Monthly Archives: April 2011

Primary biliary cirrhosis

Question: A middle aged female is sent to your office with a normal LFT profile but a positive anti-mitochondrial antibody (AMA) on two consecutive blood draws.  She wants to know if she has primary biliary cirrhosis (PBC) and if she should … Continue reading

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Definition: hyperdynamic circulatory state

The hyperdynamic circulatory state of portal hypertension refers to the hyperactivation of the neurohormonal, sympathetic and baroreflexive systems of the human body.  Through a series of vasoactive changes and volume shifts, the body is prone to end-organ dysfunction and increased morbidity and … Continue reading

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Lecture: Insulin resistance, Warburg effects and liver cancer

This lecture described the pathways associated with extra/intracellular purinergic signaling, and the relationship to neoplasia.  Adenosine triphosphate (ATP) mediates multiple physiological reactions and plays a crucial role in cellular metabolism.  Adenosine mediates immune suppression and is generated by the ectonucleotidases … Continue reading

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The Sunday Chronicles

“This is the thanks I get for Urso?”

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Earth Day, 2011

People think of (the environment) as something different than themselves, and of course it isn’t. – W. Berry

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Definition: cholestasis of sepsis

Cholestasis of sepsis involves a direct hyperbilirubinemia, and occurs most frequently with a bacterial infection in the ICU.  It is thought to be related to dysfunction of the BSEP (bile salt export protein) transporter or MRP2 transporter, and patients with heterozygosity for PFIC/BRIC mutations … Continue reading

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Lecture: Gut-liver axis, implications for liver disease

The gut microbiome is recognized as a key factor in many liver diseases.  Bacterial overgrowth is common in cirrhosis.  Bacterial translocation is thought to cause spontaneous bacterial peritonitis.  Lipopolysaccharide (LPS), a component of the gram negative bacterial cell wall, also translocates … Continue reading

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