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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.
Get ahead with VETAHEAD and join Dr. Proença on 15 minutes of ZooMed (exotic animal medicine) content. Today's episode is packed with insights on adipocytic (fat) tumors and xanthomas in our feathered friends! Join Dr. Proença as she breaks down a massive study covering 20 years of data on parrot adipocytic tumors, revealing key risk factors, common sites, and surprising associations with other health issues like arteriosclerosis and hepatic lipidosis. Ever wondered if age or species puts your patients at higher risk? Or which types of tumors are more likely to pop up in those Amazons and cockatiels? Tune in to get the lowdown on everything you need to know about these sneaky tumors, and how to better inform your clients about prognosis and care. Get ready to take your avian practice to the next level! Click here to get your VETAHEAD E-Magazine! Click here to receive a VETAHEAD Gift! Do you want to access more ZooMed (exotics) knowledge directly from specialists? Come with us and #jointhemovement #nospeciesleftbehind Head to VETAHEAD Website Join our VETAHEAD Community Follow @the_vetahead on Instagram Subscribe to @vetahead channel on YouTube Follow @vetahead on Facebook Follow @vetahead on TikTok
In this week's episode we'll discuss outcomes following hematopoietic stem cell transplantation in pediatric patients with Fanconi anemia. Then, we'll learn about how new research shows that the transcription factor Foxo1, commonly associated with glucose metabolism, regulates hepcidin expression and systemic iron homeostasis. Finally, in Latin America: using clinical networks to improve outcomes in patients with acute promyelocytic leukemia. After clinical networks were established, survival and relapse rates improved substantially, highlighting the effectiveness of this unique intervention strategy in low- and middle-income countries.Featured Articles: Outcomes of hematopoietic stem cell transplantation in 813 pediatric patients with Fanconi anemiaFoxo1 is an iron-responsive transcriptional factor regulating systemic iron homeostasisClinical networking results in continuous improvement of the outcome of patients with acute promyelocyticleukemia
Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Jasmohan Bajaj, MD Around 50 percent of people with cirrhosis have hepatic encephalopathy, which means some kind of brain dysfunction. As these patients age, it gets more and more difficult to differentiate between hepatic encephalopathy and dementia, which is why two recent studies sought to uncover how many patients with dementia have undiagnosed cirrhosis. According to the findings, the rate of undiagnosed cirrhosis and hepatic encephalopathy could be as high as 10‒13 percent. Joining Dr. Charles Turck to share further details about the studies, findings, and implications is Dr. Jasmohan Bajaj, Professor of Medicine in the Division of Gastroenterology, Hepatology, and Nutrition at Virginia Commonwealth University.
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 episode we're hearing from Rachel about her third birth. Her 2 eldest children were born via emergency c-section and a forceps assisted delivery - experiences which Rachel found traumatic - and she knew she wanted to feel more present and involved in any subsequent births. Before conceiving her third baby, Rachel was diagnosed with congenital hepatic fibrosis; a rare condition affecting the liver which can have problematic implications for birth, so she knew before becoming pregnant that her baby would need to be born via c-section and she shares all the aspects that make her planned surgery such a positive experience. She worked alongside a nutritionist, her medical team and an amazing doula to manage both her physical symptoms and her anxieties, and through learning to surrender to the circumstances outside of her control, she went on to have a beautiful caesarean birth. Rachel's IG: https://www.instagram.com/lifewith.rp/ Rachel's doula: https://www.instagram.com/marbedbirthing/ My website: www.serenalouth.com My IG: https://www.instagram.com/serenalouth/
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!
Today's show is about hepatic impairment clinical studies. I cover the rationale behind evaluating hepatic impairment, common study designs, and key factors in the analysis and interpretation of the study results. I also share a huge announcement about Aplos NCA, a cloud-based solution for calculating NCA PK parameters. Use the link below to learn more about Aplos NCA. Links discussed in the show: FDA guidance EMA guideline Aplos Analytics website You can connect with me on LinkedIn and send me a message Send me a message Sign up for my newsletter Copyright Teuscher Solutions LLC
BUFFALO, NY- March 20, 2024 – A new #research paper was #published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 16, Issue 5, entitled, “FoxO6-mediated ApoC3 upregulation promotes hepatic steatosis and hyperlipidemia in aged rats fed a high-fat diet.” FoxO6, an identified factor, induces hyperlipidemia and hepatic steatosis during aging by activating hepatic lipoprotein secretion and lipogenesis leading to increased ApoC3 concentrations in the bloodstream. However, the intricate mechanisms underlying hepatic steatosis induced by elevated FoxO6 under hyperglycemic conditions remain intricate and require further elucidation. In this new study, researchers Dae Hyun Kim, Seulah Lee, Sang Gyun Noh, Jaewon Lee, and Hae Young Chung from Pusan National University aimed to delineate the regulatory pathway involving ApoC3 controlled by FoxO6 and its resultant functional impacts. “[...] we employed a spectrum of models including liver cell cultures, aged rats subjected to HFD, transgenic mice overexpressing FoxO6 (FoxO6-Tg), and FoxO6 knockout mice (FoxO6-KO).” Their findings indicate that FoxO6 triggered ApoC3-driven lipid accumulation in the livers of aged rats on an HFD and in FoxO6-Tg, consequently leading to hepatic steatosis and hyperglycemia. Conversely, the absence of FoxO6 attenuated the expression of genes involved in lipogenesis, resulting in diminished hepatic lipid accumulation and mitigated hyperlipidemia in murine models. Additionally, the upregulation of FoxO6 due to elevated glucose levels led to increased ApoC3 expression, consequently instigating cellular triglyceride mediated lipid accumulation. The transcriptional activation of FoxO6 induced by both the HFD and high glucose levels resulted in hepatic steatosis by upregulating ApoC3 and genes associated with gluconeogenesis in aged rats and liver cell cultures. “Our conclusions indicate that the upregulation of ApoC3 by FoxO6 promotes the development of hyperlipidemia, hyperglycemia, and hepatic steatosis in vivo, and in vitro. Taken together, our findings underscore the significance of FoxO6 in driving hyperlipidemia and hepatic steatosis specifically under hyperglycemic states by enhancing the expression of ApoC3 in aged rats.” DOI - https://doi.org/10.18632/aging.205610 Corresponding author - Hae Young Chung - hyjung@pusan.ac.kr Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.205610 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, HFD-feeding aging, forkhead transcription factor O6, ApoC3, lipid accumulation, hepatic steatosis Aging publishes research papers in all fields of aging research including but not limited, aging from yeast to mammals, cellular senescence, age-related diseases such as cancer and Alzheimer's diseases and their prevention and treatment, anti-aging strategies and drug development and especially the role of signal transduction pathways such as mTOR in aging and potential approaches to modulate these signaling pathways to extend lifespan. The journal aims to promote treatment of age-related diseases by slowing down aging, validation of anti-aging drugs by treating age-related diseases, prevention of cancer by inhibiting aging. Cancer and COVID-19 are age-related diseases. Please visit our website at https://www.Aging-US.com and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM
Hepatic presentations of mitochondrial DNA depletion syndrome in children: A single tertiary liver centre experience R. Vara, et al https://doi.org/10.1002/jimd.12633
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.
Curious about the science behind muscle health during menopause? In today's episode, I dove deep into the complexities of muscle protein synthesis, amino acid metabolism, and the impact of estrogen on women's well-being. Get ready to uncover the secrets of muscle loss, discover how estrogen plays a pivotal role in muscle building, and understand the intricate connection between amino acids, weight gain, and glucose production. I break down various research, providing practical insights into personalized nutrition and exercise strategies tailored to your unique body composition and metabolic needs. Whether you're navigating weight concerns or aiming for optimal glucose levels, this episode is your go-to guide for evidence-based solutions. Tune in to gain a profound understanding of the importance of early intervention and the potential benefits of hormone replacement therapy. This episode is packed with scientific insights, and I made sure to make it accessible and actionable for you. Remember, menopause is a powerful time in our lives, and with the right knowledge and tools, we can master it for better health and vitality. Key Takeaways: [00:02:14] Dietary intake and literature review. [00:03:16] Muscle protein synthesis. [00:07:34] Estrogen's role in muscle mass and function. [00:08:09] Estrogen regulation in skeletal muscle aging. [00:13:30] Estrogen and skeletal muscle regeneration. [00:15:45] Follicular stimulating hormone and muscle building. [00:18:20] Amino acid metabolism in overweight vs. lean individuals. [00:20:31] Gluconeogenesis in perimenopause and menopause. [00:24:06] Amino acid contribution to gluconeogenesis. [00:36:26] Metabolic signature and amino acid metabolism. [00:41:05] Personalized approaches to muscle health. [00:43:34] Metabolic changes and weight gain in menopause. [00:45:48] Hormone reset and metabolic flexibility. [00:50:21] Gender inequality in research and hormone replacement. Memorable Quotes: "One weight training session, even if you whip your own butt with your trainer, is not enough because we don't have that same hardcore stimulus to muscle building that men have. So, a single session a week is not weight training. It is weight training for that one session, but it is not hard enough to cause significant muscle protein synthesis, particularly as we go through menopause." – Betty Murray "If you're doing all the right things and you're not getting the right answers, it may be the order in which you're doing things. And it may be that you have to shift a little bit and go into a therapeutic diet for a period of time to force the body to become more metabolically efficient and become metabolically flexible." – Betty Murray Links Mentioned: Free E-Book: A Woman's Guide to Kick-Ass Sleep FREE Quiz: Your Hormone Imbalance Type Resources and References: Insulin resistance and the metabolism of branched-chain amino acids in humans Physical performance in relation to menopause status and physical activity The Emergence of the Metabolic Syndrome with Menopause The Greater Contribution of Gluconeogenesis to Glucose Production in Obesity Is Related to Increased Whole-Body Protein Catabolism The Role of Oestrogen in Female Skeletal Muscle Ageing: A Systematic Review The Role of Estrogen in Insulin Resistance Decreased Consumption of Branched-Chain Amino Acids Improves Metabolic Health Separate Contribution of Diabetes, Total Fat Mass, and Fat Topography to Glucose Production, Gluconeogenesis, and Glycogenolysis Why does obesity cause diabetes? Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review A Branched-Chain Amino Acid-Related Metabolic Signature that Differentiates Obese and Lean Humans and Contributes to Insulin Resistance Follicle-stimulating hormone enhances hepatic gluconeogenesis by GRK2-mediated AMPK hyperphosphorylation at Ser485 in mice Hepatic estrogen receptor α is critical for regulation of gluconeogenesis and lipid metabolism in males Tracking the carbons supplying gluconeogenesis Weight gain during the menopause transition: Evidence for a mechanism dependent on protein leverage Role of branched-chain amino acid metabolism in the pathogenesis of obesity and type 2 diabetes-related metabolic disturbances BCAA metabolism in type 2 diabetes Branched-Chain and Aromatic Amino Acids Are Predictors of Insulin Resistance in Young Adults Estrogen Improves Insulin Sensitivity and Suppresses Gluconeogenesis via the Transcription Factor Foxo1 Connect with Betty Murray: Living Well Dallas Website Hormone Reset Website Betty Murray Website Facebook Instagram
12/10/23The Healthy Matters PodcastS03_E02 - The Mighty Liver...In Greek mythology, Prometheus' punishment for stealing fire from Zeus was to be chained to a rock where every day an eagle would come and eat part of his liver (harsh!). And since the liver is the only solid organ in the human body that grows back, that eagle must have been pretty well-fed. But why do we even need a liver? What happens to us when something goes wrong with it? And what can we do to take care of it? On Episode 2 of this season, we'll have an in-depth conversation about this unsung hero of the human body with Dr. José Debes (MD, MS, PhD), gastroenterologist at Hennepin Healthcare, and associate professor and researcher at the University of Minnesota. This episode is loaded with interesting facts about the liver, explanations of the different ailments associated with it, ways we can limit the stress we put on it, and the role coffee plays. Yep, coffee... Join us!Got a question for the doc? Or an idea for a show? Contact us!Email - healthymatters@hcmed.orgCall - 612-873-TALK (8255)Find out more at www.healthymatters.org
Recently, Sepideh Gholami implemented a Hepatic Artery Infusion Pump Program at Northwell Health. In this interview, Dr. Gholami discusses what exactly a hepatic artery infusion pump is, its benefits, and how it will affect the future treatment landscape of cancers as a whole. As well, she advocates for the implementation of these programs in more institutions across the nation.
Welcome to Episode 21 of Optimal - the Podcast! In this episode, we are joined by Dr. Julia Malkowski, who graduated with a doctorate in Naturopathic Medicine in December 2017, with advanced standing, and a doctorate in Chiropractic Medicine in April 2016 from the National University of Health Sciences. Dr. Dicken, Beth Ellen, and Dr. Malkowski discuss various topics related to health and wellness. Dr. Malkowski talks about how she came to practice naturopathic medicine. She talks about using naturopathic therapies to get her infant son back to health. She also describes her work with Doctor's Data, highlighting their emphasis on examining markers for intestinal permeability and the examination of the gut flora. At Doctor's Data, they also touch on other fields of expertise like cardiometabolic endocrinology and environmental exposure detoxification. Additionally, Dr. Malkowski covers multiple types of tests like blood, urine, hair, and stool testing and discusses numerous tests and techniques for determining toxins in the body, including glyphosate and Thallium. She also discusses nutritional assessment using tests of RBC elements and blood spots for vitamin D and DNA methylation. Ready to optimize your health? Tune in now to learn from Dr. Julia Malkowski about naturopathic medicine, gut health, toxin testing, and more in this episode of Optimal – The Podcast! Episode Highlights: (01:38) Introduction for Dr. Julia Malkowski (03:19) Dr. Mikowski's personal journey and how she became involved in healthcare and preventative medicine (06:12) Her education at the National University of Health Sciences (07:43) Dr. Mikowski's current focus and work at Doctor's Data (08:17) Functional testing and the specific tests offered by Doctor's Data (12:58) Insulin sensitivity (14:16) Hepatic detox profile and how it measures phase one and phase two detoxification (18:05) Blood spot testing and its expansion (24:01) About her day-to-day work at Doctor's Data (26:05) Geographical distribution of toxins (31:30) Diet and toxin exposure (35:07) Practical suggestions for improving health (43:41) Her article published in the Townsend Letter about bacteria and the hunter-gatherer diet Where to Reach Dr. Dicken Weatherby Dicken Weatherby LinkedIn Optimal DX Resource Center Optimal DX Blog Where to Reach Dr. Julia Malkowski Dr. Julia Malkowski Website Dr. Julia Malkowski LinkedIn Dr. Julia Malkowski Instagram Dr. Julia Malkowski Facebook Where to Reach Beth Ellen DiLuglio Nutrition Mission Beth Ellen DiLuglio LinkedIn Did you find today's episode helpful? If you enjoy today's conversation, please click here to leave a review for Optimal - The Podcast. Get notified when a new episode comes out by subscribing to Optimal - The Podcast on your favorite podcast app! Education is the most effective way to make a change. Help others get the information they need by sharing this episode!
In this episode, we review the high-yield topic of Hepatic Adenoma from the Oncology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message
In this episode, we review the high-yield topic of Hepatic Blood Flow Obstruction from the Gastrointestinal section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message
“I think that as oncology nurses, we need to keep ourselves really educated and up to date with these new therapies, because I honestly feel like we still haven't really seen the long-term effects of this treatment,” ONS member Lisa Parks, MS, APRN-CNP, ANP-BC, nurse practitioner in hepatobiliary surgery at The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center in Columbus, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about recognizing hepatic complications and understanding the basics of its symptom management strategies. This episode is part of a series on cancer symptom management basics; the others are linked below. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the disease-related biology, treatment, or symptom management, palliative care, supportive care ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by September 22, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.22, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge in cancer symptom management basics and hepatic complications. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast: Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 250: Cancer Symptom Management Basics: Dermatologic Complications Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications ONS Voice article: To Prevent Hepatotoxicity, Monitor Liver Function During Cancer Treatment Clinical Journal of Oncology Nursing articles: Checkpoint Inhibitors: Common Immune-Related Adverse Events and Their Management Identification and Management: Sinusoidal Obstruction Syndrome/Veno-Occlusive Disease Related to Hematopoietic Stem Cell Transplantation Use of Hepatic Artery Infusion Pumps in the Treatment of Hepatic Metastases ONS courses: ONS/ONCC Chemotherapy Immunotherapy Certificate Course ONS/ONCC Radiation Therapy Certificate Course ONS books: Cancer Basics (third edition)https://www.ons.org/books/cancer-basics-third-edition Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Manual for Radiation Oncology Nursing Practice and Education (fifth edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) American Gastroenterological Association American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org Highlights From Today's Episode “There is something called chemotherapy-induced liver injury. What the chemotherapy does is it has a direct hepatotoxic effect on the hepatocytes themselves. If you have preexisting liver disease such as cirrhosis, it can lead to very severe hepatotoxicity because the function of the liver is already compromised by the damage previously done to it.” TS 3:47 “The American Gastroenterological Association published guidelines on the management of HBV reactivation for patients during immunosuppressive treatment, and they basically do recommend any patients with a hep B virus that they receive antiviral prophylaxis to prevent this reactivation from occurring. Also in 2008, the CDC recommended universal HBV screening for all patients before administering chemotherapy. This one you see most commonly in patients who receive chemotherapy for a hematological cancer following hemopoietic stem cell transplantation.” TS 14:19 “One of the most common things that I've encountered in my practice is that there seems to be a thought that once hepatic complications are identified, there is treatment for this, and in these patients, we can't reverse liver injury. Really, what we offer these patients is supportive care. These patients often can decompensate really quickly, and often these patients may require being transferred to the intensive care unit and it's not because there's any intervention that we're going to do. But I think it's very frustrating for nurses to see these severe liver injuries, that are life threatening, and not to be able to do anything about it.” TS 19:06
Take My Udemy Course: https://www.udemy.com/course/draft/5505730/?referralCode=C418EDF9C393C5716D9Ecoupon good till sep 23, 20234F6C28C032B430883D56https://www.udemy.com/course/draft/5505730/?couponCode=4F6C28C032B430883D56Have you ever given much thought to the unsung hero within you called your LIVER? Your liver is a powerhouse that deserves your attention. This podcast episode unveils the fascinating world of the liver's remarkable functions. Your liver regulates blood sugar, detoxifies your body, stores essential nutrients, supports your immune system, and even has the incredible ability to regenerate itself. But wait, there's more! We delve into some unexpected dangers to your liver, and how you can nurture this amazing organ. From reducing fructose intake to embracing healthy fats and supplements, discover the keys to keeping your liver happy and thriving. So let's give a shoutout to your liver – your real-life superhero. Tune in now and join the journey of empowering your liver for a vibrant and wholesome life!
For patients with insufficient future liver remnant (FLR) volume, adequate hypertrophy after Portal Venous Embolization (PVE) is associated with reduced likelihood of post-operative hepatic insufficiency. But what happens when PVE isn't enough to obtain adequate volume prior to surgery? In this episode from the HPB team at Behind the Knife, listen in on the discussion about advances in venous deprivation techniques that can potentially increase resection rates and hypertrophy Hosts Anish J. Jain MD (@anishjayjain) is a T32 Research Fellow at the University of Texas MD Anderson Cancer Center within the Department of Surgical Oncology. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center. Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center Learning Objectives: - Develop an understanding of Portal Venous Embolization (PVE) - Develop an understanding of Sequential Hepatic Venous Embolization (HVE) - Develop an understanding of Radiological Simultaneous Porto-hepatic Venous Embolization (RASPE) - Develop an understanding of the traditional two-stage hepatectomy with PVE - Develop an understanding of the Fast Track Two-Stage Hepatectomy Papers Referenced (in the order they were mentioned in the episode): 1) Niekamp AS, Huang SY, Mahvash A, Odisio BC, Ahrar K, Tzeng CD, Vauthey JN. Hepatic vein embolization after portal vein embolization to induce additional liver hypertrophy in patients with metastatic colorectal carcinoma. Eur Radiol. 2020 Jul;30(7):3862-3868. doi: 10.1007/s00330-020-06746-4. Epub 2020 Mar 7. PMID: 32144462. 2) Laurent C, Fernandez B, Marichez A, Adam JP, Papadopoulos P, Lapuyade B, Chiche L. Radiological Simultaneous Portohepatic Vein Embolization (RASPE) Before Major Hepatectomy: A Better Way to Optimize Liver Hypertrophy Compared to Portal Vein Embolization. Ann Surg. 2020 Aug;272(2):199-205. doi: 10.1097/SLA.0000000000003905. PMID: 32675481. 3) Nishioka Y, Odisio BC, Velasco JD, Ninan E, Huang SY, Mahvash A, Tzeng CD, Tran Cao HS, Gupta S, Vauthey JN. Fast-track two-stage hepatectomy by concurrent portal vein embolization at first-stage hepatectomy in hybrid interventional radiology / operating suite. Surg Oncol. 2021 Dec;39:101648. doi: 10.1016/j.suronc.2021.101648. Epub 2021 Aug 16. PMID: 34438236. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/
Thank you for listening to this episode of "Health and Fitness" from the Nezpod Studios! Enjoy your night or the start of your day, spiced by our top-notch health and fitness/wellness updates coined from the best sources around the globe: made only for your utmost enjoyment and enlightenment… Click on subscribe to get more spicy episodes for free! See you again soon on the next episode of Health and Fitness Updates! Learn more about your ad choices. Visit megaphone.fm/adchoices
Title: ID Grand Rounds: Hepatic Infections Speaker: Merin Varghese, MD Consultant, Infectious Disease Physician Lead, Antimicrobial Stewardship No financial disclosures Objectives: Review common etiologies of liver abscesses Review common fungal etiologies of liver infections Brief overview of pathogens associated with viral hepatitis
Thank you for listening to this episode of "Health and Fitness" from the Nezpod Studios! Enjoy your night or the start of your day, spiced by our top-notch health and fitness/wellness updates coined from the best sources around the globe: made only for your utmost enjoyment and enlightenment… Click on subscribe to get more spicy episodes for free! See you again soon on the next episode of Health and fitness updates! Learn more about your ad choices. Visit megaphone.fm/adchoices
In this episode, our host Michael Barazza interviews Dr. Jafar Golzarian, interventional radiologist at the University of Minnesota, about intra-arterial and percutaneous treatment of giant hepatic hemangiomas. --- SHOW NOTES We start this episode off by highlighting the Global Embolization Symposium and Technologies (GEST) initiative that Jafar co-founded in 2007. Over time, GEST has evolved into a highly acclaimed conference, drawing an international audience of thousands of participants for its webinars. We then dive into cutting edge treatments of liver hemangiomas. Jafar discussed how he was introduced to a novel approach in 2014 when one of his friends, Dr. Shahram Akhlaghpoor, sent him a paper with his results from using transarterial bleomycin-lipiodol embolization (B/LE) to treat symptomatic giant hepatic hemangiomas. Another friend of Jafar's shared an inventive approach in shifting perspectives to view hepatic hemangiomas as low-grade venous malformations and using percutaneous injections for treatment. Then, Jafar discusses the specifics of his approach to hepatic hemangiomas and how he usually only treats hemangiomas that are large, cause pain and discomfort, or exert pressure on vital structures such as the portal vein or bile duct. Jafar notes that the patient demographic that presents with hemangiomas are typically women aged 30 to 50, and they can be self-referred or referred by hepatobiliary surgeons. In regards to treatment, Jafar prefers either 30, 45, or 60 units of bleomycin, favoring the latter for hemangiomas exceeding 10 cm. He prefers percutaneous access if feasible, but he resorts to chemoembolization in cases when insurance coverage presents issues. Minor post-treatment symptoms post-treatment include abdominal pain and occasional nausea, with extremely rare compilations being pulmonary fibrosis or allergic reactions to the bleomycin. Jafar notes that imaging at 1, 3, and 6 months post-treatment guides assessment of treatment effectiveness of, with substantial change best evaluated at the 6-month mark. Jafar's treatment has garnered high patient satisfaction, with very few patients requiring return for further therapy after the 6 months. He notes that when surgeons are shown the before and after imaging of the treatment of hemangiomas, they become big advocates of these procedures. --- RESOURCES Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma: https://pubmed.ncbi.nlm.nih.gov/29922860/
This case covers the pathophysiology, diagnosis, and management of hepatic encephalopathy with a focus on pharmacologic treatments. The corresponding video is on YouTube (https://youtu.be/bcLjGR3-gY4). **Thank you to our sponsor Doc2Doc Lending, the Personal Lending platform designed for Doctors, by Doctors. Check out https://doc2doclending.com/davinci to learn more today. DaVinci Academy YouTube Channel: https://www.youtube.com/@DaVinciAcademyMed Website: https://www.dviacademy.com/ Instagram: https://www.instagram.com/davinci_academy1/ DaVinci Academy Merch - Coffee mugs, T-shirts, hoodies and more: https://my-store-d90f46.creator-spring.com
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On this episode, I discuss isotretinoin pharmacology, side effects, drug interactions, and much more. The iPLEDGE program is in place to ensure that pregnant patients do not receive this medication. I discuss this in more detail on this episode. Sun sensitivity is an important adverse effect that patients should be aware of during seasons of high sun exposure. Hepatic issues, myalgia, and psychiatric changes are rare adverse effects associated with isotretinoin.
In this week's episode, we discuss the impact of silent cerebral infarction in patients with immune mediated thrombotic thrombocytopenic purpura (or iTTP) in clinical remission, how the survival of leukemia stem cells is highly dependent on oxidative phosphorylation in the mitochondria, and targeting iron import as a potential therapeutic approach in aggressive natural killer cell leukemia (or ANKL).
Question-based review of Acute liver failure, staging of hepatic encephalopathy (per clinical & EEG criteria), management of ALF with understanding of the severity criteria, Stage-based management of hepatic encephalopathy, Indications & Eligibility requirement for Liver transplantation, and a brief discussion on acetaminophen toxicity at the end.
Join Yvonne Brandenburg, RVT, VTS SAIM and Jordan Porter RVT, VTS SAIM as we talk about: Join us in this exciting podcast episode as we dive into the world of pet nutrition and hepatic disease management! Get ready to explore the ins and outs of energy intake optimization, the tricky protein puzzle, the fat-fascination dance, and the secret powers of vitamins. Plus, we'll unveil the fiber's heroic role in battling toxin absorption. Resources We Mentioned in the Show "Treatment liver disease: Medical and nutritional aspects (sponsored Nestle Purina)." DVM360. Available at: https://www.dvm360.com/view/treatment-liver-disease-medical-and-nutritional-aspects-sponsored-nestle-purina. "Nutritional Management of Liver Failure and Hepatic Encephalopathy." VIN - Veterinary Information Network. Available at: https://www.vin.com/apputil/content/defaultadv1.aspx?pId=12886&id=7054649&print=1. "Nutritional Management of Liver Failure and Hepatic Encephalopathy." UC Davis School of Veterinary Medicine - Health Topics. Available at: https://healthtopics.vetmed.ucdavis.edu/health-topics/canine/nutritional-management-liver-failure-and-hepatic-encephalopathy. "Nutrition in Hepatic Disease in Small Animals." Merck Veterinary Manual. Available at: https://www.merckvetmanual.com/digestive-system/hepatic-disease-in-small-animals/nutrition-in-hepatic-disease-in-small-animals. Thanks so much for tuning in. Join us again next week for another episode! Want to earn some RACE approved CE credits for listening to the podcast? You can earn between 0.5-1.0 hour of RACE approved CE credit for each podcast episode you listen to. Join the Internal Medicine For Vet Techs Membership to earn and keep track of your continuing education hours as you get your learn on! Join now! http://internalmedicineforvettechsmembership.com/ Get Access to the Membership Site for your RACE approved CE certificates Sign up at https://internalmedicineforvettechsmembership.com Get Access to the Technician Treasure Trove Sign up at https://imfpp.org/treasuretrove Thanks for listening! – Yvonne and Jordan
"...jaundice is the yellow discoloration of the skin that is seen when bilirubin levels go above approximately 3 milligrams per deciliter but it can also be seen a particularly well in the sclera so first of all we need to know a little bit about bilirubin bilirubin is a breakdown product of him and is released from red blood cells when they are destroyed now bilirubin needs to get to the liver in order to be and the way it gets there is by initially being bound by albumin and then been transported to the liver via the blood it then gets taken up into the hepatic cells and is by the enzyme glucose urinal transfer is then secreted into the biliary system now this is the distinction between conjugated and unconjugated bilirubin the presence or absence of this glucose Iran sometimes this is referred to as soluble and insoluble bilirubin now direct and indirect bilirubin are often used as equivalence to conjugate it and unconjugated bilirubin but technically correct direct bilirubin includes conjugated bilirubin and Delta bilirubin which is the bilirubin bound to albumin that we mentioned earlier from there the conjugated bilirubin is present in the bayou and is secreted into the duodenum from the duodenum it travels through the small intestine up to the terminal ileum when most of the biological hepatic circulation but conjugated bilirubin is not reabsorbed it instead passes into the colon where the bacteria remove the gluco uronic acid that was added in the liver and forms urobilinogen which is colorless which is then oxidized into Starck or billion which gives feces it's brown color this is why in cases where the common bile duct is blocked you'll end up seeing pale stools right for anyone who's not been bored out of their mind by that bit will get into the causes of jaundice that you've probably heard split up into different categories these are pre hepatic hip-hop all post hypnotic jaundice which is also sometimes known as obstructive jaundice pre hepatic jaundice will have increased levels of unconjugated bilirubin because we are talking problem occurring before the bilirubin gets deliver these are going to be causes featuring excessive hemolysis so red blood cells being destroyed quicker than usual hemolytic anemia blood transfusions and hemolytic drugs hepatic causes are due to either having damaged hepato sites which is the case in hepatitis cirrhosis..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...jaundice is the yellow discoloration of the skin that is seen when bilirubin levels go above approximately 3 milligrams per deciliter but it can also be seen a particularly well in the sclera so first of all we need to know a little bit about bilirubin bilirubin is a breakdown product of him and is released from red blood cells when they are destroyed now bilirubin needs to get to the liver in order to be and the way it gets there is by initially being bound by albumin and then been transported to the liver via the blood it then gets taken up into the hepatic cells and is by the enzyme glucose urinal transfer is then secreted into the biliary system now this is the distinction between conjugated and unconjugated bilirubin the presence or absence of this glucose Iran sometimes this is referred to as soluble and insoluble bilirubin now direct and indirect bilirubin are often used as equivalence to conjugate it and unconjugated bilirubin but technically correct direct bilirubin includes conjugated bilirubin and Delta bilirubin which is the bilirubin bound to albumin that we mentioned earlier from there the conjugated bilirubin is present in the bayou and is secreted into the duodenum from the duodenum it travels through the small intestine up to the terminal ileum when most of the biological hepatic circulation but conjugated bilirubin is not reabsorbed it instead passes into the colon where the bacteria remove the gluco uronic acid that was added in the liver and forms urobilinogen which is colorless which is then oxidized into Starck or billion which gives feces it's brown color this is why in cases where the common bile duct is blocked you'll end up seeing pale stools right for anyone who's not been bored out of their mind by that bit will get into the causes of jaundice that you've probably heard split up into different categories these are pre hepatic hip-hop all post hypnotic jaundice which is also sometimes known as obstructive jaundice pre hepatic jaundice will have increased levels of unconjugated bilirubin because we are talking problem occurring before the bilirubin gets deliver these are going to be causes featuring excessive hemolysis so red blood cells being destroyed quicker than usual hemolytic anemia blood transfusions and hemolytic drugs hepatic causes are due to either having damaged hepato sites which is the case in hepatitis cirrhosis..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...portal hypertension refers to a higher than normal blood pressure in the portal system a normal range for this pressure is 5 to 10 millimeters of mercury portal hypertension can also be defined as a portal pressure more than 5 millimeters of mercury higher than the pressure in the inferior vena cava so the portal system refers to the portal vein which drains River and the main vessels that link to the portal vein and Superior mesenteric vein which comes from the small intestines the splenic vein which of course carries blood from the spleen the inferior mesenteric connects onto the splenic vein and carries blood from the large intestine but the gastric veins connect also on to the portal vein another thing to note is the umbilical vein which is normally obliterated and becomes the round ligament of the liver but if the pressure in the portal system gets high enough it can reopen varices are dilated veins that from an increased pressure in the portal system inside the liver you have structures known as sinusoids which are specialized capillaries within the liver the hepatocyte of the a separated from these sinusoids by a space known as the space of dese venous blood from the portal system mixes with arterial blood from the hepatic artery in the sign and then flows through into a central vein these Central veins collect together in the hepatic veins which takes blood into the inferior vena cava you can also see a which collects bile produced by the hepatocyte it's and takes it down towards the gallbladder the cell in red that you see inside the sinusoid is a cup for sale A specialized type of Mac the Scavenging and phagocytic activity the orange star shaped cells are important in Portal hypertension and cirrhosis these are hepatic stellate cells found in the space of these that are involved in fiberglass this and scaf formation in response to liver injury so what causes pressure in the portal system to increase the pathophysiology of portal hypertension ultimately comes down to blood being unable to pass smoothly from the portal circulation through the liver and into the inferior vena cava we typically divide the causes into pre hepatic intrahepatic post about it causes but remember that pre hepatic here means before the blood gets into the liver meaning causes in the portal vein itself well post hypnotic causes referred to causes after that two problems involving the inferior vena cava pre hepatic causes include portal vein thrombosis splenic vein thrombosis and arteriovenous malformation and splenomegaly intrahepatic causes include the most common cause cirrhosis which can come from alcohol abuse chronic viral hepatitis metabolic..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...portal hypertension refers to a higher than normal blood pressure in the portal system a normal range for this pressure is 5 to 10 millimeters of mercury portal hypertension can also be defined as a portal pressure more than 5 millimeters of mercury higher than the pressure in the inferior vena cava so the portal system refers to the portal vein which drains River and the main vessels that link to the portal vein and Superior mesenteric vein which comes from the small intestines the splenic vein which of course carries blood from the spleen the inferior mesenteric connects onto the splenic vein and carries blood from the large intestine but the gastric veins connect also on to the portal vein another thing to note is the umbilical vein which is normally obliterated and becomes the round ligament of the liver but if the pressure in the portal system gets high enough it can reopen varices are dilated veins that from an increased pressure in the portal system inside the liver you have structures known as sinusoids which are specialized capillaries within the liver the hepatocyte of the a separated from these sinusoids by a space known as the space of dese venous blood from the portal system mixes with arterial blood from the hepatic artery in the sign and then flows through into a central vein these Central veins collect together in the hepatic veins which takes blood into the inferior vena cava you can also see a which collects bile produced by the hepatocyte it's and takes it down towards the gallbladder the cell in red that you see inside the sinusoid is a cup for sale A specialized type of Mac the Scavenging and phagocytic activity the orange star shaped cells are important in Portal hypertension and cirrhosis these are hepatic stellate cells found in the space of these that are involved in fiberglass this and scaf formation in response to liver injury so what causes pressure in the portal system to increase the pathophysiology of portal hypertension ultimately comes down to blood being unable to pass smoothly from the portal circulation through the liver and into the inferior vena cava we typically divide the causes into pre hepatic intrahepatic post about it causes but remember that pre hepatic here means before the blood gets into the liver meaning causes in the portal vein itself well post hypnotic causes referred to causes after that two problems involving the inferior vena cava pre hepatic causes include portal vein thrombosis splenic vein thrombosis and arteriovenous malformation and splenomegaly intrahepatic causes include the most common cause cirrhosis which can come from alcohol abuse chronic viral hepatitis metabolic..." Learn more about your ad choices. Visit megaphone.fm/adchoices
Lab Values Podcast (Nursing Podcast, normal lab values for nurses for NCLEX®) by NRSNG
Overview Ammonia Normal Value Range Pathophysiology Special considerations Too High: Causes, Symptoms, Treatments Too Low: Causes, Symptoms, Treatments Nursing Points General Normal value range 19-60 mcg/dL Pathophysiology Byproduct of protein metabolism Proteins → ammonia Ammonia → urea via the liver Urea excreted to the kidneys If ammonia is not converted to urea Ammonia ↑ in bloodstream Causes hepatic encephalopathy Neurotoxic ↓ Level of consciousness Confusion Altered mental status Refer to Neuro lesson 03.06 Encephalopathies Special considerations Sent in either green or lavender tube Typically sent on ice Discuss with facility lab or unit Elevations in ammonia Liver failure Treatment: Lactulose Ammonia binding agent Given PO or PR Ammonia excreted via stool Hepatic encephalopathy TPN GI hemorrhage Reye's syndrome Decreased ammonia levels Antibiotics Assessment Assess patient's cognition and level of consciousness Assess patient's ability to swallow and protect airway Therapeutic Management Lactulose via rectal tube or PO if patient can tolerate oral medications and follow directions Nursing Concepts Lab Values Gastrointestinal/Liver Metabolism
In this episode, we review the high-yield topic of Hepatic Angiosarcoma from the Oncology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
HIGH YIELD 1: Top Weird Drug Reactions Review for the USMLE Step 1 exam The podcast discusses high yield weird drug side effects that are unexpected. Cyanopsia (blue vision) with sildenafil (PDE-5 inhibitor) Hepatic necrosis with halothane (inhaled anesthetic) Tendon/cartilage damage with fluoroquinolones (antibiotics) Cinchonism with quinidine (class IA antiarrhythmic) Hemorrhagic cystitis with cyclophosphamide and ifosfamide (chemotherapeutic agents) Muscle pain and rhabdomylitis from statin use (cholesterol lowering med) Tartive dyskinesia with antipsychotics Fanconi syndrome from expired tetracyclines (antibiotics)
This episode from our clinical series is brought to you by Elanco, makers of the broadest range of parasiticides including Advocate, Milbemax, Seresto and Credelio Plus. "The question about the biochemistry is really interesting, because what your question now is, is 'what is it, and where is it?' And the problem that we have is that the liver enzymes aren't gonna tell us, because it's really hard to separate hepatic from post-hepatic on bloods. ALP is very insensitive in the cat and will go up with both hepatic and post-hepatic. ALT will go up with hepatic and post-hepatic. Bilirubin will be up. So what?!" We recorded this case-based interactive session about how to work up the jaundiced cat with one of the world's leading Small Animal Medicine specialists and teachers, Prof Jill Maddison at session our live event in 2022. Prof Jill Jill Maddison, BVSc, DipVetClinStud, PhD, SFHEA, MRCVS, is a professor of general practice, the director of professional development, and the BVetMed and CertAVP course director at Royal Veterinary College. She is also a coordinator for London Vet Show and is a consultant at a local veterinary practice and at Beaumont Sainsbury Animal Hospital in London. Dr Maddison is the senior editor of the second edition of Small Animal Clinical Pharmacology and the senior editor of Clinical Reasoning in Small Animal Practice. She has lectured worldwide on clinical problem-solving, small animal internal medicine, and clinical pharmacology. In this session she helps us reason through a case of jaundice in a cat to create a deeper understanding, rather than a simple list of facts. She also shifts some long-standing beliefs around diagnostic testing in liver disease in both dogs and cats. Topic list: 5:07 Where to begin your workup. 6:05 Defining the problem and localising the problem: Pre-hepatic, hepatic or post-hepatic? 9:17 How much does dehydration actually affect PCV? 10:43 Bilirubin - how useful is it? "It's the most over-interpreted test I reckon. I have so many vets tell me, “Oh, the bilirubin is 16, it has to have a problem with its liver…” No, it probably just has inflammatory disease." 13:14 Dd's for hepatic disease in cats. 14:20 Dd's for post-hepatic causes of jaundice. 16:04 Biochem in jaundice: ALP, ALT, GGT. "The problem that we have is that the liver enzymes aren't going to tell us." 19:51 Why bile acids are useless in the diagnosis of liver disease. "The bile acids don't tell you anything more than you already know. There is no relationship between the level of bile acids and the prognosis or reversibility of the lesion." 24:25 Can't I just trial-treat? 26:16 Ultrasound. 28:27 Signalment: how useful is it? 29:36 Cholesterol and liver disease. 30:52 Pancreatic lipase and pancreatitis in cats. "What we found was that we had 24% false negatives. So we had a quarter of our cats who had what seemed to be pancreatitis that did not have an increased Pli." 36:54 Hepatic lipidosis. For more world-class specialists in an easy-to-consume format join our community of Vet Vault Nerds at vvn.supercast.com. Visit thevetvault.com for the show notes for this episode. Join us in at Vets on Tour in Wanaka, New Zealand on 13 - 18 August 2023 for great CE, more live podcasting and snow... lots of snow! --- Send in a voice message: https://podcasters.spotify.com/pod/show/vet-vault/message
References and Inspirations Dr Guerra's lecture notes-graduate biochemistry https://youtu.be/nP4nBxMtEug --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message
Jesse rambles about mailboxes, hairballs, cold temperatures, satanic panic, and liver trouble. Happy Holidays!
In this crossover episode between BackTable VI and BackTable Innovation, Dr. Chris Beck interviews Dr. Riad Salem (Chief of Interventional Radiology at Northwestern University) and Peter Pattison (President of Interventional Oncology at Boston Scientific) about how TheraSpheres for Y90 radioembolization became a mainstay in the IR toolkit for HCC and where the technology is heading next. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PvWJlD --- SHOW NOTES To begin, Peter outlines how the original concept of TheraSpheres began at the University of Missouri, as a collaboration between Drs. Delbert Day and Gary Ehrhardt, who combined their ceramic and nuclear chemistry expertises to create radioactive glass beads and published a paper in 1987. After animal and human testing, the product was licensed to the company Nordion, where Peter worked. The product was given a humanitarian device exemption (HDE) from the FDA, which allowed TheraSpheres to be used for investigational purposes. In the late 1990s, Dr. Salem was in his early interventional oncology career and heard about TheraSpheres. He recognized the enormous potential that this technology had to ensure known amounts of radioactive doses were delivered to the tumor and minimize adverse effects. In fact, he noticed that his Y90 patients had less pain, post-embolization syndrome, and hospitalization than his transarterial chemoembolization (TACE) patients. In the mid 2000s, he collected and submitted data to various conferences and journals, but he was met with criticism from the IR world, which was more comfortable with TACE, since it was the current standard of care. In 2011, Nordion decided to run a clinical trial, EPOCH, which eventually showed that the addition of TARE to systemic therapy for colorectal metastases to the liver led to longer progression free survival. Dr. Riad has focused his efforts on training more IRs on the methodology of Y90, since this was an important step to increasing adoption and minimizing missteps with the new technology. He believes that the advent of Y90 has resulted in better angiography, since IRs are more cognizant of off-target embolization. Dr. Salem also petitioned at the US Nuclear Regulatory Committee to allow IRs to become the authorized users for Y90 injection and advocated to add TARE to the National Comprehensive Cancer Network guidelines for liver cancer. Both of these developments allowed TARE to become more widely adopted. Finally, Peter discusses the competition that TheraSpheres has faced from TACE and SIRSpheres (resin-based radioembolization). He shares exciting new developments that have occurred since acquisition by Boston Scientific. These include exploration for the extra-hepatic use of TheraSpheres in glioblastoma and prostate cancer. --- RESOURCES BackTable Ep. 223- Portal Vein Recan #ReCanDoIt with Dr. Riad Salem: https://www.backtable.com/shows/vi/podcasts/223/portal-vein-recan-recandoit Therapeutic Use of 90Y Microspheres: https://pubmed.ncbi.nlm.nih.gov/3667306/ A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/1327493/ Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up: https://pubmed.ncbi.nlm.nih.gov/7931662/ Humanitarian Device Exemption: https://www.fda.gov/medical-devices/premarket-submissions-selecting-and-preparing-correct-submission/humanitarian-device-exemption EPOCH Trial: https://ascopubs.org/doi/full/10.1200/JCO.21.01839 Radioembolization with 90Yttrium Microspheres: A State-of-the-Art Brachytherapy Treatment for Primary and Secondary Liver Malignancies: https://www.jvir.org/article/S1051-0443(07)60901-4/fulltext
How to determine whether hepatic impairment can affect drug metabolism? This episode discusses practical considerations when prescribing psychotropic medications for patients with hepatic issues. It also clarifies dosing considerations for specific medications, such as clozapine and valproate, in the context of patients with hepatic issues. Guest: Jonathan Meyer, M.D. Interviewer: Mohan Gautam, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.5 CMEs: Use of Psychotropics in Patients With Hepatic Issues - Interview with Jonathan M. Meyer, M.D.
Joining us in conversation is Dr. Jacob Stucki, to discuss the recently updated whitepaper on office-based anesthesia. Tune in today to hear what is outlined in the White Paper update and what the implications are for practitioners. Dr. Grant Stucki shares his biggest take-home from the article, and the doctors explore the critical starting point for anesthesia. Disease categories, heart failure, asthma, and renal diseases are among our talking points today, with a part of our conversation dedicated to the distinction between pediatric and adult patients. Next, we unpack what it means to treat the patient, and not the monitor, and discuss the two parts of emergency preparedness, as outlined by the White Paper update. Find out why this model is important, and why it's worth taking 20 minutes out of your day to read the paper.Key Points From This Episode:Today's topic: the recently updated whitepaper on office-based anesthesia.Reasons for the recent update: for members, and to highlight their good work for others.The importance of anesthesia for oral surgeons.AAOMS training for anesthesia and its requirements.What the White Paper includes about the history of anesthesia and AAOMS.The AAOMS team model which includes a minimum of three highly trained professionals.The dividing line when a patient experiences discomfort.Techniques including using local to reduce the need for other methods.What Dr. Grant Stucki considers the biggest take home message of the article.Where safe anesthesia starts and why it is critical.The profile of a patient you are looking for: healthy patients or those with a systemic condition that is well controlled.The difference between ASA2 and ASA3 disease and how there isn't a category for moderate diseases.Which candidates to take off your list of options to sedate.Why it is important to know enough about heart failure to be able to recognize it.Addressing the issue of asthma within candidates for anesthesia.Hepatic and renal disease.The importance of treating pediatric patients differently, and not just like small adults.Risks connected to treating pregnant patients.What it means to treat the patient, not the monitor.The two parts to emergency preparedness: systems, and practice.Dr. Grant Stucki's experience saving the lives of two patients in an emergency situation.Scenarios you should go over: multiple health issues, asthma, overdoses, heart attacks, allergic reactions, and more.The importance of having scrimmages in the different areas of the office.Simulation tools you can look forward to using to train staff.Why this model is important.Links Mentioned in Today's Episode:Dr. Jake Stucki LinkedIn — https://www.linkedin.com/in/jake-stucki-ab19a593/Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/?hl=en Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059
On this episode, we are joined by Jessa Mae Sabate and Nichole Arroyo (4th year MUSC PharmD candidates) to discuss a patient case looking into the management of advanced liver disease. We discuss hepatic encephalopathy and treatment options for hepatitis C. We also review the management of cholestatic pruritus, insomnia, and some other behavioral health issues in the patient's history. Thanks for listening! We want to give a big thanks to our main sponsor Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. You can find our account at the website below: www.patreon.com/corconsultrx If you have any questions for Cole or me, reach out to us on any of the following: Text - 415-943-6116 Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com Instagram and other social media platforms - @corconsultrx This podcast reviews current evidence-based medicine and pharmacy treatment options. This podcast is intended to be used for educational purposes only and is intended for healthcare professionals and students. This podcast is not for patients and not intended as advice or treatment.
Videos: 1. Assange Countdown: In Depth with Dr. George Szamuely (0:20) 2. Frank Zappa – 1979 3. Our freedom is under attack by those who care more for power than for the Constitution, the Bill of Rights & the American people. – Tulsi Gabbard (0:41) 4. Woody Allen speech from movie The Front (0:60) 5. A Christian Response to Wokeness (FULL VIDEO) | Noelle Mering | Leadership Institute (21:51) 6. NBC News just SMEARED real journalists in shameful hit piece | Redacted with Clayton Morris (22:00) 7. Propaganda disguised as education | Let's talk about it – Riks (Start @ 0:58) Nuts Increase Cognitive Scores Among Elderly Women Harvard University and Brigham and Women's Hospital, June 4th 2022 Researchers from Harvard University and Brigham and Women's Hospital have confirmed that eating more nuts every day will increase cognitive skills – at least among elderly women. For six years, the researchers followed 16,010 women who 70 years old or older, and 15,467 completed the final cognitive interviews. The researchers found those women who consumed five servings or more of nuts each week had higher scores on their cognitive testing compared to those who did not consume nuts. The average difference in scores was 0.08 units, which is equivalent to two years of cognition decline during the aging process. The mechanism may be related to the fact that nuts are heart-healthy. And nut consumption has been associated with cardiovascular healthand mortality in other research. Stress accelerates immune aging, study finds University of Southern California, June 13, 2022 Stress—in the form of traumatic events, job strain, everyday stressors and discrimination—accelerates aging of the immune system, potentially increasing a person's risk of cancer, cardiovascular disease and illness from infections such as COVID-19, according to a new USC study. The research, published in the Proceedings of the National Academy of Sciences (PNAS), could help explain disparities in age-related health, including the unequal toll of the pandemic, and identify possible points for intervention. USC researchers decided to see if they could tease out a connection between lifetime exposure to stress—a known contributor to poor health—and declining vigor in the immune system. As expected, people with higher stress scores had older-seeming immune profiles, with lower percentages of fresh disease fighters and higher percentages of worn-out white blood cells. The association between stressful life events and fewer ready to respond, or naive, T cells remained strong even after controlling for education, smoking, drinking, BMI and race or ethnicity. CoQ10 supplementation associated with lower pro-inflammatory factors in randomized trial Shahid Sadoughi University of Medical Sciences (Iran), June 8 2022. A double-blind trial reported in a recent issue of the International Journal of Vitamin and Nutrition Research found a reduction in markers of inflammation in mildly hypertensive patients given coenzyme Q10 (CoQ10) for twelve weeks. Participants who received CoQ10 also experienced an increase in adiponectin: a protein secreted by adipose tissue that has an anti-inflammatory effect and which has been found to be reduced in high blood pressure and cardiovascular disease. “Considering that coenzyme Q10 has attracted noticeable attention in recent years for the treatment of cardiovascular diseases and hypertension in regard to its effect on inflammatory factors such as cytokines, it is therefore hypothesized that supplementation with coenzyme Q10 reduces the proinflammatory factors,” write Nasim Bagheri Nesami of Iran's Shahid Sadoughi University of Medical Sciences and colleagues. “This study was conducted in order to determine the effects of coenzyme Q10 on proinflammatory factors as well as on adiponectin in patients with mild hypertension.” Sixty men and women were randomized to receive 100 milligrams CoQ10 or a placebo for a twelve week period. Plasma adiponectin, high-sensitivity C-reactive protein (hs-CRP, a marker of inflammation) and the cytokines interleukin 2, interleukin6 and tumor necrosis factor-alpha were measured before and after treatment. At the end of the study, participants who received CoQ10 had significant declines in interleukin-6 and hs-CRP compared with levels measured upon enrollment. They also experienced an increase in adiponectin, while levels in the placebo group slightly declined. Probiotics prevent deadly complications of liver disease Govind Ballabh Pant Hospital, New Delhi, India June 6, 2022 Probiotics are effective in preventing hepatic encephalopathy in patients with cirrhosis of the liver, according to a new study in Clinical Gastroenterology and Hepatology. Hepatic encephalopathy is a deterioration of brain function that is a serious complication of liver disease. “This rigorous new research finds that probiotics modify the gut microbiota to prevent hepatic encephalopathy in patients with cirrhosis of the liver,” said David W. Victor III, MD. “These results offer a safe, well-tolerated and perhaps cheaper alternative to current treatments.” When comparing treatment with probiotics versus placebo, the researchers found that the incidence of hepatic encephalopathy was lower in patients treated with probiotics. Probiotic supplementation was not associated with any side effects and none of the patients required discontinuation of therapy. These results suggest that probiotics are similar in effectiveness to the current standard of care, lactulose, in the prevention of hepatic encephalopathy, yet they appear to be much better tolerated. The effectiveness of lactulose, a nonabsorbable disaccharide, is limited by side effects (diarrhea, bloating and gas) and a narrow therapeutic window. Chelation therapy and vitamin supplements cut heart disease risk by over 25% Columbia University, June 9, 2022 A combination of high-dose multivitamins and chelation therapy may protect heart attack survivors from future cardiovascular events and death, according to a multicenter study published in the American Heart Journal. Intravenous chelation, in which the chemical ethylenediaminetetraacetic acid (EDTA) is injected into the bloodstream in order to bind to minerals and help flush them from the body, is an FDA-approved treatment for heavy metal poisoning that was first used during World War I. “They're all in our environment. Any of us who are of an age to have been exposed to leaded gasoline have lead in our bones. If we get an infusion of EDTA, we'll have lead in our urine. It's just the way it is. And as you get older and become osteoporotic, that lead starts getting released.” In a randomized, double-blind trial, the researchers randomly assigned 1,708 stable heart attack survivors at 134 clinics across the United States to one of four experimental conditions: high-dose oral multivitamins plus chelation, chelation plus a vitamin-mimicking placebo, vitamins plus a chelation-mimicking placebo or double placebo. Participants had to get a 500 cc intravenous infusion once per week for 30 weeks, followed by another 10 infusions spaced two to eight weeks apart. All participants also had to take six large capsules daily. The researchers found that chelation alone led to a statistically significant 18 percent reduction in primary endpoint, relative to placebo. Chelation plus multivitamins led to a 26 percent reduction in risk over placebo. Chelation plus multivitamin also reduced the secondary endpoint by 34 percent, compared with placebo. Diabetic participants benefited even more dramatically. Among diabetics, chelation resulted in a 41 percent reduction in primary endpoint, while chelation plus vitamins resulted in a 51 percent reduction. The rate of all-cause mortality in diabetic patients dropped 43 percent with chelation alone, and the secondary endpoint was also reduced. Natural Pain Killer With Powerful Ability to Remove Blood Clots and Dead Tissue GreenMed Info, June 13th 2022 Serrapeptase, also known as serratiopeptidase or serralysin, is a systemic enzyme, specifically it is a proteolytic enzyme. Serrapeptase was first derived from a species of bacteria found in the intestine of the silkworm. The bacteria, Serratia mercesans E1, produces serrapeptase to help breakdown the silkworm coccoon to free the silk moth. A review study summarized that serrapeptase has immense applications in therapeutic areas which have been validated by several in vitro, in vivo, and clinical studies. “These applications are attributable to its versatile properties including anti-inflammatory, anti-biofilm, analgesic, anti-edemic, and fibrinolytic effects.” Serrapeptase has been used for a wide range of health concerns: Serrapeptase for Joint Swelling Serrapeptase is effective in reducing post-operative joint swelling in comparison to other therapies such as applying ice. Serrapeptase Dissolves Blood Clots, Dead Tissue, Biofilms Anticoagulants and antiplatelet drugs are used for managing cardiovascular diseases but they are unable to dissolve an existing blood clot. Serrapeptase dissolves a fibrin clot within a blood vessel. Studies have shown that serrapeptase can digest dead tissues, blood clots, cysts, biofilm and arterial plaques. Serrapeptase for Acute or Chronic Ear, Nose and Throat Conditions The Journal of International Medical Research published the results of a study evaluating the efficacy and tolerability of serrapeptase using a double-blind, placebo-controlled study of 193 subjects suffering from acute or chronic ear, nose or throat disorders. Patients treated with serrapeptase reported significant symptom regression within 3 – 4 days. It was concluded that serrapeptase “has anti-inflammatory, anti-oedemic and fibrinolytic activity and acts rapidly on localized inflammation.” COVID-19 and Chronic Respiratory Conditions A 2021 study, showed, “Proteolytic enzymes can be useful in the treatment of nosocomial, viral, and resistant infections, especially in pediatric and geriatric age groups due to its relative safety, less tolerance and resistance and its synergic effects.” Physicians have observed many COVID-19 cases with heart problems, kidney problems, and the presence of blood clots. Serrapeptase helps patients with chronic airway disease by reducing coughing and lessening viscosity of sputum. As a natural anticoagulant it interferes with platelet aggregation and the blood coagulation cascade. Serrapeptase has an anti-inflammatory impact on the tissue inflammation that contributes to the blood clot formation.
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