Love this idea. Especially for patients who don’t get transfused during the admission.

If endoscopists were paid by number of polyps removed instead of by number of procedures (with/without one polyp removed), would colon cancer rates go up or down (or be unchanged) ?

Recommendation from me: Check iron levels in patients following up in your clinic after admissions for GI bleeding or where significant anemia is noted. It’s easy to have all the focus go to the decompensations or questions of TIPS and transplant, but iron repletion is a pretty easy win for patients

Bejan Saeedi, MD PhD received the Sunder J. Mehta, MD Memorial Lectureship Mehta-Makhijani Fellow Award for commitment to excellence in education, participation & contribution to Grand Rounds, clinical enthusiasm, & research potential! @prashanthfrancis.bsky.social @jchristiemd.bsky.social 💪🏆🥳

This may be the paper that changes my worldview the most this year. One set of implications is how we approach clinical vs research training. Had never considered that what clinical reps under stress induce can be called habits…and how/why that’s the opposite setup needed for research ideation.

The court ordered that NIH grant funding be unfrozen, so The Regime found a way around it. For NIH grants to be funded, a review panel must rank them. In order for a review panel to meet, they must post it on the Federal Register. Submissions to the Federal Register are now on hold “indefinitely”.

Love this! It addresses so many of my frequent questions of FMT studies: Was it the abx or the FMT? Was there engraftment? What’s the mechanism? How long does it last? Really looking forward to seeing this with a larger n and new approaches/refinement to engraftment.

I suppose it’s better to replace a huge number of referrals for incidentally found low risk hepatic steatosis with a smaller number of referrals for elevated liver stiffness in setting of very elevated liver enzymes, but this still seems like an area we can improve upon.

When the lab brings cookies

All is merry and bright🌟 at CU Gastro Hep! We spent a festive 🎅evening together for fun 🎶, friends🎳 & fellowship🥂 to celebrate our hard work & accomplishments. Happy Holidays! 💩@swatipatelmd.bsky.social @bilalmohammadmd.bsky.social @frankiscottmd.bsky.social @prashanthfrancis.bsky.social

Did a chalk talk on (how we arrived at) carvedilol for cirrhosis with portal HTN with the (Fellow/Resident) team and it's really surprising to me how quickly we were able to get MASLD/MASH/MetALD disseminated relative to this change in diagnosis and medical treatment of a large group of patients.

Ecstatic for this class! Congrats to all who matched today!

Happy to see more and more of my #livertwitter friends making the transition to #liversky! Let’s try to rebuild/improve upon the wonderful education/information sharing community here!

When it’s time to write the conclusions, impact and future directions section of the grant open.spotify.com/track/2A7qdr...

In general, I find that our centers are pretty good at accomplishing this and the main reminder that our team has to recommend is to repeat a paracentesis at 48 hours to ensure adequate treatment.

It's a strange time where the indications for GLP1 medications are like to keep expanding (hello MASLD/MASH) but access to the medication and staying on the therapy long term remains poor - only ~20% at 2 years by one estimate. If a new medication can't actually be taken, are lives really saved?

With apologies to Bradley Cooper and Jason Isbell, maybe it’s NOT time to let the old ways die. open.spotify.com/track/6jMbPs...

Like the radioactive spider, but more targeted/limited in scope.

Maybe one way to think about the size or activity of a field is to think about how often a podcast about the field would release an episode.

Saw iron dosed incorrectly so much that I made a SmartText to be able to quickly add it to my notes as a GI Fellow. Stop torturing patients with multiple times a day iron! Hepcidin is smarter than this and is often torturing the bowels as payback.

DIPG is a brain tumor that is uniformly fatal in the children in whom it occurs with a median survival of 11 months. In a Phase 1 study of this CAR T cell therapy, they hit 20 months with 2 of 11 patients still alive 30 months later with resolved neurologic symptoms. Just truly remarkable results.

Beautiful!

AASLD get on Blue Sky challenge (I asked our President Elect about this and she seemed positively inclined. Not sure who decides this, though)

After those great MASLD late breakers, I’m left thinking this is a race by the different therapy teams/companies to define their territory/use cases. My inclination is to say GLP-1RAs for early disease and those with obesity/T2DM given broader benefits, but in lean pts and as fibrosis advances: TBD.

Dear San Diego, So long and thanks for all the fish! Regards, #tlm24

The Late Breaking Abstracts delivered! The past few Liver Meetings have felt a bit like Avengers Infinity War. Lots of trials against MASLD/MASH as well as HBV/HDV, PBC, etc, that didn’t end up winning out. But this year? This year we’re back and it feels like Avengers Endgame. #tlm24 #liversky

Due to lack of other content I am learning a lot about Colorado Uni gastro division, no complains ☺️@bilalmohammadmd.bsky.social

🥳🎖️👏 @prashanthfrancis.bsky.social for his CU DOM Diversity, Equity, Inclusion & Justice Grant Award w/ Elena Lebduska MD for "Equidad por Todos: A Community-Focused Approach to Tackle Spanish-Language Disparities in CRC Screening" We💜Dr. Francis’s commitment to advancing DEI&J! @medsky.social #GISky

Snack break

Reflecting on Liver Meeting’s post-grad course and it just really feels like Hepatology has its groove back. There was a bit of a dry spell after DAAs/in COVID where it seemed like we mostly had negative trials for MASLD and HBV, but almost every disease had an important update or new therapy #TLM24

The Division of Gastroenterology and Hepatology is part of #CUAnschutz, the largest academic health center in Colorado and the Rocky Mountain region ⛰️. Follow us for the latest in #Gastroenterology #Hepatology #LiverSky #GastroSky 🩺Learn more about us here: medschool.cuanschutz.edu/gastroentero...

Frantically tries to remember if I ordered meropenem in my sleep…in another city @cudivofid.bsky.social

Look, I’m not casting any shade on prior Liver Meeting locations, but I enjoy being able to sit by the ocean in the sun and eat a delicious lunch during the break. #tlm24

Great first part of the Post-Grad Course at #tlm24 focused on alcohol and metabolic steatotic liver disease. As I walked through the clinical MASLD/MASH posters afterwards, I’m struck by how much the bar is raised for (my) expectations for potential therapeutics now. Real broad solutions feel close.

The very best from the very best. So glad she’s over here in the good place.

I think how the immune system - whose core function can be defined as identifying self from non-self - functions in pregnancy is a bit mind bending. And if cancer can co-opt these pathways to induce tolerance…why can’t the world of transplant?

There’s not a lot that can make me leave this type of 58 degree day in Colorado…but the Liver Meeting in San Diego is one of them. See you soon, Liver Lovers! #TLM24

A tale of two platforms: BlueSky user numbers have hit a new record high in recent days, while the number of people deleting their accounts on X/Twitter has rocketed 🚀

Eh hem. *taps mic* 🗣️ TWO DAYS UNTIL THE LIVER MEETING!!! #tlm24

Ok, that’s good. I will pause my usual disparagement of the puny kidneys for one (1) day.

My first #HepSky #LiverSky hot take: compensated Advanced Chronic Liver Disease (cACLD) with CSPH is a clunky term (pronounced cackled with chutzpah?) for a clunky concept and we would have been better off just calling it Cirrhosis Stage 1 - 2 - 3 (compensated, compensated with CSPH, decomp)

Colorado is sunny today after 5 days of snow, but I can’t wait to get to San Diego! #TLM24

We all knew the data was coming. Excited to see it!

Sharing #gisky and #liversky Will add to it by end of day Let me know and I will update go.bsky.app/8Pho2tp