liver disease

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, Jürgen K. Rockstroh, MD, and Giada Sebastiani, MD, discuss key strategies to appropriately screen for, identify, and manage nonalcoholic steatohepatitis in persons with HIV. They also answer pressing questions from healthcare professionals.

Presenters: 

Jürgen K. Rockstroh, MD
Professor of Medicine
University Hospital Bonn
Department of Medicine I
Bonn, Germany

Giada Sebastiani, MD
Associate Professor of Medicine
McGill University Health Centre
Division of Gastroenterology and Hepatology and Division of Infectious Diseases
Clinician Scientist
Research Institute of McGill University Health Centre
Montreal, Quebec, Canada

Content based on an online CME program supported by an educational grant from Theratechnologies Inc.

Link to full program:
https://bit.ly/363orZ9

Unfortunately with Omicron Dr. Armitstead has now seen enough post-COVID patients from various strains to create this podcast.  Good news is if you have gotten COVID and still feel off in any way she has some health tips to help you feel like your old self again.  

Post COVID or long haul COVID are the terms used when symptoms or signs persist for more than two weeks after COVID-19 onset.  Dr. Armitstead explains that symptoms can continue for months after and include fatigue, headaches, poor focus or attention, shortness of breath, and so much more.  Symptoms after having COVID-19 continue after the initial infection because the SARS-CoV-2 virus goes into the body causing more inflammation than the average virus.  The number one place that inflammation hits is the air ways and lungs because that’s how it gets into the body. Then Dr. Armitstead explains that the second place this virus hits is the liver and things you can do to boost up your immune system to reduce the inflammation while supporting the lungs and liver.  She also shares that the SARS-CoV-2 virus attacks the liver similar to the way the Epstein Barr virus (EBV) does to the liver and how they both attack the thyroid as well.  So please listen to this episode if you have a thyroid imbalance,  especially Hashimoto's, liver concerns or any other autoimmune disease for Dr. Armitstead shares her theory of all autoimmune diseases and it's not what you think.

Please share this episode with your friends and family so we can help each other post-COVID.

Resources:

Thyroid Healing Book: https://www.medicalmedium.com/thyroid-healing

Post COVID study: https://www.nature.com/articles/s41598-021-95565-8

Inflammation relief: https://healingartsnyc.com/shop/inflammation-relief

Wellness Blend https://healingartsnyc.com/shop/wellnessblend

Hydroxygen https://healingartsnyc.com/shop/hydroxygen-cellcore

Glutathione: https://healingartsnyc.com/shop/glutathione

Health Benefits of Turmeric: https://healingartsnyc.blogspot.com/2016/04/turmericis-brain-health-miracle.html

Sleep Well Podcast: https://www.buzzsprout.com/894679/3795920

In this episode of Bowel Sounds, hosts Drs. Peter Lu and Jennifer Lee talk to former NASPGHAN President Dr. John Barnard about the past, current, and future of pediatric GI research.  We ask him to reflect upon his career as a leader in the field of pediatric GI and specifically in advancing pediatric GI research for the past several decades.  We ask him how research interest and funding is changing over time, how researchers can best position themselves in today's research landscape, and what he feels are the most important factors for success as a medical researcher.  We also discuss how our community can better support women and underrepresented minorities in academic medicine.  Finally, he talks to us about the advice that has guided him throughout his career.

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Produced by: Peter Lu

Special requests:

Thank you to everyone for listening to our podcast. If you enjoyed this content and thought it was useful, we ask you to consider doing any or all of the following three things:

1. Tell one person who you think would like this type of content about the podcast.  We want to reach more GI doctors and trainees and general pediatricians, pediatric residents, and medical students.
2. Leave a review on Apple Podcasts -- this helps more people discover our podcast.
3. You can also support the show by making a donation to the NASPGHAN Foundation

Support the show (https://www.naspghan.org/content/87/en/foundation/donate

This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Check out our merch website!

Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.

Click here to support the show.

This show is sponsored by LUMEN (discount below) | In this episode, you will learn about have to AVOID FATTY LIVER! 

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Show Sponsors:

My Supplement Regimen: shoot me a DM on Instagram, FaceBook, or Twitter for info. 

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FOLLOW ALONG:

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DISCLAIMER: https://docs.google.com/document/d/1r3fz8KZE6dVhJHo4V9DHGayU-zmPHtAs31JhokQgJKA/edit?usp=sharing

Hepatitis delta is the most severe form of viral hepatitis, and many patients remain undiagnosed. In this episode, Maria Buti, MD, and Robert G. Gish, MD, discuss the prevalence and severity of hepatitis delta. Hear their personal experiences from the clinic and their call to action for universal screening of patients with hepatitis B for coinfection with hepatitis delta.

Presenters:
Maria Buti, MD
Professor of Medicine
Hospital Universitario Vall d'Hebron
Barcelona, Spain

Robert G. Gish, MD
Professor of Medicine
Loma Linda University
Loma Linda, California
Medical Director
Hepatitis B Foundation
Washington, DC

Link to full program:
https://bit.ly/3E9xKSx

In this episode of Bowel Sounds, hosts Drs. Peter Lu and Jason Silverman talk to Dr. Rohit Kohli about non-alcoholic fatty liver disease (NAFLD) in children. He explains the evaluation and diagnosis of NAFLD and discusses some of the challenges that come with treating children with this disease.  He tells us about how a mentor inspired him to dedicate his career to the study of NAFLD and how he has come to recognize the need for advocacy to truly make an impact on preventing this disease. 

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Produced by: Peter Lu

Special requests:

Thank you to everyone for listening to our podcast. If you enjoyed this content and thought it was useful, we ask you to consider doing any or all of the following three things:

1. Tell one person who you think would like this type of content about the podcast.  We want to reach more GI doctors and trainees and general pediatricians, pediatric residents, and medical students.
2. Leave a review on Apple Podcasts -- this helps more people discover our podcast.
3. You can also support the show by making a donation to the NASPGHAN Foundation

Support the show (https://www.naspghan.org/content/87/en/foundation/donate

This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Check out our merch website!

Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.

Click here to support the show.

This episode covers liver transplants.

Written notes can be found at https://zerotofinals.com/surgery/general/livertransplant/ or in the general surgery section of the Zero to Finals surgery book.

The audio in the episode was expertly edited by Harry Watchman.

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.

Let's talk about Cirrhosis! Learn about the signs and symptoms, the complications, and what you, as the nurse, can do about it.

Over 44,000 people die every year from cirrhosis, so it’s the 9th leading cause of death in the US. Cirrhosis is an incurable form of liver disease that happens slowly due to inflammation and scarring of the liver tissue. When you think of cirrhosis, think of scarring, or “Scarosis”. The main cause is chronic hepatitis C. The other two causes are: drinking too much alcohol, and nonalcoholic fatty liver disease. Nonalcoholic fatty liver disease is when too much fat gets stored in the liver cells, and this can be from obesity or diabetes.

So the liver cells get damaged, they try to fix themselves, but just wind up making scar tissue instead. So instead of having a nice, smooth liver, you’ve got a lumpy mess of a liver with constrictive bands that cut off the flow of blood and bile. Remember bile is made in the liver, and then has to go to the gallbladder to be stored. 

So why do we care so much about the liver? What does it do for us?

Our liver detoxifies alcohol and drugs. It breaks down proteins and carbs, and steroid hormones. It makes blood clotting factors, so if your liver isn’t working, you’re gonna have a decrease in every coagulation factor, except factor 8. The liver makes blood proteins, like Albumin, and if you remember, Albumin is the main protein in your blood, and the main thing regulating your oncotic pressure, or the thing that’s keeping your fluids in your blood vessels, and not seeping out into the tissue. So when the liver isn’t making enough Albumin, we’re gonna see edema and ascites. Ascites is when too much fluid builds up in the peritoneal cavity, causing a big swollen belly. 

A normal liver will store glucose as glycogen for later use, but with an impaired liver, we could see hypoglycemia or hyperglycemia cause the body’s having a hard time regulating the glucose levels. The liver makes bile, and bile absorbs fat and gets rid of bilirubin. Bilirubin is a yellow pigment that’s a byproduct of your old red blood cells getting broken down. A healthy liver will take that bilirubin and put it in your poop with bile to get rid of it. This is what makes your poop brown. So without that bile, your poop is gonna be pale and clay-colored, because you’re not getting rid of the bilirubin pigment, and that bilirubin is gonna keep building up building up and make your skin and the whites of your eyes yellow. 

In this episode, Professor Markus Cornberg is joined by Dr Christiane Eberhardt and Professor Daniel Shouval to answer a range of questions raised by EASL’s Patient Synergies regarding the recently approved COVID-19 vaccinations.

They address topics including the reasons for the rapid development of the vaccines, whether immunocompromised liver transplant patients should receive the vaccine, real-world data from vaccination programmes worldwide and the potential duration of immunity.

Discover on our website more educational materials on COVID-19 and the liver.

My guest today is Andy Di Santis MS. RD.  He is a private practice dietitian, blogger, and author of 7 books from Toronto, Canada. He graduated from the University of Toronto School Of Public Health with a Master's degree in public health nutrition before working for Diabetes Canada on the research and education team.

We will be discussing: 

• NAFLD, what causes it and why is it such a common ailment in not only Canada but the USA
• 5 most prescribed medications, why avoiding them, to begin with, is the best step and WHEN is it NOT possible to not take meds 
• the latest on Intermittent Fasting, what we know , we DON’T and who SHOULDN’T IF.
• Debunking the Soy Myths. Soy. Does it mimic estrogen? Is it an endocrine disruptor and what is the latest Science on Non-GMO Organic soy?
• Will consuming Soy-based products lowers Testosterone
• Let’s talk Poop 101. What is normal, what isn’t and when should they seek medical help And..much more!! 

Thanks for tuning in! 

If you find this information helpful you can support the show below: 
https://www.venmo.com/healyounaturally
https://www.paypal.me/healyounaturally​ Thanks in advance!

In this episode of Bowel Sounds, hosts Drs. Peter Lu and Jennifer Lee talk to Dr. Evelyn Hsu about liver transplantation in children and how to become a pediatric transplant hepatologist.  We talk about what inspired her to become a transplant hepatologist and introduce the topic of pediatric liver transplantation, including its indications, contraindications, and the components of transplant evaluation.  We discuss the improvements in transplant outcomes over time and the new standards for a successful outcome. Finally, we talk about transplant hepatology fellowship training and what the Society of Pediatric Liver Transplantation (SPLIT) is doing to help educate GI trainees with an interest in liver transplantation.

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

References:
Dominique Ansel's MasterClass on French Pastry Fundamentals
Hyperbole and a Half by Allie Brosh
The Great Pottery Throw Down on HBO
The American Barbecue Showdown on Netflix
Society of Pediatric Liver Transplantation (SPLIT) website

Produced by: Peter Lu

Special requests:

Thank you to everyone for listening to our podcast. If you enjoyed this content and thought it was useful, we ask you to consider doing any or all of the following three things:

1. Tell one person that you think would like this type of content about the podcast.  We want to reach more GI doctors and trainees as well as general pediatricians, pediatric residents and medical students.
2. Leave a review on Apple Podcasts -- this helps more people discover our podcast.
3. You can also support the show by making a donation to the

This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Check out our merch website!

Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.

Click here to support the show.

Danny Hiles, received a liver transplant which saved his life. He was diagnosed with Wilson's disease which is a rare autoimmune disease. He shares his story about receiving his diagnosis and what it means to be an organ recipient.

Danny's YouTube page:
https://www.youtube.com/channel/UC7XGBd1JjV7U2ddoGeFooiQ

Danny's Instagram:
https://instagram.com/danny_hiles86?igshid=puzgnurvka08

Thank you for listening! For more information please visit adoctorsview.uk
email: adoctorsview@gmail.com
instagram: @adoctorsview
twitter: @DrPolyvios

Fatty liver disease can effect more than just those who consume a lot of alcohol. In fact, this dangerous disease is common, affecting 1 in 4 of people–some without even knowing. We sat down with Ogden Clinic Gastroenterologist, Dr. Chad Gonzales, to talk about fatty liver disease, how to prevent it, and how to help the condition.

In this episode of Bowel Sounds, host Dr. Peter Lu and Dr. Jason Silverman talk to Dr. Binita Kamath about Alagille Syndrome and its place in the differential and workup of cholestatic liver disease, including the role of molecular diagnostics in diagnosis, management and family counselling. We discuss her important work in the area of frailty in pediatric liver transplant patients. We also discuss the importance of trainee mentorship in her career, and advice on defining your academic identity. 
 
As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Produced by: Jason Silverman

Special requests:

Thank you to everyone for listening to our podcast. If you enjoyed this content and thought it was useful, we ask you to consider doing any or all of the following three things:

1. Tell one person that you think would like this type of content about the podcast.  We want to reach more GI doctors and trainees as well as general pediatricians, pediatric residents and medical students.
2. Leave a review on Apple Podcasts -- this helps more people discover our podcast.
3. You can also support the show by making a donation to the NASPGHAN Foundation 

This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Check out our merch website!

Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.

Click here to support the show.

In this episode of Bowel Sounds, hosts Dr. Peter Lu and Dr. Jennifer Lee talk to former NASPGHAN President Dr. Jim Heubi about inborn errors of bile acid metabolism, including how to identify, diagnose, and treat these rare diseases. We also discuss highlights of his career and advice on how to build a career based on experience with a single patient.
 
As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Produced by: Jennifer Lee

Special requests:

Thank you to everyone for listening to our podcast. If you enjoyed this content and thought it was useful, we ask you to consider doing any or all of the following three things:

1. Tell one person that you think would like this type of content about the podcast.  We want to reach more GI doctors and trainees as well as general pediatricians, pediatric residents and medical students.
2. Leave a review on Apple Podcasts -- this helps more people discover our podcast.
3. You can also support the show by making a donation to the NASPGHAN Foundation 

This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Check out our merch website!

Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.

Click here to support the show.