Why new leaders or novel technologies end up disappointing us? They follow the Gartner Hype Cycle. It's human nature. It consists of a typical pattern of false expectations leading to over-enthusiasm and then disillusionment, followed by eventual productivity.

#mentoringadvice

Everybody talks about using the biomarker PEth to detect alcohol intake. But it's costly: $100-300.

Instead, start doing a good motivational interviewing with the patient following the RULE method. It takes time and empathy, but it's much cheaper.

#livertwitter #medX

Why two people that drink the same amount of alcohol, one develops cirrhosis and the other does not?

In the GenomALC Consortium, we found 20 genetic variants that influence susceptibility to cirrhosis.

t.ly/13NJ1 Hepatology Communications #livertwitter

See our results testing ANAKINRA (IL-1b antagonist) plus Zinc, in alcohol-associated hepatitis:
🔸Increase mortality
🔸Favors AKI

Blocking inflammatory cytokines may have deleterious effects in these patients.

journal-of-hepatology.eu/article/S0168-… EASL Education Journal of Hepatology #livertwitter

What diseases can cause PAINFUL HEPATOMEGALY ?
- Budd-Chiari or subacute right heart failure.
- Alcohol-associated hepatitis especially in young people.
- Biliary obstruction (sometimes no hepatomegaly).
- Some cases liver infiltration/polycystosis/abscess.

#livertwitter #medX

In >10k people with metabolic risk factors, MODERATE alcohol intake increased liver-related mortality.

So data DO NOT support recommending some alcohol because its potential beneficial effects !

t.ly/euePB #livertwitter #MedX

A 53 yo patient with heavy daily alcohol intake and subacute onset of jaundice was referred to my clinic with the diagnosis of alcohol-associated hepatitis (AH). Blood work showed AST 89, ALT 35, GGT 454, AlcPhos 434. Such elevation of AlcPhos is not commonly seen in AH. I

Corticosteroid-free algorithm for management of severe immunotherapy induced liver injury:
doi.org/10.1111/apt.17…
👉 67% improve without steroids
👉 quicker improve in those managed without steroids
🛑several pts excluded due to an alternative diagnosis, mainly progression

It’s only me, that when I am hospitalized, I trust a little more my nurse than my doctor ?

#HappyNursesDay

(Sunday pic #116). Happy Mother's Day in America and many other places.

#livertwitter #MothersDay

Genetic risk scores for alcohol-related #cirrhosis are here

journals.lww.com/hepcomm/fullte… Hepatology Communications Prof Devanshi Seth (she/her) Naga Chalasani Ramon Bataller

To me, a key strategy in conflict resolution is equanimity: 'the ability to maintain a calm, balanced, and impartial state of mind'.

When we're in the heat of a conflict, it's so easy for our emotions to get control of our words and decisions !

#mentoringadvice

Very nice study in CGH by Maja Thiele

Screening at risk populations for MASLD/ALD with VCTE is associated w/ 📉 alcohol consumption, 📉 calories/healthier 🥗,📈 exercise, especially in patients who screened➕with >8 kpa

Screening may ♻️behavior!

cghjournal.org/article/S1542-…

We visited a young woman with history of recurrent alcohol-associated hepatitis (AH). In the 4th episode, we discovered that her generalized anxiety was due to a PTSD related to sexual abuse. Our addiction counselor underwent specific training to treat this condition and was able

🗣️ Hi #hepatologist ! Today we talk about #MPP in #hepatology in one of the most beautiful cities in the world 💃

💻 If you are not lucky enough to be here, you can follow it on-line

👉 aeeh.es/microsite/jorn…

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