risk factors – Rogalevich http://rogalevich.org/ Sat, 26 Mar 2022 12:35:19 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://rogalevich.org/wp-content/uploads/2021/10/icon-120x120.png risk factors – Rogalevich http://rogalevich.org/ 32 32 Exposure to room lighting during sleep may impair blood sugar and cardiovascular regulation https://rogalevich.org/exposure-to-room-lighting-during-sleep-may-impair-blood-sugar-and-cardiovascular-regulation/ Mon, 14 Mar 2022 20:18:00 +0000 https://rogalevich.org/exposure-to-room-lighting-during-sleep-may-impair-blood-sugar-and-cardiovascular-regulation/ Close blinds, draw curtains and turn off all lights before bed: Exposure to even moderate ambient lighting during nighttime sleep, compared to sleeping in a dimly lit room, impairs your cardiovascular function during sleep and increases your insulin resistance the next morning, reports a new study from Northwestern Medicine published in PNAS. The results […]]]>

Close blinds, draw curtains and turn off all lights before bed: Exposure to even moderate ambient lighting during nighttime sleep, compared to sleeping in a dimly lit room, impairs your cardiovascular function during sleep and increases your insulin resistance the next morning, reports a new study from Northwestern Medicine published in PNAS.

The results of this study demonstrate that a single night of exposure to moderate ambient light during sleep can impair blood sugar and cardiovascular regulation, which are risk factors for heart disease, diabetes and metabolic syndrome. It is important for people to avoid or minimize the amount of light exposure during sleep.”


Phyllis Zee, MD, PhD, chief of sleep medicine in the Department of Neurology Ken and Ruth Davee, physician at Northwestern Medicine and senior study author

There is already evidence that exposure to light during the day increases heart rate via activation of the sympathetic nervous system, which kicks your heart into high gear and increases alertness to meet the challenges of the day.

“Our results indicate that a similar effect is also present when light exposure occurs during nocturnal sleep,” Zee said.

The heart rate increases in a lighted room and the body cannot rest properly

“We have shown that your heart rate increases when you sleep in a moderately lit room,” said Daniela Grimaldi, MD, PhD, study co-first author and research assistant professor of neurology in the division of sleep medicine. . “Even if you’re sleeping, your autonomic nervous system is activated. That’s bad. Usually your heart rate and other cardiovascular parameters are lower at night and higher during the day.”

There are sympathetic and parasympathetic nervous systems that regulate our physiology during the day and night. The sympathetic takes charge during the day and the parasympathetic is believed to control the physiology at night, when it transmits restoration to the whole body.

How nighttime light while sleeping can lead to diabetes and obesity

Investigators found that insulin resistance occurred the morning after people slept in a bright room. Insulin resistance occurs when your muscle, fat, and liver cells don’t respond well to insulin and can’t use glucose from your blood for energy. To compensate for this, your pancreas makes more insulin. Over time, your blood sugar rises.

An earlier study published in JAMA Internal Medicine looked at a large population of healthy people who were exposed to light while sleeping. They were more overweight and obese, Zee said.

“Now we’re showing a mechanism that could be fundamental to why this happens. We’re showing that it affects your ability to regulate glucose,” Zee said.

Study participants were unaware of biological changes in their bodies at night.

“But the brain feels it,” Grimaldi said. “It acts like the brain of someone with light and fragmented sleep. Sleep physiology is not resting as it should.”

Exposure to artificial light at night during sleep is common

Exposure to artificial light at night during sleep is common, whether from indoor electroluminescent devices or from sources outside the home, especially in large urban areas. A significant proportion of individuals (up to 40%) sleep with a bedside lamp on or with a light on in the bedroom, or keep the television on.

Light and its relationship to health are a double-edged sword.

“In addition to sleep, nutrition and exercise, light exposure during the day is an important factor for health, but during the night we show that even modest light intensity can alter measurements of heart and endocrine health,” Zee said.

The study tested the effect of sleeping with 100 lux (moderate light) versus 3 lux (low light) in participants over a single night. Investigators found that moderate exposure to light puts the body into a higher state of alert. In this state, the heart rate increases along with the force with which the heart contracts and the rate at which blood is driven to your blood vessels for oxygenated blood flow.

“These findings are particularly important for those living in modern societies where exposure to indoor and outdoor nighttime light is increasingly prevalent,” Zee said.

Zee’s Top Tips for Dimming Light While Sleeping

  1. Don’t turn on the lights. If you need to have a light on (which older people may want for safety), make it a dim light closer to the ground.
  2. Color is important. Amber or a red or orange light is less stimulating for the brain. Do not use white or blue light and keep it away from the sleeping person.
  3. Blackout blinds or eye masks are good if you can’t control outside light. Move your bed so outside light doesn’t shine on your face.

Is my bedroom too bright?

“If you’re able to see things well, it’s probably too clear,” Zee said.

Other Northwestern authors are co-first author Ivy Mason, PhD, who at the time of the study was a postdoctoral fellow at Northwestern and is now a research fellow at Harvard Medical School; Kathryn Reid, PhD, research professor of neurology in the division of sleep medicine; Chloe Warlick; Roneil Malkani, MD, associate professor of neurology in the division of sleep medicine; and Sabra Abbott, MD, PhD, assistant professor of neurology in the division of sleep medicine.

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World leaders celebrate liver disease successes and prepare for challenges ahead https://rogalevich.org/world-leaders-celebrate-liver-disease-successes-and-prepare-for-challenges-ahead/ Mon, 07 Mar 2022 20:14:45 +0000 https://rogalevich.org/world-leaders-celebrate-liver-disease-successes-and-prepare-for-challenges-ahead/ Yale’s liver program began with a biopsy in October 1947, one of the first liver biopsies ever performed. Gerald Klatskin, MD, founded the Liver Study Unit and developed the techniques that allowed him to perform the biopsy, even designing the biopsy needle. Klatskin, who was David Paige Smith Professor at the Yale School of Medicine […]]]>

Yale’s liver program began with a biopsy in October 1947, one of the first liver biopsies ever performed. Gerald Klatskin, MD, founded the Liver Study Unit and developed the techniques that allowed him to perform the biopsy, even designing the biopsy needle. Klatskin, who was David Paige Smith Professor at the Yale School of Medicine (YSM), was also an amateur photographer. During his career, he assembled about 50,000 Kodachromes from 10,000 liver biopsies, said James L. Boyer, MD, FACEP, who trained with Klatskin in 1969.

Boyer, an associate professor of medicine (digestive diseases) and director emeritus of the Yale Liver Center, recalled how Klatskin recorded his data with a McBee Card Co punch card system. were when they were taken,” Boyer said at a talk celebrating Yale’s liver program.

The Yale Diamond Jubilee, Celebrating 75 years of Academic Hepatology at Yale, was held on February 25. The virtual meeting attracted an international roster of presenters and audience members, many of whom were former or current members of the Liver Program. Nearly 350 people registered for the one-day event. Presenters discussed the program’s global impact, its many successes in diagnosing and treating liver disease, while preparing for the challenges ahead.

The day began with welcoming remarks from Michael H. Nathanson, MD, PhD, Gladys Phillips Crofoot Professor of Medicine (Digestive Diseases) and Professor of Cell Biology, and Director of the Yale Liver Center. The keynote address was delivered by Dean Nancy J. Brown, MD.

The Liver Center is one of only three research centers in the country that focuses entirely on the liver and is sponsored by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK). Now in his 36’sand year of funding, the center has 86 members from 24 YSM departments and sections. Of those, 75% have joint posts with other center members, Nathanson said. The three thematic areas of the center are immunology/inflammation, hepatic metabolism and epithelial biology.

Nathanson pointed to the growing need for liver care in Connecticut. In the past year, one in seven people discharged from Yale New Haven Hospital had a primary or secondary liver diagnosis; The Yale Liver Tumor Committee discussed 619 patients; 2,170 liver-related interventional radiology procedures were performed; and 1,024 liver biopsies were reviewed. Yale has 65 outpatient liver clinics each week, including fatty liver clinics; liver cancer; Gaucher disease and other inherited liver diseases; viral hepatitis; liver transplant; alcohol and addiction in liver disease; and undiagnosed liver disease.

Today, the Yale Liver Center is more diverse than ever, Nathanson said. Of the clinical hepatology faculty members, half are women and more than 20% belong to underrepresented minorities.

One of its pioneering wives, Guadalupe Garcia-Tsao, MD, FRCP, Professor of Medicine (Digestive Diseases) and Chief of Digestive Diseases at VA-CT Hospital in West Haven, discussed groundbreaking hypertension research portal that she conducted with her mentor, Roberto Groszmann, MD. Garcia-Tsao also reported on the VA Hospital’s clinical practice of evaluating all veterans for hepatitis C (HCV) risk factors. The West Haven VA was one of four National Hepatitis C Resource Centers that created and implemented performance measures and initiatives to ensure patients with HCV were diagnosed and treated, a- she declared. Currently, about 90% of veterans with HCV have been treated and cured, she said.

The clinical practice also includes a tele-hepatology clinic that allows West Haven hepatologists to speak to veterans at clinics in central and western Massachusetts. “We can save patients a lot of time that it would take them to travel to us,” she said.

A tumor tracking system, based on radiology reports, was first implemented in West Haven VA, and has been expanded to include many other sites. The system was created by Tamar Taddei, MD, who will succeed Garcia-Tsao as VA Liver Chief beginning in July 2022.

In his presentation, Mario Strazzabosco, MD, PhD, professor of medicine and co-director of the Yale Liver Center, discussed future challenges in the diagnosis and treatment of liver disease. “Despite the tremendous therapeutic advances generated by academic hepatology, liver disease remains a growing global and national healthcare challenge, and the second leading cause of lost working life years,” Strazzabosco said. He urged the medical community to focus on prevention, screening, early diagnosis and therapy. “Clinical guidance in patients with liver disease is always oriented towards advanced disease and its complications, whereas the early and reversible stages of disease are often ignored and overlooked,” he explained. Liver disease results from potentially preventable epidemics of viral hepatitis, alcohol consumption, obesity, diabetes, and inequalities in underserved populations, including lack of health insurance that does not allow for a proper prevention.

Addressing the stigma often associated with liver disease should also be a priority, he added. Fear of being stigmatized causes people to delay or avoid seeing a doctor, and can lead to an increase in unhealthy behaviors as well as social isolation. As a result, more people will have serious liver disease in the future, he said.

As an introduction to subsequent sessions, Strazzabosco showed that liver research at Yale transcends the boundaries of specialties, sections, and departments. He reminded the audience that although improvements in medicine have thus far been driven by specialization, this will not hold in a future where hepatology must adopt models of care geared towards centered liver care. on the patient beyond traditional medical boundaries. The Liver Center can facilitate this transition by ensuring that clinical practice and research remain close, because there is research in health care and health care in research, he said.

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World leaders celebrate liver disease successes and prepare for challenges ahead https://rogalevich.org/world-leaders-celebrate-liver-disease-successes-and-prepare-for-challenges-ahead-2/ Mon, 07 Mar 2022 18:55:09 +0000 https://rogalevich.org/world-leaders-celebrate-liver-disease-successes-and-prepare-for-challenges-ahead-2/ Yale’s liver program began with a biopsy in October 1947, one of the first liver biopsies ever performed. Gerald Klatskin, MD, founded the Liver Study Unit and developed the techniques that allowed him to perform the biopsy, even designing the biopsy needle. Klatskin, who was David Paige Smith Professor at the Yale School of Medicine […]]]>

Yale’s liver program began with a biopsy in October 1947, one of the first liver biopsies ever performed. Gerald Klatskin, MD, founded the Liver Study Unit and developed the techniques that allowed him to perform the biopsy, even designing the biopsy needle. Klatskin, who was David Paige Smith Professor at the Yale School of Medicine (YSM), was also an amateur photographer. During his career, he assembled about 50,000 Kodachromes from 10,000 liver biopsies, said James L. Boyer, MD, FACEP, who trained with Klatskin in 1969.

Boyer, an associate professor of medicine (digestive diseases) and director emeritus of the Yale Liver Center, recalled how Klatskin recorded his data with a McBee Card Co punch card system. were when they were taken,” Boyer said at a talk celebrating Yale’s liver program.

The Yale Diamond Jubilee, Celebrating 75 years of Academic Hepatology at Yale, was held on February 25. The virtual meeting attracted an international roster of presenters and audience members, many of whom were former or current members of the Liver Program. Nearly 350 people registered for the one-day event. Presenters discussed the program’s global impact, its many successes in diagnosing and treating liver disease, while preparing for the challenges ahead.

The day began with welcoming remarks from Michael H. Nathanson, MD, PhD, Gladys Phillips Crofoot Professor of Medicine (Digestive Diseases) and Professor of Cell Biology, and Director of the Yale Liver Center. The keynote address was delivered by Dean Nancy J. Brown, MD.

The Liver Center is one of only three research centers in the country that focuses entirely on the liver and is sponsored by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK). Now in his 36’sand year of funding, the center has 86 members from 24 YSM departments and sections. Of those, 75% have joint posts with other center members, Nathanson said. The three thematic areas of the center are immunology/inflammation, hepatic metabolism and epithelial biology.

Nathanson pointed to the growing need for liver care in Connecticut. In the past year, one in seven people discharged from Yale New Haven Hospital had a primary or secondary liver diagnosis; The Yale Liver Tumor Committee discussed 619 patients; 2,170 liver-related interventional radiology procedures were performed; and 1,024 liver biopsies were reviewed. Yale has 65 outpatient liver clinics each week, including fatty liver clinics; liver cancer; Gaucher disease and other inherited liver diseases; viral hepatitis; liver transplant; alcohol and addiction in liver disease; and undiagnosed liver disease.

Today, the Yale Liver Center is more diverse than ever, Nathanson said. Of the clinical hepatology faculty members, half are women and more than 20% belong to underrepresented minorities.

One of its pioneering wives, Guadalupe Garcia-Tsao, MD, FRCP, Professor of Medicine (Digestive Diseases) and Chief of Digestive Diseases at VA-CT Hospital in West Haven, discussed groundbreaking hypertension research portal that she conducted with her mentor, Roberto Groszmann, MD. Garcia-Tsao also reported on the VA Hospital’s clinical practice of evaluating all veterans for hepatitis C (HCV) risk factors. The West Haven VA was one of four National Hepatitis C Resource Centers that created and implemented performance measures and initiatives to ensure patients with HCV were diagnosed and treated, a- she declared. Currently, about 90% of veterans with HCV have been treated and cured, she said.

The clinical practice also includes a tele-hepatology clinic that allows West Haven hepatologists to speak to veterans at clinics in central and western Massachusetts. “We can save patients a lot of time that it would take them to travel to us,” she said.

A tumor tracking system, based on radiology reports, was first implemented in West Haven VA, and has been expanded to include many other sites. The system was created by Tamar Taddei, MD, who will succeed Garcia-Tsao as VA Liver Chief beginning in July 2022.

In his presentation, Mario Strazzabosco, MD, PhD, professor of medicine and co-director of the Yale Liver Center, discussed future challenges in the diagnosis and treatment of liver disease. “Despite the tremendous therapeutic advances generated by academic hepatology, liver disease remains a growing global and national healthcare challenge, and the second leading cause of lost working life years,” Strazzabosco said. He urged the medical community to focus on prevention, screening, early diagnosis and therapy. “Clinical guidance in patients with liver disease is always oriented towards advanced disease and its complications, whereas the early and reversible stages of disease are often ignored and overlooked,” he explained. Liver disease results from potentially preventable epidemics of viral hepatitis, alcohol consumption, obesity, diabetes, and inequalities in underserved populations, including lack of health insurance that does not allow for a proper prevention.

Addressing the stigma often associated with liver disease should also be a priority, he added. Fear of being stigmatized causes people to delay or avoid seeing a doctor, and can lead to an increase in unhealthy behaviors as well as social isolation. As a result, more people will have serious liver disease in the future, he said.

As an introduction to subsequent sessions, Strazzabosco showed that liver research at Yale transcends the boundaries of specialties, sections, and departments. He reminded the audience that although improvements in medicine have thus far been driven by specialization, this will not hold in a future where hepatology must adopt models of care geared towards centered liver care. on the patient beyond traditional medical boundaries. The Liver Center can facilitate this transition by ensuring that clinical practice and research remain close, because there is research in health care and health care in research, he said.

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High Fructose Intake May Trigger Fatty Liver Disease https://rogalevich.org/high-fructose-intake-may-trigger-fatty-liver-disease/ Mon, 07 Mar 2022 18:40:15 +0000 https://rogalevich.org/high-fructose-intake-may-trigger-fatty-liver-disease/ Adding high fructose beverages to a diet that already includes a high fat content may accelerate the risk of foie gras disease, according to scientists from the University of Barcelona. What there is to know: High Fructose Intake May Increase Risk of Non-Alcoholic Fatty Liver Diseasein which too much fat is stored in liver cells. […]]]>

Adding high fructose beverages to a diet that already includes a high fat content may accelerate the risk of foie gras disease, according to scientists from the University of Barcelona.

What there is to know:

  • High Fructose Intake May Increase Risk of Non-Alcoholic Fatty Liver Diseasein which too much fat is stored in liver cells.

  • High fructose corn syrup is one of the most common sweeteners in the food industry and is used for sweeten many products despite scientific evidence that it is associated with metabolic disorders that are risk factors for cardiovascular disease.

  • The researchers found that consumption a diet high in fructose for long periods of time may result in deterioration of the layer of cells that creates the intestinal barrier that prevents bacteria and toxins from entering the bloodstream and affecting the liver.

  • Fatty liver disease can lead to liver inflammation and liver damage, resulting in non-alcoholic steatohepatitis, one more aggressive disease which in turn can evolve into scarring of the liver (cirrhosis), liver cancerand liver failure.

  • Severe fatty liver disease and liver tumors deterioration of the intestinal barrier created by excessive consumption of fructose can be avoided with medications.

This is a summary of the article, “A New Study Relates Liquid Fructose Intake to Fatty Liver Disease“, published in Molecular Nutrition and Food Research on March 4, 2022. The full article can be found at newswise.com.

For more information, follow Medscape on Facebook, Twitter, instagramand YouTube.

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Supporting the 3rd leading cause of cancer-related death https://rogalevich.org/supporting-the-3rd-leading-cause-of-cancer-related-death/ Mon, 07 Mar 2022 15:18:52 +0000 https://rogalevich.org/supporting-the-3rd-leading-cause-of-cancer-related-death/ Liver cancer is the third leading cause of cancer-related death worldwide, and the incidence of primary liver cancer in the United States has tripled over the past four decades. While chronic viral hepatitis is the primary route to liver cancer in the United States, non-infectious causes such as morbid obesity, type 2 diabetes, non-alcoholic fatty […]]]>

Liver cancer is the third leading cause of cancer-related death worldwide, and the incidence of primary liver cancer in the United States has tripled over the past four decades. While chronic viral hepatitis is the primary route to liver cancer in the United States, non-infectious causes such as morbid obesity, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and non-infectious steatohepatitis associated alcoholism (NASH) increased rapidly. We will describe each of these pathways, starting with viral hepatitis (HCV and HBV) and alcoholic cirrhosis.


There is a morbid saying that cancer eventually affects us all, unless something else affects us first.

While some cancers currently have no accessible prevention, some can be effectively prevented. Hepatocellular carcinoma (HCC) is one of those that can be prevented, but once HCC is established and symptomatic, survival rates drop sharply. While liver cancer is the 8and location of cancer site by prevalence (Figure 1), this is the 3rd leading cause of death (Figure 2). HCC has a high mortality profile with a median survival after diagnosis of 6-20 months, and in the United States it has a 5-year survival rate of only 10% (Golabi, et al., 2017)

Figure 1. Top 10 cancer sites by case (Sung et al, 2021)

Top 10 cancer sites by death

Figure 2. Top 10 cancer sites by death (Sung et al, 2021)

The COVID-19 pandemic has rightly occupied the minds and efforts of nearly everyone in healthcare for the past two years, but HCC has not gone away and continues to cause daily damage. . HCC was on 4and leading cause of cancer-related death in 2019 (Yang et al., 2019), and has been steadily increasing – it has tripled in the United States (Rawla, Sunkara, Muralidharan & Raj, 2018).

Although your daily chance of encountering a patient with HCC is still small, it increases year by year and there is a serious risk of missing the window of opportunity to prevent full-blown HCC.

This blog will describe how to be alert to the causes and cases of HCC, and we will provide you with tools and resources to help you identify HCC, ways to connect your patient with appropriate specialists, and help you find appropriate studies and trials for your patient.

There are four main HCC risk factors:

  1. Hepatitis B (HBV)
  2. Hepatitis C (HCV)
  3. Excessive consumption of alcohol
  4. Non-alcoholic fatty liver disease (NAFLD) resulting in non-alcoholic steatohepatitis (NASH)

How likely are you to encounter hepatocellular carcinoma in patients?

In the near future, it is unlikely that any specific patient you see will already have HCC. That’s great, but it’s also a problem because you’re less likely to recognize it immediately. For HCC, delay is the killer.

However, you are very likely to see a patient who, regardless of their primary complaint, is already on one or more of the four main HCC pathways. The picture is also skewed when race is taken into account – while the overall rate of HBV infection has declined significantly since 1991, it remains a concern for the African American population. In 2017, non-Hispanic African Americans were 1.5 times more likely to die from viral hepatitis than whites, and almost twice as likely to die from HCV. (HHS-OMH”Hepatitis and African Americans”)

Anything you can do to increase HBV vaccination rates and prevent HCV infection will help steer your patients away from the viral pathway. It is therefore important to use screening tests for HBV and HCV and to strongly encourage HBV vaccination even if patients are not in high-risk categories. Likewise, addressing alcohol use and encouraging your patients to follow guidelines will help steer them away from alcohol’s path to HCC.

the NAFLD/NASH pathway talks about lifestyle changes that are inherently healthier and worth discussing. Discussing healthy eating, limiting portion sizes, and maintaining a healthy weight with your patients can help steer them away from this path.

Patient history that should raise your index of suspicion includes past unprotected sex, use of needles, binge drinking or binge drinking, or increasing obesity. However, it is important to keep in mind that many patients who had no obvious risk factors in their history nevertheless went on to have HCC. Although atypical, HCC can be the result of maternal HBV infection or HCV transmitted to children. For an example, see “Better off bald: a life in 147 days

How to discuss staging with patients

Discussing staging with patients can be difficult, and the literature is often either aimed at clinicians or contains misleading information. Blue Faery provides clinically accurate yet understandable materials to help you describe the staging and help the patient understand where they are on the spectrum.

These materials include:

  • The HCC patient education brochures is written in plain language and intended to be read by the patient.
  • The Blue Faery and Exelixis staging discussion pad contains anatomical graphics and easy-to-understand text. Each double-sided sheet allows the doctor to add notes that his patient can use after the appointment.
  • the Liver Cancer Patient Resource Guide is a 20-page booklet containing relevant explanations and resources for HCC patients and their caregivers.

Blue Faery will send these documents free of charge to any doctor who requests them.

How to Find Hepatocellular Carcinoma Specialists, Treatment Options and Clinical Trials

Treatment of HCC is best approached with a multidisciplinary team coordinated by a primary care physician. The most effective approach will likely require the expertise of multiple healthcare professionals, including the primary care physician, and may include an oncologist with experience in HCC, gastroenterologist, hepatologist, radiologist interventionist, a radiation oncologist, a surgical oncologist and a transplant surgeon.

Where to find clinical trials specific to hepatocellular carcinoma

To find all clinical trials, the best option is clinicaltrials.gov, but this website can be confusing and difficult to navigate. To help physicians guide their patients to relevant trials, Blue Faery has a custom HCC clinical trial browser.

Where can patients find community support?

Patient communities are very helpful in providing patients with practical guidance for their care journey and are often a source of emotional support from people who understand the experience.

the Blue Fairy Liver Cancer Community is a free, HIPAA-compliant online community where patients and caregivers are invited to join and seek or exchange relevant information about HCC care. Members ask questions, discuss concerns and find common ground along their cancer journey. Forum moderators include Community Ambassadors who were former caregivers of HCC patients.

For individual patient support, Blue Faery has partnered with Imerman Angels, a non-profit organization that provides peer-to-peer support services to the liver cancer community. Blue Faery and Imerman Angels believe that no one should face cancer alone.

Conclusion

With proper screening, testing and inoculation, the viral pathway to HCC can often be interrupted. Blue Faery provides free, patient-readable and clinically accurate materials to help physicians discuss their patients’ staging, options and resources.

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Being Well Is Easier Than You Think • Coral Springs Talk https://rogalevich.org/being-well-is-easier-than-you-think-coral-springs-talk/ Wed, 02 Mar 2022 20:04:50 +0000 https://rogalevich.org/being-well-is-easier-than-you-think-coral-springs-talk/ Shawnette Sadler, MD By Diana Hanford Age is more than a number. It is a leading indicator of health conditions that could determine whether patients are at risk for debilitating or life-threatening illnesses. “As we age, our bodies gradually change,” said Shawnette Saddler, MD, an internal medicine physician with the Broward Health Physician Group. She […]]]>

Shawnette Sadler, MD

By Diana Hanford

Age is more than a number. It is a leading indicator of health conditions that could determine whether patients are at risk for debilitating or life-threatening illnesses.

“As we age, our bodies gradually change,” said Shawnette Saddler, MD, an internal medicine physician with the Broward Health Physician Group. She stressed the importance of seeing a health care provider regularly and following recommended health screenings and exams.

“When we hit 40, it’s a good idea to look under the hood and check the engine light, especially if you haven’t had regular physicals,” she said. “During an annual physical, a primary care physician will perform a physical assessment, order a blood test, and most importantly, have a meaningful conversation.”

Annual screenings can help you maintain a healthy lifestyle, make adjustments to improve your health, and in some cases lead to early diagnoses, which can mean better outcomes. And often, Dr. Saddler said, we’ve gotten so used to certain symptoms that we no longer recognize it’s something your doctor should be treating.

Run for Beigel

“Communication is key,” said Dr. Saddler, who also practices at Broward Health Coral Springs. “It’s human nature to adapt to problems and move on. Many patients become accustomed to suffering from aches, pains, and hearing or vision loss, believing that they are the realities of aging. However, these conditions can also be a sign of a more serious problem. By discussing what you are really feeling, we as doctors can help determine what is or is not normal and refer a patient to a specialist for conclusive testing if necessary.

Types of screenings

The Centers for Disease Control and Prevention recommends that all adults 18 and older get tested for at least one hepatitis C virus in their lifetime, a liver infection caused by the hepatitis C virus (HCV) . Chronic HCV infection has no obvious symptoms but can lead to cirrhosis and liver cancer. The good news is that hepatitis C can be treated with medication and can even be cured.

There are annual screenings for women, and Dr. Saddler encourages prioritizing annual mammograms and Pap smears based on health care provider recommendations. Postponing annual screenings, even for a year or two, greatly increases the risk of a delayed or missed diagnosis. This is especially true for cancer, in which early detection improves survival rates.

Another significant change affecting both men and women is the new recommended age for colon cancer screenings, which has been lowered to 45, according to the US Preventive Services Task Force, an independent voluntary group of experts. in prevention and evidence-based medicine.

Risk factors

Dr. Saddler acknowledges that many older patients don’t know their family’s medical history or don’t share known hereditary risks with their doctor and family, such as heart disease and high blood pressure.

Generations of Americans are eating more processed fast foods. As people age, their hormones change and their metabolism slows down, which increases risk factors. This is also why early detection and prevention are so important.

“We emphasize that the road to optimal long-term health begins with good habits at home, but must also be complemented by the guidance of a healthcare professional,” said Dr. Saddler. “Set a good example for your children by incorporating a healthy lifestyle that the whole family can build on. It can be as simple as cooking meals at home, limiting screen time, and participating in outdoor activities.

A short guide to maintaining your health and well-being:

  • Know your baseline blood counts.
  • Drink water, four to six 8oz cups is the daily recommendation.
  • Get at least 200 minutes of exercise per week.
  • Sleep seven hours every night.
  • Prioritize self-care to decompress.
  • If you are sedentary, get up every 30 minutes and stretch.
  • Monitor and share what you eat.
  • Be aware of the symptoms of depression, as poor mental health affects our physical well-being.

“There’s no better time than the present to prioritize your well-being,” Dr. Saddler said. “We want to provide patients with the help they need so they can thrive and live healthy, happy lives.”

To learn more about how to improve your health and well-being, visit BrowardHealth.org/Wellness.

Send your news to Coral Springs #1 award-winning news site Right here.

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Oregon man diagnosed with ‘terminal’ liver cancer continues to thrive https://rogalevich.org/oregon-man-diagnosed-with-terminal-liver-cancer-continues-to-thrive/ Thu, 24 Feb 2022 18:48:22 +0000 https://rogalevich.org/oregon-man-diagnosed-with-terminal-liver-cancer-continues-to-thrive/ Understanding liver cancer and the importance of second opinions Larry Sullivan was diagnosed with ‘terminal’ liver cancer in 2019. But now, thanks to an individualized treatment approach curated by multiple doctors, he feels better than he has in a long time, with his cancer nearly having faded away. Liver cancer begins in the liver, an […]]]>

Understanding liver cancer and the importance of second opinions

  • Larry Sullivan was diagnosed with ‘terminal’ liver cancer in 2019. But now, thanks to an individualized treatment approach curated by multiple doctors, he feels better than he has in a long time, with his cancer nearly having faded away.
  • Liver cancer begins in the liver, an organ located below the diaphragm and above the stomach. The most common form of the disease is hepatocellular carcinoma, but there are also other types of liver cancers.
  • One of the greatest cancer researchers of our time told SurvivorNet that people should get “multiple” opinions after a cancer diagnosis.

When Larry Sullivan was diagnosed with “terminal” liver cancer in 2019, his mind started racing. But thanks to an individualized treatment approach from multiple doctors, Sullivan’s cancer is almost gone today.

“It’s so amazing and unexpected for me,” he said where he is today. “It’s been a tough trip but I’m doing great.”

With the help of Oregon Cancer Alliance which strives to bring together leading cancer specialists to provide coordinated expert care, Sullivan received a treatment plan organized by several specialists from different clinics. To begin with, Sullivan underwent radioembolization. This procedure involves injecting small beads (called microspheres) with a radioactive isotope (yttrium-90 or Y-90) attached into the hepatic artery that supplies blood to the liver and gallbladder. Then the beads emit small amounts of radiation to the tumor site for several days.

“It allows us to go to where the tumors are and deliver treatment,” says the interventional radiologist, Dr. Donald Garbett, who performed the procedure. “By delivering the treatment directly into the tumour, the rest of the body doesn’t feel it as it would with other treatment procedures. We were able to treat all of Mr. Sullivan’s tumor and it immediately started to shrink.

From there, Sullivan was prescribed a combination of immunotherapy drugs, Yervoy and Opdivo, to treat the cancer that had spread to his lungs and bones. Immunotherapy, in general, has been shown to be extremely effective in treating several cancers, although it does not work for everyone.

Fighting cancer with the body’s own cells: the immunotherapy revolution

After this treatment, doctors could no longer see the cancer in Sullivan’s lungs and bones. In addition to these treatments, Sullivan also underwent spinal surgery and radiation therapy.

Now Sullivan is feeling well and is returning to work as a part-time school psychologist. He also spends time with his family, travels and even restores boats.

“I’m very lucky. I didn’t even imagine six months ago that this would happen. says Sullivan. “It’s been difficult at times, but now I can do things again and have a little joy in my life. am really excited to have more time with my family.

Understanding Liver Cancer

Liver cancer begins in the liver, an organ located below the diaphragm and above the stomach. American Cancer Society estimates that approximately 41,260 new cases (28,600 in men and 12,660 in women) of primary liver cancer and cancer of the intrahepatic bile ducts will be diagnosed in 2022. The most common form of the disease is hepatocellular carcinoma, but there are also other types of liver cancer.

Several risk factors may increase the risk of developing hepatocellular carcinoma (HCC), including but not limited to the following:

  • Gender (hepatocellular carcinoma is much more common in men than in women)
  • Race/ethnicity (In the United States, Asian Americans and Pacific Islanders have the highest rates of liver cancer, followed by Hispanics/Latinos, American Indians/Alaska Natives , African Americans and Whites)
  • Chronic viral hepatitis
  • Cirrhosis (a disease in which liver cells are damaged and replaced by scar tissue)
  • Excessive consumption of alcohol
  • Smoking
  • Obesity
  • Type 2 diabetes

Cancer survivor Joel Naftelberg learned to dance to his problems

Blood tests, ultrasounds, CT scans (x-ray images), MRIs (medical imaging), and angiograms are usually used to confirm a diagnosis of liver cancer. A liver biopsy, where a small piece of tissue is removed and analyzed for cancer cells, may also be performed.

Often a liver transplant is considered the best plan when the patient is eligible. For cases of recurrent liver cancer and cancer that has spread throughout the body, your doctor may consider targeted therapy, immunotherapy, or chemotherapy as the next step.

The importance of getting a second opinion

After you’ve been diagnosed with cancer, it’s important to remember that you can, and should, talk to other cancer specialists about your disease.

“If I had any advice for you following a cancer diagnosis, it would be to first seek several opinions on the best care”, National Cancer Institute Chief of Surgery Steven Rosenberg said SurvivorNet in a previous interview. “Because finding a doctor who is up to date with the latest information is important.”

RELATED: Second (and third) opinions are important when deciding between surgery or radiation therapy

As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree about the right treatment, and advances in genetics and immunotherapy create new options. Moreover, in some cases, the specific treatment is not clearly defined. This is one more reason why it is crucial to understand the potential approaches to your disease.

At the National Cancer Institute, there is a patient referral service that “will guide patients to the right group based on their disease state so that they can access these experimental new treatments,” says Rosenberg.

Cancer research legend urges patients to get multiple opinions

Additionally, getting another opinion can also help you avoid doctor bias. For example, some surgeons have radiotherapy centers. “So there may be a conflict of interest if you go to a surgeon who recommends radiation therapy, because that type of facility is partly owned by that type of facility,” Dr. Jim Hudirector of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.

Other reasons to get a second opinion include:

  • To see a doctor who is more experienced in treating your type of cancer
  • You have a rare type of cancer
  • There are many ways to treat your cancer
  • You feel like your doctor isn’t listening to you or giving you good advice
  • You have trouble understanding your doctor
  • You do not like the treatment recommended by your doctor or are worried about its possible side effects
  • Your insurance company wants you to get another medical opinion
  • Your cancer is not getting better with your current treatment

Be Insistent, Be Your Own Advocate, Says Leading Expert

Ultimately, being proactive about your health could be a matter of life and death. Learn as much as you can from as many experts as you can, so you know you’ve done your best to take control of your health.

Contributor: Marisa Sullivan

Learn more about SurvivorNet’s rigorous medical review process.

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Should I get tested for COVID-19 if I have a sore throat? https://rogalevich.org/should-i-get-tested-for-covid-19-if-i-have-a-sore-throat/ Thu, 24 Feb 2022 04:52:28 +0000 https://rogalevich.org/should-i-get-tested-for-covid-19-if-i-have-a-sore-throat/ What are the potential complications of COVID-19? About 80% of people infected with COVID-19 experience mild to moderate symptoms and can recover without requiring hospitalization. However, about 15% become seriously ill and need oxygen. About 5% become seriously ill and require immediate medical attention. COVID-19 has the potential to cause health complications and even death […]]]>

What are the potential complications of COVID-19?

About 80% of people infected with COVID-19 experience mild to moderate symptoms and can recover without requiring hospitalization. However, about 15% become seriously ill and need oxygen. About 5% become seriously ill and require immediate medical attention.

COVID-19 has the potential to cause health complications and even death in susceptible people. Complications include:

Older adults and those with the following conditions are at higher risk of complications from COVID-19:

Which organs can be damaged by COVID-19?

Lungs

COVID-19 can cause lung problems such as pneumonia and acute respiratory distress syndrome (ARDS) in severe cases.

Pneumonia: Pneumonia causes the lungs to swell and fill with fluid. This can lead to breathing difficulties, which can become so severe that hospitalization, oxygen therapy, and monitoring of oxygen saturation may be required. While most people recover from pneumonia without any long-term consequences, pneumonia caused by COVID-19 can be quite dangerous. Even after the infection clears, damage to the lungs can cause breathing problems that last for months, leading to further complications.

Acute respiratory distress: ARDS is a condition in which excess fluid builds up in the small air sacs of the lungs, causing blood oxygen levels to drop below normal (hypoxemia). In most cases of COVID-19, the virus sticks to the upper airways around the throat, triggering an immune response. In rare cases, however, the virus can cross the upper respiratory tract and enter the lungs and alveoli, resulting in ARDS, which usually appears 8 days after the first symptoms appear. Risk factors such as older age, diabetes, and high blood pressure increase the likelihood of having ARDS with COVID-19.

Heart

Underlying heart conditions such as hypertension, diabetes, and cardiovascular disease have been linked to poor outcomes in patients with COVID-19. Cardiovascular complications such as myocardial damage, heart failure and arrhythmias have also been associated with poor survival.

In a recent study, researchers detected cardiac abnormalities in 78% of patients with COVID-19, as well as ongoing myocardial inflammation in 60%. Although their heart function appeared to be preserved, elevated levels of the blood enzyme troponin (an indication of heart damage) were identified in 76% of patients. Notably, most people in the study did not require hospitalization.

Kidneys

Even patients who did not have kidney problems before COVID-19 infection have been shown to have kidney failure and tissue destruction after illness. According to some reports, up to 30% of COVID-19 patients admitted to hospitals in China and New York had moderate or severe kidney damage. Proteinuria or excess protein in the urine and abnormal blood components are both indicators of kidney failure.

Because the kidneys contain angiotensin converting enzyme 2 (ACE2) receptors, they are vulnerable to COVID-19 infection. The virus triggers an immune response that can be aggressive and lead to a cytokine storm that destroys kidney cells.

Liver

Since the liver also contains ACE2 receptors, people with COVID-19 are at risk for liver damage. Some patients with COVID-19 have been shown to have higher levels of liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which are signs of liver damage.

Patients diagnosed with COVID-19 who also have a history of cirrhosis (liver tissue damage) or pre-existing liver disease (chronic liver disease) are at higher risk of death.

The nervous system

There has been an increase in the frequency of COVID-19 patients reporting neurological symptoms such as brain inflammation, seizures and hallucinations.

According to a study published in JAMA Neurology by a group of Chinese doctors, more than a third of 214 COVID-19 patients in Wuhan who were hospitalized with severe symptoms had neurological symptoms. The most common symptoms were dizziness, headache, impaired consciousness, loss of taste and smell, and skeletal damage. According to the study, the most dangerous symptoms, although rare, were seizures and strokes.

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Patients with cirrhosis have a ‘sufficiently high risk’ of liver cancer https://rogalevich.org/patients-with-cirrhosis-have-a-sufficiently-high-risk-of-liver-cancer/ Wed, 23 Feb 2022 15:40:19 +0000 https://rogalevich.org/patients-with-cirrhosis-have-a-sufficiently-high-risk-of-liver-cancer/ February 23, 2022 2 minute read Source/Disclosures Published by: Source: Tapper E. Presentation: HCC Surveillance: Who, How and Expected Benefits. Presented at: GUILD 2022; February 20-23, 2022 (hybrid meeting). Disclosures: Tapper reports research support from Ambys, Gilead, Novo Nordisk and Valeant. ADD A SUBJECT TO EMAIL ALERTS Receive an email […]]]>

February 23, 2022

2 minute read

Source:

Tapper E. Presentation: HCC Surveillance: Who, How and Expected Benefits. Presented at: GUILD 2022; February 20-23, 2022 (hybrid meeting).


Disclosures: Tapper reports research support from Ambys, Gilead, Novo Nordisk and Valeant.


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Screening for hepatocellular carcinoma is essential in high-risk patients, according to a presentation at the GUILD 2022 conference.

“The incidence of liver cancer is multiplied by several, especially in the South and West. … At the same time as the incidence increases, so does the mortality, almost doubling,” Elliot B Type, MARYLAND, associate professor of medicine at the University of Michigan, said. “When you look under the hood to ask who this is happening to, you can see some very important clues to tell us a bit about where this disease is going.”


“Screen for liver cancer every 6 months and pay attention to the dominant risk factors: namely age, biological sex, history of viral hepatitis and family history of liver cancer.  But in a nutshell, we are interested in the history of cirrhosis and viral hepatitis.  Elliot B. Tapper, MD



Modeled projections to 2030 indicate that while the number of liver cancers has increased and will increase in patients aged 65 to 84, younger age groups will see less incidence of HCC over time. In addition, the incidence of HCC is “several times” higher in men than in women.

While the conventional risk factors for liver cancer — stage of fibrosis and active hepatitis C and hepatitis B status — are still prevalent, Tapper noted that cirrhosis and fatty liver disease have become major drivers of disease.

“Screen for liver cancer every 6 months and pay attention to the dominant risk factors: namely age, biological sex, history of viral hepatitis and family history of liver cancer,” said Tapper, advising participants to follow the recent practical advice of the AASLD. “The age thresholds are different depending on epidemiological factors, which are indicators of how long you’ve had hepatitis B. But in a nutshell, we’re looking at history of cirrhosis and viral hepatitis.”

As for screening modalities, ultrasound is quite popular, although the sensitivity (about 50%) and specificity for detecting early liver cancer is lacking. In addition, hindering factors, such as operator dependency, inconvenience, and patient-to-patient variability, decrease the quality of the analysis and limit its performance. Blood biomarker tests continue to be studied for use in screening populations at risk.

“The people who don’t benefit from screening are those who have a low risk of liver cancer: that is, people who don’t have cirrhosis; people who just have non-cirrhotic fatty liver disease,” Tapper concluded. “Although this is not true at this time, it may become clear in the future that several years after being cured of your hepatitis C, you would have a lower risk, but at this time, as long as you have cirrhosis , you will have sufficiently high risk of liver cancer and should therefore be considered for screening.

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Non-Alcoholic Steatohepatitis Clinical Trials Market Report https://rogalevich.org/non-alcoholic-steatohepatitis-clinical-trials-market-report/ Tue, 22 Feb 2022 10:08:39 +0000 https://rogalevich.org/non-alcoholic-steatohepatitis-clinical-trials-market-report/ Dublin, 22 Feb. 2022 (GLOBE NEWSWIRE) — The “Non-Alcoholic Steatohepatitis Clinical Trials Market Size, Share and Trends Analysis Report by Phase (Phase I, II, III, IV), by Plan Study (Interventional, Expanded Access), By Region (APAC, Europe) and Segment Forecasts Report, 2022-2030″ has been added to from ResearchAndMarkets.com offer. The global non-alcoholic steatohepatitis clinical trial market […]]]>

Dublin, 22 Feb. 2022 (GLOBE NEWSWIRE) — The “Non-Alcoholic Steatohepatitis Clinical Trials Market Size, Share and Trends Analysis Report by Phase (Phase I, II, III, IV), by Plan Study (Interventional, Expanded Access), By Region (APAC, Europe) and Segment Forecasts Report, 2022-2030″ has been added to from ResearchAndMarkets.com offer.

The global non-alcoholic steatohepatitis clinical trial market size is expected to reach USD 4.2 billion by 2030, registering a CAGR of 6.5% over the forecast period.

Rising healthcare expenditure, obesity cases and prevalence of non-alcoholic steatohepatitis (NASH) are the growth factors of this market. Due to the COVID-19 pandemic, enrollment in new drug clinical trials for NASH patients has been halted, but people have turned to other means of data collection, such as virtual visits. Non-alcoholic steatohepatitis is fatty liver disease that causes scarring and damage to the liver.

NASH has no FDA-approved treatment and can go to the point where patients need liver transplants in extreme situations. NASH, like diabetes, is linked to obesity and high sugar diets. Some pharmaceutical companies are testing whether diabetes drugs could help NASH patients. However, the COVID-19 pandemic has thrown a wrench into every element of NASH clinical trials, from patient recruitment to intellectual property administration and safety oversight to data integrity. As clinical research monitors are not allowed to travel, remote electronic monitoring is a viable alternative to traditional on-site monitoring. Monitors could receive information from research locations by paper mail, email (allowing direct access to electronic medical records), or remote monitoring systems.

In December, the FDA issued guidelines urging the pharmaceutical industry to develop and confirm improved biomarkers for the diagnosis and progression of NASH. In many ways, breaking the biopsy barrier is important compared to a general lack of awareness of NASH, which is why it is essential that pharmaceutical companies invest in innovations (such as a variety of techniques for imaging) to ease this burden on the patient, and then persuade the FDA with positive data to accept these advances as appropriate endpoint markers for clinical trials.

Non-Alcoholic Steatohepatitis Clinical Trials Market Report Highlights

  • The phase III segment dominated the global market in 2021. These trials cost more than $100 million
  • The interventional study design segment held the largest revenue share in 2021. There were 84 ongoing interventional studies with patients enrolled in December 2019 to assess the therapeutic efficacy of NASH treatments
  • North America led the global market in 2021 owing to the increase in the number of NASH patients in the region
  • According to the US National Library of Medicine 2018, NASH cases in the US are expected to increase by 63% from 16.52 million to 27.00 million cases by 2030
  • Asia-Pacific is expected to register the fastest CAGR over the forecast period due to the increasing incidence of associated risk factors, such as obesity, type 2 diabetes (T2D), dyslipidemia and other metabolic diseases with substantial diagnostic improvements using ultrasound and biomarkers

Main topics covered:

Chapter 1 Methodology and Scope

Chapter 2 Executive Summary

Chapter 3 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Variables, Trends and Scope
3.1 Market Segmentation and Scope
3.2 Market Dynamics
3.2.1 Market Driver Analysis
3.2.1.1 Increase investments in pharmaceutical R&D
3.2.1.2 Increase in the diabetic population and obesity
3.2.1.3 Increase in health expenditure
3.2.2 Market Restraint Analysis
3.2.2.1 Lack of awareness
3.2.2.2 Barriers to registration
3.2.2.3 Approval process for lethargic drugs
3.3 Mapping penetration and growth prospects
3.4 Impact of COVID-19 on the market
3.5 Analysis of major transactions and strategic alliances
3.6 NASH clinical trials: market analysis tools

Chapter 4 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Phase Segment Analysis

Chapter 5 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Study Design Segment Analysis

Chapter 6 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Regional Analysis

Chapter 7 Company Profiles

  • Pfizer Inc.
  • Shire Plc
  • Novartis AG
  • Plc icon.
  • LabCorp
  • Allergan AG
  • Cadila Healthcare Ltd.
  • Eli Lily
  • Novo Nordisk
  • Glaxosmith Kline

For more information about this report visit https://www.researchandmarkets.com/r/qfzcnj

About ResearchAndMarkets.com
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  • Global Non-Alcoholic Steatohepatitis Clinical Trials Market

        
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