Juan Turnes

Nuestro Servicio de Digestivo recibe el Premio Ciudad de Pontevedra 🙌

Un premio como este, de los ciudadanos a los que nos debemos, es un honor que supera con creces cualquier otro. Y un refuerzo extra para seguir avanzando e innovando todos juntos 💪

The greatest review written on liver biopsy: indications, interpretation, and its future

By Dr Purva Gopal and colleagues in HepCommJournal

Open access journals.lww.com/hepcomm/full...

#liversky #pathsky

Long-term risk of chronic liver disease in patients with celiac disease: a nationwide population-based, sibling-controlled cohort study CeD is associated with a persistently increased risk of any incident CLD, although the absolute risk is low. Physicians should be vigilant to early signs of liver dysfunction in patients with CeD.

Long-term risk of chronic liver disease in patients with celiac disease: a nationwide population-based, sibling-controlled cohort study

New research in The Lancet Regional Health - Europe

www.thelancet.com/journals/lan...

#GastroSky #LiverSky #MedSky

Two maps, first showing the distribution of HBV infection worldwide and then showing the location of clinical trials. Trials are least representative of high burden settings, especially for Africa.

There is urgent need for clinical trials for #HBV in #Africa.

Studies must deliver:
1. Quick start-up
2. Site potential, access to participants
3. High quality research leading to impact

www.thelancet.com/journals/lan...
🧪 #HepSky #LiverSky @mariondelphin.bsky.social @crick.ac.uk

Un estudio revela que los datos utilizados para entrenar la #IA están concentrando el poder en manos de unas pocas empresas, creando un oligopolio alineado con los intereses y objetivos de corporaciones con fines lucrativos

www.technologyreview.es/s/16958/asi-...

An article caught my eye, which I suppose may be of interest due to the peculiarities of the US healthcare system

In Europe, it hasn't been necessary to be on the verge of achieving the WHO elimination goals

Admittedly the cool name of the study group first caught my 👁️

POSEIDON study group showed
✅alfapump 📉need for LVP
✅similar complications
✅improved QOL
@amcollegegastro.bsky.social

journals.lww.com/ajg/abstract...

#liversky

YouTube video by Maja Thiele The three rules of biomarker appraisal

The three critical rules of biomarker appraisal:

✋Truthful? = analytical validity
👍Meaningful? = clinical validity
🙌Useful? = clinical utility

youtu.be/zCjxDeyXgfU?...
#liversky #biomarkers #medicine

The key may be in the selection. There are so many variables (types of surgery, types of decompensation) that it is impossible to address from a prospective study at this point in time. It may be worthwhile to have a registry to help glean what is futile versus what is possible.

Key recommendations in portal vein thrombosis in patients with cirrhosis:

✅Identify recent thrombosis and extent
✅Anticoagulate if recent & >50% obstruction
❌ No anticoagulants if chronic cavernomas
✅DOACs safe if compensated
🤏 TIPS sometimes
💡 Image every 3m

doi.org/10.1053/j.ga...

#LiverSky

Sex Differences, Menses‐Related Symptoms and Menopause in Disorders of Gut–Brain Interaction Our global epidemiology study shows symptom differences within the five most common DGBI based on sex, menopause, age, and menses. Sex hormone-mediated effects may contribute to greater symptom burde....

Q: Does gender play a role in GI symptoms? menopause? fascinating study.
A: women have more symptoms of GI disorders than men, & there are different symptoms w/age, maybe b/c hormone changes #menopause
onlinelibrary.wiley.com/doi/pdf/10.1...

Ulcerative colitis in pts with PSC (compared to UC w/o PSC)

- more extensive (pancolitis)
- milder disease course
- heavier disease burden on right
- rectal sparing + ileitis
- higher risk of dysplasia and colorectal cancer (annual screening)

#IBDSky #LiverSky #GISky @natrevgastrohep.bsky.social

Good point 😂

Interesting arguments, although the 4th would make for a good debate if you add the guys from the Clinic Hospital of Barcelona and the Ramón y Cajal of Madrid to the discussion 😉

Out of curiosity, what were the arguments of @brettefortune.bsky.social?

I once lost a debate in spectacular fashion to @brettefortune.bsky.social. Popular vote landslide AND electoral college

He was for early TIPS after variceal bleeding. I was against

My points were:

#liversky

Indeed, in the real world, the ability to place a TIPS at the most appropriate time for the patient is as important as selecting the patient who can benefit most from it. Two conditions that are rarely met ...

⚠️ A recent study in patients with cirrhosis and portal hypertension shows that preoperative placement of TIPS is associated with increased postoperative mortality 🤨

doi.org/10.1097/hc9....

#LiverSky #MedSky

Albumin is the closest thing to a "universal remedy" in cirrhosis

We use it to treat different complications, with good evidence but also with debatable or negative evidence

Excellent analysis by Jonel Trebicka & @ggarciatsao.bsky.social

doi.org/10.1097/hep.0000000000000521

#LiverSky

Incidence of cancer in PSC

#liversky

Decompensated cirrhosis has often been considered the irreversible, terminal stage of liver disease, but this is not actually always the case

Have you heard of the concept of cirrhosis "recompensation"?

➡️ doi.org/10.1016/j.jhepr.2024.101233

#LiverSky

Today marks the end of my journey as Associate Editor at Liver International. It’s been a fantastic experience, and I’m confident the journal will continue to grow 📈

I encourage researchers to submit their valuable work and contribute to its success!

#liverSky

⁉️ Crees que la implantación de la #IA generativa en tu trabajo es lenta o inexistente? @emollick.bsky.social lo explica en Co-Intelligence:
🚫 Exceso de centralización y burocracia
🐢 Estrategias obsoletas
🔑 El verdadero poder está en quienes conocen los problemas reales y ya están probando soluciones

Early Terli

Giving terlipressin at lower creatinines (1.5-2.0) or within 12 hours of presentation (skipping the “albumin challenge”)

1. From the RCTs journals.lww.com/hepcomm/page...
2. Pilot trial doi.org/10.1007/s106...

#liversky

Dicen que ChatGPT se ha marcado un «Black Mirror» intentando «escapar» para salvarse de sus ser borrado por sus creadores OpenAI alerta sobre las capacidades de engaño en las IAs, tras descubrir intentos de «autoconservación» en ChatGPT.

OpenAI alerta sobre las capacidades de engaño en las IAs, tras descubrir intentos de «autoconservación» en ChatGPT | #IA | por @Alvy www.microsiervos.com/archivo/ia/c...

Over on the Twitter I have liked hundreds of match day celebrations

Observations:
1. Bluesky still needs more value for learners and research discussions. It is growing but needs to be sustained
2. Match day reminds: America and American medicine still attracts the worlds best and brightest

What do hepatic encephalopathy and irritable bowel syndrome have in common?

Read this hot take from @jasmohanbajaj.bsky.social and @markpimentelmd.bsky.social in #AJG on whether HE is the original disorder of gut brain interaction (DGBI)

#GISky #LiverSky

Link: journals.lww.com/ajg/fulltext...

We’re serious about @bsky.app’s future 🤝

Xalnesiran with or without an Immunomodulator in Chronic Hepatitis B | NEJM Xalnesiran, a small interfering RNA molecule that targets a conserved region of the hepatitis B virus (HBV) genome and silences multiple HBV transcripts, may have efficacy, with or without an immun...

The siRNA xalnesiran with or without an immunomodulator in chronic hepatitis B - the Piranga ph 2 study

www.nejm.org/doi/pdf/10.1...

#MedSky #LiverSky #IDSky

Locoregional Therapies for Hepatocellular Carcinoma This systematic review and meta-analysis compares findings from randomized clinical trials on the use of locoregional therapies as monotherapy or combination therapy in the treatment of nonmetastatic ...

Systematic review & meta-analysis of locoregional therapies for #HCC in @jama.com network open

✅Inclusion:
RCTs with PFS and OS as endpoints

✅Conclusions:
Resection > thermal ablation ~ RT ~ HAIC > embolization

#oncsky #radonc #radsky #liversky

ja.ma/3ONRpQ1

Tirzepatide for Obesity Treatment and Diabetes Prevention | NEJM Obesity is chronic disease and causal precursor to myriad other conditions, including type 2 diabetes. In an earlier analysis of the SURMOUNT-1 trial, tirzepatide was shown to provide substantial a...

3-yr data for SURMOUNT-1: up to 20% TBW loss w/ #tirzepatide @elilillyandco.bsky.social
15 mg dose maintained. 94% risk reduction in diabetes among prediabetics. Mostly GI AEs almost all in first 20 weeks.
#liversky