Resham Ramkissoon, MD
@rayrammd.bsky.social
Transplant Hepatologist at University Hospitals. Assistant Professor of Medicine at CWRU School of Medicine. Interested in all things #LiverSky.
Phenomenal narrative review of SBP prophylaxis by @vinayjaha.bsky.social in @liverfellownetwork.bsky.social.
www.aasld.org/liver-fellow...
Discusses the literature, new and old, and the emerging antibiotic resistance. Certainly something to share with my trainees! @cwruim.bsky.social
www.aasld.org/liver-fellow...
Discusses the literature, new and old, and the emerging antibiotic resistance. Certainly something to share with my trainees! @cwruim.bsky.social
https://aasld.org/liver-fellow-n…
June 22, 2025 at 8:32 PM
Phenomenal narrative review of SBP prophylaxis by @vinayjaha.bsky.social in @liverfellownetwork.bsky.social.
www.aasld.org/liver-fellow...
Discusses the literature, new and old, and the emerging antibiotic resistance. Certainly something to share with my trainees! @cwruim.bsky.social
www.aasld.org/liver-fellow...
Discusses the literature, new and old, and the emerging antibiotic resistance. Certainly something to share with my trainees! @cwruim.bsky.social
Reposted by Resham Ramkissoon, MD
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
We need to work on strategies to 📉 alcohol use in this population! #liversky
Past-month binge drinking among young adult females in 2021-2023 was higher than among males, reversing 2017-2019 patterns, whereas males in other age groups continued to binge and heavy drink at higher rates. https://ja.ma/42pf2V6 #MedSky
Sex-Based Differences in Binge and Heavy Drinking
This cross-sectional study compares differences in binge and heavy drinking among male and female adults in recent years.
ja.ma
April 17, 2025 at 1:42 AM
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
We need to work on strategies to 📉 alcohol use in this population! #liversky
Reposted by Resham Ramkissoon, MD
A practical review of new AGA guidance on PVT management by @drjessicadavis.bsky.social
#liversky
📍don’t delay AC
📍can hold AC for EGD for 48 hours
📍AC does NOT increase risk of bleeding from varices while you wait for EGD
#liversky
📍don’t delay AC
📍can hold AC for EGD for 48 hours
📍AC does NOT increase risk of bleeding from varices while you wait for EGD
April 5, 2025 at 2:00 PM
A practical review of new AGA guidance on PVT management by @drjessicadavis.bsky.social
#liversky
📍don’t delay AC
📍can hold AC for EGD for 48 hours
📍AC does NOT increase risk of bleeding from varices while you wait for EGD
#liversky
📍don’t delay AC
📍can hold AC for EGD for 48 hours
📍AC does NOT increase risk of bleeding from varices while you wait for EGD
Reposted by Resham Ramkissoon, MD
Congrats to Thailand for nearly eliminating vertical transmission of hepatitis B
The vaccine works
doi.org/10.12932/ap-...
The vaccine works
doi.org/10.12932/ap-...
March 31, 2025 at 12:13 AM
Congrats to Thailand for nearly eliminating vertical transmission of hepatitis B
The vaccine works
doi.org/10.12932/ap-...
The vaccine works
doi.org/10.12932/ap-...
The famous "Table 7" from the Gupta et al. paper on surveillance of colon polyps. A paper I refer to regularly in my practice and when teaching fellows. A must-read for all GI trainees. Note the second surveillance intervals.
#GISKY #MedSky @cwruim.bsky.social
pubmed.ncbi.nlm.nih.gov/32044092/
#GISKY #MedSky @cwruim.bsky.social
pubmed.ncbi.nlm.nih.gov/32044092/
March 31, 2025 at 8:23 PM
The famous "Table 7" from the Gupta et al. paper on surveillance of colon polyps. A paper I refer to regularly in my practice and when teaching fellows. A must-read for all GI trainees. Note the second surveillance intervals.
#GISKY #MedSky @cwruim.bsky.social
pubmed.ncbi.nlm.nih.gov/32044092/
#GISKY #MedSky @cwruim.bsky.social
pubmed.ncbi.nlm.nih.gov/32044092/
Great consensus statement about de novo malignancy screening after liver transplant. It also reviews management of immunosuppression with de novo malignancies, including mTOR inhibitors.
#Liversky
journals.lww.com/transplantjo...
#Liversky
journals.lww.com/transplantjo...
De Novo Malignancy After Liver Transplantation: Risk... : Transplantation
- to 3-fold higher in transplant recipients than in age- and sex-matched healthy controls. Long-term immunosuppressive therapy, which is the key in maintaining host tolerance and achieving good long-t...
journals.lww.com
March 23, 2025 at 7:50 PM
Great consensus statement about de novo malignancy screening after liver transplant. It also reviews management of immunosuppression with de novo malignancies, including mTOR inhibitors.
#Liversky
journals.lww.com/transplantjo...
#Liversky
journals.lww.com/transplantjo...
It was a privilege to share and moderate a great case presentation by Dr. Satoi at #LiverRounds with @ohioliver.bsky.social There was a great turnout of hepatologists, fellows, and residents.
March 23, 2025 at 7:49 PM
It was a privilege to share and moderate a great case presentation by Dr. Satoi at #LiverRounds with @ohioliver.bsky.social There was a great turnout of hepatologists, fellows, and residents.
Reposted by Resham Ramkissoon, MD
This is an interesting letter to the editor that highlights the pitfalls of poorly validated ICD-10 codes and confirms my growing concerns with the increasingly popular but alarmingly weak TriNetX database and platform
@zachsmithgi.bsky.social
#gisky #liversky
@zachsmithgi.bsky.social
#gisky #liversky
March 9, 2025 at 1:47 AM
This is an interesting letter to the editor that highlights the pitfalls of poorly validated ICD-10 codes and confirms my growing concerns with the increasingly popular but alarmingly weak TriNetX database and platform
@zachsmithgi.bsky.social
#gisky #liversky
@zachsmithgi.bsky.social
#gisky #liversky
A well-written review of new and established therapies for PBC and PSC that covers:
✅️Drug mechanisms
✅️Clinical trial results/efficacy
✅️Side effects
#Liversky #GiSky
pubmed.ncbi.nlm.nih.gov/39480026/#:~....
✅️Drug mechanisms
✅️Clinical trial results/efficacy
✅️Side effects
#Liversky #GiSky
pubmed.ncbi.nlm.nih.gov/39480026/#:~....
Primary Biliary Cholangitis and Primary Sclerosing Cholangitis Therapy Landscape - PubMed
Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are rare, and chronic cholestatic diseases that can progress to liver failure. The goals of treatment are to halt the progres...
pubmed.ncbi.nlm.nih.gov
March 3, 2025 at 1:19 AM
A well-written review of new and established therapies for PBC and PSC that covers:
✅️Drug mechanisms
✅️Clinical trial results/efficacy
✅️Side effects
#Liversky #GiSky
pubmed.ncbi.nlm.nih.gov/39480026/#:~....
✅️Drug mechanisms
✅️Clinical trial results/efficacy
✅️Side effects
#Liversky #GiSky
pubmed.ncbi.nlm.nih.gov/39480026/#:~....
Reposted by Resham Ramkissoon, MD
There are three reasons why platelets are low in advanced liver disease
Low TPO
Portal hypertension (sequestration)
Immune-related destruction
#liversky
Low TPO
Portal hypertension (sequestration)
Immune-related destruction
#liversky
Case Record of the MGH: A 65-year-old woman was evaluated for back pain and pancytopenia. A peripheral-blood smear was notable for nucleated red cells, large platelets, and immature granulocytes. A diagnosis was made. Full case details: nej.md/4bfXXBf
#MedSky #Oncology
#MedSky #Oncology
March 1, 2025 at 9:11 PM
There are three reasons why platelets are low in advanced liver disease
Low TPO
Portal hypertension (sequestration)
Immune-related destruction
#liversky
Low TPO
Portal hypertension (sequestration)
Immune-related destruction
#liversky
Reposted by Resham Ramkissoon, MD
Our first edition of Tavill Liver rounds is coming up March 5, 2025 at Embassy suites in Independence OH
Look for educational, passionate discussions and great educational content. Come support our trainees from @metrohealthcle.bsky.social @clevelandclinic.bsky.social and university hospitals!
Look for educational, passionate discussions and great educational content. Come support our trainees from @metrohealthcle.bsky.social @clevelandclinic.bsky.social and university hospitals!
Anthony S. Tavill, MD Liver Rounds Registration
app.etapestry.com
February 23, 2025 at 1:53 PM
Our first edition of Tavill Liver rounds is coming up March 5, 2025 at Embassy suites in Independence OH
Look for educational, passionate discussions and great educational content. Come support our trainees from @metrohealthcle.bsky.social @clevelandclinic.bsky.social and university hospitals!
Look for educational, passionate discussions and great educational content. Come support our trainees from @metrohealthcle.bsky.social @clevelandclinic.bsky.social and university hospitals!
Reposted by Resham Ramkissoon, MD
Challenge for #liversky :
Monitoring regression/progression on resmetirom & deciding on alternative treatments
▶️ AASLD provided guidance
▶️ We commented on the role of LSM: doi.org/10.1097/HEP....
‼️ Random variation in LSM >25%
‼️ Consider overall medical benefit (e.g., GLP-1)
Monitoring regression/progression on resmetirom & deciding on alternative treatments
▶️ AASLD provided guidance
▶️ We commented on the role of LSM: doi.org/10.1097/HEP....
‼️ Random variation in LSM >25%
‼️ Consider overall medical benefit (e.g., GLP-1)
February 15, 2025 at 10:49 AM
Challenge for #liversky :
Monitoring regression/progression on resmetirom & deciding on alternative treatments
▶️ AASLD provided guidance
▶️ We commented on the role of LSM: doi.org/10.1097/HEP....
‼️ Random variation in LSM >25%
‼️ Consider overall medical benefit (e.g., GLP-1)
Monitoring regression/progression on resmetirom & deciding on alternative treatments
▶️ AASLD provided guidance
▶️ We commented on the role of LSM: doi.org/10.1097/HEP....
‼️ Random variation in LSM >25%
‼️ Consider overall medical benefit (e.g., GLP-1)
The correct term is conjunctival icterus.
The expression "scleral icterus" was previously and incorrectly perpetuated. See this scathing remark in @jama.com by an ophthalmologist.
jamanetwork.com/journals/jam...
#Liversky #GiSky #Medsky @cwruim.bsky.social
The expression "scleral icterus" was previously and incorrectly perpetuated. See this scathing remark in @jama.com by an ophthalmologist.
jamanetwork.com/journals/jam...
#Liversky #GiSky #Medsky @cwruim.bsky.social
'Conjunctival Icterus,' Not 'Scleral Icterus'
To the Editor.—
The expression "scleral icterus" generally used by physicians is grossly incorrect. For decades, physical diagnosis primers have cued medical students to look for "scleral icterus...
jamanetwork.com
February 13, 2025 at 1:39 AM
The correct term is conjunctival icterus.
The expression "scleral icterus" was previously and incorrectly perpetuated. See this scathing remark in @jama.com by an ophthalmologist.
jamanetwork.com/journals/jam...
#Liversky #GiSky #Medsky @cwruim.bsky.social
The expression "scleral icterus" was previously and incorrectly perpetuated. See this scathing remark in @jama.com by an ophthalmologist.
jamanetwork.com/journals/jam...
#Liversky #GiSky #Medsky @cwruim.bsky.social
Great review of hemangiomas, FNH, & more by @renumathyd.bsky.social! I encourage all learners to read the classic imaging features.
✅️Review the imaging yourself
✅️Follow up if >5cm
✅️Biopsy for atypical appearance
journals.lww.com/hepcomm/fullte…
@jhepatology.bsky.socia#Liverskyk#GITwitterer
✅️Review the imaging yourself
✅️Follow up if >5cm
✅️Biopsy for atypical appearance
journals.lww.com/hepcomm/fullte…
@jhepatology.bsky.socia#Liverskyk#GITwitterer
https://journals.lww.com/hepcomm/fullte…
February 11, 2025 at 1:39 AM
Great review of hemangiomas, FNH, & more by @renumathyd.bsky.social! I encourage all learners to read the classic imaging features.
✅️Review the imaging yourself
✅️Follow up if >5cm
✅️Biopsy for atypical appearance
journals.lww.com/hepcomm/fullte…
@jhepatology.bsky.socia#Liverskyk#GITwitterer
✅️Review the imaging yourself
✅️Follow up if >5cm
✅️Biopsy for atypical appearance
journals.lww.com/hepcomm/fullte…
@jhepatology.bsky.socia#Liverskyk#GITwitterer
Great case-based review of acute pancreatitis in @AmJGastro.
Remember:
✅️Classic pain + Lipase >3x ULN = Dx
✅️CT isn't always needed
✅️Early, goal-directed fluids! ⬇️BUN ⬇️HGB ⬆️UOP
✅️Early nutrition
pubmed.ncbi.nlm.nih.gov/38857482/
#GISky #MedSky
@cwruim.bsky.social
Remember:
✅️Classic pain + Lipase >3x ULN = Dx
✅️CT isn't always needed
✅️Early, goal-directed fluids! ⬇️BUN ⬇️HGB ⬆️UOP
✅️Early nutrition
pubmed.ncbi.nlm.nih.gov/38857482/
#GISky #MedSky
@cwruim.bsky.social
February 9, 2025 at 8:21 PM
Great case-based review of acute pancreatitis in @AmJGastro.
Remember:
✅️Classic pain + Lipase >3x ULN = Dx
✅️CT isn't always needed
✅️Early, goal-directed fluids! ⬇️BUN ⬇️HGB ⬆️UOP
✅️Early nutrition
pubmed.ncbi.nlm.nih.gov/38857482/
#GISky #MedSky
@cwruim.bsky.social
Remember:
✅️Classic pain + Lipase >3x ULN = Dx
✅️CT isn't always needed
✅️Early, goal-directed fluids! ⬇️BUN ⬇️HGB ⬆️UOP
✅️Early nutrition
pubmed.ncbi.nlm.nih.gov/38857482/
#GISky #MedSky
@cwruim.bsky.social
Must-read concise and case-based review of #AIH and therapies published in AJG
✅️Identify the AIH phenotype
✅️Pred+MMF could be >Pred+AZA
✅️Beware! MMF teratogenicity
✅️Tacro troughs: 6-8, then 3-5
#LiverSky #GiSky #MedSky
@cwruim.bsky.social
journals.lww.com/ajg/citation...
✅️Identify the AIH phenotype
✅️Pred+MMF could be >Pred+AZA
✅️Beware! MMF teratogenicity
✅️Tacro troughs: 6-8, then 3-5
#LiverSky #GiSky #MedSky
@cwruim.bsky.social
journals.lww.com/ajg/citation...
Autoimmune Hepatitis and the Pathways and Targets for... : Official journal of the American College of Gastroenterology | ACG
An abstract is unavailable.
journals.lww.com
February 2, 2025 at 6:24 PM
Must-read concise and case-based review of #AIH and therapies published in AJG
✅️Identify the AIH phenotype
✅️Pred+MMF could be >Pred+AZA
✅️Beware! MMF teratogenicity
✅️Tacro troughs: 6-8, then 3-5
#LiverSky #GiSky #MedSky
@cwruim.bsky.social
journals.lww.com/ajg/citation...
✅️Identify the AIH phenotype
✅️Pred+MMF could be >Pred+AZA
✅️Beware! MMF teratogenicity
✅️Tacro troughs: 6-8, then 3-5
#LiverSky #GiSky #MedSky
@cwruim.bsky.social
journals.lww.com/ajg/citation...
Prednisolone for alcohol associated hepatitis? Literature suggests waiting ~1 week before starting. Here's reasons I avoid it:
⛔️Infection
⛔️GI Bleeding
⛔️Renal failure
⛔️Critical illness
⛔️Noncompliance
journals.lww.com/hep/abstract/9…#LiverSkyk#GiSkyk#MedSkyky
⛔️Infection
⛔️GI Bleeding
⛔️Renal failure
⛔️Critical illness
⛔️Noncompliance
journals.lww.com/hep/abstract/9…#LiverSkyk#GiSkyk#MedSkyky
https://journals.lww.com/hep/abstract/9…
February 2, 2025 at 5:57 PM
Prednisolone for alcohol associated hepatitis? Literature suggests waiting ~1 week before starting. Here's reasons I avoid it:
⛔️Infection
⛔️GI Bleeding
⛔️Renal failure
⛔️Critical illness
⛔️Noncompliance
journals.lww.com/hep/abstract/9…#LiverSkyk#GiSkyk#MedSkyky
⛔️Infection
⛔️GI Bleeding
⛔️Renal failure
⛔️Critical illness
⛔️Noncompliance
journals.lww.com/hep/abstract/9…#LiverSkyk#GiSkyk#MedSkyky
A citywide collaboration with @clevelandclinic.bsky.social, @UniversityHospitals, and @metrohealthcle.bsky.social to promote knowledge and liver health.
Check out the link for the 2025 program calendar!
mailchi.mp/170574b9a487...
#Liversky #GiSky #Medsky
@livermd.bsky.social
Check out the link for the 2025 program calendar!
mailchi.mp/170574b9a487...
#Liversky #GiSky #Medsky
@livermd.bsky.social
NEOLA in the 2025!
mailchi.mp
February 1, 2025 at 10:25 PM
A citywide collaboration with @clevelandclinic.bsky.social, @UniversityHospitals, and @metrohealthcle.bsky.social to promote knowledge and liver health.
Check out the link for the 2025 program calendar!
mailchi.mp/170574b9a487...
#Liversky #GiSky #Medsky
@livermd.bsky.social
Check out the link for the 2025 program calendar!
mailchi.mp/170574b9a487...
#Liversky #GiSky #Medsky
@livermd.bsky.social
Beautiful sunset after a productive afternoon in transplant clinic. @UHhospitals @SeidmanCancerCenter
January 29, 2025 at 10:02 PM
Beautiful sunset after a productive afternoon in transplant clinic. @UHhospitals @SeidmanCancerCenter
Reposted by Resham Ramkissoon, MD
ACG is proud to be hosting a summit on AI in GI, covering responsible, practical, and sustainable applications to improve clinical practice and patient outcomes.
Thanks to our many experts and innovators for helping shape the future of AI in our field! #AIinGI #GastroSky
Thanks to our many experts and innovators for helping shape the future of AI in our field! #AIinGI #GastroSky
January 24, 2025 at 9:54 PM
ACG is proud to be hosting a summit on AI in GI, covering responsible, practical, and sustainable applications to improve clinical practice and patient outcomes.
Thanks to our many experts and innovators for helping shape the future of AI in our field! #AIinGI #GastroSky
Thanks to our many experts and innovators for helping shape the future of AI in our field! #AIinGI #GastroSky
journals.lww.com/hepcomm/full...
Great review covering risk factors for #HCC:
✅️ HBV is the #1 cause of HCC
✅️ Aflatoxin and its expanding contamination with #GlobalWarming
✅️ Vinyl chloride is associated with HCC and angiosarcomas
✅️ Others like pollution, arsenic, T2DM
#LiverSky #GISky #MedSky
Great review covering risk factors for #HCC:
✅️ HBV is the #1 cause of HCC
✅️ Aflatoxin and its expanding contamination with #GlobalWarming
✅️ Vinyl chloride is associated with HCC and angiosarcomas
✅️ Others like pollution, arsenic, T2DM
#LiverSky #GISky #MedSky
January 28, 2025 at 2:11 AM
journals.lww.com/hepcomm/full...
Great review covering risk factors for #HCC:
✅️ HBV is the #1 cause of HCC
✅️ Aflatoxin and its expanding contamination with #GlobalWarming
✅️ Vinyl chloride is associated with HCC and angiosarcomas
✅️ Others like pollution, arsenic, T2DM
#LiverSky #GISky #MedSky
Great review covering risk factors for #HCC:
✅️ HBV is the #1 cause of HCC
✅️ Aflatoxin and its expanding contamination with #GlobalWarming
✅️ Vinyl chloride is associated with HCC and angiosarcomas
✅️ Others like pollution, arsenic, T2DM
#LiverSky #GISky #MedSky
Reposted by Resham Ramkissoon, MD
💡PEth gets another win!
Compared to previously used non-invasive tests in differentiating MetALD from MASLD
#liversky
onlinelibrary.wiley.com/doi/abs/10.1...
Compared to previously used non-invasive tests in differentiating MetALD from MASLD
#liversky
onlinelibrary.wiley.com/doi/abs/10.1...
Head‐to‐Head Comparison Between Phosphatidylethanol Versus Indirect Alcohol Biomarkers for Diagnosis of MetALD Versus MASLD: A Prospective Study
Using a well-phenotyped prospective cohort with systematic assessment through MRI-PDFF, MRE, and PEth testing, this study demonstrates that PEth is an accurate, quantitative, objective alcohol biomar...
onlinelibrary.wiley.com
January 27, 2025 at 5:19 PM
💡PEth gets another win!
Compared to previously used non-invasive tests in differentiating MetALD from MASLD
#liversky
onlinelibrary.wiley.com/doi/abs/10.1...
Compared to previously used non-invasive tests in differentiating MetALD from MASLD
#liversky
onlinelibrary.wiley.com/doi/abs/10.1...