Podcasts about hepatic

Today's Case A 60-year-old female with a history of type 2 diabetes mellitus, hypothyroidism, and hypercalcemia complicated by recurrent nephrolithiasis and recurrent urinary tract infections presents to the emergency department from her urology appointment with a blood pressure of 80/34 mmHg. Over the past few months, she has also experienced a 60 lb weight loss, shortness of breath, and generalized fatigue. She was admitted to the hospital where her lab tests were notable for hypercalcemia (16.6 mg/dL), elevated alkaline phosphatase (305 U/L), aspartate aminotransferase (52 U/L), alanine aminotransferase (24 U/L), and total bilirubin (0.8 mg/dL). Today's Reader Jared Fehlman is an Internal Medicine Resident at Huntington Health Hospital in Pasadena, California. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠The Dr. Raj Podcast⁠⁠ ⁠⁠Dr. Raj on Twitter⁠⁠ ⁠⁠Dr. Raj on Instagram⁠⁠ Want more board review content? ⁠⁠USMLE Step 1 Ad-Free Bundle⁠⁠ ⁠⁠Crush Step 1⁠⁠ ⁠⁠Step 2 Secrets⁠⁠ ⁠⁠Beyond the Pearls⁠⁠ ⁠⁠The Dr. Raj Podcast⁠⁠ ⁠⁠Beyond the Pearls Premium⁠⁠ ⁠⁠USMLE Step 3 Review⁠⁠ ⁠⁠MedPrepTGo Step 1 Questions⁠⁠ ⁠⁠MedPrepTGo Step 2 Questions⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

When a liver tumor is hard to see, the limits of conventional image guidance can become the limits of treatment. In this episode of the BackTable Podcast, Netherlands interventional oncologist Dr. Maarten (M.L.J.) Smits shares a step-by-step walkthrough of the new hepatic arteriography and C-arm CT–guided ablation (HepACAGA) technique, punctuated with a real-world case series at the end. Find out how intra-arterial contrast, cone-beam CT, and 3D needle guidance can improve tumor conspicuity, targeting accuracy, and ablation margin assessment within a single angiography suite. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:55 - Netherlands Tech Access04:31 - Origin of HepACAGA07:14 - Why Use a Catheter?11:24 - Tools and Setup13:13 - Catheters and Devices17:06 - Contrast Protocol Basics22:51 - Targeting and Needle Guidance31:09 - Patient Selection35:56 - Extra Benefits and Multimodal39:58 - Workflow and Outcomes46:14 - Evidence and Early Studies51:41 - Rethinking Size Cutoffs57:54 - HCC Case Walkthrough01:02:27 - Hard-to-See Metastasis01:06:22 - Margin Driven Reablation01:11:04 - Bleeding and Embolization01:16:05 - Renal ACAGA Expansion01:23:31 - Adoption and Next Steps --- More about this episode Dr. Smits explains the origins of HepACAGA and why catheter-based contrast delivery can meaningfully change ablation planning, particularly for small lesions, poorly visualized tumors, and cases where ultrasound or conventional CT guidance may be insufficient. He walks through the practical setup, including catheter positioning, contrast dilution, timing protocols, needle navigation, apnea/end-expiration technique, and built-in fusion for immediate ablation verification. He also describes how the angio suite environment supports multimodal treatment, including intraprocedural embolization when bleeding occurs or when additional transarterial therapy is needed. The episode also examines early outcomes from Dr. Smits' group, including a reported reduction in local recurrence from approximately 25% to 5%, with a modest increase in procedure time. Case examples include HCC, small colorectal liver metastases, margin-driven re-ablation, hemorrhage management, and extension of the ACAGA concept to renal tumors (RenACAGA). --- Resources Hepatic Arteriography and C-Arm CT-Guided Ablation (HepACAGA) to Improve Tumor Visualization, Navigation and Margin Confirmation in Percutaneous Liver Tumor Ablationhttps://pubmed.ncbi.nlm.nih.gov/37704863/ Renal Arteriography and C-arm CT-Guided Ablation (RenACAGA) for Thermal Ablation of Challenging Renal Tumorshttps://pubmed.ncbi.nlm.nih.gov/40295401/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

In this replay episode from 2 years ago, we delve into the world of adult congenital heart disease to review the topic of liver disease in the Fontan patient and specifically, hepatocellular carcinoma (HCC). What is the prevalence of this disease in the Fontan single ventricle adult patient? How effective are scores like the MELD-XI or Fibrosis-4 Index at identification of HCC in the Fontan patient? How should the Fontan adult patient be surveilled for this form of cancer? What evidence is there that earlier identification of HCC is associated with better outcomes? What may prove to be the most important factor in protection of the liver in the Fontan patient? Dr. Yuli Kim, Director of the ACHD program at The University of Pennsylvania shares her deep insights this week into this important topic.DOI: 10.1093/eurheartj/ehad788

Welcome to those that inhibit the "De Novo Synthesis" of cholesterol. We talk about the statins and the new kid on the block Bempedoic acid brand name Nexletol.

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hepatic Angiosarcoma⁠ from the Oncology section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

Navigating hepatic encephalopathy can be complex, and the role of ammonia levels is often misunderstood. In this concise episode, we clarify why hepatic encephalopathy is fundamentally a clinical diagnosis, not one based solely on lab values, and reveal the crucial limitations of ammonia testing. Learn when ammonia levels are genuinely helpful - specifically in acute liver failure - and why relying on them for routine diagnosis or trending can lead clinicians astray, diverting focus from essential clinical assessment. Subscribe to our Substack: https://substack.com/@rokeefemd

Beth Lehman went through a tumultuous year in 2020.  Thanks to heavy drinking, she was diagnosed with cirrhosis, then basal cell carcinoma, a type of skin cancer, followed by hepatocellular carcinoma, a form of liver cancer.  She underwent radioactive embolization in order to get a liver transplant.  Beth said the two-hour operation wasn't so tough, but the after-effects were difficult, including nausea and vomiting.  Then she experienced a procedure to get rid of the skin cancer on her right temple.  She says between her physical and emotional recovery, she advocates for cancer patients and is happier than ever.   Beth's alcohol consumption had soared to four or five bottles of wine a day.  In 2020, she began to have a buildup of fluid in her stomach, known as ascites.  For a long time, she avoided consulting a doctor, suspecting a doctor would tell her to quit drinking; but when ascites asserted itself, she sought medical attention.  She was diagnosed with cirrhosis.  Upon further examination, five tumors were discovered in her liver, which led to a diagnosis of hepatocellular carcinoma, a form of liver cancer.   This diagnosis came after another diagnosis of basal cell carcinoma, but the skin cancer had to take back seat to the liver cancer.   Beth said her care team first had to determine whether the cancer had spread beyond her liver.  Thankfully, it hadn't.  In order to complete a liver transplant, doctors wanted to execute radioactive embolization, in which radiation beads would be injected into her arteries through her wrist or groin and targeted at the tumors.  However, for that to happen, the tumors had to be 2cm, but her largest tumor was 1.87cm.  Incredibly, Beth's care team told her to go home and let the tumors grow so they would be large enough for it to go through with the radioactive embolization.   Once the tumors grew, Beth went through the procedure, also known as Y-90.  She had to go through the procedure a second time.  Usually, a second procedure comes eight to twelve weeks after the first procedure.  Beth's second procedure came just four weeks later.  She said she was awake during each procedure, each lasted about two hours, but the toughest part was post-treatment, as she had a great amount of radiation in her body, so much that upon returning home, she had to be sequestered from her husband and her pet cats. Once she recovered from her liver transplant, she had her skin cancer treated.  She said her doctors had to go seven layers deep to get all the cancer, but they did such an outstanding job that her incision is not visible.   Beth Lehman once had a lucrative IT position, but these days she works as an advocate for cancer patients, especially liver cancer patients and says she is happier than ever.   Additional Resources:   Support Groups:   The American Liver Foundation https://www.liverfoundation.org   Beth's Nonprofit, The Liver Circle https://www.thelivercircle.org   Beth's Personal Page with Her Story: https://www.bethlehmanliver.com          

Hepatic encephalopathy (HE) can feel like it comes out of nowhere: one day a patient is baseline, the next they're confused after “just” constipation, a little dehydration, or a routine diuretic tweak. In this episode, we unpack why seemingly benign stressors can flip a fragile gut–liver–brain system past its tipping point.Subscribe to the Point of Care Medicine Substack.

In this episode, we break down why lactulose and rifaximin work specifically for HE: lactulose acidifies the colon to “trap” ammonia as ammonium (NH4⁺) and rapidly clears nitrogen substrates via catharsis, while rifaximin reshapes the gut microbiome and dampens gut-derived inflammatory signaling - benefits that don't always correlate with serum ammonia levels. We also cover why other antibiotics fell out of favor, where polyethylene glycol fits, and how to think mechanistically about the best risk–reward strategy for preventing and treating HE.Subscribe to the Point of Care Medicine Substack

In this episode of the JIMD Podcast, Terry G. J. Derks, Alessandro Rossi, Sarah C. Grünert and Yunkoo Kang talk about the evolving role of continuous glucose monitoring (CGM) in liver glycogen storage diseases. The conversation spans international consensus on CGM use and an exciting deep-learning approach to predicting hypoglycaemia, pointing towards more personalised and preventive care for people living with GSD. State of the Art and Consensus Statements by Healthcare Providers, Patients, and Caregivers on Continuous Glucose Monitoring in Liver Glycogen Storage Diseases Terry G. J. Derks, et al https://doi.org/10.1002/jimd.70040 and A deep learning approach for blood glucose monitoring and hypoglycemia prediction in glycogen storage disease Ji Seung Ryu, et al https://www.nature.com/articles/s41598-025-97391-8

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Minimal-Hepatic-Encephalopathy-A-Covert-Operation/39788/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Minimal-Hepatic-Encephalopathy-Hiding-in-Plain-Sight/39787/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Hepatic-Encephalopathy-More-Common-Than-You-Think/39786/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Treatment-of-Hepatic-Encephalopathy-Primary-vs-Secondary-Prophylaxis/39791/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/The-Slippery-Slope-of-Overt-Hepatic-Encephalopathy/39789/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Treatment-of-Hepatic-Encephalopathy-When-What-How-and-Why/39790/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Optimizing-Care-of-the-Hospitalized-Patient-With-Overt-Hepatic-Encephalopathy/39792/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/Current-Treatment-of-Hepatic-Encephalopathy-Is-It-Meeting-Our-Patients-Needs/39793/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

CME credits: 1.00 Valid until: 11-12-2026 Claim your CME credit at https://reachmd.com/programs/cme/advances-in-the-oreatment-of-overt-hepatic-encephalopathy-whats-in-the-pipeline/39794/ This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

In this episode, Gregory J. Tiesi, MD, FACS, FSSO, hosted a discussion about the use of hepatic artery infusion (HAI) in colon cancer and liver cancer management. Dr Tiesi is the medical director of Hepatobiliary Surgery at the Hackensack Meridian Jersey Shore University Medical Center in Toms River and Brick, New Jersey. He was joined by: Anthony Scholer, MD, FACS, FSSO, a surgical oncologist specializing in hepatobiliary surgery, at Hackensack Meridian Medical Group and Jersey Shore University Medical Center in Neptune, New Jersey Benjamin Jon Golas, MD, FACS, regional chief of Surgical Oncology for Hackensack Meridian Health's Central Region, surgical director of Oncology Services at Jersey Shore University Medical Center, vice chair of Surgery at Jersey Shore University Medical Center Cancer Surgery, and an associate professor of surgery at the Hackensack Meridian School of Medicine in Neptune and Edison, New Jersey Eric Pletcher, MD, a surgeon specializing in Complex General Surgical Oncology at Hackensack Meridian JFK University Medical Center in Edison Drs Tiesi, Scholer, Golas, and Pletcher explained that HAI is a longstanding regional therapy used for treating primary and metastatic tumors to the liver, notably unresectable colorectal liver metastases and intrahepatic cholangiocarcinoma. The physiologic mechanism of this treatment leverages the dual blood supply of the liver, capitalizing on the fact that these malignancies primarily derive their perfusion from the hepatic artery, the experts noted. They emphasized that by delivering chemotherapeutic agents, such as floxuridine, directly via the gastroduodenal artery, HAI concentrates drug exposure at the tumor site, maximizing antitumor effect and minimizing extrahepatic toxicity.  They explained that patient selection requires fitness for surgery and good liver function, excluding those with cirrhosis or portal hypertension. They also noted that the procedure involves implanting a subcutaneous pump, followed by rigorous intraoperative and postoperative nuclear medicine studies to confirm the absence of extrahepatic perfusion. Evidence supports that HAI combined with systemic therapy achieves higher intrahepatic objective responses, improves local disease control, and enhances conversion to resectability, correlating with improved long-term survival, the experts reported. However, potential complications include pump pocket infections, biliary sclerosis, and gastric ulcers, they added. The experts concluded by highlighting that establishing an HAI program necessitates a robust, multidisciplinary approach involving surgical oncology, medical oncology, and interventional radiology.

For World Antimicrobial Awareness Week 2025 (“Act Now: Protect Our Present, Secure Our Future”), this EASL Studio explores the balance between rifaximin's benefits in hepatic encephalopathy and the global challenge of antimicrobial resistance.Moderator: Debbie ShawcrossSpeakers: Rajiv Jalan, Vishal Patel, Jonel TrebickaAll EASL Studio Podcasts are available on EASL Campus.Click here to see all EASL Video Podcasts on Apple Podcasts.This EASL Studio is supported by Alfasigma and Norgine. EASL has received no input from Alfasigma or Norgine with regards to the content of this programme.

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠Hepatic Encephalopathy⁠⁠ from the Gastrointestinal section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-unmet-therapeutic-needs/39665/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-an-ominous-sign/39666/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-whats-sarcopenia-got-to-do-with-it/39663/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/treatment-of-overt-hepatic-encephalopathy/39664/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/diagnosing-minimal-hepatic-encephalopathy-theres-an-app-for-that/39662/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-tipping-the-balance/39660/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/the-clinical-spectrum-of-hepatic-encephalopathy/39304/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

CME credits: 1.00 Valid until: 23-10-2026 Claim your CME credit at https://reachmd.com/cme/gastroenterology-and-hepatology/hepatic-encephalopathy-an-ominous-sign/39278/ This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

Contributor: Alec Coston, MD Educational Pearls: Hepatic encephalopathy (HE) is defined as a disruption in brain function that results from impaired liver function or portosystemic shunting. Manifests as various neurologic and psychiatric symptoms such as confusion, inattention, and cognitive dysfunction Although ammonia levels have historically been recognized as important criteria for HE, the diagnosis is ultimately made clinically. An elevated ammonia level lacks sensitivity and specificity for HE Trends in ammonia levels do not correlate with disease improvement or resolution A 2020 study published in the American Journal of Gastroenterology evaluated 551 patients diagnosed with hepatic encephalopathy and treated with standard therapy Only 60% of patients had an elevated ammonia level, demonstrating the limitations of ammonia levels However, a normal ammonia level in a patient with concern for HE should raise suspicion for other pathology. In patients with cirrhosis presenting with neuropsychiatric symptoms, consider HE as the diagnosis after excluding other potential causes of altered mental status (i.e., Seizure, infection, intracranial hemorrhage) The primary treatment is lactulose Works by acidifying the gastrointestinal tract. Ammonia (NH₃) is converted into ammonium (NH₄⁺), which is poorly absorbed and subsequently eliminated from the body Also exerts a laxative effect, further enhancing elimination References: Haj M, Rockey DC. Ammonia Levels Do Not Guide Clinical Management of Patients With Hepatic Encephalopathy Caused by Cirrhosis. Am J Gastroenterol. 2020 May;115(5):723-728. doi: 10.14309/ajg.0000000000000343. PMID: 31658104. Lee F, Frederick RT. Hepatic Encephalopathy-A Guide to Laboratory Testing. Clin Liver Dis. 2024 May;28(2):225-236. doi: 10.1016/j.cld.2024.01.003. Epub 2024 Jan 30. PMID: 38548435. Vilstrup, Hendrik1; Amodio, Piero2; Bajaj, Jasmohan3,4; Cordoba, Juan1,5; Ferenci, Peter6; Mullen, Kevin D.7; Weissenborn, Karin8; Wong, Philip9. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study Of Liver Diseases and the European Association for the Study of the Liver. Hepatology 60(2):p 715-735, August 2014. | DOI: 10.1002/hep.27210 Weissenborn K. Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles. Drugs. 2019 Feb;79(Suppl 1):5-9. doi: 10.1007/s40265-018-1018-z. PMID: 30706420; PMCID: PMC6416238. Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4 Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/ Donate: https://emergencymedicalminute.org/donate/  

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In this episode, we review the high-yield topic ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hepatic Adenoma⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Oncology section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

Podcast family, in this episode we will reply to 2 questions raised by our 2 of our podcast family members. The first pertains to a real world, HORRIBLE tragedy of hepatic rupture in pregnancy (no identifiable information released). We will review how and why this happens and what is the single, 5-letter, clinical diagnosis that makes this a possibility. Secondly, we will answer this question: Can MagSo4 ALONE lead to pulmonary edema. The answer is YES. Listen in for details.1. ACOG PB 222;20202. COMMONLY USED MAGNESIUM SULFATE UNCOMMONLY CAUSING PULMONARY EDEMAVYATA, VISHRUTH et al.CHEST, Volume 162, Issue 4, A10293. Singh Y, Kochar S, Biswas M, Singh KJ. Hepatic Rupture Complicating HELLP Syndrome in Pregnancy. Med J Armed Forces India. 2009 Jan;65(1):89-90. doi: 10.1016/S0377-1237(09)80072-5. Epub 2011 Jul 21. PMID: 27408207; PMCID: PMC4921511.4. Escobar Vidarte MF, Montes D, Pérez A, Loaiza-Osorio S, José Nieto Calvache A. Hepatic rupture associated with preeclampsia, report of three cases and literature review. J Matern Fetal Neonatal Med. 2019 Aug;32(16):2767-2773. doi: 10.1080/14767058.2018.1446209. 

A Chinese trial found dapagliflozin improved MASH outcomes, with higher resolution and fibrosis improvement rates than placebo. A JAMA Network Open survey showed 42% of abortion providers in ban states relocated, mostly to states with protections, highlighting growing care gaps. An oncology study found AI analysis of body composition better predicted chemo dose reductions than body surface area, especially in women.

Full article: Attenuation Coefficient for Hepatic Steatosis Using a Single Ultrasound System: Associations of Measurement Parameters With Interoperator Agreement and Diagnostic Performance Morgan McLuckey, MD, discusses the AJR article by Ferraioli et al. exploring attenuation coefficient for hepatic steatosis evaluation using a single ultrasound system.

Lucas Agnoletto and Dr Rebecca Halligan report work looking at sleep quality in children with hepatic GSDs, considering whether sleep is impacted by poor glycemic control or our efforts to improve this through overnight feeding. Sleep quality in children with hepatic glycogen storage diseases, a prospective observational pilot study Lucas Agnoletto, et al https://doi.org/10.1002/jmd2.12462

Radiology read to you! Vikas Shah is joined by Joe to discuss all things hepatic adenoma. Understanding of subtypes and imaging characteristics has evolved in recent years, so this will be a useful update for many listeners. Plus Andrew and Frank chat about X-Boost, pineapples, Minecraft, comedy and an MRI-inspired symphony!  Radiopaedia's hepatic adenoma article ► https://radiopaedia.org/articles/hepatic-adenoma Radiopaedia 2025 Virtual Conference ► https://radiopaedia.org/courses/radiopaedia-2025-virtual-conference Pineapple essay ► https://worksinprogress.co/issue/king-of-fruits/ Jaakko Kuusisto website ► https://www.jaakkokuusisto.fi/ Jaakko Kuusisto Symphony, Op. 39 ► https://www.youtube.com/watch?v=6cezFaagT5w Become a supporter ► https://radiopaedia.org/supporters Get an All-Access Pass ► https://radiopaedia.org/courses/all-access-course-pass Radiopaedia Community chat ► http://radiopaedia.org/chat Ideas and Feedback ► podcast@radiopaedia.org   The Reading Room is a radiology podcast intended primarily for radiologists, radiology registrars and residents. 

In this episode, we review the high-yield topic ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hepatic Encephalopathy ⁠⁠⁠⁠⁠⁠⁠⁠from the Gastrointestinal section at ⁠⁠⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠ 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

References Guerra, DJ.2025. Biochemistry Notes Cell Metabolism 2024.  Issue 6P. Volume 36: 1371-1393.e7 Habershon, Ada R. in 1907. "Will the Circle be Unbroken" on Earl Scruggs Revue lp. https://youtu.be/cslIdg2Q5oM?si=KgxebBDyyK1bncDX Hayward, J. 1968"the Actor" Moody Blues. https://youtu.be/sFHUJeTHznk?si=idGJ5N5WxMxgS453

Episode 31  In this episode, we will be discussing hepatic failure.  Topics include:Functions of the liver as a basis for understanding the diseaseFindings in cirrhotic liver diseaseDiagnostic findings in cirrhotic liver diseaseTreatment of liver diseaseHead over to my website to subscribe to my email group!  I send out sample CCRN & PCCN Questions and will be starting a newsletter in 2025!  Click here to join:  https://kayhoppepresents.com/To get my full CCRN Review Online Course, click here:   https://kay-hoppe-presents.teachable.com/p/ccrn-reviewTo get my full PCCN Review Online Course, CLICK HERE:  https://kay-hoppe-presents.teachable.com/p/pccn-review

BUFFALO, NY - December 9, 2024 – A new #research paper was #published in Oncotarget's Volume 15 on November 22, 2024, entitled “Computed tomography-based radiomics and body composition model for predicting hepatic decompensation." Mayo Clinic researchers Yashbir Singh, John E. Eaton, Sudhakar K. Venkatesh, and Bradley J. Erickson have developed an innovative AI tool to predict hepatic decompensation in individuals with primary sclerosing cholangitis (PSC). PSC is a chronic disease that damages the bile ducts and can lead to liver failure. Hepatic decompensation marks a critical stage of advanced liver disease, and clinicians have long faced challenges in predicting who is at risk. The Mayo Clinic's new AI tool addresses this gap by combining body fat and muscle composition data with insights extracted from computed tomography (CT) scans using computational radiomics. By analyzing these tissues, the AI model identifies patterns linked to an increased risk of liver failure. The study involved 80 PSC patients, including 30 with hepatic decompensation, 30 without, and 20 patients in an external validation set. The AI model achieved impressive results, correctly identifying at-risk patients with 97% accuracy. By recognizing these risks early, clinicians may be able to intervene sooner and improve patient outcomes. While the study focused on PSC, the team emphasized the broader implications of their work. “It may hold promise for the detection of other PSC-related complications, such as cholangiocarcinoma, as well as applications in more prevalent chronic liver diseases like non-alcoholic fatty liver disease (NAFLD).” This non-invasive, data-driven approach offers a powerful way to assess health risks and provide more tailored treatments. Despite the promising findings, the researchers acknowledge the limitations of the study, which include a limited sample size and a single-center design. “However, further research is necessary to validate our findings on a large-scale, independent dataset, ensuring the robustness and generalizability of the model.” In conclusion, this study shows how detailed information from CT scans can help clinicians predict severe liver problems in patients with PSC. By identifying hidden patterns in the images, they can better understand risks and create personalized treatment plans. This approach could improve care for PSC and other long-term liver diseases. DOI - https://doi.org/10.18632/oncotarget.28673 Correspondence to - Bradley J. Erickson - bje@mayo.edu Video short - https://www.youtube.com/watch?v=QCekNtYni4w Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28673 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, radiomics, body composition, machine learning, primary sclerosing cholangitis, computer tomography About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Host: Darryl S. Chutka, M.D. [@chutkaMD] Guest: Alina M. Allen, M.D., M.S. Fat deposits in the liver are quite common and many individuals have no idea they have the condition. A minority of those individuals will develop an associated hepatic inflammation. It's not entirely clear why some progress to this state, although there are some known risk factors. Steatohepatitis is a potentially serious health problem and can lead to end-stage liver disease. It's also associated with cardiovascular disease and all of its complications. The topic for today's podcast is Hepatic Inflammation and Metabolic Dysfunction-Associated Steatohepatitis. My guest is Alina M. Allen, M.D., M.S., from the Division of Gastroenterology and Hepatology at the Mayo Clinic. What are the risk factors for this health problem? Should we be screening patients for its presence and how should it be managed. These are just some of the topics we'll discuss in this podcast. These talks on Inflammation and Cardiometabolic Disease are sponsored by Novo Nordisk Learn more about this series HERE Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

When the diseased liver is unable to filter out neurotoxins like ammonia, we can see a spectrum of the neuropsychiatric symptoms of hepatic encephalopathy. For the final installment in our liver failure series, host Sarah Lorenzini highlights a complicated case of hepatic encephalopathy where critical thinking and interdisciplinary teamwork were key to preventing further complications.She examines the common signs and symptoms of hepatic encephalopathy, factors that trigger or exacerbate the condition, and challenges nurses face in the diagnostic process. This episode also dives into treatment strategies and how to differentiate between hepatic encephalopathy and alcohol withdrawal.Tune in to learn how cirrhosis can lead to hepatic encephalopathy, the effect of neurotoxins in the brain, and how you, as a nurse, can manage patient care!Topics discussed in this episode:Assessment of Sarah's rapid response consult patientThe team's interventions and patient outcomePathophysiology of hepatic encephalopathySigns and symptoms of hepatic encephalopathyDiagnostic challenges and aggravating factorsStrategies to manage hepatic encephalopathyHepatic encephalopathy versus alcohol withdrawalMentioned in this episode:AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!Rapid Response and Rescue Intro CourseCONNECT

In this episode, we explore the safety of antipsychotics in patients with liver disease. How can psychiatrists navigate the risk–benefit balance when treating medically complex individuals? Dr. Sydney LeFay discusses key insights from a recent review article, guiding antipsychotic selection and monitoring. Faculty: Sydney LeFay, D.O. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 56 Antipsychotic Safety in Liver Disease

In today's VETgirl online veterinary CE podcast, we interview Dr. Jasper Burke, DACVECC on her publication entitled Hepatic abscessation in dogs: A multicenter study of 56 cases (2010-;2019). While rare, tune in to learn everything you need to know - from diagnostic work up, clinical signs, clinicopathologic findings, treatment, and prognosis - about hepatic abscessation in dogs!

In today's VETgirl online veterinary CE podcast, we interview Dr. Jasper Burke, DACVECC on her publication entitled Hepatic abscessation in dogs: A multicenter study of 56 cases (2010–2019). If you're presented a middle-aged dog with "ADR" (ain't doing right!) signs who has elevated liver enzymes, hypoalbuminemia, thrombocytopenia, and a neutrophilia, this podcast is a must. While rare, tune in to learn everything you need to know - from diagnostic work up, clinical signs, clinicopathologic findings, treatment, and prognosis - about hepatic abscessation in dogs!Sponsored By: Royal Canin

You might have heard the buzz around berberine, often referred to as “nature's Ozempic”.   Berberine is a powerhouse for many things, from reducing inflammation to regulating blood sugar levels. Tune in to hear which benefits the science supports (and the surprising ones it doesn't) and get a simple dosing guide.  And if you have any additional questions you would like answered in the future, let me know in the comments!   Watch/Read Next… Diets Debunked: The Noom Program: https://drruscio.com/noom-debunked/  Diets Debunked: Weight Watchers: https://drruscio.com/weight-watchers/  Genetic Testing for Weight Loss Isn't Worth it. Here's what is: https://drruscio.com/genetic-testing-for-weight-loss/  How to Heal Your Gut Naturally: https://drruscio.com/how-to-heal-your-gut-naturally/     Timestamps 00:00 Intro  01:00 What is berberine?  01:37 Weight loss 02:34 Cholesterol 05:52 Blood sugar  08:47 Gut health  11:15 SIBO  12:53 Berberine dosing guide    Featured Studies  Biological properties and clinical applications of berberine: https://pubmed.ncbi.nlm.nih.gov/32335802/ Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Cardiovascular, Metabolic, Hepatic, and Renal Disorders: https://pubmed.ncbi.nlm.nih.gov/30186157/  The Effect of Berberine on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Control Trials: https://pubmed.ncbi.nlm.nih.gov/31915452/ The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials: https://pubmed.ncbi.nlm.nih.gov/32690176/ The effect of berberine supplementation on lipid profile and obesity indices: An umbrella review of meta-analysis: https://www.sciencedirect.com/science/article/abs/pii/S2213434423000361  Berberine decreases plasma triglyceride levels and upregulates hepatic TRIB1 in LDLR wild type mice and in LDLR deficient mice: https://pubmed.ncbi.nlm.nih.gov/31666640/  Berberine decreases cholesterol levels in rats through multiple mechanisms, including inhibition of cholesterol absorption: https://pubmed.ncbi.nlm.nih.gov/25002181/ Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials: https://pubmed.ncbi.nlm.nih.gov/36941490/ Efficacy and Safety of Berberine Alone or Combined with Statins for the Treatment of Hyperlipidemia: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials: https://pubmed.ncbi.nlm.nih.gov/31094214/ The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials: https://pubmed.ncbi.nlm.nih.gov/34956436/ Overall and Sex-Specific Effect of Berberine on Glycemic and Insulin-Related Traits: a Systematic Review and Meta-Analysis of Randomized Controlled Trials: https://pubmed.ncbi.nlm.nih.gov/37598753/ Effects of berberine and barberry on selected inflammatory biomarkers in adults: A systematic review and dose-response meta-analysis of randomized clinical trials: https://pubmed.ncbi.nlm.nih.gov/37675930/ Berberine improves intestinal epithelial tight junctions by upregulating A20 expression in IBS-D mice: https://pubmed.ncbi.nlm.nih.gov/31306972/ Berberine Enhances Intestinal Mucosal Barrier Function by Promoting Vitamin D Receptor Activity: https://pubmed.ncbi.nlm.nih.gov/37046128/ Berberine influences multiple diseases by modifying gut microbiota: https://pubmed.ncbi.nlm.nih.gov/37599699/ Berberine Improves Intestinal Motility and Visceral Pain in the Mouse Models Mimicking Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D) Symptoms in an Opioid-Receptor Dependent Manner: https://pubmed.ncbi.nlm.nih.gov/26700862/ A Randomized Clinical Trial of Berberine Hydrochloride in Patients with Diarrhea-Predominant Irritable Bowel Syndrome: https://pubmed.ncbi.nlm.nih.gov/26400188/ Efficacy and safety of berberine in preventing recurrence of colorectal adenomas: A systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/34509605/ Berberine and rifaximin effects on small intestinal bacterial overgrowth: Study protocol for an investigator-initiated, double-arm, open-label, randomized clinical trial (BRIEF-SIBO study): https://pubmed.ncbi.nlm.nih.gov/36873985/ Berberine and health outcomes: An umbrella review: https://pubmed.ncbi.nlm.nih.gov/36999891/ Bioavailability study of berberine and the enhancing effects of TPGS on intestinal absorption in rats: https://pubmed.ncbi.nlm.nih.gov/21637946/  Efficacy of berberine in patients with type 2 diabetes mellitus: https://pubmed.ncbi.nlm.nih.gov/18442638/    Get the Latest Updates Facebook - https://www.facebook.com/DrRusciodc Instagram - https://www.instagram.com/drrusciodc/ Pinterest - https://www.pinterest.com/drmichaelrusciodc    DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Music featured in this video: "Modern Technology" by Andrew G, https://audiojungle.net/user/andrew_g  *Full transcript available on YouTube by clicking the “Show transcript” button on the bottom right of the video.