1) I have had the pleasure of listening to this podcast episode by @ebtapper and @ShreyaTrivediMD among others.
It is hands down the best review of alcohol-associated hepatitis I have had the pleasure of perusing in the past few years.
It is hands down the best review of alcohol-associated hepatitis I have had the pleasure of perusing in the past few years.
@ebtapper @ShreyaTrivediMD 2) Here is the link.
https://twitter.com/COREIMpodcast/status/1590313911878025220?t=_KOOW-xsH9I8ZfFIDPjiSA&s=19
3) These are the important pearls from this segment in csase you don't have 40 mins to listen to the podcast!
coreimpodcast.com/2022/11/09/alc…
coreimpodcast.com/2022/11/09/alc…
4) What is the most important thing I learnt from this episode?
1. Patients with AAH almost always have some form of malnutrition.
2. Alcohol is the BIG BULLY of the gut --> it gets absorbed faster and prevents other macro and micronutrients from getting in!
1. Patients with AAH almost always have some form of malnutrition.
2. Alcohol is the BIG BULLY of the gut --> it gets absorbed faster and prevents other macro and micronutrients from getting in!
5) Contd from above
3. The most important interventions to improve mortality?
Alcohol cessation and nutritional support!
3. The most important interventions to improve mortality?
Alcohol cessation and nutritional support!
6) CFA
4. The most important cause of death --> infections
Check the skin, teeth, backside, basically everywhere for the first sign of infection --> these will kill!
4. The most important cause of death --> infections
Check the skin, teeth, backside, basically everywhere for the first sign of infection --> these will kill!
7) CFA
5. Steroids can be used for severe cases (MELD>20 or Maddrey DF > 32) provided INFECTION HAS BEEN RULED OUT.
STOPAH trial is most cited.
The mortality benefit of prednisolone (or prednisone) extend only to 28 days and not to 90 days!
5. Steroids can be used for severe cases (MELD>20 or Maddrey DF > 32) provided INFECTION HAS BEEN RULED OUT.
STOPAH trial is most cited.
The mortality benefit of prednisolone (or prednisone) extend only to 28 days and not to 90 days!
8) CFA
6. Pentoxifyline +/- NAC --> doubtful benefit.
7. Liver transplant is an ethical gray zone.
8. NEVER FORGET to refer to a psychiatrist like @askdheeraj IN HOSPITAL to start treatment for alcohol use disorder!
6. Pentoxifyline +/- NAC --> doubtful benefit.
7. Liver transplant is an ethical gray zone.
8. NEVER FORGET to refer to a psychiatrist like @askdheeraj IN HOSPITAL to start treatment for alcohol use disorder!
9) This was a great episode!
@anujtiwari11 @ashwinrajenesh @medicinewalidoc @theliverdr @ebtapper
#MedTwitter
#gastrotwitter
#hepatology
@anujtiwari11 @ashwinrajenesh @medicinewalidoc @theliverdr @ebtapper
#MedTwitter
#gastrotwitter
#hepatology
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