Howard D Lee
@howiethedoc
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USAF Physician. Transplant Hepatologist/GI. Former CMR|AASLD ELS ‘18| @USC_KeckGILiver @SAUSHEC_GI @SAUSHECIMRes #MedEd #ClinicalReasoning #LiverTwitter
Joined January 2016
📢 It’s OVER. The “lean MASLD paradox”? Just bad measurement. ❎MASLD with overweight BMI weren’t healthier! We were using the wrong metric. ↗️Waist circumference-related indices show a dose-dependent mortality risk across 3 prospective cohorts. Let’s reframe how we assess
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😳20% of ALI w/ therapeutic doses ALI w/ therapeutic doses all coincided w/ excess 🍷or fasting ➡️worse prognosis (need to incorporate fasting pattern into my hx taking) If ALI patients are jaundiced- EtOH is involved #TLM24 @livertox @AASLDtweets Credit- Dr. Alexander Louvet
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🚨🚨GI/hep fellows studying for boards!🚨🚨🚨 ⬇️76 hepatology practice questions now available thanks to @AASLDtweets & @LiverFellow
https://t.co/yT4VjmigVe 👏 👏👏Major kudos to fellow authors & faculty editor Matt Odenwald! #livertwitter #gitwitter #meded
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Another amazing opportunity presented by @LiverFellow . I can attest to @AyyalaDivya being a selfless, amazing mentor hoping to improve trainee education!
@LiverFellow announces: Poster & oral presentation practice weekly in October + Webinar! For: Trainees w/ Liver-focused abstracts @AmCollegeGastro #ACG2024 & @AASLDtweets #TLM24 #livertwitter To Present: https://t.co/F3IRy40aJU Register for Webinar: https://t.co/aKSVzZaIdl
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Great conversation with GI #livertwitter program directors with @LiverFellow! 🔹There is no "perfect" GI candidate 🔹GI is competitive--you have to be interested in medicine & clinically 🦾 🔹If you don't directly apply from residency, Why?"
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Interested in learning more? Email Denofrio@stanford.edu for an exciting course tailored to GI/hepatology inclined trainees!
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Amazing webinar on improving PC in liver dz as part of @LiverFellow Key Takeaways: 1. Primary PC should be in the armamentarium of hepatologists to address symptom mgmt and social/psychological needs for both pts & caregiver 2. “Headline” statements when discussing bad news
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Register ahead of time. Only two days left to register! https://t.co/Jxu36zbXcP
@LiverFellow #livertwitter #transplant
One of the most challenging aspects of txp hep for me is the difficult conversations with pts and their families, particularly after the decision to decline for listing. Please join the panel & me below in navigating this important aspect of liver care! https://t.co/Jxu36zbpnh
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AUD is a chronic disease and alcohol relapse after transplant for ALD is unfortunately common. Amazing work from my previous co-fellow @AyyalaDivya and PD @HelenHanMD @USC_KeckGILiver in looking at how we can serve this patient population!
Important study alert🚨🚨🚨 Safety of acamprosate for alcohol use disorder Post-Liver transplant Do you give to high risk AUD post-LT pts? @ayyala @norahterrault @HelenHanMD @USC_KeckGILiver @TJUHospital
https://t.co/pIIO562c68
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One of the most challenging aspects of txp hep for me is the difficult conversations with pts and their families, particularly after the decision to decline for listing. Please join the panel & me below in navigating this important aspect of liver care! https://t.co/Jxu36zbpnh
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Congrats to our tx hepatology graduates. #exceptional #toomanyaccoladestocount #goodhumans #alwayshustling This group was “consistent persistent and willing to work for it” ~TB @howiethedoc @AyyalaDivya @melanie_a_hundt @USC_KeckGILiver @USCLiverTx @JeffreyAKahn @norahterrault
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Curious about serious illness communication (SIC) in cirrhosis care? @NnekaUfereMD @gishilpz @KerenLadin and I explore barriers and solutions to SIC in our recently published @AGA_GHAdvances narrative review below: https://t.co/ozJMBCSS6P
#palliativehepatology #livertwitter
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Another generation of fine military gastroenterologist from @SAUSHEC_GI ! Congrats!
Congrats to all our third-year fellows graduating today! ▪️Maj Joe Cook 🔜 @TeamEglin ▪️COL Chris Cowan 🔜 @FortCampbell ▪️MAJ Carl Kay 🔜 @fortcavazosarmy ▪️Maj Billy-Joe Liane 🔜 @NellisAFB
#GITwitter
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In addition to all the important leadership skills the program imparts, it provides such an amazing opportunity to meet and network with like-minded peers and develop relationships that sustain far beyond the weekend. @CarlKayMD @JosephHabibi_MD @BalissMichelle @AlanLHutchison
The #ACGInstitute Emerging Leadership Program allows GI fellows in 3rd or 4th year of training to develop skills in communication, negotiation, change/time management & promoting DEI. 2025 apps are open Sept. 16-Nov. 15! About #ELP ➡️ https://t.co/AUOw3jiQ99
#ACGInstituteWeek
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We are doing a disservice to our patients with ALD when < 20% admitted patients receive pharmacotherapy for AUD on discharge. Rx for AUD therapy should be in the wheelhouse of gastroenterologists and hepatologists alike
Naltrexone in AUD and liver disease: 🥇Should be 1st line 🔹Start: 50 mg daily, also available as monthly subcutaneous 🔹Use freely in Child’s A/B, ⚠️ in C but benefits will probably outweigh the theoretical risks as 🍸is ☠️for liver #AGAGastroSquad @AASLDtweets @DDWMeeting
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👋 #LiverTwitter! Heading to #DDW2024 and don't know where to start? We have curated a guide of hepato-centric and career building sessions that you should not miss!👇 #GItwitter #MedEd @AASLDtweets @AASLDPresident @AmerGastroAssn
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Great tips on minimizing the stigma associated with AUD while establishing a therapeutic relationship with the patient
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
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Acute-on-chronic liver failure (ACLF) is a morbid diagnosis that carries high risk of short-term mortality. This Perspective describes a framework to guide the difficult conversations regarding initiating RRT to ease distress for all parties involved https://t.co/PTnUXTfKPC
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So lucky to have @AniKardashianMD @USC_KeckGILiver studying and advocating for equity in the treatment of liver disease!
Today, @MichiganLiver, we were treated to a masterclass in patient-oriented research. @AniKardashianMD is a ⭐️ - Defining burden of food insecurity in liver disease - Ways we can improve the burden - Leading the way by example #livertwitter
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Hyponatremia in cirrhosis is a common clinical dilemma, particular in those with profound portal hypertension. Excellent case base review by @VelezNephHepato below
1/n Hyponatremia in cirrhosis rounds: case 1: ESLD 2/2 ETOH. Admitted at OUH 2/2 abd distension/lethargy w/sNa 133. Kept on spirono + furosem + lactulose. Gradual ⬇️in sNa in 10 days. Transferred 4 ⬆️level of care. Arrives with sNa 125, sCr 0.8. Alert, jaundice, ascites, no edema
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