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Gi doctor with interests in endoscopy, gut health, liver & medicine in general.
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American Association of Clinical Endocrinology Clinical Practice
Guideline on Pharmacologic Management of Adults
With Dyslipidemia. September 2024
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🔆How to take duodenal biopsies for coeliac disease:
✅ 4x D2 biopsies
✅ 2x D1 biopsies
✅ D1 biopsy from 9 and 12 o’clock
✅ Single bites (less distortion)
✅ Separate pots - D1 has more Brunner’s glands and shorter villi
✅ Should be on gluten
From this prospective cohort study of 77 patients.
“There is no obvious explanation as to why villous atrophy is more severe in the 9- and 12-o'clock positions of the duodenal bulb; however, a plausible argument could be that these sites are the most exposed areas subjected to gluten because food traverses the duodenal bulb into the second part of the duodenum”
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Lifestyle Intervention Effects on Blood Pressure
1️⃣ Regular exercise: 4/8mmHg
2️⃣ Reduced alcohol intake: 4mmHg
3️⃣ Weight loss: 5mmHg
4️⃣ Reduced sodium intake: 5/6mmHg
5️⃣ Increased potassium intake: 3/4mmHg
These lifestyle changes led to:
1) 15% reduction in all-cause mortality
2) 25% reduction in stroke risk
3) 30% reduction in heart failure risk
