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Iron and the (fatty) liver
Prof. Antonello Pietrangelo, Hepatology Specialist at the University Modena and Reggio Emilia, Modena, Italy
Thursday, June 20, 2019 · 6:03 p.m. · 40m 10s
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is it uh
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this uh uh one for you wanted to meet an old friend was
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now busy writing but i didn't know if we've been going for years
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jeff also is a great friend of mine so we spend many years uh uh in the with phil
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uh are born with much in the in the in the perfect so
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that's the uh title of my or my subject i run i added for everything
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because of course for vince very much into iraq and the uh and the fact that
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uh i think it is important first of all that the uh we about some
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uh come on uh uh understanding why room uh the problem so we set the scene
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uh some uh let's say a a background on iraq um uh
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and the leader so this is um is scheme as the in
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uh holding for for many as i mean actually is is
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still um uh is the lead to what you see here that
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uh i haven't is mainly a meat i wrote almost is is to support the bone marrow
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so it's very good for our friend uh uh uh uh uh tomato just was not so good at the time
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for the uh uh a pathologist because the labour was just considered reservoir
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for i'm needed higher so i don't know would enter the body you need to
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survive twelve twenty milligram of i'm going to do it every two sides every day
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then i will be will be released in this situation go on and on and on
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so and that it was just a side of higher on the position when you don't need iraq
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in the last three years yeah we had that a
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dramatic a change of our our understanding of all all been
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all this mechanism says that's that's basically the story or wire on a
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um in the past the couple centuries uh if you're interested you can find
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uh this uh uh this publication yeah but just to tell you it is a long story
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made by clinicians by scientists by by kinds bother me a break to was in year two thousand
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with the ire or moan was discovered obscene is that i'm or one
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and uh this is completely change our perception our understandable byron
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metabolism and now uh i'm is really spreading outside the lever
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and many other uh disorders and disease i have now
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uh uh involvement all this new attack that new or more
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and in fact this store is completely changed now uh that's the revenge of the a pathologist
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uh the lever is not at the centre is not only the sight of i'm the
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position much up to use the regulator of all our uh in the body which means that
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each liver disease especially the severe liver disease may affect
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i don't trafficking in the old body and this is very important it is incomplete in your calls
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so uh this is uh uh actually that's a very interesting story is
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uh and uh and the michael but peptide is made by the leader
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uh the saying is in those up we go i in the law
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for the liberal does offer that is that is the fat body again fact
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uh which is important for us to be and the uh in
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my mouse i've seen is made almost all only by the liver
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so the major produces so the me the leader makes argument a lot about and also a lot of obsidian
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like the pack just make insulin it is important to keep in mind this correlation between
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uh the labour hire absent in the time trance good uh a glucose and insulin okay
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so why it had to be called a pack try to control i'm traffic
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the this was that a really a shock for us we could not understand us
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but if you if you go back to your story to evolution
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of our evolution basically and you look here you can see that
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we do means of life so i i is essential for us
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that even more say she's for a bacteria fungi or problems ah
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so uh the first uh a sign of life on her that we're happy because although our cat
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so uh uh the uh the bacteria were able to use i've also for classes to produce energy and
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uh the billions of infection is really i dependent on the ability to get i run
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for all the bacteria from the host so whenever you that
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any infection the pathogen will look for iron in your body
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and try to take out iraq from even the from the proteins
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so i believe it's a a specialist system uh to do so
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well so uh i have seen as no i'm gonna call but peptide
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so why is it is it is so important for us
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to defend ourselves from the but yet because is the gate keeper
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so since i really still important for uh for but tia actually is produced by the leader
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goes to the black and then catch the only important we have but uh in our body
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so the only channel that takes i'm from being tested in into the blah this
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is the best life outside of the exercise or from the macrophages to do that
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so i think we'll go there which patch of reporting which
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is the ira uh important if perot porting would be destroyed
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so is a negative regulator which is me made just to close the gate not too i'm coming in
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so that's two we bought that when a pathogen comes in find our own
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in your body so the consequence of this if if we if we got got this point
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that look here this is very interesting to this is that um the the wind also are basically
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uh uh uh uh the dots or uh uh the messenger ne although i've seen in the lever
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so uh this is actually produce in perry portal area is the
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centre bane which is black but the white dots i'm pretty portal area
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where i was coming from the got of course i rounded he's going
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from the got to deliver to the cells all in get to portray
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there you had a really dramatic expression basically all that's in but you could just challenge
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you'll be there with the uh the the um like a protein up up and sacrifice from
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bacteria look at the what explosion of transcription of the duet so jean which is very sensitive
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to back to the product so is really our gatekeeper and this
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kind of response when you have an infection if this goes on
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on and on i guess to the window disorder code
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and the of chronic disease all and you know all information
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you find this disorder in any condition viral infection infection disease chronic disease in cass
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it all to all the moon uh this or this remote product travis in other
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in uh uh the intestinal disorders so uh
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we're doing the uh i'm thinking for yes
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what is that as possible for any of chronic disease now we know that at the
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end there is possible is a a on x. so when you have too much obscene produce
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uh you wouldn't blockade of of recording so this will lead macrophages to
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store i don't entirety but that uses squishy you you will have little higher
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so your patient had little i don't look custody separation of very high fair eat
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if this goes on and on finally the bone marrow we'll we'll have no i
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want to make a a at the right side story you end up with anita
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so i mean how many chronic disease is due to the interaction of obscene
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from the lever you two into looking six uh uh mainly
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in this uh in the actual we keep i don't away from the blast but also from the bone marrow
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and finally you end up with the very see any condition that we have in our
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chronic patients in fact now there is a lot of you or of interest from the company
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to to block obscene to find that in all the way to
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block at because of course is a big uh uh issue for patients
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so in fact we know that if the pageant found too much i
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don't you have a a really uh increase the lesson for instance it
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uh you have the every c. d. or l. each other infection although uh with
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your c. you know come opposes in dallas email so impatiently at all all i don
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but if if you look at malaria malaria in africa was
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less frequent uh where you have a i one deficient patients
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but when uh the government start to be either supplement patient
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was a disaster because they were getting i want to the kids
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the malaria was really exploding because of this because the pathogen would take advantage
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of this iraq so this just to tell you how much is important for
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for pathogens uh i'm uh in about this isn't into the story going to uh to malaria
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you know many of signal um uh we discovered a disease that
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we call the purporting disease because you to mediation all for put to
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now i found dissipation a specific i only black people
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so all black people from africa at this notation and
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or black americans of course coming from indirectly from africa
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and we could not understand why this was so common in now this paper came up
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in science showing that probably uh i actually
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this invitation will make the microfiche is i'm deficient
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so because the the the the the for reporting you to
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the mutation will it's creek or the time i run out
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so this the microfiche which would be a really mean iron deficient so the plus moulded we found in unfair portable
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situation there i cannot i cannot complete the cycle so the
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people with this notation at an advantage over the other people
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in an area it does get them a selection so that it could be selected over the centuries
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it to be but you know a a protected and that's why this
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uh uh probably uh this notation and spread it through uh the black people
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so that's just to give you an idea but i've seen is produced by the leader is it to you
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uh the issues that as it which is a critical issue actually is a sensitive too many signals
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isn't it should face protein was made to defend us
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so is basically to have any anything any stress situation
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so first of all is sensitive to information about degree to into looking six
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this was our first publication then of course the k. amass cents higher so and
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on the part aside to dry proteins including h. i. v. which i'm sure you know
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which which are important to make i wanna sensitive to the f. c. g. so this is the sensor for right
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more interesting for the discussion today we discovered that that uh your stress
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can uh also in use obscene okay yesterday signal is is uh uh is is
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very common uh and it's been involved in uh basically uh in a in byron disorders
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it in diabetes so in maybe a metabolic a condition and finally we also found that
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a nutrient logo gen x. signal bit things
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together but you had initially resistance can use apps
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so the which means that seem uh that are important for us today which
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are related to the mic about it but we can directly influence apps in okay
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uh that's is the setting of the scene probably many many uh uh
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uh data i uh uh information i can assure you we're much more
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because the the past twenty years wasn't really incredible in terms of discoveries
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but now this it as i was telling us completely changed the story
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let's now go to more to the clinic about which we are
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more familiar with okay so i don't fight and it aborted these orders
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there is the in always this knowledge in the general population we know that all the i'm stores
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associate with uh the development of glucose intolerance back to back to this in us
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men when you knew that no that it is there yet but
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uh usually uh and the uh and elevated uh putting a concentration
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and also in other areas that are being studies in you up in us in in asia
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i prefer eating uh seems to uh associate with the recycled to develop type two diabetes
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so we had been you know a used to this concept
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that high higher or five verity can represent the risk for diabetes
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and uh i'm actually looking at now i run
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an insulin resistance we know that a practical systemic
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i don't overload is the reported in metabolic syndrome or something that he does as i told you
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uh we at the at the many studies showing that i don't access
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will uh uh worsened insulin sensitivity so we did you used to using resistance
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and also in this condition it is beep on induction all the uh all the
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um in and it's so this would be mainly populations obvious or retrospective starts okay
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and uh and then we had some more interesting data that you could
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assume for anything else in my own can increase the risk of diabetes
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so this has been a again a a a publisher study in a um in um
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at three different studies actually uh well then they put in relation
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any but it was very separation and the risk of that it is
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very cool i was it does come back to the baby this a
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a large uh a review a a a systematic review again supported this link
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and even increase director are on or i was horse was associated with a
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higher risk of that it's so there is a lot of all uh we'll
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like that number all studies in that that showing this us all suggesting that i associate
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the last one was the other two's big large studies uh coming from the
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uh um like christy and i ever make a group will show that uh
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in a in a large population uh there yet aimed
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in association uh uh between elevator stereo separation again i run
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impatient barbecues and mortality so now they're association is not uh with the risk of developing the disease but
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to die because of the disease so it was even more uh uh mm important
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so what about our our topic i mean chronic lever chronic liver disease
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uh of course we are used to this concept we have different condition of
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crime use these in which you can find a a i'm fat i'm an indelible
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so i've caught liver disease in ash even uh in chronic especially at sea
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uh i'm going to buy a bad this is this is you can add fart interviewed a you can have some degree of byron
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in your biopsy that's that has been described many uh many years ago
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and that in a nash enough for the from thirty five to fifty percent of people it seems to
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say and they may show some uh a patrick i wonder at the position
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which is never like an incremental this is a minute is a moderate uh as never a ball but
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three agreed you know a great we all the over all i run out of accommodation in the lever
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some studies show that you can have an excellent the progression liver disease in
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h. c. c. nash if you have a this i run at the position
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hi for everything seems also to uh be possibly a predictor all the particle fibrosis
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uh um and the uh especially when the cyrus is in the rate you going
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to do the cells which are the macrophages i mean ethical for sales or pseudo themselves
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since since uh to be even stronger this uh
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association uh would match not this everywhere mostly retrospective studies
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and the and that new start this i basically a a correcting
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some uh some of this uh uh um uh assumption and um
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but even in this case we have a a
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starry a couple years ago showing the integrated super everything
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is associated even with increasing the mortality it in apple be
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uh now now this vision is a viterbi print because new status uh i've been
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a a been down i will show you a more a more controlled studies uh
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uh and uh uh even uh uh studies perspectives that this so this is a but still uh um
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we had a lot about national uh in the liver failed to this issue of what i wanna accommodation
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uh within the area on after the it has been a a
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described in now is recognised this uh this class there of patients
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we operation with unexplained attic iran access the position
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not dramatic about just a modest about the current
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which goes boating depart ascended macrophages easily resistance known permission
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hi seem fair to in order to post any separation these are the most common vision we see
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in our in our outpatient clinic which are those that have some higher uh
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in the lever in the in the large people pick up a should we definitely
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not this patient i've been code this metabolic this syndrome this metabolic are overloads syndrome
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okay or usually resistance associated i'm not overload
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a this is the fraction of patients of the net for the group which seems to be those that
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uh i'm a more common rule it depend on make
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a then i risk of developing lever fibrosis end the um
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which is below server that by uh the french group in a over sixty percent of the cases
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so uh this remote patient the one on the on on which uh we're now focus our uh operation
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and the uh um uh interest when linking i
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run two of chronic liver disease and especially for this
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now i'm in only start with other eye and a half years ago as shown
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a couple years ago very good study actually in a larger number or navigation so we'd better uh
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this high school fair thingy the major the taming of the size
00:18:42
you want verity enough for d. is uh the back to cairo
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so uh uh regardless of the fact is we we see that we
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know that freddy is very nonspecific m. a. uh let's see i marker
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uh all the information on on the crowd ticket event or metabolic it does or this let's do this seems to
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be this association also because uh uh this perfectly we
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have we have a a can a um a everything sorry
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uh putting together for and the sixty a patient would biopsy proven after d.
00:19:15
and coming from two different area uh for uh of
00:19:19
of uh of uh uh uh europe england and uh
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and sicily so extreme area because in this does or does your that made many different
00:19:28
uh many many people is uh because of the
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uh different population which um what uh and it started
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eh because of course uh of viterbi the prince the genetic
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difference between notice out you so we decide to do this study
00:19:44
uh does it was a collaboration we mustn't been sunny group and then uh we support vector and
00:19:50
the uh or what or what bob said i we started associates so not of everything would be about
00:19:55
other parameters um and this is what we found
00:19:59
better thing about i was family twenty five percent so
00:20:04
roughly one third of your patient yeah i don't know uh uh deliver a pretty start
00:20:09
is there was a wider range from fourteen to all of them the two fifty percent
00:20:14
um the most common pattern was uh uh makes it part and
00:20:18
so i don't both in a part two sites and income versus
00:20:22
a a this is also a in agreement with the previous studies so that's
00:20:27
is is being confronted by a a difference that so this is now is established
00:20:32
and uh uh what was interesting uh which was alluded to by a really started but
00:20:38
it makes it part in a bind the position is independent associated to the presence on h.
00:20:43
so uh this was what was found actually uh on the biopsies
00:20:49
and uh uh another it is the uh stories
00:20:52
about the association of carotene still seem unfair eighteen
00:20:56
uh well scorsese associated with the degree of the opposes but did not associate with nash so
00:21:02
you can not pretty uh whether or not you have a nation based on your soon for it
00:21:08
but increasing severity in this patient may be a a suggested all
00:21:12
increasing uh staples at least what uh was founded in this that it
00:21:17
and uh a more interesting it does it become frame with uh with this i was that
00:21:21
was confirmatory of previous that is super idea seemed to increase from f. zero to have to you
00:21:28
so we have at least three studies showing bits and then drops at f. four
00:21:33
when you are at a at this erotic stage so at the overall i mean if you do a
00:21:40
uh the data that i mean that is not the the the in uh absolute association of single parenting
00:21:46
with the fibrosis because all the f. four stage about that if you take each step
00:21:51
uh one by one you can find this kind of all the uh all the relationship
00:21:57
assume for editing usually desire impatient with the party guy room
00:22:01
which is supporting the bit previous study that i should i should buy the group of ryan
00:22:07
especially uh i suggested of all of our topic i
00:22:10
run in the makes it part so apart asides encompasses
00:22:15
the best predictor in our study of ice you felt it was a a a party cairo again
00:22:21
so this was interesting because we have been uh in the past few years
00:22:24
always thinking that i very clean enough for the is in inflammatory uh a parameter
00:22:32
uh as is often a in other condition but uh uh uh according to
00:22:37
our study but also a a pretty study that i showed you paid people were
00:22:41
uh for editing a really in a uh in the station can really
00:22:46
associate with i uh with it but i don't uh uh the position
00:22:50
and maybe maybe uh indicate on it but i haven't uh uh uh the position just a few words on seem fair teen
00:22:58
see you in fact in a is a a very common market uh we will use it in our patient
00:23:03
is made by two uh subunits it at the end is they really uh uh um
00:23:09
the the the the name of this province to keep i run
00:23:13
stored in a way from oxygen so is a protected protein because whenever i'm found oxygen
00:23:19
may uh may start a free radical uh uh reactions so elite to accept under stress
00:23:26
so apparently is being made as a defence it into several system of editing can be secrete it
00:23:31
so we found some parenting is allegedly accounted for
00:23:35
execution by the macrophages okay but can be also released
00:23:39
buy parental must uh may i macrophages so when a macrophages upset makes obsidian
00:23:45
so that's all all always happen in metabolic disorder in inflammatory disorders in cancer
00:23:50
so this heifer everything comes mostly from the macrophages okay um
00:23:57
the again as i said we know that uh for things associated with our overloading okamoto dues you
00:24:03
know that is all about we also know that is very non specific and a racks too many condition
00:24:08
so um eh and we know that is associated with the colleges cancer
00:24:12
that babies with a in general with different components of the metabolic see
00:24:17
so uh i wanna you know conclude of my uh my talk going to a a practical
00:24:24
uh you should know when we see patients we're the station with a um hi sue infrared thing
00:24:29
it's always important uh to do very simple thing to check for trance very
00:24:34
separation okay would you the the level of iron uh uh in the bad usually
00:24:39
how well enough for the initiation are uh in the middle situation high fair to normal
00:24:45
or you below sometimes uh that's very separation you could find very lotus there is a separation in obese patients
00:24:52
sometimes even i mean yeah so the more uh is important uh you do the basic distribution the
00:24:58
more beget iron deficient it this is classic rock but that if you go to the baseline i mean
00:25:05
most all first of all as a clinician you have to roll out the
00:25:08
usual condition that we know associated with high freddy in normal tones very situation
00:25:13
and all we if we're going to base in this or negative you could think to raise situation
00:25:19
and if you don't tell an email so in a normal situation uh you need to have a um
00:25:24
a of course uh in in a ride that tell you the details whether or not
00:25:29
you have a i don't believe or in the screen in the spine in this will help you to differentiate among
00:25:35
re this is a like like a good she disease or the purporting disease that the disease i mentioned to you
00:25:41
or if you don't have any any higher and of course can be in either
00:25:45
a very situation which is a a if i'm in a situation of life everything
00:25:50
and and uh uh no i don't uh uh in the
00:25:53
body this patient father model the sun habit it cataract usually
00:25:58
this is a very very strange but on the other side when you have
00:26:01
a high for editing and heightens the separation of course we know one yeah
00:26:06
again you have to roll out arc or inflammation of the situation and of
00:26:09
course especially in the liver setting you go to the age of feed the testing
00:26:13
and uh you go through the usual uh work out to that
00:26:18
you know was a classical composer or unknown plastic uh and uh incremental
00:26:24
you may yeah that was a situation in which your hi-fi
00:26:28
everything heightens the sense which is associated with i mean yeah
00:26:31
so usually does are a bit the classic him up a logical
00:26:35
at this for a does or the uh as as it would in
00:26:38
effect the uh i mean people use is already a conditional like i
00:26:42
posted in email and other uh for the re uh they re eh
00:26:47
so maybe the work at is the c. of course you are very uh uh in rated
00:26:51
cases a treaty cases uh each page is different from the other but as a general approach
00:26:57
uh i believe this is a very practical and the easy to use
00:27:01
now we go on i don't i'm not sure how much time it maybe
00:27:07
then if i'm okay so just because it's all this uh accommodation
00:27:11
would be able already him and said that a portal several necrosis inflammation
00:27:16
uh you may yeah them polymorphism aldrich iffy over the i would use my
00:27:21
especially as i told you know i've seen can be it's set modulated by factors
00:27:26
so we know for instance then many factors which are imported in in chronic liver disease
00:27:31
uh uh your stress at all due uh h. c.
00:27:34
d. hardcore can directly uh uh talk to the gene
00:27:39
so that they can stimulate or oppress epstein in this of course will change the lead all by ron uh uh
00:27:44
we didn't believe if this is not changed since technically in
00:27:48
this uh this uh i multi band attack accommodate we will
00:27:52
uh can accelerate the liver disease and this is no but the most
00:27:57
important thing is not about the chronically this is bad about about zeros
00:28:01
so you know in staging little disease that to consider that you may
00:28:05
have lost all that simple using liver mass which means not only argument
00:28:10
my also at c. d. in a transparent we not longer be produce
00:28:14
so this expose the patient would sue wrote a cleaver or
00:28:17
end stage liver disease to iron overload without adding heineken bottles
00:28:22
but if you look at the heart you have i don't overload like enable criminals in the station preference but
00:28:28
so that it is important tool i remember this progressive
00:28:32
are also all functional little mass producing apps seem also prosperity
00:28:36
okay and of course all cool enough to to interfere all about all the advances roses
00:28:42
it this can expand the level of iron in the bladder
00:28:45
is so i can uh actually the process that the damage
00:28:49
in the little but also you know the organs and especially
00:28:54
uh this is something uh i really care a lot about as i told you at
00:28:58
my in my uh uh mm uh introduction
00:29:02
this we've created very fair bow situation for pathogens
00:29:06
especially for you call i brought a passion that i had a patient the packages
00:29:10
which are very common your liver diseases in s. p. g. that
00:29:14
is so this can be a really high risk for a four
00:29:18
uh uh because of the infection or for a may favour or
00:29:22
worse and they infection of our case because of ways of course
00:29:27
yeah it is it it has been a a possibly that the
00:29:30
ironic can uh uh interfere with the signalling that all but uh easily
00:29:35
of the sun and settle this would favour as it would you use
00:29:39
wind resistance of course in that sorry in the context of the lever
00:29:46
uh off in the contest all delivered like in national
00:29:49
or international of caloric uh a step apartheid is i run
00:29:54
uh that makes it part of iron the position that we so what is a very common kind of course
00:30:00
have a damaging effect in depart aside to access the rest but i don't go for cell can also october
00:30:07
this site again signal your partridge in response of compresses so made
00:30:11
a a negative effect on the on that a bit on the
00:30:16
uh on the lever is their true very rapidly at least database where suggesting that for about to me was perfect
00:30:23
for that for the bottom was first used uh in any malls play bottom is it was the uh we we was not is
00:30:28
that blood donation would protect from a a deadbeat is risk again
00:30:33
you know the concert you to cairo the way you improve easily sensitivity
00:30:37
eh in seoul this uh uh studies uh started the to use a a been a section
00:30:42
in out patient would never do you realise that is from italy from about include with with with what was
00:30:48
very we're very positive suggest that you soon resistance could
00:30:52
be reduce the enough would be using for the bottom
00:30:56
and this afford is being challenged it or uh we
00:31:00
had a um systematically review showing but probably this wasn't true
00:31:04
and finally uh uh the last paper uh in a couple that we have
00:31:09
to go by the group of being a bit they did a really buried
00:31:13
in a a good start a a year with the uh you know arundel
00:31:16
my starting impatient uh would not be undergoing upper bottoming in found no effect
00:31:23
as compared to the lifestyle change so one group was
00:31:27
the bottom a lifestyle data only lifestyle at the end results
00:31:30
were the same so probably did not added anything after one year of of uh for the bottom so to sum up
00:31:38
chronic liver disease neck company would increase imperative and
00:31:41
a pack and combinations that may affect progression and problems
00:31:45
this has been shown so if you have a little bit of too much
00:31:48
i'm there with other uh energy factors this may accelerate because of the disease
00:31:55
see room for existing process it would increase the park i don't know enough will be would step roses and
00:32:01
five rows it until a priest a prison reduced each not in not in this reduced each
00:32:07
up to one third of our um not for the patient may present a uh increase the part i
00:32:11
am usually makes it part to the makes it part then more frequent uh more frequently associate with nash
00:32:18
for the bottom it does not appear to improve it patrick and metabolic features impatiently does not about a terrible syndrome
00:32:24
however in it basically the disease the loss of a a
00:32:27
practical lever mass may lead to operational local and systemic i download
00:32:32
may aggravate the disease or potentially the risk of a uh infection in our nation
00:32:38
thank you very much for your patient
00:32:47
a a question it's it's
00:32:58
i really i think it's a leash a
00:33:04
fish shoe from a general practitioner me h. t.
00:33:13
it just makes for change huh
00:33:18
yeah i just there's region yeah i don't don't stick suffrage
00:33:24
yeah it's really supposed to fifty four on those who see a fortress she she teach
00:33:32
so i feel sheepish challenge those presentations commie
00:33:37
ten a i assume from adults uh but uh
00:33:45
fifteen fifteen you but we don't sort which research which still
00:33:53
how much legal which teaches crossed additional
00:33:58
it uh carry the uh was i go to city
00:34:03
is not a disease they may is a predisposition to disease
00:34:07
okay first second is very unusual that you apply for editing the notice the separation
00:34:13
because this means that your your patient is uh is bleeding there is
00:34:18
something wrong uh because uh uh that's the situation is the all mark
00:34:23
you don't have class came up with all this without titans participation
00:34:28
so this is this is uh is that i mean the the there must be something that's
00:34:34
so uh it depends i mean that sometimes you find this kind of uh uh of to the situation when you have little
00:34:39
plumbers your patient at the end of it i mean you infer bottom i'm not uh you know if you're patient new patient
00:34:45
uh a master that we know that a translucent result was
00:34:49
up early in the first second the the key than than thirty
00:34:52
after the second that could cause a a goes up so you must have some other reason for that
00:34:57
uh but over the goes it alone i especially on those i
00:35:00
got with a slightly i transfer this is rachel man no ferret
00:35:04
so now it's very difficult to to i mean they are the genetic put a a a pretty
00:35:09
studies shown or told you can screen uh the stalls i mean the tail of of basic issue
00:35:15
but uh we have been discussing this uh in a in different
00:35:18
committees international committees whether or not you should be able to my suspicions
00:35:22
which e. which is an issue uh uh of course amid but
00:35:27
donations would would be perfect if is a nineteen year old man
00:35:31
uh uh uh but in some country you you can do that in my country you you uh
00:35:36
uh you can because the the page is really good with a disease so cannot donate oh i don't
00:35:42
um but but does it can be done in other countries in the in euro
00:35:48
but um yeah that's that's a uh um the recognition in the cage
00:35:56
yes yes yes yes yes
00:36:03
yeah yeah yeah
00:36:08
yeah that's a of course is a very good question there's been a lot of uh
00:36:14
uh uh the excitement of course uh uh in the field that with that with this new
00:36:18
uh and uh uh you warm and uh the the reason
00:36:22
there are now i'm sorry uh let's say reliable uh i say
00:36:27
uh you know say for a for a um actually i'm always
00:36:32
go so when i have to answer this question because it you know
00:36:35
uh as a show you actually need is a very sensitive uh a gene to any kind of stress
00:36:42
so uh you must be very good clinician interpreting that
00:36:46
the data uh so that's that's my major major 'cause
00:36:50
but uh in certain setting can be very useful but i would not run actually in any condition
00:36:56
in all condition because it really can be very tricky the interpretation big is a really extremely sensitive
00:37:03
it's uh you know uh if if you take all iron for one the obscene goes up a fifty times
00:37:09
uh so is really extremely sensitive but also is is sensitive to to bacteria
00:37:14
a tool or stress also told to either a other kind of thing a site occurrence incredibly sensitive
00:37:21
uh but it is a initial so and i'm not sure whether will become routine
00:37:27
uh about the instructor said the same thing the um setting the game useful
00:37:33
very quickly it is but not a study of or a challenge with
00:37:35
current measuring a ups in a this is this it can be uh
00:37:40
uh is the non in this metabolic i recall but look to see whether there was a problem there
00:37:44
and that was a problem as compared to normal person the studies do not again by the volume to group
00:37:51
so in a in a um experimental setting i think there can
00:37:54
be a useful tool but include the settings they'll probably too early
00:38:00
yeah i guess so
00:38:09
i asked you know so if yeah it goes off just
00:38:16
was absolutely absolutely absolutely goes up with that is that is that
00:38:22
'cause if you get this uh test on like the warm hostesses been abused a lapse in the past
00:38:29
from uh actually in the does metabolic situation which gives you also
00:38:32
the the timing if you're interested when you should look good the peak
00:38:39
yes it does
00:38:48
which is
00:38:51
yeah i mean uh uh and uh historically that that the target is been of fifty noted from
00:38:57
of uh of uh for it in the hole and or a a slight an email this was the
00:39:04
uh the uh uh started to no no it is been a scene that if you push too much
00:39:11
you can have a a a feedback effect on the intestine
00:39:16
and then even the more i was absorbed up uh afterwards so uh
00:39:21
uh some group uh started to uh to raise this uh this level
00:39:27
uh but i still speak to the uh to the traditional uh because uh i think there's
00:39:33
you really need to have a a to be sure that i um is out
00:39:37
at that there would be study showing that even adding the uh it's a small increase of those very saturation
00:39:42
still ha at a certain level uh in the station not completely i would the
00:39:47
people will will not eliminate the risk for complications so i think uh uh that's my
00:39:55
sorry
Conference Program
Iron and the (fatty) liver
Prof. Antonello Pietrangelo, Hepatology Specialist at the University Modena and Reggio Emilia, Modena, Italy
June 20, 2019 · 6:03 p.m.
179 views
Celiac Disease and the Liver
Prof. Umberto Volta, Diagnostic Immunopathology, Postgraduate School of Internal Medicine, University of Bologna, Bologna, Italy
June 20, 2019 · 6:54 p.m.
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