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Reposted by Hanna Blaney, MD, MPH

Elliot Tapper @ebtapper.bsky.social · 29/05/2025

There are two articles in NEJM this year that say naltrexone is 'contraindicated for cirrhosis'. This saddens me. It is not supported by an evidence. Alcohol is 'contraindicated for cirrhosis'. That is supported by evidence

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 29/05/2025

An important message on naltrexone in patients with liver disease: ✅Naltrexone can help reduce alcohol use without harming the liver. 🚫Alcohol DOES harm the liver. We do not need any more barriers to treat patients with AUD➕ALD! @nejm.org @ebtapper.bsky.social www.nejm.org/doi/full/10....

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 14/05/2025

Do you want to support the future of the best speciality? As an Emerging Liver Scholar and Advanced Transplant Hepatology awardee, @aasldfoundation.bsky.social has shaped my career. 🙏 to all who support our pathways into hepatology @aasldnews.bsky.social 🙏Donate👇 www.aasldfoundation.org/donate

aasldfoundation.org

Donate Now - Community Hub

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 08/05/2025

📢 PSA: 👩‍⚕️👨‍⚕️Primary care doctors and internists: ‼️Please 🛑 telling patients “it’s just fatty liver” Common, yes. But not benign! ✅ Take 🍺🍸history, perform brief intervention ✅ Manage metabolic risk factors 🧐Fibrosis (FIB-4) ☎️ Your friendly hepatologist if you need help! #liversky #medsky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 06/05/2025

In an epidemic of alcohol-use disorder, alcohol-associated liver disease, and cancers driven partially by 🥂🍸🍺, click-bait headlines like these are extremely harmful for population health. Let’s do better for our patients and public health. @theguardian.com @nytimes.com @cnn.com @washingtonpost.com

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 03/05/2025

When did the hotel mini-bar get not-so-mini?! As an alcohol-associated liver disease focused hepatologist, this trend is very concerning!

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 01/05/2025

Alcohol use is pervasive. I’ve had conversations about how to prevent harmful drinking in teenagers and children (one study I did on an AUD population the average age of first drink was 11). Here is one idea (that can be applied to other habits)! What else can we do help reduce underage drinking?

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 29/04/2025

Most of what we see on the liver transplant wards are sick, young patients with alcohol-associated liver disease. We frequently see patients in their 20s and 30s, many who drank at “socially acceptable levels,” with severe liver disease resulting in either transplant or ☠️. #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 26/04/2025

As a clinician scientist who has devoted my life to improving health + advancing science, the last few months have been terrifying. I don't understand why the US doesn't want to continue leading in health + science Supporting medical science in the USA - The Lancet www.thelancet.com/journals/lan...

thelancet.com

Supporting medical science in the USA

The pursuit of rigorous medical science is not compatible with capitulation to government demands aimed at weaponising and eroding science. On April 14, Edwin R Martin Jr, the Trump-appointed interim ...

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Reposted by Hanna Blaney, MD, MPH

WHO @who.int · 24/04/2025

It’s #WorldImmunizationWeek Vaccines have saved 154 million lives in the last 50 years. That’s 6 lives every minute. A reminder of what is #HumanlyPossible. Science saves lives. #VaccinesWork bit.ly/wiw2025

Every 10 seconds vaccination saves a life.
Immunization for all is Humanly Possible

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 21/04/2025

Unsurprisingly, this administration misses the 🎯 on why many people don’t have more children: 💰(a one time $5k bonus isn’t enough) My PGY4, I spent more than my salary on childcare (and we had a very reasonably priced day care at the time for the area, ~$1300/m) www.nytimes.com/2025/04/21/u...

nytimes.com

Trump Aides Solicit Ideas to Raise Birthrate, From Baby Bonuses to Fertility Planning

Baby bonuses and menstrual cycle classes are among the ideas pitched to Trump aides as they consider plans to try boosting the birthrate.

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 18/04/2025

Home *slightly* early on this gorgeous Friday afternoon for some light reading with my 12.3 lb besties on enteral feeding in hospitalized patients. @nejm.org This is the life! @GISky @liversky @medsky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 17/04/2025

This trend is *very* concerning given that alcohol damages the liver of females at 2x the rate of males. We are seeing so many young females (20s and 30s) who get very sick and often die from🍸🍷🍻-associated liver disease! We need to work on strategies to 📉 alcohol use in this population! #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 17/04/2025

An estimated 3.3 million Americans are living with viral hepatitis. I see many of them daily with complications including liver cancer and cirrhosis. We see periodic outbreaks of hepatitis across our country, on top of a growing IVDU-related HCV epidemic. This is pure bananas 🍌.

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Reposted by Hanna Blaney, MD, MPH

Shematologist, MD @shematologist.medsky.social · 09/04/2025

PSA: You can have iron deficiency without anemia and it still matters and can cause serious symptoms and absolutely warrants treatment.

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 05/04/2025

“DEI and proud” “Donald Trump’s worst nightmare” Happy to be in NYC and supporting ReelAbilities Comedy Night

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 04/04/2025

Wise words from Dr Scott Winder: Congratulate your AUD/ALD on their progress for reducing alcohol use, even if they haven’t achieved abstinence. Addiction is hard. Recognize success. #liversky #ALD-ALLY #medsky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 04/04/2025

Naltrexone in 🍷🍸🍺-associated liver disease ✅ Overall, safe for treatment of alcohol use disorder in this population Black box warning for chronic liver disease was REMOVED in 2013: 🚫 evidence of harm 🔑 Alcohol causes harm to the liver, naltrexone does NOT Slides: #ALD-ALLY Lamia Haque #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 02/04/2025

As a constituent who formally worked at NIH: yes and yes.

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 01/04/2025

Heading to @amergastroassn.bsky.social DDW? Apply for 🌈@rainbowingastro.bsky.social inaugural Health Equity Travel Awards! Would love to see a 🌱 hepatologist awarded! 📆Deadline to apply is April 18th! urldefense.com/v3/__https:/...

urldefense.com

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 31/03/2025

I frequently see patients with “new” cirrhosis only to find that on chart review they had low platelets/some other finding concerning for cirrhosis or liver disease often YEARS before. Thrombocytopenia should prompt a search for cirrhosis and may save lives/livers! #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 31/03/2025

Encouraging #GISky and #liversky Fellows to apply! 📆 Apply by April 1st!

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 31/03/2025

Who has completely deleted their Twitter/X account? I’ve struggled to given what #MedTwitter was and the connections made. Just logged into check and was overwhelmed with xenophobia/islamaphobia/white supremacy and I cannot 🤯. Haven’t pulled the plug just yet but wow…things have gotten very 💩

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Reposted by Hanna Blaney, MD, MPH

Elliot Tapper @ebtapper.bsky.social · 26/03/2025

“Moderate” alcohol-associated hepatitis MELD < 20 journals.lww.com/hepcomm/full... #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 27/03/2025

This picture reminds me how I have always been extremely goal oriented (Also: So much fun to share this with my mini-me. Bonus: my dad teaching my son how to aim as well as fly fish in high desert streams!)

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Reposted by Hanna Blaney, MD, MPH

Elliot Tapper @ebtapper.bsky.social · 22/03/2025

Ascites is like carrying around a hot tub: Huge energy bill! 1⃣Kilocalorie= energy to 🔥1L by 1°C 2⃣Ascites=Heating ~5-10L to 36°C 24hrs/day 3⃣Energy comes from body breakdown (sarcopenia) If you⬇️ascites➡️the energy bill falls Help patients. ⬇️the ascites!!! #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 12/03/2025

Having trained at a center that did a high volume of stem cell transplants, we frequently encountered NRH post-chemo and transplant. These patients do not behave like our patients w/ cirrhosis, with different plt thresholds associated with portal HTN. Carvedilol still works!

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 11/03/2025

We are so lucky to have you, Bernie! Hopefully the US can continue to work on global public health initiatives.

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 11/03/2025

As a hepatologist focused on alcohol-associated liver disease, I often remind my patients that the liver isn’t the only organ alcohol impacts. Alcohol use is also associated with cancer as well as brain 🧠 health As a🗺️ community, we need to do more to educate on the health consequences of alcohol!

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 11/03/2025

I personally lean 🌱/🐟-based. My favorites are lentils and other legumes (cheap and delicious!😋 ), Greek yogurt, fish, and eggs (if available). Also: ❤️ healthy! Also, remember that many products/snacks have ⬆️ sodium including another personal favorite: 🧀 (though mozzarella and Swiss have ⬇️)

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 11/03/2025

I saw a picture of a pregnant person getting an ultrasound and immediately thought—“I hope they give albumin.” 🤣🤦‍♀️ Note to self: conditions other than ascites and massive hepatosplenomegaly can cause abdominal distention #medsky #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 10/03/2025

Really liking this trend of puppies, especially given everything else going on with the world and science. Her is mine when she was a pup! Now is a ~13lbs.

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 10/03/2025

It’s fun being on a teaching team in a teaching hospital where you learn so much from your trainees and from the consulting services!

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 05/03/2025

Please delve deeper into “social” drinking with your patients, especially in those with evidence of liver disease. More often than not, drinking that is considered socially acceptable is harmful to the liver. Sometimes a brief intervention/educational moment is enough to save a liver! #liversky

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Reposted by Hanna Blaney, MD, MPH

Elliot Tapper @ebtapper.bsky.social · 02/03/2025

One need not worry about bleeding when banding varices in patients with low platelets I am not sure why this study excluded people with platelets less than 30 Nevertheless … doi.org/10.3390/dise... #liversky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 01/03/2025

Amazing #liversky conference by @aasldnews.bsky.social @juanpabloarab.bsky.social + Mazen Noureddin on alcohol-associated liver disease and MetALD. So many great minds working in this area to improve our patients’ lives. Always 👌 time to be a Hepatologist! @vinayjaha.bsky.social #medsky #academicsky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 28/02/2025

FANTASTIC presentation by phenomenal patient advocate Jennifer Jones. Hearing from patients about their experience moving through our system is 👀. 👏 We need to take every opportunity to diagnose liver disease AND we need to continue to work on stigma: language matters! @juanpabloarab.bsky.social

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Reposted by Hanna Blaney, MD, MPH

Ilan Schwartz @germhuntermd.bsky.social · 25/02/2025

Invasive fungal infections in patients with liver disease: immunological and clinical considerations for the intensive care unit Epelbaum, Gallo de Moraes, Olson, & Lionakis link.springer.com/article/10.1... #IDSky #HepSky #MedMycoSky

Diagram of the normal innate and cellular adaptive immune responses to fungal organisms highlighting the central role of macrophages and dendritic cells (DC). Should fungi succeed in breaching the host’s external barriers, the first immune cells they encounter as part of the innate response are the professional phagocytes residing in tissues: macrophages and DCs. Macrophages are responsible for both phagocytosis and, through signaling based on molecular recognition as detailed in the figure, for elaborating pro-inflammatory cytokines, such as TNF-α and IL-1β, which attract blood-borne effector cells (neutrophils and monocytes) to the site of invasion. Likewise, DCs contribute to the innate immune response not only through phagocytosis but also by stimulating natural killer cells, which, once activated, release cytotoxins for direct pathogen elimination. The other critical function of DCs is their migration to surrounding lymph nodes, where they promote the diffe

The liver is a vital cog in human immune defenses against infection, both locally and systemically. The main immune function of the liver is antimicrobial surveillance of splanchnic blood returning from the portal circulation and flowing through liver sinusoids into hepatic venules. Kupffer cells (KC) are macrophage derivatives that reside within hepatic sinusoids where they serve as the primary phagocytes and are also very important antigen presenting cells (APCs). KCs as well as dendritic cells (DC), the other prominent APCs residing in the liver, are major producers of both pro- (e.g., TNF-α) and anti-inflammatory cytokines (e.g., IL-10) and are thus instrumental in calibrating the liver’s immune response. Unlike KCs, DCs are not confined to the lumen of hepatic sinusoids, so they are can traverse the Space of Disse and migrate to locoregional lymph nodes, where they initiate an adaptive immune response by priming naïve CD4 + lymphocytes. In the hepatic sinusoids, KCs and DCs interact with a variety of intrahepatic lymphocytes, most numerous among them being natural killer (NK) cells. Even structural cells in the liver, ie hepatocytes and sinusoidal endothelial cells, play a number of immunological roles, including elaboration of cytokines, release of soluble pattern recognition receptors, and phagocytosis. The major liver-resident cells with immune functions are depicted in the top left section of the diagram. Aside from disrupting local antimicrobial defenses, liver cirrhosis also negatively impacts the systemic immune response. Despite an overall hyperinflammatory systemic milieu, specific circulating immune cells are rendered dysfunctional in liver failure as part of a phenomenon called immune cell paralysis. Neutrophils become less effective with respect to chemotaxis and phagocytosis. The oxidative burst critical for effective pathogen elimination by monocytes is impaired, and both a quantitative & qualitative defect in T cell lymphocyte immunity develops

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 25/02/2025

Apparently, all the residents/med students at our connected hospitals interested in GI/liver know I like research! It’s been so fun to mentor residents/students through projects—especially when they bring their own ideas! Can’t wait to continue this as an attending. #liversky #GISky #academicsky

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 17/02/2025

Yes! 💯 Would also love to see alcohol taxed with proceeds going to fund addiction and ALD research, projects helping those hurt by addiction, treatment…

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 15/02/2025

Us moms in medical training always feel guilty about not being good enough in either part of life—not good enough residents/fellows & not good enough as a parent. But we are. To moms in training—my 👶 is now 7 and it’s all he knows. It gets easier, the guilt is still there. I see you!

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Reposted by Hanna Blaney, MD, MPH

The Lancet @thelancet.com · 10/02/2025

Read our latest issue in full ➡️ tinyurl.com/2rz7b357 bsky.app/profile/thel...

Cover of The Lancet Feb 8, 2025 issue. Quote on cover reads: "Health institutions may be hesitant to criticise the new administration publicly, but this timidity is a mistake. Trump's actions must be called out for the damage they are doing."

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Hanna Blaney, MD, MPH @blaneymd.medsky.social · 09/02/2025

This is just one of MANY reasons why DEI is so important in science and medicine. Lives depend on it!

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