Elliot Tapper Profile picture
Hepatologist @michiganliver @vaannarbor; #cirrhosis; encephalopathy; frailty; quality improvement; father; husband. #livertwitter Co-EIC of @HepCommJournal

Mar 29, 2020, 7 tweets

Today I would like to read and tweet about non-#covid things

Will start a string of pearls and 🔥🌶takes from recent papers #livertwitter #gitwitter #cirrhosis

This paper in #amjgastro compared refeeding @ 24 v48 hrs after endoscopic interventions for peptic ulcers. 24 hours was “not noninferior”. multiple limits
1️⃣ ⬆️mortality in 48h
2️⃣diff duration of iv ppi
My 🌶🌶 take: feed your patients when they want!

This @LiverInt multinational study shows that noninvasive tests help sort high from low risk for liver-related events and, to a degree, ❤️events in #nafld

🌶take: this is how we need to do #nafld epi from now on

🛑the madness!

Biofire PCR tests 4 stool “infections” are positive in 14% of healthy controls (!!!) & offer limited to no prognostic information in ppl with #ibd

🌶🌶🌶take: These tests are out of control, riddled with false positives. Check cdiff &manage clinically. @ibddoctor

PEARL ALERT:

Memory is preserved in Minimal hepatic encephalopathy

WHY THIS @AGA_CGH PAPER MATTERS:

As ppl w/#cirrhosis age, there is overlap between causes of cognitive dysfunction

WHAT @JasmohanBajaj DID

1️⃣mHE matters even when MCI present
2️⃣norms for older persons

TPOag ⬆️platelets in #cirrhosis

Do we need them before procedures?

WHY I LIKED THIS @AGA_CGH PAPER
1️⃣mainly before HCC treatment. 🌶: shouldn’t be used before egd
WHAT COULD BE BETTER
1️⃣weird bleeding defn. No diff periop!
2️⃣🌶I wish the comparison was no plts!

PMID:32205226

“Have I told u FIB-4 rocks?” Vol 47

👉200000 people without known liver disease followed for 1.7million person-years in korean health exam database
👉high fib-4 = ⬆️⬆️mortality

Pmid: 32090451

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