Happy #worldwaterday ! One of my big daily goals is to drink enough water and it's tough! The more that goes in, the more that comes out and I don't have time for that (can anyone else relate? 🙋) I also make it a goal to reduce my direct and indirect water usage and an easy way is by supporting companies that are environmentally aware like @rothys. I'm on my feet all day (bad back = standing desk for the win) and I'm always looking for cute and comfy shoes that will last. I know a lot of you are on your feet all day too so I wanted to share!
Rothys are my absolute fav. They're made of woven recycled water bottles so they reduce waste and mold to your feet (no digging into your heels!) And the best part is that I can throw them into the washing machine and they're like new again. I wear these almost every day and I'm completely hooked (I've had this pair for over a year and they look brand new). They're a little pricey (but cheaper than Tieks which I also have and don't love) but if you want to try them I can send you a code! #reducereuserecycle#environmentallyfriendly#rothys
A elderly woman was diagnosed with IDC (invasive ductal carcinoma) of the left breast. She underwent mastectomy and chemotherapy with aromatase inhibitor. Ten years after the diagnosis, bone metastases were noted. She was treated with capecitabine. Three years after the diagnosis of bone metastasis, PET-CT of the abdomen showed infiltrative hepatic involvement with increased uptake of FDG and a cirrhosis like appearance. Three month after the diagnosis of liver involvement, worsening of the liver function: ALT 81 μ/l, AST 216 μ/l, ALP 481 μ/l. PET-CT was detected pseudocirrhosis with surface nodularity, esophageal varices, ascites, splenomegaly.
Pseudocirrhosis (PC) is a radiological diagnosis describing diffuse hepatic nodularity without histopathological confirmation of cirrhosis.
It is defined by morphological changes that mimic cirrhosis including:
1) capsular retraction
3) parenchyma atrophy
4) caudate lobe hypertrophy
Like in cirrhosis, portal hypertension is often seen in patients with PC.
Breast cancer with liver metastasis treated with chemotherapy is the most commonly reported cause of PC.
1) Response of hepatic tumors to chemotherapy resulting in scarring and capsular retraction.
2) Fibrosis surrounding infiltrating hepatic metastatic masses.
3) Nodular regenerative hyperplasia (NRH) in response to ischemia from chemotherapy-induced hepatic injury.
4) Sinusoidal obstruction with venous obstruction as a result of chemotherapy.
Chemotherapeutic agents associated with the formation of NRH.
PC progresses rapidly compared with 'true' liver cirrhosis.