#End-stage Liver Disease

[drforambhuta]

The liver transplant procedure requires precise execution, with the surgical team meticulously performing each step. The damaged liver is delicately removed to minimize harm to surrounding organs and tissues. Subsequently, a healthy liver from either a living donor or deceased donor is transplanted to the recipient, and the surgical team skillfully connects the blood vessels and bile ducts to ensure proper function. Advanced imaging technology and state-of-the-art surgical tools are utilized to enhance precision and increase the likelihood of a successful liver transplant procedure.

Following the transplant, careful management is crucial in the post-transplant phase to prevent organ rejection and identify potential complications. Immunosuppressant medications are employed as the primary defense against rejection by suppressing the recipient's immune response. Dosage adjustments are made to reduce infection risks and prevent rejection. During the early recovery period, intensive care unit monitoring aids in timely detection and management of complications, while infection control measures safeguard the new liver from potential infections.

The recovery process after a liver transplant is gradual, and patients may spend several weeks in the hospital. The medical team offers comprehensive support, managing post-surgical pain with appropriate medications and addressing any complications that may arise. Proper nutrition is essential for aiding recovery and promoting healing. Individualized physical therapy and rehabilitation programs assist patients in regaining strength and mobility. Emotional support and counseling are also provided to recipients and their families, helping them navigate post-transplant challenges with a positive outlook.

If you are suffering from a severe end-stage liver disease or liver failure, you may need to undergo a liver transplantation procedure.

There are many good hospitals and doctors in Mumbai who can perform the procedure successfully for you. The cost of liver transplant in Mumbai generally varies depending on the choice of doctor and hospital, the condition of the patient, and type of procedure being performed.

[seemabhatnagar]

"High Court Orders Expedited Approval for Minor's Donation of liver tissue to Save Father's Life"

The High Court of Madhya Pradesh directed state authorities to expedite the approval process for a minor to donate her liver tissue to her father, emphasizing the father's severe health condition and the minor's medical fitness for the donation.

Shiv Narayan Batham v. Vishesh Jupitor Hospital & Others

W.P. 16491/2024

Before the High Court of Madya Pradesh at Indore

Heard by Hon'ble Mr. Justice Vishal Mishra J

Fact

The petitioner, Shivnarayan Batham, was suffering from end-stage chronic liver disease and urgently needed a liver transplant to save his life. His daughter, Preeti Batham, who was under 18, was willing to donate a part of her liver. However, due to her minor status, the doctor had refused the organ donation without prior state approval.

Legal Issue

Whether the court can direct the state authorities to permit a minor, who is medically fit, to donate liver tissue to save the life of her father.

Court's Observation

The court noted the urgency of the situation, the medical fitness of the donor (Preeti Batham), and the need for prior state approval as per Rule 5(3)(g) of the Transplantation of Human Organs and Tissues Rules, 2014. The court criticized the state's delay in decision-making, emphasizing the severe health condition of the petitioner and the necessity for prompt action.

Order

The High Court of Madhya Pradesh directed the respondents to permit Preeti Batham to donate liver tissue to her father, Shivnarayan Batham, subject to the following conditions:

The procedure should be conducted in a specialized center with an expert team of at least three doctors who will inform the family about the risks and related factors.

Doctors must take all necessary precautions and provide essential medical facilities during the procedure.

Post-operative care must be extended to the donor.

The procedure must be carried out expeditiously with all required precautions.

The petition was disposed of without any order as to costs.

[scientia-rex]

I also spend a lot of time trying to convince people to prevent problems, because prevention still works better than cures. Don't fucking smoke! I would instantly become the best doctor who ever lived if I could just convince all my patients to quit smoking. Avoid alcohol! Don't do meth! Don't do fentanyl! Things that are poisons will poison you in ways you understand, in the short term, but also ways you can't really understand until you've watched dozens of people die from it thirty years later, struggling to breathe from their COPD or weak and nauseated beyond bearing from their end-stage liver disease. I watched a man take 3 weeks in the ICU to die from what meth did to his heart. Your heart isn't meant to beat 145 times a minute for weeks on end. Your liver isn't meant to metabolize 5 shots of gin a day. You aren't going to be able to use denial and willpower to repair the damage your own habits did.

I drink a lot less now than I did before I went into medicine. Lot of different reasons, including that I'm older and more settled. But I can't look at it the same way I used to; I can't brush off as a "fun quirk" what I know is alcohol use on a level that risks withdrawal seizures if they were to suddenly stop, like some of my family members do, nervously asking me about their loved one's drinking when we're alone because beneath the jokes they know it's a problem.

If you're having more than one, maybe two drinks a day on average, over a long period of time, you are damaging your body in ways you don't understand. You're setting up a permanent heightened inflammatory state. Your heart cells don't like alcohol; Google "alcohol-induced cardiomyopathy." Your esophagus and stomach respond to incessant bathing in poison by first developing wounds and then cancer. Your liver, of course, doesn't like it. Your liver not only converts poisons to harmless substances you can excrete, it also makes your platelets, so your blood can clot. It makes albumin, a protein that's essentially for keeping water in your blood vessels and not letting it leach into your tissues. So people who are dying of liver failure are in pain and weak and tired and sad the whole fucking time! And the only solution, a liver transplant, will come with a lifetime of medication and specialist check-ups and the knowledge that if you fuck up and kill this liver, too, no one is going to be eager to give you another try.

I don't guilt-trip my alcoholic patients with liver disease. I don't guilt-trip my smokers with COPD. They chose to cope with substances for reasons, even if I disagree with their reasons, even if those reasons are opaque to me. They will suffer the natural consequences of those actions whether I guilt-trip them or not. I want them to continue to see me, I want them to be honest with me. Other people will lay enough guilt on them. And nothing I can say or do would ever compare to the physical and mental suffering that goes with those diseases.

But if you can prevent these diseases in yourself, prevent them. Quit smoking. Do it now. Your lungs are going to look better starting almost immediately, with positive changes continuing for many years. Drink less alcohol. Sure, it's fun, sure, it's a longstanding human tradition, but it is also unfortunately a straight up poison and your body knows that no matter how persuasively you argue about the obvious failure of Prohibition. You can't argue with a cell. You can't convince your kidneys that high blood pressure shouldn't damage them. They are a system; they do what they do; they existed long before prefrontal cortex existed to justify what we want to do but know to be harmful.



[mariacallous]

On a recent Thursday afternoon, researchers Lanuza Faccioli and Zhiping Hu wheeled an inconspicuous black and white plastic cooler from an operating room at a hospital in downtown Pittsburgh. Inside was a badly scarred liver, just removed from a 47-year-old man undergoing a transplant to receive a new one from a donor.

But what if patients could avoid that fate? Faccioli and Hu are part of a University of Pittsburgh team led by Alejandro Soto-Gutiérrez attempting to revive badly damaged livers like these—as well as kidneys, hearts, and lungs. Using messenger RNA, the same technology used in some of the Covid-19 vaccines, they’re aiming to reprogram terminally ill organs to be fit and functioning again. With donor livers in short supply, they think mRNA could one day provide an alternative to transplants. The team plans to begin a clinical trial next year to test the idea in people with end-stage liver disease.

Alcohol use, hepatitis infection, and a buildup of fat in the liver can cause scarring over time. When there’s too much damage, the liver starts to fail. “Right now, if you get end-stage liver disease, it’s irreversible,” Soto-Gutiérrez says. “Well, we found that is not true. It is reversible.”

Soto-Gutiérrez and his team have been experimenting on rats and organs taken from people undergoing transplants at the University of Pittsburgh Medical Center, one of the busiest transplant centers in the US. To help design the mRNA and figure out how to deliver it to the human liver, they’ve partnered with Drew Weissman, a physician and immunologist at the University of Pennsylvania who won the 2023 Nobel Prize in Physiology or Medicine for his pioneering work on mRNA. Together, Soto-Gutiérrez and Weissman lead the Center for Transcriptional Medicine, launched in April with the goal of bringing these medicines to patients.

On the day I visited, I followed Faccioli and Hu through a maze of hallways until they deposited the freshly explanted liver at a pathology lab, where a team of scientists was anticipating the special delivery. After infusing the liver with an experimental mRNA therapy, they placed the organ in an oxygenated bath meant to maintain its function for several days.

A healthy liver is spongy and reddish-brown in color with a smooth appearance. But when the surgeons took this one out of the cooler, it was hard, marbled, and covered in bumps—evidence of cirrhosis, a type of end-stage liver disease. Over time, the man’s healthy liver cells had been replaced by scar tissue, and eventually, his liver stopped working. His only option was to get a new one.

Livers are the second most in-demand organ. In 2023, a record 10,660 liver transplants were performed in the US, driven in part by a steadily growing number of living donors. In a living liver transplant, a piece is taken from a healthy person’s liver and transplanted into a recipient. But even with this uptick in transplants, not everyone who needs a new liver receives one. Patients may have other health problems that disqualify them from a transplant, and others may die while waiting for one. In 2022, the latest year for which data is available, the Centers for Disease Control and Prevention recorded nearly 55,000 deaths due to chronic liver disease.

Living donor transplants are possible because of the liver’s unique capacity to regenerate itself—more so than any other organ in the body. In a healthy person, the liver can regrow to its normal size even after up to 90 percent of it has been removed. But disease and lifestyle factors can cause permanent damage, rendering the liver unable to repair itself.

When Soto-Gutiérrez was studying medicine at the University of Guadalajara in Mexico, his uncle died of liver disease. From then on, he became dedicated to finding a treatment for patients like his uncle. In the early years of his medical career, he noticed that some patients with scarred livers were bound to a hospital bed waiting for a transplant, while other people with cirrhosis were walking around, seemingly living normal lives. He figured there must be cellular differences in these livers.

He teamed up with UPMC transplant surgeon Ira Fox to look for transcription factors—master regulators that can dial up or down the expression of groups of genes—that can potentially reprogram injured organs. Genes rely on transcription factors to perform many essential functions in organs. Together, Soto-Gutiérrez and Fox have analyzed more than 400 failing livers donated by transplant patients. When they compared them with dozens of normal donated livers that acted as controls, they identified eight transcription factors essential for organ development and function.

They zeroed in on one in particular, HNF4 alpha, that seems to act like a main control panel, regulating much of the gene expression in liver cells. In healthy liver cells, levels of HNF4 alpha were turned up, and so were other proteins it controls. But in the cirrhotic livers they examined, HNF4 alpha was almost nonexistent.

The team needed a way to get the transcription factor into liver cells, so they turned to mRNA technology. Used in some of the Covid-19 vaccines, mRNA is a molecule that carries instructions for making proteins, including transcription factors. In the Covid vaccines, the mRNA codes for a part of the virus known as the spike protein. When injected into a person’s arm, the mRNA enters cells and kicks off the protein-making process. The body recognizes these spike proteins as foreign and generates antibodies and other defenders against it.

The Pitt team is using mRNA instead to essentially turn back time in injured organs. “What we’re proposing to do with mRNA is use it to deliver proteins that have the capacity to repair those damaged liver cells,” Weissman says. “Our hope is that we can treat end-stage liver disease and turn the livers around, maybe forever, or at least until patients can get a transplanted organ liver.” Instead of delivering instructions for a foreign protein to generate an immune response, they’re delivering the genetic code for producing a transcription factor—HNF4 alpha.

In a paper published in 2021, the approach revived human liver cells in lab dishes. The researchers have since tested the mRNA therapy in rats with cirrhosis and liver failure. They treated a group of rats every three days for three weeks while a second group served as a control. The animals that were receiving the injection of HNF4 alpha started being more active. The untreated rats continued to decline and eventually died, the expected result at their stage of disease. Some of the treated rats were still living six weeks after receiving the mRNA medicine. Those results have not yet been published in a peer reviewed journal.

The team is also testing the mRNA infusions in human livers removed from patients undergoing transplants—the process I got to observe. Unlike live rats, explanted human livers can’t be observed for weeks on end. Livers have to be retrieved quickly and infused with the mRNA treatment soon after they’re removed from the body. They stay fresh for just four days or so in a preservation fluid. Six hours after the mRNA infusion, levels of HNF4 alpha start going up and last for two to three days. When HNF4 alpha peaks, other essential liver proteins, such as albumin, start to increase as well. That’s important, Soto-Gutiérrez says, because maintaining those protein levels could mean the difference between a patient needing a transplant or not.

Ideally, Soto-Gutiérrez says the mRNA therapy would be something patients could get once a week or every other week in an outpatient facility and go back home. But initially, they’ll need to test the experimental treatment in very sick patients, likely ones that are hospitalized, to make sure it’s safe. The team is gathering data from the rat and human liver experiments to submit a clinical trial application to the Food and Drug Administration in the coming months.

While livers are the first target, Fox thinks other injured organs may be amenable to this approach. “We’ve been wondering whether the same process might be taking place in other organs,” he says. Currently, the team is searching for similar transcription factors in lungs with chronic obstructive pulmonary disease and kidneys with chronic kidney disease.

Josh Levitsky, a liver transplant specialist at Northwestern University who isn’t involved in the work, says new treatments for chronic liver disease are sorely needed. Current therapies can help slow down scar tissue buildup and ease symptoms but don’t address the underlying disease. “The concept of reprogramming and being able to reverse liver failure could be really game changing if it were to pan out in clinical studies,” he says.

But lots of questions remain. How much damage could be reversed? Would patients need to be on the therapy indefinitely? Or would their livers rebound enough to go off it? Could a liver ever be restored back to normal?

“It certainly has a lot of promise,” Levitsky says, “but the clinical development is going to take a long time.”

[sggk]

My dad just got end stage months left liver disease diagnosis so . Think that may actually cap off the worst this week can get finally

[darkmaga-retard]

Robert F. Kennedy Jr. spent decades as an environmental lawyer fighting polluters and supported 'green' organizations for environmental justice. He is now setting his crosshairs on the pharmaceutical industry and cleaning up the nation's food supply chain of ultra-processed foods and seed oils that poison consumers. He has determined that suspending his presidential campaign to team up with former President Trump will be necessary for the strongest success rate in making Americans healthier again, not through big pharma's Ozempic shots but instead revitalizing small farms and shaking up corrupted federal agencies.

Lifelong liberals like RFK Jr. backing Trump is one of the strongest indicators of just how extreme the ticket, unoriginal Vice President Kamala Harris and Democrats have become. Harris' team recently announced their first proposed economic policy, which was rooted in communism and included disastrous price controls. It appears the far-left ticket is being advised and heavily influenced by Marxists. 

Between RFK Jr's special announcement earlier Friday and his speech at Trump's packed campaign rally in Glendale, Arizona, the liberal with millions of supporters nationwide appears to have made a deal with Trump to join the campaign with a shot at waging war against corrupt federal health and food agencies, resetting the nation's poisonous food supply chain, and launch a crusade against big pharma if the Trump team wins in November. 

RFK Jr. informed journalists at his special press conference in the early afternoon of Friday that America's health crisis stems from ultra-processed foods pushed by giant food/pharma companies that have corrupted various federal agencies: 

Autism rates were about one in 10,000 in my generation - in my kids Generation 1 in 34. I'll repeat in California 1 and 22. Why are we letting this happen? Why are we allowing this to happen to our children? These are the most precious assets that we have in this country how can we let this happen to them. About 18% of American teens now have fatty liver disease, that's like one out of every five - that disease when I was a kid only affected late stage alcoholics who were elderly. Cancer rates are skyrocketing in the Young and the old young. Adult cancers are up 70 79%. One in four American women is on anti-depressant medication. About 40% of teens have a mental health diagnosis and 15% of high schoolers are on Aderall, and half a million children on SSRIs. So what's causing this suffering? I'll name two culprits first and the worst is ultra-processed food. About 70% of American children's diet is ultra-processed that means industrial manufacturing - these Foods consist primarily of processed sugar, ultra-processed grains, and seed oils. Scientists who, for many of them, formerly worked for the cigarette industry, which purchased all the big food companies in the 1970s and 80s, deployed thousands of scientists to figure out chemicals new chemicals to make the food more addictive, and these ingredients didn't exist a 100 years ago. Humans aren't biologically adapted to eat them. Hundreds of these chemicals are now banned in Europe but ubiquitous in American processed foods. The second culprit is toxic chemicals in our food and our medicine and our environment pesticides food additives pharmaceutical drugs and toxic waste permeate every cell of our bodies. The Assault on our children's cells and hormones is unrelenting - name just one problem many of these chemicals increase estrogen - because young children are ingesting so many of these hormone disruptors, America's puberty rate is now occurring at age 10 to 13, which is six years earlier than girls were reaching puberty in 1900 our country has the earliest puberty rates of any continent on the Earth and no this isn't because of better nutrition - this is not normal - breast cancer is also estrogen-driven and it now strikes one in eight women. We are mass poisoning all of our children. 

RFK Jr. then touched on the processed food industry lobbyists who have corrupted Washington, resulting in a food supply chain filled with poison that is killing Americans. He said several federal agencies that are supposed to protect consumers have also been corrupted. 

[pudding-parade]

I had to euthanize one of my cats on Wednesday.

It wasn't completely unexpected. She had chronic kidney disease, and when it was diagnosed about two years ago, it had already progressed to the Stage Two/Three border, of four stages. I'd been doing supportive care with her since diagnosis, which means doing things like giving her subcutaneous fluids (which means stabbing her with an IV needle in the scruff of the neck and then putting about 150ml of fluid under her skin) every third or fourth day and giving her phosphate binders twice a day after she ate. Basically, it was labor-intensive, but I didn't mind at all because it extended her quality of life. In fact, I felt a level of solidarity with her because I, too, am dealing with the dysfunction and slow death of major organs. (The kidneys in her case, the liver in mine.) She was doing pretty well, considering, mostly keeping weight on, eating (her prescription diet) and drinking well, peeing a lot but not throwing up, etc.. Keeping her going with a decent quality of life bonded us together because we were in this together.

And now we're not. She took a hard and fast turn about a week ago, and it was clear at the end that she was ready to go. Blood tests showed that she was well into Stage Four with nothing to be done, and I'm not one to make an animal suffer just to keep them around so that I don't have to go through the grieving process. (I feel the same way about people, but that's a far more controversial opinion, I guess.)

I'm not even close to done with grieving, but what's hitting me hardest is that I'm now realizing that my life had become structured, to a certain extent, around her care. I had to be home at certain times to give her her food and the phosphate binder. I had reminders set up on my devices regarding giving her her fluids. I couldn't just pack up and go somewhere for a week. I was tracking things like her weight and eating habits. And now I don't have to do any of that and while maybe I should be happy about that, it's instead making me feel worse and more bereft. I was bawling my head off when I canceled all the reminders on my devices. Which is weird, but it's where I'm at.

Anyway, yeah. I was sort of planning to come back here, had been playing Sims a bit here and there, wanted to get back to my Random Legacy thingie, but now I don't think I'll be here at all until I'm dealing with this better. Sorry, y'all.

[theplottdump]

Val: And there were really no warning signs? You had no idea?

Chad: I don't know. The last thing I told him was to stay away from us, from me. I was so mad I can't really remember exactly what I said.

I just know that I meant it.

Chad: Who knew- Chet Chinsley, the famed and revered 009, taken down by a late stage liver disease. Val: Cirrhosis. Chad: Gesundheit.

Chad: What if he was trying to tell me- at dinner. What if some part of this my fault? Val: Chad, no. Chad: Val they found him dead on the floor of his bathroom. Completely alone. No one deserves that, not even my father. If I had just listened to him, kept my temper in check-

Val: That's unfair to yourself and you know it. Chad: Yeah but- Val: No. No buts. He was horrible and mean, and not even in a fun way. If he wanted you to know he would have said something directly instead of trying to guilt trip you.

Val: But he didn't and you can't blame yourself for that. Chad: Val he was still my father. Val: Was he really? In the end? Because right now I'm looking at a father, and while the resemblance is uncanny, he is nothing like the man who unfortunately didn't die from some kind of blood explosion.

[drforambhuta]

Liver transplantation serves as a definitive and potentially life-saving remedy for individuals dealing with portal hypertension and end-stage liver disease. The primary goal is to replace the malfunctioning or diseased liver with a healthy one, thereby restoring typical liver function and mitigating complications linked to portal hypertension.

The Transplantation Procedure

Patient Assessment: A thorough evaluation examines a patient's suitability for a liver transplant. This evaluation encompasses medical, psychological, and financial aspects to ensure the patient's ability to undergo the procedure and adhere to post-transplant care. It also takes into account the patient's social support system and their capacity to follow medication regimens, which are vital for long-term success.

Waiting List: Eligible patients are added to a waiting list for a compatible donor liver. The waiting period can vary, ranging from a few days to several months, contingent on factors like donor availability, the patient's medical condition, and considerations such as blood type and organ size compatibility.

Surgical Procedure: When a suitable donor liver becomes accessible, the transplantation surgery is scheduled. The patient's diseased liver is meticulously replaced with the donor liver. This intricate procedure necessitates a highly skilled surgical team and can take several hours.

Recovery and Post-Transplant Care: Following the transplantation, patients require intensive care and monitoring to ensure the new liver functions as anticipated. Anti-rejection medications are prescribed to prevent the immune system from attacking the transplanted organ. Managing these immunosuppressants is crucial, as they have side effects and require long-term use. Regular follow-up appointments with transplant specialists are essential to monitor the patient's progress and address potential complications.

You can contact a good gastroenterologist, like Dr. Amit Maydeo practicing at H N Reliance Hospital in Mumbai, to assess your liver condition and know about your different treatment options , including a liver transplant procedure.

[anarchywoofwoof]

in 1758, a Swedish doctor by the name of Samuel-Auguste Tissot claimed semen was an “essential oil" and that cum depletion would lead to all sorts of terrible health effects and came up with the idea of Post Orgasmic Illness Syndrome (POIS)

in 1838, a French psychiatrist named Jean-Étienne Dominique Esquirol wrote that masturbation was “recognized in all countries as a cause of insanity.”

here is just a small list of the shit that these dudes and their colleagues blamed on jerking off too much:

Loss of appetite

Increased appetite

Paralysis

Impotence

Loss of libido

Weakness

Vision and hearing loss

Coughing

Back pain

Cognitive decline

Rage

Headaches

Blood in the urine

Neuralgia

Liver and kidney disease

Urinary problems

Uterine cancer

Epilepsy

Suicide

also they said if you bust too many nuts you'll end up being this guy

Representing the last stage of mental and bodily exhaustion from Onanism or Self-pollution

translation: oops camed too much

nofap has existed for hundreds of years and they've been dumb as fuck the whole time so i wouldn't worry too much about what they think. just in case you were wondering.

[insipid-drivel]

Your follow-up to the horse info post is just as good as the first one, and I offer a sincere thanks because those sorts of posts take forever, and are a lot of work.

But the reason I’m sending this is because of the joy of seeing the horsey prosthetics. I was aware that injury didn’t and doesn’t mean instant euthanasia, but I didn’t know what advances had been made and it’s a lovely thing to be able to help a friend live their best life.

For instances where euthanasia is the only course of action, would that be something like a horse has sustained a break that has gone septic in a time prior to antibiotics? So the horse would likely die anyway and it would be more humane to put it down than to let nature run its course, I’m thinking. Or is that completely wrong?

Thanks again for all of the hard work you put into these posts and answers!

Eugh, infections are a really horrible and scary part of horse health crisis management, because they can be very touch-and-go depending on where the actual infection is and how early it's treated with antibiotics. Once sepsis has taken hold, there usually isn't a lot modern medicine can do but try to provide comfort measures through medications, and pump the horse with large-bore doses of IV antibiotics, stress-reducing medications to keep them from panicking and their bodies from working too hard, and fluids while hoping the immune system is still strong enough to put the antibiotics to use and win against a case of sepsis. Sometimes, the bacterial load in the body is just too much or the infection has caused irreparable damage to a critical organ like the heart, and there isn't any other way to show the animal mercy but to euthanize. Most cases of sepsis, before death, result in a comatose state before the body completely shuts down from multiple organ failure, and it's an extremely miserable way to die. So yes, when euthanasia is discussed with horses, it's primarily when there is nothing else that can be done to make the horse's quality of life better while its suffering is only going to get worse (usually resulting in death) regardless of veterinary science or a limitless budget.

The problem with antibiotics in general is that they take time to work. If you've ever been miserable from something like a UTI or a chest infection, you know waiting 2-3 days for oral antibiotics to fully kick in sucks (IV antibiotics tend to work much faster, but still take a bit of time to reach full potency), because the infection is still there and causing intense pain and discomfort. The reason it takes so long is because antibiotics stimulate an immune system into going ham on an infection and destroying it. If there isn't enough time, or the immune system is already shot, then antibiotics may not be enough. End-stage or late-stage sepsis in pretty much any mammal is pretty much gonna be deadly, because sepsis is commonly called "blood poisoning" and kills by causing multiple essential organs to stop working in rapid succession - brain, heart, liver, lungs, etc. - like fairy lights on a string going out one by one after the first light fails. "Too far gone" happens, and that's when euthanasia becomes an open subject, because there's nothing left to anticipate for the animal but more suffering before they're going to die of their infection/injury.

Good vets will ALWAYS try to fight until the bitter end to provide options and other forms of intervention in saving an animal's life from disease or injury, but they also are specifically trained to know when a situation is just too beyond what they're capable of addressing and when continuing to try to treat an animal is only going to prolong its suffering before it inevitably succumbs to death. That's why prosthetics are becoming a thing for horses now! The cost of 3D printers have been going down, more designs for prosthetics are being published, and better materials are being employed for optimal horse comfort and recovery. Most injuries that result in a disabled leg in horses are caught and treated rapidly by owners and vet teams with no serious infections setting in, and so the main reason euthanasia has been employed for leg breaks and cases of amputation was more for preventing the horse from suffering without a mobility aid or prosthetic. Now, humans are catching up and figuring out what materials and structural designs work best in prostheses for horses, and we're seeing a huge increase in cases of horses surviving and living long, happy lives even after losing a leg!

[expertacademicassignmenthelp]

The Physiology Of The Liver

The liver is a vital organ responsible for numerous functions including metabolism, immunity, digestion, detoxification, and vitamin storage. It weighs around 2% of an adult’s body weight and is unique due to its dual blood supply from the portal vein (75%) and the hepatic artery (25%).

Cellular Structure

The liver’s functional unit is the lobule, which is hexagonal in shape. Each corner of the hexagon has a portal triad consisting of the portal vein, hepatic artery, and bile duct. The lobule is composed mainly of hepatocytes, which have distinct apical and basolateral membranes. Hepatocytes are categorized into three zones based on their function and blood supply:

Zone I (periportal region): Closest to the blood supply, involved in oxidative metabolism (e.g., gluconeogenesis, bile formation).

Zone II (pericentral region): Sits between Zones I and III.

Zone III: Farthest from the blood supply, primarily involved in detoxification and biotransformation.

Blood and bile flow in opposite directions within the liver. The space of Disse, between the hepatocytes and the sinusoidal lumen, contains Kupffer cells (macrophages) and Ito cells (fat-storing stellate cells).

Development

The liver develops from endodermal cells of the foregut as the hepatic diverticulum around the fourth week of embryonic development. It undergoes complex differentiation influenced by various pathways (e.g., Wnt/β-catenin, FGF). By the sixth week, the liver participates in hematopoiesis, and hepatocytes begin bile production by the 12th week.

Organ Systems and Functions

The liver interacts with multiple body systems:

Digestive and Metabolic Roles: Aids in digestion, stores fat-soluble vitamins, and handles cholesterol.

Hematological Functions: Produces clotting factors and proteins.

Detoxification: Metabolizes drugs and other xenobiotics through phase I (oxidation, reduction, hydrolysis) and phase II (conjugation) reactions.

Bilirubin Metabolism: Converts heme to unconjugated bilirubin, then conjugates it for excretion.

Hormonal and Protein Synthesis: Involved in thyroid hormone activation and synthesis of nearly all plasma proteins.

Related Testing

Liver function tests (LFTs), including ALT, AST, bilirubin, alkaline phosphatase, and gamma-glutamyl transpeptidase (GGT), help assess liver health. Imaging techniques like ultrasound, CT, and MRI are also employed to identify liver abnormalities.

Pathophysiology

Cirrhosis results from chronic liver injury (e.g., due to alcoholism, hepatitis B and C), leading to fibrosis and necrosis. It causes symptoms like portal hypertension, coagulopathy, and jaundice. Hepatitis viruses (A, B, C, D, E), autoimmune diseases (e.g., primary biliary cholangitis), and metabolic conditions (e.g., non-alcoholic fatty liver disease) also contribute to liver pathology.

Clinical Significance

Understanding liver physiology helps manage conditions like viral hepatitis, alcoholic liver disease, benign liver lesions, and liver cancers. Early detection through appropriate testing and management strategies is essential for preventing end-stage liver disease and improving patient outcomes

As academic students and researchers navigate the challenges of their assignments and research endeavors, Expert Academic Assignment Help stands ready to provide professional guidance and assistance. Whether you require support with assignment writing, research paper assistance, or essay help, our team of experts is dedicated to helping you achieve academic excellence. Reach out to us today at expertassignment46@gmail.com and let us support you on your academic journey. We wish you success and professional excellence.

[smores100]

time for another rare personal post......i need a liver transplant 🙃

really thought i had hit rock bottom these past hellish months, but i guess there's always lower you can go.

with the disease i have it was always gonna end with a need for a liver transplant, but it was supposed to be several years into the future. but i'm not getting any better, i'm getting worse actually, steroids haven't done shit and i've run out of options. i'm still not at the 'must replace now or die' stage (hope i won't get there either....), but my liver specialist said there's no avoiding it anymore, it must be replaced, so we're slowly starting the process, which means getting my name out there (the transplant center where the magic will happen), meeting up and discussing everything with them whenever they call me in (2 hours away from where i live), doing a shit ton of tests they'll ask of me....gonna be a long process, probably several months minimum, but it's time to start getting the ball rolling so everything will be ready when the time comes.

so. yeah. 2023 is shaping up to be a wonderful year, i'm doing really well mentally and emotionally rn 🙃 anyway. i'm generally a private person but i just felt the need to share and tell someone about this shit, so. thanks for listening to me rambling into the void. good health to you all 💛

[sammyiztalking]

🌙 Day 2 🌙

Breakfast: 286

Lunch: 518

Dinner: 648

Total: 1,434

💬✨Thoughts ✨💬

I fucked up and ate more than yesterday.

Urgh!

Also, today hasn’t been good. I saw my boyfriend mum earlier on. She’s dying from end stage liver disease and keeps getting progressively worse. She barely eats, which triggers me and I’m ngl: it makes me feel guilty.

I’m literally doing this to myself while her illness makes her starve. The doctors haven’t given her long to live and that, plus a plethora of shit too long to list, has made me relapse.

I wore tighter than normal clothing and I just wanted to cry - especially at my thighs. God, I really HATE the way I look right now. All day I kept looking at thinner girls and wishing I could look like them. Be pretty like them.

God dammit. I can’t stand this. The way I feel. It’s shit. It’s weird because I’ve been feeling sad, yet not depressed. It feels odd.

But anyway, here’s hoping my saddle spell ends soon.