hepatic

12/10/23

The Healthy Matters Podcast

S03_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.org

Call - 612-873-TALK (8255)

Find out more at www.healthymatters.org

In this episode from the series “Key Decisions in HIV Care,” Jonathan Appelbaum, MD, FACP, AAHIVS, and Jens D. Lundgren, MD, DMSc, discuss important considerations for antiretroviral therapy (ART) use in older patients with renal and hepatic impairment.

• European AIDS Clinical Society guideline screening recommendations for kidney disease in people with HIV
• Antiretroviral dose adjustment recommendations based on estimated glomerular filtration rate
• Data on the use of full-dose lamivudine with renal impairment
• Data on the use of 2-drug nucleos(t)ide reverse-transcriptase inhibitor–sparing ART regimens, including GEMINI-1 and -2, TANGO, and SALSA for dolutegravir/lamivudine; SWORD-1 and -2 for dolutegravir/lamivudine; and ATLAS and FLAIR for long-acting cabotegravir plus rilpivirine
• US Department of Health and Human Services recommendations on the use of ART agents with hepatic impairment
• Recommendations from the American Gastroenterological Association on screening and diagnosis of nonalcoholic fatty liver disease (NAFLD)
• Prevalence of NAFLD, nonalcoholic steatohepatitis, and liver fibrosis in people with HIV
• Overlapping risk factors between HIV and NAFLD

Presenters:

Jonathan Appelbaum, MD, FACP, AAHIVS
Laurie L. Dozier Jr, MD, Education Director
Professor of Internal Medicine
Chair, Department of Clinical Sciences
Florida State University College of Medicine
Tallahassee, Florida 

Jens D. Lundgren, MD, DMSc
Professor
Rigshospital, University of Copenhagen
Director
Centre of Excellence for Health, Immunity and Infection (CHIP)
Rigshospital, University of Copenhagen
Copenhagen, Denmark 

Content based on an online CME program supported by educational grants from Gilead Sciences, Inc.; Janssen Therapeutics, Division of Janssen Products, LP; and ViiV Healthcare.

Follow along with the slides at:
https://bit.ly/3gAsu19

Link to full program:
https://bit.ly/3fOl0XX

In this episode from the series “Key Decisions in HIV Care,” Jonathan Appelbaum, MD, FACP, AAHIVS, and Jens D. Lundgren, MD, DMSc, discuss important considerations for ART use in older PWH, including:

• DHHS, EACS, IAS, and WHO recommendations for first-line ART
• Virologic outcomes for older PWH in clinical trials and results from the HealthHIV Second Annual National Survey
• Polypharmacy and its potential consequences, including common non-ARV medications prescribed in the VACS cohort, drug–drug interactions with common concomitant medications, common comorbidities in older PWH, and drug–disease state interactions including renal and hepatic impairment
• Cardiovascular risk considerations including data from the D:A:D study and RESPOND cohort and lipid changes in the TANGO study of switching to DTG/3TC from TAF-based ART

Presenters:

Jonathan Appelbaum, MD, FACP, AAHIVS
Laurie L. Dozier Jr, MD, Education Director
Professor of Internal Medicine  
Chair, Department of Clinical Sciences
Florida State University College of Medicine
Tallahassee, Florida  

Jens D. Lundgren, MD, DMSc
Professor
Rigshospital, University of Copenhagen
Copenhagen, Denmark
Director
Centre of Excellence for Health, Immunity and Infection (CHIP)
Rigshospital, University of Copenhagen
Copenhagen, Denmark  

Content based on an online CME program supported by educational grants from Gilead Sciences, Inc.; Janssen Therapeutics, Division of Janssen Products, LP; and ViiV Healthcare.

Follow along with the slides at:
https://bit.ly/3miT6qH

See the entire program at: 
https://bit.ly/2TXTYWx

Thanks again Luke for coming on the show! Fantastic work getting out solid answers with great exam technique. 

All the best with your exam!

Please support us on our patreon

https://www.patreon.com/anaesthesia

All proceeds will go to Fund a Fellow, to help train anaesthetists in developing countries.

Please rate, post a review and subscribe!

Check out https://anaesthesiacollective.com/education/first-part-exam/ for general information and a collection of model answers

and 
sign up to the ABCs of Anaesthesia facebook group https://www.facebook.com/groups/2082807131964430

and check out the ABCs of Anaesthesia YouTube channel for more content
https://www.youtube.com/c/ABCsofAnaesthesia

If you have any questions, please email Lahiruandstan@gmail.com 

Disclaimer:

The information contained in this podcast is for medical practitioner education only. It is not and will not be relevant for the general public.

This contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. 

The medical information is provided “as is” without any representations or warranties, express or implied. 

The presenter makes no representations or warranties in relation to the medical information on this episode. 

You must not rely on the information as an alternative to assessing and managing your patient with your treating team and consultant.

You should seek your own advice from your medical practitioner in relation to any of the topics discussed in this episode’

Medical information can change rapidly, and the author/s make all reasonable attempts to provide accurate information at the time of filming. There is no guarantee that the information will be accurate at the time of viewing

The information provided is within the scope of a specialist anaesthetist (FANZCA) working in Australia.

The information presented here does not represent the views of any hospital or ANZCA.

These podcasts are solely for training and education of medical practitioners, and are not an advertisement. They were not sponsored and offer no discounts, gifts or other inducements. 

This disclaimer was created based on a Contractology template available at http://www.contractology.com. 

Supplemental methionine modulated liver protein abundance and enzyme activity, stabilizing  metabolism and making cows less susceptible to the metabolic disruptions caused by heat stress.

Based on two 2021 American Dairy Science Association (ADSA) abstracts:
436 Rumen-protected methionine during heat stress alters hepatic cystathionine β-synthase and methionine adenosyltransferase activity. 
438 Hepatic insulin and antioxidant signaling are altered by rumen-protected methionine during heat stress in response to lipopolysaccharide challenge.

Features Dr. Danielle Coleman, Ruminant R&I Science Manager with Adisseo; research conducted while a graduate student at the University of Illinois. Dr. Brian Sloan, Global Director of Ruminant Amino Acids and Protected Nutrient Business, Adisseo. Dr. Dan Luchini, Head of Ruminant R&D, Adisseo .

To view abstracts, go to : https://www.adisseo.com/en/products/smartline/smart-science-series-ruminant-podcasts/

Dr Craig Webb is a specialist gastroenterologist from Colorado State University. He found a passion for veterinary medicine after his family cat received excellent treatment at the University of Wisconsin veterinary hospital. This episode provides a thorough and practical approach to managing liver disease in clinic. 

Topics discussed include:

• ALT vs ALP, what elevations in these enzymes signify
• The clinical significance of elevated ALT, and what could be causing this
• The importance of assessing the patient as a whole, rather than the biochemistry alone
• When should you recheck liver enzymes?
• Dr Webb's step-wise approach to diagnosis of liver disease
• Do you really need to check clotting factors before conducting liver tissue sampling?
• How to approach management when finances are prohibitive 
• Dr Webb's favoured nutraceuticals for liver support, including S-Adenosylmethionine, milk thistle and vitamin E
• How diet can be a valuable preventative approach to reducing liver disease risk in certain animals 

You can find Dr Craig Webb at http://www.cvmbs.colostate.edu/directorysearch/search/memberprofile/cvmbs/1059/webb/craig 

See omnystudio.com/listener for privacy information.