These are 5 TIPS so my patients feel comfortable to talk about alcohol and they DON’T UNDER-REPORT its use:

1.⁠ ⁠I first talk about the potential cause of their liver disease in a SUBTLE way. Some patients will immediately tell me that changes are due to alcohol and will feel…

How frequent are mental disorders in stetatotic liver disease ?

This huge study including 2.1 million people shows:
🔸26% have depression.
🔸37% have anxiety.
🔸51% are stressed.

We should tackle this to promote lifestyle changes.
t.ly/aU4ZA #livertwitter

There are liver clinics that are fighting to get a dedicated dietitian for people with steatotic liver disease.

With the cost of Resmetirom to treat a patient for 2 years (47k/year), we can probably hire such specialist to help multiple patients. We need both.

#livertwitter

(Sunday pic #115). The old lighthouse and the boat in Cancun, Mexico.

#Mexico #livertwitter #Cancun #photography

The best advice for career development while enjoying the journey is to focus on what you are good at. Promotions will eventually happen.

If being promoted becomes your main goal, you may become a ‘careerist” and you will not fully enjoy the journey.

#mentoringadvice

Variations in genes causing metabolic disorders predispose to cirrhosis in stetaotic liver disease. Results from a huge genetic study including almost 4M people:

🔸HFE: gene causing hemochromatosis.
🔸SERPINA1: gene causing alpha 1 antitrypsin deficiency.…

In cultures of politeness, dissent is a threat to social harmony. People nod and smile even if they disagree, and silence fuels groupthink.

In cultures of integrity, dissent is a sign of commitment to quality. People voice their views, and respectful debate improves decisions.

Even brief anger is bad for your blood vessels (and cardiovascular health), results from a randomized trial
ahajournals.org/doi/full/10.11… Daichi Shimbo MD
P.S. don't let the results get you angry 😉

In the era of Ozempic, it is refreshing that Nature Reviews Gastroenterology & Hepatology, the leading journal in GI, devotes an article and a beautiful cover to the effects of dietary fiber on metabolic health and obesity.

Pills do not replace a healthy lifestyle.

t.ly/L_m2N #livertwitter …

Embarrassing to be Danish🙂‍↕️ WHO/Europe report #Denmark again worst among 44 countries in alcohol use among 15 yr olds

Politicians keep age limit 16 yr, refuse to limit marketing, accept low prices - wake up‼️ Alcohol related harm is a real thing!

who.int/europe/publica…

Every Monday, I do liver consultations. A usual consult: “Male patient with advanced liver disease and active alcohol intake with a recent fall that develops agitation”.

My usual diagnostic dilemma:
- Fall-related brain injury?
- Withdrawal syndrome?
- Hepatic encephalopathy?
-…

This week, the liver community has learned two lessons. First, the great appreciation that we have for each other. And second, that life is precious and it must be lived to the fullest, beyond academics.

#livertwitter

Proof-of-concept clinical trial showing that a GLUTEN-free-diet ameliorates MASLD.

Is it due to decreased carbs intake and BMI or to immune effects ?

Any biomarker for personalized medicine ?

#livertwitter roypounder.apt t.ly/BfN1z

How exercise promotes a healthy immune response, reduces inflammation, and may slow the aging process
cell.com/cell-metabolis… Cell Metabolism P. Kent Langston

So sad about the passing of Stephen Harrison, one of the most influential leaders in hepatology, and a great person.

His legacy, including the first drug for MASLD, his talent and his kind demeanor will remain with us.

#livertwitter EASLnews AASLD

🍻 Alcohol causes immense personal and economic harm in Europe, leading to over 3 million deaths worldwide each year. Almost half of liver disease deaths in Europe are alcohol-related, yet all are preventable.
Reducing alcohol consumption in the general population through…

Hepatorenal syndrome:
🔸Why does it happen ?
🔸How to diagnose and grade it ?
🔸How to use terlipressin and when is RRT needed?

This great review in Gastroenterology tells you all.

#livertwitter t.ly/vnI2X

What is the risk of cirrhosis and HCC across steatotic liver disease subtypes?

New article in AJG - The American Journal of Gastroenterology from Taiwan reports that risk of cirrhosis and HCC were highest for:
(1) ALD
(2) MetALD
(3) MASLD
(4) Non-SLD (i.e., no cardiometabolic risk factors)

journals.lww.com/ajg/fulltext/9…

Compared to ascites, hepatic HYDROTHORAX:

- Poor response to diuretics, >AKI and HipoNa.
- Repeated thoracocentesis is hard: consider TIPS.
-Increased mortality with lower MELD.

This study in HEPATOLOGY Journal shows its poor prognosis.

#LiverTwitter
tinyurl.com/4jfs4ce7

🍺❌Alcohol-related Liver Disease (ArLD) is preventable.

On #WorldLiverDay , let's work together to implement effective policies to reduce alcohol consumption and save lives.

🚨Remember: there is NO safe level of alcohol consumption.

#ArLD #LiverHealth #Alcohol #Livertwitter