thelancet.com/journals/langas/article/PIIS2468-1253(25)00006-8/fulltext?dgcid=buzzsprout_icw_podcast_generic_langasContinue this conversation on social! Follow us today at... https://bsky.app/profile/lancetgastrohep.bsky.social https://www.linkedin.com/company/langastro/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://youtube.com/thelancettv
In this episode of the Onc Now Podcast, host Jonathan Sackier is joined by Stephen Chan, Clinical Professor at the Department of Clinical Oncology of the Chinese University of Hong Kong, to discuss groundbreaking trials in hepatobiliary cancers, the role of diet in chronic liver disease, and the future of liver cancer care. Timestamps: 00:00 – Introduction 02:09 – CARES-310 trial for liver cancer 4:33 – Camrelizumab + rivoceranib versus sorafenib 7:07 – Prevention and early detection of liver cancer 10:30 – Impact of lifestyle and diet on liver disease 12:38 – KEYNOTE-966 trial for biliary tract cancer 14:45 – Alternative strategies for liver cancer treatment 17:14 – Key initiatives of the International Liver Cancer Association 19:26 – Chan's three wishes for healthcare
In this podcast, expert faculty, Dr Stuart Gordon and Dr Nancy Reau discuss an illustrative patient case to demonstrate how they individualize primary biliary cholangitis (PBC) therapy for patients with cirrhosis. Topics covered include:AASLD guideline recommendations for second-line therapy for PBCConsiderations when using newer agents for second-line treatment of PBC in patients with cirrhosis: elafibranor and seladelparPresenters:Stuart C. Gordon, MD Professor of MedicineWayne State University School of MedicineDirector, Division of HepatologyHenry Ford HealthDetroit, MichiganNancy Reau, MD Professor of MedicineRichard B. Capps Chair of HepatologyChief, Section of HepatologyAssociate Director, Solid Organ TransplantationRush University Medical CenterChicago, IllinoisTo learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.
Send us a textDr. Chari A. Cohen, DrPH, MPH ( https://blumberginstitute.org/faculty/chari-a-cohen/ ) is the President of the Hepatitis B Foundation ( https://www.hepb.org/ ), a global nonprofit dedicated to finding a cure and improving the quality of life for people affected by hepatitis B worldwide.Dr. Cohen conducts research and implements programs to reduce health disparities and improve health outcomes associated with hepatitis B, as well as hepatitis D, and liver cancer. Dr. Cohen is also co-chair of the Hep B United Coalition, co-founder and chair of Hep B United Philadelphia, co-founder and chair of CHIPO: Coalition Against Hepatitis for People of African Origin; and immediate past co-chair of the Hep Free PA Coalition. Dr. Cohen is also a member of the International Coalition to Eliminate of HBV (ICE-HBV) steering committee, HepVu advisory committee (an online platform that visualizes data and disseminates insights on the viral hepatitis epidemic across the U.S), and HBV Forum for Collaborative Research. Dr. Cohen serves as both a Professor at the Baruch S. Blumberg Institute, and adjunct faculty for Geisinger Commonwealth School of Medicine. Dr. Cohen received her DrPH in Community Health and Prevention from Drexel University and her MPH from Temple University.The Baruch S. Blumberg Institute ( https://blumberginstitute.org/ ) is a nonprofit translational research organization focused on understanding the pathobiology of hepatitis B virus and related diseases, developing diagnostics for early detection of liver cancer, and discovering therapeutics, antivirals and immune modulators for the cure of chronic HBV and other RNA viruses that cause hepatitis and hemorrhagic fever.#ChariCohen #HepatitisBFoundation #HepBVaccine #BaruchSBlumberg #LiverCancer #Cirrhosis #AntiVirals #HarmReduction #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #ViralPodcast #STEM #Innovation #Technology #Science #ResearchSupport the show
In this podcast, listen as experts Alan Bonder, MD, AGAF, and Aparna Goel, MD, discuss how they assess the symptoms of primary biliary cholangitis (PBC) and explore how new therapeutic agents may help alleviate symptom burden. Topics include:Strategies and tools for assessing pruritusNonpharmacologic and pharmacologic management of pruritusSecond-line agents and their impact on pruritusInvestigational treatments for pruritusPresenters:Alan Bonder, MD, AGAFAssociate Professor of MedicineMedical Director of Liver TransplantDepartment of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBoston, MassachusettsAparna Goel, MDAssociate Clinical Professor of MedicineDivision of Gastroenterology and HepatologyStanford UniversityPalo Alto, CaliforniaContent based on an online CME program supported by independent educational grants from Gilead Sciences, Inc., and Ipsen Biopharmaceuticals, Inc.To learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.
How do you decide when to move from first-line to second-line treatment for primary biliary cholangitis (PBC)? In this podcast, listen as experts Alan Bonder, MD, AGAF, and Aparna Goel, MD, discuss this question and more, including:How and when to measure treatment responseEvidence-based goals of therapyConsiderations for second-line treatmentNew agents for second-line treatment: PPAR agonistsPresenters:Alan Bonder, MD, AGAFAssociate Professor of MedicineMedical Director of Liver TransplantDepartment of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBoston, MassachusettsAparna Goel, MDAssociate Clinical Professor of MedicineDivision of Gastroenterology and HepatologyStanford UniversityPalo Alto, CaliforniaContent based on an online CME program supported by independent educational grants from Gilead Sciences, Inc., and Ipsen Biopharmaceuticals, Inc.To learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.Supported by educational grants from Gilead Sciences, Inc. and Ipsen Biopharmaceuticals, Inc
You can't see it. You can't taste it. But could the air you breathe every day be silently damaging your liver? An intriguing new study published in the Journal of Environmental Sciences reveals that even low levels of traffic-related air pollution may increase the risk of metabolic-associated fatty liver disease (MAFLD)—now the most common liver disease worldwide.
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from February 1-7, 2025.
CME credits: 0.50 Valid until: 24-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/acute-kidney-injury-in-cirrhosis-multidisciplinary-decision-making/26986/ In patients with decompensated cirrhosis and multi-organ failure, intensive care units must coordinate care between hepatologists, transplant surgeons, intensivists, and nephrologists to optimize patient outcomes. This roundtable highlights the importance of well-coordinated processes between floor units and ICU teams, including early response systems and regular multidisciplinary rounds to discuss management strategies and transplant considerations. Different specialists must collaborate effectively to make decisions about various treatments, including terlipressin administration, dialysis initiation, and transplant timing, particularly in challenging cases like alcoholic hepatitis. This activity also covers how teams must carefully balance improving kidney function against maintaining transplant priority scores.=
CME credits: 0.50 Valid until: 24-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/preparing-the-patient-with-decompensated-cirrhosis-for-liver-transplant-icu-discussions-considerations-and-dialysis/26987/ In patients with cirrhosis and kidney dysfunction who are candidates for liver transplantation, transplant decisions are impacted by kidney function impacting MELD scores. This podcast explores ICU management of these patients, including the use of dialysis, and emphasizes the importance of considering multiple factors such as the etiology of liver disease, presence of chronic kidney disease, and individual patient characteristics. The experts highlight recent changes in transplant criteria, particularly for alcoholic hepatitis patients, and discuss the challenges of managing an increasingly diverse patient population ranging from young alcohol-related liver disease patients to older patients with metabolic-associated liver disease and multiple comorbidities. =
Joanne Alves e Marcela Belleza convidam Ana Carolina Malvaccini, R3 de Clínica Médica do HCFMUSP, para falar sobre como fazer o diagnóstico de cirrose: quando suspeitar? como confirmar o diagnóstico?Referências:1. Smith, Andrew et al. “Cirrhosis: Diagnosis and Management.” American family physician vol. 100,12 (2019): 759-770.2. Udell JA, Wang CS, Tinmouth J, et al. Does This Patient With Liver Disease Have Cirrhosis? JAMA.2012;307(8):832–842. doi:10.1001/jama.2012.1863. Bonacini, M et al. “Utility of a discriminant score for diagnosing advanced fibrosis or cirrhosis in patients with chronic hepatitis C virus infection.” The American journal of gastroenterology vol. 92,8 (1997): 1302-4.4. Lok, Anna S F et al. “Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: results of the HALT-C cohort.” Hepatology (Baltimore, Md.) vol. 42,2 (2005): 282-92. doi:10.1002/hep.207725. Ginès, Pere et al. “Liver cirrhosis.” Lancet (London, England) vol. 398,10308 (2021): 1359-1376. doi:10.1016/S0140-6736(21)01374-X6. Wilson, Rachel, and Donna M Williams. “Cirrhosis.” The Medical clinics of North America vol. 106,3 (2022): 437-446. doi:10.1016/j.mcna.2021.12.001
CME credits: 0.25 Valid until: 17-01-2026 Claim your CME credit at https://reachmd.com/programs/cme/evaluation-and-management-of-aki-in-cirrhosis-at-the-interface-of-gastroenterology-and-nephrology/26988/ In patients with advanced liver disease, decompensated cirrhosis and portal hypertension can impact kidney function through development of acute kidney injury (AKI). Multiple different etiologies of AKI can be seen in cirrhotic patients, including prerenal AKI, acute tubular injury, and hepatorenal syndrome (HRS), which require different treatment approaches. This podcast will emphasize the importance of multidisciplinary care and use of established protocols in treating these patients, particularly when considering a bridge to liver transplantation, and discuss specific considerations for patients with transjugular intrahepatic portosystemic shunt (TIPS).=
Update your approach to cirrhosis evaluation and management with Dr. Scott Matherly Associate Professor of Hepatology and Gastroenterology at Virginia Commonwealth University Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro, disclaimer, guest bio Case from Kashlak; Definitions Cirrhosis Diagnosis and Initial Evaluation Cirrhosis Physical Examination Decompensated Cirrhosis Management Ascites and TIPS MELD and transplant consideration Outro Credits Written and Produced by: Elena Gibson MD Infographic and Cover Art: Edison Jyang MD Hosts: Paul Williams MD, FACP; Elena Gibson MD Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Scott Matherly MD Sponsor: Rocket Money Cancel your unwanted subscriptions and reach your financial goals faster with Rocket Money. Go to RocketMoney.com/CURB today. Sponsor: Rosetta Stone Visit rosettastone.com/curbsiders for 50% off unlimited access to 25 language courses for the rest of your life. Sponsor: Grammarly Download Grammarly for FREE at grammarly.com/PODCAST.
In this episode, Sonal Kumar, MD, MPH, discusses key findings from primary biliary cholangitis (PBC) studies presented at AASLD 2024, including:ELATIVE, a phase III trial of elafibranor for PBCRESPONSE, a phase III trial of seladelpar for PBCASSURE, another phase III trial of seladelpar for PBCPresenter:Sonal Kumar, MD, MPHDirector, Clinical Gastroenterology and HepatologyAssistant Professor of MedicineWeill Cornell Medical CollegeNew York, New YorkLink to full program:https://bit.ly/41tvSDuGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
In this episode, Sonal Kumar, MD, MPH, discusses key findings from primary biliary cholangitis (PBC) studies presented at AASLD 2024, including:ELATIVE, a phase III trial of elafibranor for PBCRESPONSE, a phase III trial of seladelpar for PBCASSURE, another phase III trial of seladelpar for PBCPresenter:Sonal Kumar, MD, MPHDirector, Clinical Gastroenterology and HepatologyAssistant Professor of MedicineWeill Cornell Medical CollegeNew York, New YorkLink to full program:https://bit.ly/41tvSDuGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
Dr. Tom Roselle DC discusses how to heal and reprogram a dysregulated nervous system for maximum function and capacity. For all episodes of Ageless Health with Dr. Tom Roselle, DC, visit https://www.drtomroselle.com #agelesshealth #podcast @wmaldc #nervoussystem #neuropathy #peripheralneuropathy #proximalneuropathy #focalneuropathy #autonomicneuropathy #chronicpain #paresthesia #muscleweakness #numbness #cirrhosis #diabetes #hypothyroidism #shingles #vitaminDdeficiency #lymedisease #kidneydisease #autoimmunedisease #erectiledysfunction #spinalstenosis #carpeltunnelsyndrome #nerveinjury #facialparalysis
Today we welcome back Karla Adkins to share her inspiring journey of freedom from alcohol, faith, and transformation. Karla's story is one of resilience and hope, offering a candid look at her struggles with alcohol, shame, and vulnerability—and how she found freedom through faith and sharing her inspiring story. Karla reflects on her initial reluctance to share her experiences with liver failure publicly. Hearing how her story touched others gave her the courage to keep sharing, creating a ripple effect of hope for women struggling to control their drinking. Karla dives deep into the challenges of confronting shame, the healing power of vulnerability, and the transformation that comes from building a personal relationship with Jesus. She recounts her battle with liver failure and cirrhosis, her wake-up call to surrender her life to God, and the profound shift from seeing faith as a religion to experiencing it as an intimate relationship. Together, Christy, Meade, and Karla explore the misconceptions surrounding sobriety and the subtle but dangerous grip alcohol can have on our lives. Karla emphasizes the importance of understanding its impact—not just on our bodies but on our relationships and spiritual health. Karla's testimony highlights how vulnerability can lead to healing—not just for the person sharing, but for everyone who hears it. She encourages listeners to view fear as an opportunity for growth and to take the leap toward freedom, no matter how uncertain the path may seem. Her gratitude for the chance to share her journey shines through, offering a beacon of hope for anyone facing their own struggle with alcohol. Today's episode is a reminder that no struggle is too great, and no story is too small to make an impact. Listen to Karla's first episode with us, here. Get Karla's book, “And She Came Tumbling Down” here. JOIN THE BJDW COMMUNITY HERE! https://butjesusdrankwine.com/community Get Christy's Book: Love Life Sober, A 40 Day Alcohol Fast To Rediscover Your Joy, Improve Your Health and Renew Your Mind http://lovelifesober40dayfast.com Learn More about Coaching with Christy Learn More about Coaching with Meade Connect with us on Instagram! @imnotsoberimfree @lovelifesoberwithchristy @butjesusdrankwine You can find this episode on YouTube HERE The creators, hosts, and producers of the But Jesus Drank Wine podcast are not healthcare practitioners and therefore do not give medical, psychological or professional advice nor do they intend for the podcast, any communication on behalf of BJDW or otherwise to be a substitute for such. Additionally, the views and opinions expressed in any mention of and/or linked resources are those of the authors/owners of those resources and do not necessarily reflect the views or opinions of the But Jesus Drank Wine podcast team or guests of the show.
In this podcast, Dr. Eugene Lambert reviews the current state of alcohol use disorders, its healthcare system impact and utilization. He also describes the increasing prevalence of the dual pathology of alcohol use disorders and associated liver disease, including the advanced liver disease entity of AUD-cirrhosis. Additionally, Dr. Lambert reviews the current state of AUD-cirrhosis management and discusses an addiction-focused and multidisciplinary approach to the effective treatment and management of AUD-cirrhosis.
Dr. Tom Roselle DC discusses the major warning signs in affected nerves of diabetic neuropathy including symptoms like pain and numbness in legs, hands, and feet. Also to be addressed problems in the digestive system, urinary tract, blood vessels, and heart. For all episodes of Ageless Health® with Dr. Tom Roselle, DC, visit https://www.drtomroselle.com #agelesshealth #podcast @wmaldc #neuropathy #peripheralneuropathy #proximalneuropathy #focalneuropathy #autonomicneuropathy #chronicpain #paresthesia #muscleweakness #numbness #cirrhosis #diabetes # hypothyroidism #shingles #vitaminDdeficiency #lymedisease #kidneydisease #autoimmunedisease #erectiledysfunction #spinalstenosis #carpeltunnelsyndrome #nerveinjury #facialparalysis
Yes! You are in for seconds with Resilient Richard. First time? Back up one episode if you will. What gifts from God, these Dudes have been from the Central Valley of California. Do you love or need a story of Hope and redemption? Me too! As I love to ask the skeptic, does this broken planet need more Hope or Hopelessness. Hope, here you go...Wow! Thank you Richard! And thank you Daniel the Faithful, Rogelio the Real and Powerful Paul. Thank you Spirit Filled Church in Indio, CA and getting me up near Big Bear, CA. Thank you Life Church, Visalia and the others in that area for sending me those Bold Brothers. What a series! What a gift! Note that, I prayed and asked specifically. God delivered exactly what he thought best. Not what I was thinking. What he was thinking. We are all blessed by it.If you haven't seen the article posted, you can find some pictures of the guys and event here...https://www.fridudes.com/post/giving-thanks-for-visalia-caA few challenges for you...Most important, are you ready to give a stranger or loved one the reason that you have Hope? 1 Peter 3:15. Each of these brothers were ready. Practice and then pray for God to tee you up. Get ready, you will be sharing and encouraging more shortly.Next challenge. Since many of you listen across the states and some around the world, pray on making a pilgrimage to Cali. You have brothers and sisters here. If you haven't seen Sequoia and Yosemite yet (check that post), schedule that trip and add Life Church in Visalia to your itinerary. Fresno is nearest airport.And/or come to the Coachella Valley. You have brothers and sisters here too. Palm Springs is nearest airport. You could also fly into Ontario, LAX or San Diego. Check out overflowshowers.org calendar for service sights and locations. Check out Spirit Filled Church, Victory in Christ, RedDoor, Abundant Life Churches in Indio and Southwest Church in Indian Wells. Want to learn more. Questions for the brothers and/or sisters, hit us up at FriDudes.com. Bonus, sign up and qualify for a Deep Hike in the region (actual hiking and Bible study in the desert and/or up in the surrounding mountains). Hint: Check out Joshua Tree National Park or Painted Canyon in Mecca).Philippians 4:6-8, New International Version6 Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. 7 And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.8 Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things.
Dr. Tom Roselle DC discusses neuropathy types and distinguishes the causes and effects of peripheral, proximal, focal, and autonomic neuropathy. For all episodes of Ageless Health® with Dr. Tom Roselle, DC, visit https://www.drtomroselle.com #agelesshealth #podcast @wmaldc #neuropathy #peripheralneuropathy #proximalneuropathy #focalneuropathy #autonomicneuropathy #chronicpain #paresthesia #muscleweakness #numbness #cirrhosis #diabetes # hypothyroidism #shingles #vitaminDdeficiency #lymedisease #kidneydisease #autoimmunedisease #erectiledysfunction #spinalstenosis #carpeltunnelsyndrome #nerveinjury #facialparalysis
Liver cancer or hepatocellular cancer is the 6th most common cause of cancer and the 3rd leading cause of cancer deaths worldwide. In the US, liver cancer is the 6th leading cause of death. Common risk factors of liver cancer:•Cirrhosis or liver scarring and it's underlying risk factors (20% of cases of liver cancer form without cirrhosis present, yet in the presence of or more of the below conditions) •Metabolic Dysfunction-Associated Steatotic Liver Disease (formerly, non-alcoholic fatty liver disease) of which obesity, diabetes and high cholesterol are risk factors •Hepatitis B and Hepatitis C (transmitted via body fluids, commonly during sex, childbirth (mother to fetus) or with IV drug use) •Alcohol •Smoking •Aflatoxin (a fungus that may grow on grains and nuts improperly store in hot and humid environments) Common symptoms of liver cancer:•None•Abdominal discomfort•Abdominal swelling •Nausea or vomiting•Gastrointestinal bleeding•Weight loss•Loss of appetite •Jaundice (yellowing of the skin and whites of the eyes)•Easy bruising or bleeding•Persistent itching•Fatigue•Fever Populations at increased risk for liver cancer:Nationally, the highest rates are seen in Asian/Pacific Islanders and American Indian/Alaskan Natives. Rising rates have been noted in the Latinx population. Globally, rates are actually highest outside the US, in sub-Saharan Africa and Southeast Asia. Liver cancer prevention:•Eat whole food, plant-forward nutrition (fruits, vegetables, lean proteins, whole grains, minimal saturated fat)•Reduce alcohol intake or abstain https://www.cdc.gov/alcohol/about-alcohol-use/index.html •Get screened for and vaccinated against hepatitis B (infants, children and adults) https://www.cdc.gov/hepatitis-b/index.html*Get screened and treated for hepatitis C (no vaccine currently exists and many patients are without symptoms, which often only occur with advanced disease.) https://www.cdc.gov/hepatitis-c/index.html •Practice safer sex with regular condom use (including same gender couples)•Get screened for STDs annually or with every new partnerSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
On this edition of Clean and Sober Radio, host Gary Hendler and cohost Mark Sigmund welcome former Major League Baseball pitcher, Randy Lerch. Randy had a stellar career including his September 30, 1978 two home runs in a 10-8 win that clinched the National League East division championship for the Philadelphia Phillies. Randy had many ups and downs in his career including an amphetamine scandal that rocked the team. Also, Randy developed Cirrhosis of the liver. Today, Randy speaks nationwide about his career and the addiction that caused his condition. A down to earth guy with a fabulous story.
Live Nursing Review with Regina MSN, RN! Every Monday & Wednesday we are live. LIKE, FOLLOW, & SUB @ReMarNurse for more. ► NCLEX V2 - https://study.remarnurse.com/vit/ ► Get Quick Facts Next Gen - https://bit.ly/QF-NGN ► Subscribe Now - http://bit.ly/ReMar-Subscription ► GET THE PODCAST: https://remarnurse.podbean.com/ ► WATCH LESSONS: http://bit.ly/ReMarNCLEXLectures/ ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/ Quick Facts for NCLEX Next Gen Study Guide here - https://bit.ly/QF-NGN Study with Professor Regina MSN, RN every Monday as you prepare for NCLEX Next Gen. ReMar Review features weekly NCLEX review questions and lectures from Regina M. Callion MSN, RN. ReMar is the #1 content-based NCLEX review and has helped thousands of repeat testers pass NCLEX with a 99.2% student success rate! ReMar focuses on 100% core nursing content and as a result, has the best review to help nursing students to pass boards - fast!
It's been a long time, but we are back!Apologies on the audio quality from Dr. Jenkins. Apparently he was recording from inside a cardboard box.Today we talk about important, practice changing studies in internal medicine from the last several months. What's the best anticoagulant in patients with cirrhosis and atrial fibrillation? Why do doctors use so much unfractionated heparin for acute PE? Should we still be using beta blockers in patients with acute MI? Does finerenone improve outcomes in HFpEF? Is continuous infusion of antibiotics better than intermittent? And will the cefepime vs piperacillin-tazobactam battle ever end?Apixaban, Rivaroxaban and Warfarin in Cirrhosis for AFAnticoagulation Trends for Acute PEBeta Blockers for Acute MI with Normal EF Finerenone for HFpEF FINEARTS-HFContinuous vs Intermittent Infusion of Beta-Lactams BLING IIIProlonged vs Intermittent Infusions of Beta-Lactams Meta-analysisPiperacillin-Tazobactam vs Cefepime for SepsisRecurrent SBP in Patients on Secondary Prophylaxis
Interview with Fasiha Kanwal, MD, MSHS, author of GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease. Hosted by Eve Rittenberg, MD, and Grace Yuan Zhang, MD Related Content: GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease
Interview with Fasiha Kanwal, MD, MSHS, author of GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease. Hosted by Eve Rittenberg, MD, and Grace Yuan Zhang, MD Related Content: GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease
In this episode, we review the high-yield topic of Cirrhosis from the Gastrointestinal section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
Episode 172: NAFLD and ObesityFuture Dr. Nguyen explains the pathophysiology of non-alcoholic fatty liver disease and how it relates to obesity. Dr. Arreaza gives information about screening and diagnosis of NAFLD. Written by Ryan Nguyen, MS4, Ross University School of Medicine. Comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction/PathophysiologyNonalcoholic fatty liver disease (NAFLD) refers to the buildup of excess fat in liver cells, occurring without the influence of alcohol or drugs. Nonalcoholic steatohepatitis (NASH) represents a more severe form of NAFLD, characterized by inflammation and liver cell injury due to fat accumulation. If left untreated, NASH can progress to liver fibrosis or cirrhosis. Typically, NAFLD/NASH is diagnosed after other liver conditions are ruled out, making it a diagnosis of exclusion.NAFLD -> NASH -> Cirrhosis -> Liver failure. Another term for NAFLD is metabolic dysfunction-associated steatotic liver disease. Fatty liver disease is identified when more than 5% of liver weight consists of fat, whereas, NASH is diagnosed when this fat accumulation is accompanied by inflammation and liver cell injury, sometimes leading to fibrosis. Understanding these distinctions is crucial in recognizing and managing the spectrum of liver conditions associated with obesity and metabolic syndrome.BMI serves as a tool to gauge body fat levels: individuals are categorized as normal weight if their BMI falls between 18.5 and 24.9, overweight if it ranges from 25 to 29.9. Class I obesity is diagnosed with a BMI of 30 to 34.9, class II obesity between 35 and 39.9, and class III obesity when BMI exceeds 40.Obesity puts you at risk of NAFLD, but you can also see NAFLD in non-obese patients, but the prevalence is very low, about 5%. What did you learn about the demographics of NAFLD?NAFLD is most widespread in regions like South Asia, the Middle East, Mexico, Central and South America, with prevalence rates exceeding 30%. In the United States, prevalence varies with approximately 23-27%, notably higher among Asians at 30%, followed by Hispanic individuals at 21%, White individuals at 12.5%, and Black individuals at 11.6%. Across all racial groups, obesity plays a significant role, affecting more than two-thirds of individuals diagnosed with NAFLD. Understanding these demographics underscores the global impact of obesity on NAFLD prevalence.Diagnosis: Screening/Labs/Imaging/ToolsThe American Association for the Study of Liver Diseases does not recommend screening for NAFLD, but if it is discovered an appropriate workup is warranted. AST/ALT RatioLiver health can be assessed by a series of tests aimed at assessing fat accumulation, inflammation, and fibrosis. Initial screening often includes laboratory tests such as measuring the ratio between aspartate transaminase (AST) and alanine transaminase (ALT), where a ratio less than 1 may suggest possible NAFLD, although it is not diagnostic on its own. Normally, AST is slightly more elevated than ALT. So, if the AST/ALT ratio is lower, then means that ALT is higher than AST. FibroSure®.Additionally, you can measure indirect markers of fibrosis with tests such as FibroSure or FibroTest blood tests that combine several biomarkers including age, sex, gamma-glutamyl-transferase (GGT), total bilirubin, alpha-2-macroglobulin, apolipoprotein A1, haptoglobin, and ALT to provide insights into liver health.Some people may be more familiar with FibroSure before Hepatitis C treatment. You can get a fibrosis score (F0-F4), and it is considered significant fibrosis if the score is > or equal to F2. Imaging plays a crucial role in diagnosing NAFLD without the need for invasive procedures like liver biopsy. Vibration-controlled transient elastography (Fibroscan) uses ultrasound to measure liver stiffness, indicating potential fibrosis and inflammation. While noninvasive and portable, it focuses solely on liver ultrasound and may not be universally accessible. MRI with proton density fat fraction (MRI-PDFF) offers a comprehensive assessment of liver fat content, commonly used in clinical and research settings for NAFLD and NASH evaluation.For evaluating hepatic fibrosis in patients with suspected NAFLD, tools like the Fibrosis-4 Index (FIB-4) incorporate age, AST, ALT, and platelet count to estimate the likelihood of liver disease progression. These screening methods collectively aid in diagnosing and monitoring NAFLD, particularly in individuals at risk due to factors like prediabetes, type 2 diabetes, obesity, and abnormal liver enzyme ratios. With the FIB-4 you can get a faster answer than FibroSure because you only need 4 elements: Age, platelet count, AST and ALT. Cirrhosis is less likely if FIB-4 is 3.25. Understanding these diagnostic approaches is essential for early detection and management of NAFLD in clinical practice.Some researchers are invested in diagnosis and treating NAFLD while others recommend against labeling patients with NAFLD. A 2018 Lancet article concluded that the risks of over-diagnosing and overtreating NAFLD exceed the benefits of screening or periodic imaging because of “the low hepatic mortality, high false-positive rate of ultrasonography, selection bias of current studies, and lack of viable treatment.” However, patients who suffer from metabolic syndrome should be counseled about dietary modification and physical activity regardless of their liver condition. NAFLD and obesityFatty liver disease is often caused by multiple insults towards either genetically or environmentally predisposed individuals. Family history of NAFLD and having specific genetic variants are important risk factors for NAFLD. Those with prior health conditions can have increased susceptibility to NAFLD including T2DM leading to insulin resistance, metabolic syndrome, sleep apnea, hepatitis C, and cardiovascular or chronic kidney disease. A sedentary lifestyle and unhealthy nutrition (especially high intake of processed carbohydrates) cause an increase in free fatty acids leading to hepatic fat deposition → ballooning of hepatocytes → leading to hepatocyte injury/death → inflammation with fibroblast recruitment → end result of fibrosis/cirrhosis. Just a quick reminder, NAFLD is defined as fatty liver with >5% hepatic fat and NASH is defined as fatty liver with >5% hepatic fat with inflammation, hepatocyte injury, with or without fibrosis that we can determine through imaging. A leading concern for the development of NAFLD is the consumption of high fructose corn syrup. High fructose corn syrup (HFCS), commonly found in candy, processed sweets, soda, fruit juices, and other processed foods, is linked to non-alcoholic fatty liver disease (NAFLD). Unlike natural whole fruits, which contain fiber and are generally healthier due to their slower absorption, HFCS lacks fiber and is quickly absorbed, leading to rapid transport to the liver. This process contributes to NAFLD by increasing the hepatic synthesis of lipids and interfering with insulin signaling. To avoid HFCS, individuals are encouraged to consume whole fruits rather than fruit juices and adopt diets rich in whole grains, lean meats, plant-based proteins, fruits, and vegetables, such as the Mediterranean or DASH diets, which are less likely to promote NAFLD, especially in those with healthy body weight.NAFLD treatment.Avoiding alcohol seems very obvious, but we need to mention it. Avoiding heavy alcohol consumption is recommended and complete abstinence is suggested.Weight loss is crucial; even a modest reduction of 3–5% in body weight can alleviate hepatic steatosis, with greater improvements typically seen with 7–10% weight loss, particularly beneficial for addressing histopathological features of NASH, such as fibrosis. We must focus on tailored medical nutrition therapy and regular physical activity. A strategic meal plan is essential, emphasizing achieving a healthy body weight while limiting trans fats and ultra-processed carbohydrates. Options like the Mediterranean diet, which balances lean proteins and restricts processed carbohydrates have shown promise. Dynamic aerobic and resistance exercises play a significant role in managing NAFLD. They help maintain a healthy weight and enhance peripheral insulin sensitivity, reduce circulating free fatty acids and glucose levels, and boost intrahepatic fatty acid oxidation while curbing fatty acid synthesis. These benefits contribute to mitigating liver damage associated with NAFLD, offering therapeutic advantages beyond mere weight reduction.Exercise may not be a great tool for weight loss, but it is a great tool for weight maintenance, liver health, and overall health as well. “Most patients with NAFLD die from vascular causes, but NAFLD puts patients at increased risk of cardiovascular death”. Medications for NAFLD.Regarding pharmacotherapy, while no medications are currently FDA-approved specifically for NAFLD treatment, some options show promise in clinical settings. Vitamin E supplementation at 800 IU (international units) daily has demonstrated biochemical and histological improvements in NASH cases without diabetes or cirrhosis, though long-term use may elevate prostate cancer risks. It is important to make a shared decision with the patient before starting Vitamin E supplementation. Medications like pioglitazone can reduce liver fat and improve NASH, even as they may increase body weight. But our favorite, GLP-1 receptor agonists, such as liraglutide and semaglutide, also show potential in reducing liver fat and improving NASH symptoms, and this is an emerging therapeutic option for managing this condition.If you decide to treat, then you should monitor as part of the treatment. An aminotransferase check is recommended 6 months after starting a weight loss program. If levels do not improve or do not return to normal after 5-7% of weight loss, another cause of elevated transaminases needs to be investigated.You also need to monitor fibrosis in patients with >F2. If fibrosis has been proven by liver biopsy, you can order FibroSure every 3-4 years. Having a fatty liver may be a red flag that your patient has a metabolic problem. If you discover it, start interventions that would benefit not only the liver but the whole metabolic profile of your patient. The Obesity Medicine Association (OMA) issued a Clinical Practice Statement (CPS) regarding NAFLD and obesity stating that patients with obesity are at increased risk for NAFLD and NASH. It recommends that clinicians strive to understand the etiology, diagnosis, and optimal treatment of NAFLD with a goal to prevent NASH in their patients.Regular exercise, even walking 30 minutes a day can show many benefits in curbing fatty accumulation in the liver. Having a proper diet with avoidance of high fructose corn syrup can overall help in reducing NAFLD/NASH. _____________________Conclusion: Now we conclude episode number 172, “NAFLD and Obesity.” Future Dr. Nguyen explained that NAFLD and obesity are closely related and NAFLD can lead to NASH and cirrhosis in some patients. Dr. Arreaza explained that screening may not be recommended by some medical societies, but others are in favor of screening and treating this disease. However, most people agree that NAFLD is a sign of metabolic disease and a good reason to talk about healthy eating and physical activity with our patients. There are no FDA-approved medications to treat NAFLD, but some evidence suggests that Vitamin E can improve it and GLP-1 receptor agonists are a promising option. This week we thank Hector Arreaza and Ryan Nguyen. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Karjoo S, Auriemma A, Fraker T, Edward H. Nonalcoholic fatty liver disease and obesity: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. https://doi.org/10.1016/j.obpill.2022.100027.Curry M, Afdhal N. Noninvasive assessment of hepatic fibrosis: Overview of serologic tests and imaging examinations. https://www.uptodate.com/contents/noninvasive-assessment-of-hepatic-fibrosis-overview-of-serologic-tests-and-imaging-examinationsRoyalty-free music used for this episode: Cool Groove (Alt-Mix) by Videvo, downloaded on Nov 06, 2023, from https://www.videvo.net
Join us as we review recent practice-changing articles on preventive PCI, andexanet alfa for ICH, aspirin for fatty liver, naltrexone in cirrhosis, pivmecillinam for UTI, cefepime vs pip-tazo, MDRO decolonization, microplastics and MACE, and more! Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Rahul Ganatra MD, MPH; Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH; Emi Okamoto MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Preventive PCI Andexanet alfa for ICH Aspirin for MASLD Naltrexone for AUD in cirrhosis Pivmecillinam for UTI MDRO decolonization Cefepime vs pip/tazo Microplastics Pax-NO-vid Outro Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: ACP MKSAP Learn more about ACP MKSAP at acponline.org/acpmksap Sponsor: Litter Robot Whisker is currently offering $50 off Litter-Robot bundles. As a special offer to listeners of the show, go tostopscooping.com/CURB and use promo code CURB to save an additional $50 on any Litter-Robot bundle.
The edible beads that could combat cirrhosis and other gut conditions. And on This Day in History; The First Distinguished Flying Cross is awarded for one famous flight. Edible Carbon Beads Can Reduce Cirrhosis Liver Disease By Restoring Gut Microbiome TDIH: On June 11, 1927, Charles Lindbergh received the first Distinguished Flying Cross THE LEGEND OF LUCKY LINDBERGH | | azdailysun.com Contact the Show: coolstufcommute@gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices
More clinical pearls from ACP #IM2024, including emerging infectious diseases in the US (malaria, dengue, super gonorrhea, and a resurgence of syphilis), new C. diff treatments, coagulopathy and cirrhosis, fatty liver disease, HFpEF, peripheral arterial disease, Lp(a) and ApoB, CAR T-cells for autoimmune disease, SGLT2i for gout, and hematology updates. Paul and Watto are joined by Drs. Nora Taranto, Beth Garbitelli, and of course Chris “The Chiu Man” Chiu. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Tropical Diseases: Resurgence of Malaria and Dengue Fever 03:44 Infectious Diseases: Syphilis Rates and New Treatments for C. diff 08:28 Coagulopathy and Cirrhosis: Managing Hemostasis and Portal Vein Thrombosis 11:34 Fatty Liver Disease: Risk Stratification and Treatment 14:59 Cardiology Updates: Cardiovascular Kidney Metabolic Syndrome 31:03 New Medications for Hypertension 32:54 Renal Denervation and Hypertension 33:51 Lp(a) Drugs and Their Potential 36:01 Peripheral Arterial Disease and Claudication 38:10 SGLT2 Inhibitors and Gout 41:50 APO-B and LDL Cholesterol 42:45 Secondary Hypogonadism and Head and Neck Radiation 45:30 VEXAS: A Genetic Autoimmune Condition 49:08 Obesity-Induced Leukocytosis 52:49 CAR T-Cell Therapy in Rheumatologic Diseases Credits Producers/Writers/Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD, Chris Chiu MD, Beth Garbitelli MD CME, Cover Art: Beth Garbitelli MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Reviewer: Nora Taranto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor: Litter Robot Go to stopscooping.com/CURB and enter promocode CURB to save an EXTRA $50 on any Litter-Robot bundle. Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Beginly Visit beginlyhealth.com/curbsiders for the job matching platform for every Physician and Advanced Practice Clinician, from training to practice
In this episode, hosts Drs. Jason Silverman and Temara Hajjat talk to Drs. Michael Narkewicz and Zachary Sellers about screening, evaluation and management of children with cystic fibrosis with hepatobiliary involvement and advanced CF liver disease. We review the new consensus recommendations paper published in the May issue of Hepatology (open access link below). Dr. Narkewicz is a pediatric gastroenterologist and transplant hepatologist at Children's Hospital Colorado and professor of pediatrics at the University of Colorado with a strong clinical and research interest in cystic fibrosis and in particular on liver disease in cystic fibrosis who has presented and published extensively in this area over his career.Dr. Sellers is a pediatric gastroenterologist, Adjunct professor and physician-scientist at Stanford with clinical interests in the GI manifestations of cystic fibrosis and pancreatitis in children who has worked with the INSPPIRE consortium and has presented and published widely on CF and liver disease in CF.Learning objectives:Define cystic fibrosis with hepatobiliary involvement (CFHBI) and advanced cystic fibrosis liver disease (aCFLD)Outline recommendations for screening and evaluation for patients with CF and liver involvementOutline the recommendations for management of patients with CF and liver involvementPapers discussed in this episode (both are open access!:Cystic fibrosis screening, evaluation, and management of hepatobiliary disease consensus recommendationsTowards a Standardized Classification of the Hepatobiliary Manifestations in Cystic Fibrosis (CFHBI): A Joint ESPGHAN/NASPGHAN Position PaperSupport the Show.This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.
Contributor: Travis Barlock MD Educational Pearls: How do you differentiate between compensated and decompensated cirrhosis? Use the acronym VIBE to look for signs of being decompensated. V-Volume Cirrhosis can cause volume overload through a variety of mechanisms such as by increasing pressure in the portal vein system and the decreased production of albumin. Look for pulmonary edema (dyspnea, orthopnea, wheezing/crackles, coughing up frothy pink sputum, etc.) or a tense abdomen. I-Infection The ascitic fluid can become infected with bacteria, a complication called Spontaneous Bacterial Peritonitis (SBP). Look for abdominal pain, fever, hypotension, and tachycardia. Diagnosis is made with ascitic fluid cell analyses (polymorphonuclear neutrophils >250/mm3) B-Bleeding Another consequence of increased portal pressure is that blood backs up into smaller blood vessels, including those in the esophagus. Over time, this increased pressure can result in the development of dilated, fragile veins called esophageal varices, which are prone to bleeding. Look for hematemesis, melena, lightheadedness, and pale skin. E-Encephalopathy A failing liver also does not clear toxins which can affect the brain. Look for asterixis (flapping motion of the hands when you tell the patient to hold their hands up like they are going to stop a bus) Other complications to look out for. Hepatorenal syndrome Hepatopulmonary syndrome References Engelmann, C., Clària, J., Szabo, G., Bosch, J., & Bernardi, M. (2021). Pathophysiology of decompensated cirrhosis: Portal hypertension, circulatory dysfunction, inflammation, metabolism and mitochondrial dysfunction. Journal of hepatology, 75 Suppl 1(Suppl 1), S49–S66. https://doi.org/10.1016/j.jhep.2021.01.002 Enomoto, H., Inoue, S., Matsuhisa, A., & Nishiguchi, S. (2014). Diagnosis of spontaneous bacterial peritonitis and an in situ hybridization approach to detect an "unidentified" pathogen. International journal of hepatology, 2014, 634617. https://doi.org/10.1155/2014/634617 Mansour, D., & McPherson, S. (2018). Management of decompensated cirrhosis. Clinical medicine (London, England), 18(Suppl 2), s60–s65. https://doi.org/10.7861/clinmedicine.18-2-s60 Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMS II
Where can you find the Fountain of Youth? It can be found in a simple liver detox. In this episode, we're exploring the transformative world of liver detoxification. Discover why a liver detox is the ultimate beauty serum. Can a liver detox result in the reduction of visible fine lines and wrinkles? Absolutely! The answer to youthful, glowing skin is a liver detox away. Many women also report losing up to 10 pounds on my 14-day liver detox. Tune into this episode and discover how to age backward and glow with my simple liver detox kit!Liver detoxification is also the foundation of health. When you have a healthy liver, you can enjoy better digestion, hormone balance, a reduction in anxiety and depression, better sleep, weight loss, a stronger immune system, more energy, a reduction in joint pain, and anti-aging at the cellular level.You'll learn exactly how to activate all three phases of a liver detox safely. If you've had a drop of alcohol or fried food in the last year, you'll benefit from the life-changing benefits of liver detoxification.What's Your #1 Hormone Blocker? How Can You Optimize Hormonal Balance & Shed That Stubborn Mid-Section? Take This FREE 60-Second Quiz To Find Out! Are You Ready To Feel Good In Your Clothes Again? Start your journey with my exclusive Fasting Guide and 5 day meal plan! Support your hormone balance with Hormone Tame Essentials Multivitamin. Connect with Dr. Tabatha and the Team at Her Higher Health: Schedule Free a Zoom CallWant to learn more? Watch my new webinar about Mastering your hormones. Dr. Tabatha's Facebook: https://www.facebook.com/DrTabathaDr. Tabatha's IG: https://www.instagram.com/thegutsygynecologist/Dr. Tabatha's YouTube: https://www.youtube.com/c/TheGutsyGynecologist
Episode 36! In this episode we talk about tranexamic acid in GI bleeds. We flip the script a little bit and talk about our OLD article first, HALT-IT or "Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis: A randomized controlled trial" published in Lancet in 2020. This sets the stage for our new trial "Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis" published in Kumar et al in Hepatology (a new journal for us!)HALT-IT: https://pubmed.ncbi.nlm.nih.gov/32563378/TXA and cirrhosis: https://pubmed.ncbi.nlm.nih.gov/38441903/If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
In today's flashback, an outtake from Episode 455, my conversation with author Min Jin Lee. The episode first aired on January 9, 2019. Min Jin Lee is the author of the novels Free Food for Millionaires and Pachinko, a finalist for the National Book Award, and runner-up for the Dayton Literary Peace Prize. In 2022, Lee received the Manhae Grand Prize for Literature, the Bucheon Diaspora Literary Award, and the Samsung Happiness for Tomorrow Award for Creativity from South Korea. She is the recipient of fellowships in Fiction from the Guggenheim Foundation, the Radcliffe Institute of Advanced Study at Harvard, and the New York Foundation for the Arts. Lee is an inductee of the New York Foundation for the Arts Hall of Fame and the New York State Writers Hall of Fame. In 2023, Lee served as the Editor of Best American Short Stories. She is a Writer-in-Residence at Amherst College. She is at work on her third novel, American Hagwon and a nonfiction work, Name Recognition. *** Otherppl with Brad Listi is a weekly literary podcast featuring in-depth interviews with today's leading writers. Available where podcasts are available: Apple Podcasts, Spotify, YouTube, etc. Subscribe to Brad Listi's email newsletter. Support the show on Patreon Merch @otherppl Instagram TikTok Email the show: letters [at] otherppl [dot] com The podcast is a proud affiliate partner of Bookshop, working to support local, independent bookstores. Learn more about your ad choices. Visit megaphone.fm/adchoices
Today, I'm going to share 22 signs of a magnesium deficiency. Sixty percent of magnesium is in the bone, 20% is in the muscle, 19% is in the soft tissue, and 1% is in the blood. Magnesium deficiency is the most overlooked deficiency because it cannot be detected by a blood test. The top causes of magnesium deficiency include: • Consumption of sugar and refined carbs • Alcohol consumption • Cirrhosis of the liver • NPK fertilizer leads to crops that are low in magnesium • Malabsorption from gut inflammation • Diuretics • PPIs • Gastric bypass surgery • Low vitamin D • Inflammation Diabetes, high blood pressure, arthritis, osteoporosis, and cardiovascular disease are all associated with low magnesium. The best sources of magnesium are leafy greens, almonds, and dark chocolate, but some of these foods contain oxalates. Oxalates block the absorption of magnesium. Meat, cheese, and shellfish contain magnesium and do not contain oxalates. Here are 22 surprising signs of magnesium deficiency: • Anxiety • Insomnia • Depression • Migraines • Restless leg syndrome • Muscle cramps • Fatigue • Tourette's syndrome • Oxidative cholesterol • High homocysteine levels • High blood pressure • Calcification of the arteries • Arrhythmias • Stroke • Metabolic syndrome • Polycystic ovarian syndrome • Kidney stones • Higher levels of calcium in the blood • Inflammation • Nystagmus • Asthma Neuromuscular excitability, or tetany, is the number 1 earliest sign of a magnesium deficiency. Tetany is a twitching of the muscles, often affecting the left eye. Magnesium is required for proper nerve function. When you're deficient, the nerves become more excited, leading to faster nerve impulses.
Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volume depletion Albumin repletes volume stores and reduces renal impairment Albumin binds inflammatory cytokines and expands plasma volume Reduced all-cause mortality if IV albumin is given with antibiotics Hepatorenal syndrome Cirrhosis of the liver causes the release of endogenous vasodilators The renin-angiotensin-aldosterone system (RAAS) fails systemically but maintains vasoconstriction at the kidneys, leading to decreased renal perfusion IV albumin expands plasma volume and prevents failure of the RAAS Large volume paracentesis Large-volume removal may lead to circulatory dysfunction IV albumin is associated with a reduced risk of paracentesis-associated circulatory dysfunction There are many other FDA-approved conditions for which to use exogenous albumin but the data are conflicted about the benefits on mortality References 1. Arroyo V, Fernandez J. Pathophysiological basis of albumin use in cirrhosis. Ann Hepatol. 2011;10(SUPPL. 1):S6-S14. doi:10.1016/s1665-2681(19)31600-x 2. Bai Z, Wang L, Wang R, et al. Use of human albumin infusion in cirrhotic patients: a systematic review and meta-analysis of randomized controlled trials. Hepatol Int. 2022;16(6):1468-1483. doi:10.1007/s12072-022-10374-z 3. Batool S, Waheed MD, Vuthaluru K, et al. Efficacy of Intravenous Albumin for Spontaneous Bacterial Peritonitis Infection Among Patients With Cirrhosis: A Meta-Analysis of Randomized Control Trials. Cureus. 2022;14(12). doi:10.7759/cureus.33124 4. Kwok CS, Krupa L, Mahtani A, et al. Albumin reduces paracentesis-induced circulatory dysfunction and reduces death and renal impairment among patients with cirrhosis and infection: A systematic review and meta-analysis. Biomed Res Int. 2013;2013. doi:10.1155/2013/295153 5. Sort P, Navasa M, Arroyo V, et al. Effect of Intravenous Albumin on Renal Impairment and Mortality in Patients with Cirrhosis and Spontaneous Bacterial Peritonitis. N Engl J Med. 1999;341(6):403-409. Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit
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