Liver specialist at Virginia Commonwealth University and Richmond VAMC . Interested in the brain liver gut axis. Co-EIC of Am J Gastro. Tweets are personal.
@EASLnews
international award to Dr Patrick Kamath!! Extremely well deserved award to one of the best doctors mentors and human beings I have come across!! Wonderful intro by Dr Gines
Studying
#cirrhosis
disparities, a lot needs to be done to improve access, but
🙏
#CLEARED
consortium 90 ctrs, 25 countries &growing in 6 continents!
🙏
@LancetGastroHep
🙏
@LaurenNephewMD
for an incredible commentary
✅Together we need to make things better!
thanks to
@Gut_BMJ
for an electric-fast review and for accepting our multi-center North American paper comparing
#Cirrhosis
+COVID-19 to contemporaneous patients with
#COVID__19
alone & Cirrhosis alone i.e. denominators
#NACSELD
. Full results when paper comes online!
#livers
everywhere! My
#patient
with
#cirrhosis
who is an avid gardener grew this striking
#heirloomtomato
. She presented it to me since it reminded her of the
#liver
. Grateful for these gestures that remind us of the humanity behind the medical diagnoses. BTW was delicious 😋
Taking a break from avoiding politics to post
#idlisambhar
(microwave heated so not ideal but still my go-to) that i am about to consume in honor of our newly elected Vice President
@KamalaHarris
!!!!
@JoeBiden
Honored to present the 27th Annual Schiff Lectureship on
#hepaticencephalopathy
@univmiami
Especially grateful considering the stalwarts who presented this before me. Special thanks to Dr Eugene Schiff!
#cirrhosis
millions of $ in time wasted making papers fit journal guidelines. Fortunately
@AmJGastro
encourages
#hasslefree
submissions. Anything to reduce the burden to authors!
@MLongMD
@AmCollegeGastro
So submit now!
🔥🔥🔥
Rapid
#RCT
review process now
@AmJGastro
@MLongMD
🌟 Selected RCTs will get peer-reviewed w decisions w/in 10 days
🌟if accepted online soon after
Details⤵️
1st rapid RCT accepted
@AnandVKulkarni2
Where
#terlipressin
is unavailable, what is the risk of
#respiratoryfailure
in
#cirrhosis
?
Look no more!
🔑15% rate in a 🇺🇸🇨🇦cohort
🔑Related to GI bleed, albumin use & nosocomial pneumonia
🔑Most albumin use was not evidence-based
Read
@AmJGastro
⤵️
➡️Sex differences in gut-brain axis in
#cirrhosis
?
➡️
#microbiota
related to feminization in men with
#hepaticencephalopathy
?
Yes & Yes!
Read our study of >750 pts with varying response to lactulose & rifaximin. Collab w for
#AI
Cannot believe it has been 20 years!🙏
@AmCollegeGastro
for the education, support and feeling of
#ACGFamily
for all these years and hoping for many many more! Shout out to all those who work behind the scenes to make this great organization tick!
@AmJGastro
Take a GOOD look at this study.
It is not only brilliant and practice changing, but also life changing.
Older people develop dementia.
"Dementia is the general name for a decline in cognitive abilities that impacts a person's ability to perform everyday activities. This…
just finished
#hepaticencephalopathy
session
#TLMdX
✴️ new diagnoses: Flicker-App, speech
✴️ new gut-based Rx:
#FMT
, Soluble rifaximin
✴️ new brain-targeted Rx: Golexanolone ⛔️ neurosteroids
The field is vibrant! 🙏 to all participants
Great discussion and presentations!
Why is the
#microbiome
hostile in
#cirrhosis
? We found virulence factor genes for
#biofilm
& adhesion
🔑⬆️ w decompensation
🔑 ⬆️ ☠️& 🏥 risk indep of clinical factors
🔑 distinct in pts with SBP & UTI
🔑⬇️ w
#FMT
⤵️
💯💩Microbial function>>>composition
We heard our reviewers!
@MLongMD
This was a data-driven approach thru a reviewer survey (n>500) & listened to feedback. A menu of options for recognition was requested - & we responded! We want
@AmJGastro
to be the 🏡for authors, readers and reviewers! ✅hassle free submissions!
Do
#BCAA
improve sarcopenia? Yes thru data at
#ILC2020
. Pilot RCT showed ⬆️muscle mass over 12 weeks. Controlled for diet and exercise! Hope these nice results can be extended to decompensated pts . Our patients need sarcopenia Rx.
@EASLnews
@EASLedu
@JenLaiLiverDoc
BREAKING NEWS:
The 2020
#NobelPrize
in Physiology or Medicine has been awarded jointly to Harvey J. Alter, Michael Houghton and Charles M. Rice “for the discovery of Hepatitis C virus.”
Have suffered thru this as an author and editor. Have been tempted to be rude as a reviewer and have sometimes been guilty of it. Especially younger reviewers please be kind but firm! Rude paper reviews are pervasive and sometimes harmful, study finds |
#FMT
to reduce
#antibioticresistance
in
#cirrhosis
? Yes we can!
Metagenomic analysis of 2 trials in pts on rifaximin, lactulose & PPI. ⬇️vancomycin & beta lactamases whether enema or capsule or pre-FMT abx. Read for free ➡️
Had a 👀 - what a fabulous & varied programme 👏👏
@DrSamirAShah1
This 👇particular one really caught my eye (despite not
#IBD
😊)
Too ⏰ for this year - 🤞will be there in 2023
Thyroxine &
#hepaticencephalopathy
?
Our
@AGA_CGH
study of
#cirrhosis
inpatients found
🔑 Admission serum
#metabolomics
⬇️ thyroxine & ⬆️ microbial metabolites ➡️ advanced HE
🔑but these are difficult to do quickly
🔑 ⬇️ thyroxine validated in a local lab
A little creatinine goes a long way in
#cirrhosis
🔑Acute Kidney Disease (AKD): Creatinine b/w normal kidney fn & AKI
🔑In
#NACSELD
study of >1200 inpts, AKD ⬆️ mortality
🔑 second infection &
#diabetes
relate
@LiverInt
Ignore creatinine at your peril!
🙏 to
@Mayo_liverdoc
& 🇪🇬 friends for an illuminating
@AASLDtweets
-ESLC 1st conference in
#Cairo
!
✅Excellent exchange of ideas, great food & of course 10k years of history
🤩Visits to Giza (pic 🚫 photoshopped!), Alexandria (pic in library) & El Alammein. Hope to many more!
Do we continue ⬇️ rounds,
#PPE
,❌ ICU visitors in
#cirrhosis
? YES!
In 2
#cirrhosis
ICU group w/o
#COVID19
#1
pre-vs
#2
w
#COVID19
restrictions, we found that group 2 had
⬇️nosocomial infections (⬇️ human contact)
⬆️liver tx
despite ⬆️MELD & qSOFA
read⤵️
Ammonia scavengers for
#hepaticencephalopathy
?
Multi-center, dose-ranging RCT of Ornithine phenylacetate vs placebo in inpts
🔑⬇️time to recovery but 🚫significant...BUT
🔑if entry central lab NH3 level was⬆️,it worked!
Read
@AGA_CGH
⤵️
@AmerGastroAssn