Fatty liver disease - warning signs of silent killer one in three of us are already developing

While many of us associate alcohol with liver diseases, there's one insidious condition that experts fear is fast becoming a silent epidemic.

The lesser-known Non-Alcoholic Fatty Liver Disease (or NALFD) is perhaps a hidden illness you have never come across before - and one in three of us are already developing it.

NALFD is a catch-all term for a number of conditions triggered by a build of fat in your liver. The condition isn't caused by alcohol but drinking can make it worse.

Back in 2016, NALFD’s profile skyrocketed after a coroner’s report listed it as among the causes of death for pop superstar George Michael, who passed away at just 53. When this illness merges with other causes of liver ailments (infections such as hepatitis or drinking more than the recommended 14 units a week), it puts liver disease as the biggest killer of adults in their 30s and 40s.

The British Liver Trust chief executive officer Pamela Healy says many don't realise how weight can be a risk factor: “The liver is just as vital an organ as the heart but people often fail to appreciate the importance of keeping it healthy. There are also lots of myths surrounding it.

"For example, many people believe you need to be an alcoholic to develop liver disease, whereas one in five of us are drinking at a level that puts our liver at risk. Many also fail to realise that being overweight is a major risk factor.”

PA Non-Alcoholic Fatty Liver Disease (NALFD) contributed to the death of pop megastar George Michael

Liver disease is mostly preventable, with the organ being highly resilient and the only one in the human body that can regenerate.

So why does carrying a few extra pounds – not even necessarily being obese – raise such a red flag? Basically, a healthy liver should contain little or no fat. Yet poor diet and extra weight means up to one in three people in the UK is now in the early stages of NAFLD.

Essentially this means they already have small amounts of fat in their liver which may not yet be causing them a problem, but as the levels rise will increase the risk of high blood pressure, kidney complaints and diabetes.

Initially the build-up of fat causes no symptoms, but left unchecked can transform into a more serious condition called non-alcohol steatohepatitis, or NASH, where the liver becomes inflamed. As time goes by, this inflammation scars both blood vessels and the liver. The unwitting sufferer would still have no clue as the liver is able to function normally.

The NHS says some people may experience symptoms such as:

• a dull or aching pain in the top right of the tummy (over the lower right side of the ribs),
• extreme tiredness
• unexplained weight loss
• weakness

Problems usually became clear much further down the line once cirrhosis sets in, where years of inflammation causes the liver to get lumpy and reduce in size. At this stage symptoms include:

• yellowing of the skin and the whites of the eyes
• itchy skin
• swelling in the legs, ankles, feet or tummy

The damage is often irreversible and the chances of liver failure and liver cancer increase dramatically.

PA You don't need to be overweight to develop the early stages of Non-Alcoholic Fatty Liver Disease

Because this illness is so creeping and often goes unnoticed, experts stress it is vital to make lifestyle changes earlier in life.

Professor Jonathan Fallowfield, head of liver research at the University of Edinburgh, says “The 5 per cent who get NASH is expected to increase to 7 per cent by 2030.

“By and large most people don’t know they have a fatty liver. These are often people who are thin on the outside and fat on the inside. They tend to carry visceral fat around the abdomen and rarely have any symptoms other than fatigue.”

Prof Fallowfield says although NAFLD is not strictly related to booze, there is a major overlap with liver disease that is caused by alcohol. Essentially, people who drink too much are more likely to have a poor diet and lifestyle.

The professor says the very best treatment for NAFLD is simply to lose weight.

“You only have to lose about 10 per cent of your body weight to reverse it and possibly even reverse liver fibrosis too, boosting your quality of life”, he says.

Reference: Mirror: Paul Speed:

Chagas disease: the parasite that lurks for decades

Chagas disease: the parasite that lurks for decades

Reference: Stars Insider

Virus found in pig heart used in human transplant 

Researchers trying to learn what killed the first person to receive a heart transplant from a pig have discovered the organ harbored an animal virus but cannot yet say if it played any role in the man’s death.

Provided by Associated Press FILE - In this photo provided by the University of Maryland School of Medicine, members of the surgical team show the pig heart for transplant into patient David Bennett in Baltimore on Friday, Jan. 7, 2022. Researchers trying to learn what killed Bennett, the first person to receive a heart transplant from a pig, have discovered signs of an animal virus in the organ but cannot yet say if it played any role in the man’s death. (Mark Teske/University of Maryland School of Medicine via AP, File)

A Maryland man, 57-year-old David Bennett Sr., died in March, two months after the groundbreaking experimental transplant. University of Maryland doctors said Thursday they found an unwelcome surprise — viral DNA inside the pig heart. They did not find signs that this bug, called porcine cytomegalovirus, was causing an active infection.

 Provided by Associated Press FILE - In this photo provided by the University of Maryland School of Medicine, David Bennett Jr., right, stands next to his father's hospital bed in Baltimore, Md., on Jan. 12, 2022, five days after doctors transplanted a pig heart into Bennett Sr., in a last-ditch effort to save his life. Researchers trying to learn what killed Bennett Sr., the first person to receive a heart transplant from a pig, have discovered signs of an animal virus in the organ but cannot yet say if it played any role in the man’s death. (University of Maryland School of Medicine via AP)

But a major worry about animal-to-human transplants is the risk that it could introduce new kinds of infections to people.

Because some viruses are “latent,” meaning they lurk without causing disease, “it could be a hitchhiker,” Dr. Bartley Griffith, the surgeon who performed Bennett’s transplant, told The Associated Press.

Still, development is under way of more sophisticated tests to “make sure that we don’t miss these kinds of viruses,” added Dr. Muhammad Mohiuddin, scientific director of the university’s xenotransplant program.

The animal virus was first reported by MIT Technology Review, citing a scientific presentation Griffith gave to the American Society of Transplantation last month.

For decades, doctors have tried using animal organs to save human lives without success. Bennett, who was dying and ineligible for a human heart transplant, underwent the last-ditch operation using a heart from a pig genetically modified to lower the risk that his immune system would rapidly reject such a foreign organ.

The Maryland team said the donor pig was healthy, had passed testing required by the Food and Drug Administration to check for infections, and was raised in a facility designed to prevent animals from spreading infections. Revivicor, the company that provided the animal, declined to comment.

Griffith said his patient, while very ill, had been recovering fairly well from the transplant when one morning he woke up worse, with symptoms similar to an infection. Doctors ran numerous tests to try to understand the cause, and gave Bennett a variety of antibiotics, antiviral medication and an immune-boosting treatment. But the pig heart became swollen, filled with fluid and eventually quit functioning.

“What was the virus doing, if anything, that might have caused the swelling in his heart?” Griffith asked. “Honestly we don’t know."

The reaction also didn't appear to be a typical organ rejection, he said, noting the investigation still is underway.

Meanwhile doctors at other medical centers around the country have been experimenting with animal organs in donated human bodies and are anxious to attempt formal studies in living patients soon. It’s not clear how the pig virus will affect those plans. 

Reference: Associated Press: By LAURAN NEERGAARD, AP Medical Writer  

Black doctors say they face discrimination based on race

ATLANTA (AP) — Dr. Dare Adewumi was thrilled when he was hired to lead the neurosurgery practice at an Atlanta-area hospital near where he grew up. But he says he quickly faced racial discrimination that ultimately led to his firing and has prevented him from getting permanent work elsewhere.

© Provided by Associated Press Dr. Dare Adewumi poses for a portrait, Tuesday, March 15, 2022, in Atlanta. Adewumi was thrilled when he was hired to lead the neurosurgery practice at Wellstar Cobb Hospital in Austell, Ga., in the Atlanta-area near where he grew up. But he says he quickly faced racial discrimination that ultimately led to his firing and has prevented him from getting permanent work elsewhere. His lawyers and other advocates say he's not alone. (AP Photo/Mike Stewart) 

His lawyers and other advocates say he's not alone, that Black doctors across the country commonly experience discrimination, ranging from microaggressions to career-threatening disciplinary actions. Biases, conscious or not, can become magnified in the fiercely competitive hospital environment, they say, and the underrepresentation of Black doctors can discourage them from speaking up.

“Too many of us are worried about retaliation, what happens when you say something," said Dr. Rachel Villanueva, president of the National Medical Association, which represents Black doctors. “We have scores of doctors that are sending us letters about these same discriminatory practices all the time and seeking our help as an association in fighting that.”

According to the Association of American Medical Colleges, Black doctors made up just 5% of active physicians in the U.S. in 2018, the most recent data available. People who identify as Black alone represent 12.4% of the total U.S. population, according to the 2020 U.S. census. For the 2021-2022 academic year, 8.1% of students enrolled in medical schools identified as Black alone. The medical school association and the National Medical Association in 2020 announced an initiative to address the scarcity of Black men in medicine — they made up only 2.9% of 2019-2020 enrolled students.