Presence and Implications of Sarcopenia in Non-alcoholic Steatohepatitis.

Sarcopenia, defined as the loss of muscle strength, mass, and functionality, confers a poor prognosis in the setting of cirrhosis. Given its clinical significance, a better understanding of the underlying mechanisms leading to cirrhosis, sarcopenia, and their co-occurrence may improve these patients\u27 outcomes. Non-alcoholic steatohepatitis (NASH) shares many of the same etiologies as sarcopenia, including insulin resistance, chronic inflammation, and ectopic adipocyte deposition, which are hallmarks of metabolic syndrome (MS). NASH thus serves as a prime candidate for further exploration into the underlying pathophysiology and relationship between these three conditions. In this review, we discuss the natural history of NASH and sarcopenia, explore the interplay between these conditions in the scope of MS, and seek to better define how an assessment of muscle mass, strength, and functionality in this population is key to improved diagnosis and management of patients with sarcopenia and NASH

Sugar Crash! Time to Insulin Administration in the Emergency Department for Diabetic Ketoacidosis

Project AIM: The time to insulin administration from ordering through JIIP protocol has been delayed in the Emergency Department. We have established a way to store prepared insulin infusions in the Emergency Department so they are readily available for administration. We anticipate to see a decrease in time to administration with our intervention of about 30 minutes