Michele Gilbert Popular Books
Michele Gilbert Biography & Facts
Gilbert syndrome (GS) is a syndrome in which the liver of affected individuals processes bilirubin more slowly than the majority. Many people never have symptoms. Occasionally jaundice (a slight yellowish color of the skin or whites of the eyes) may occur. Gilbert syndrome is due to a genetic variant in the UGT1A1 gene which results in decreased activity of the bilirubin uridine diphosphate glucuronosyltransferase enzyme. It is typically inherited in an autosomal recessive pattern and occasionally in an autosomal dominant pattern depending on the type of variant. Episodes of jaundice may be triggered by stress such as exercise, menstruation, or not eating. Diagnosis is based on higher levels of unconjugated bilirubin in the blood without either signs of other liver problems or red blood cell breakdown. Typically no treatment is needed. Gilbert syndrome is associated with decreased cardiovascular health risks. If jaundice is significant phenobarbital may be used, which aids in the conjugation of bilirubin. Gilbert syndrome affects about 5% of people in the United States. Males are more often diagnosed than females. It is often not noticed until late childhood to early adulthood. The condition was first described in 1901 by Augustin Nicolas Gilbert. Signs and symptoms Jaundice Gilbert syndrome produces an elevated level of unconjugated bilirubin in the bloodstream, but normally has no consequences. Mild jaundice may appear under conditions of exertion, stress, fasting, and infections, but the condition is otherwise usually asymptomatic. Severe cases are seen by yellowing of the skin tone and yellowing of the conjunctiva in the eye. Gilbert syndrome has been reported to contribute to an accelerated onset of neonatal jaundice. The syndrome cannot cause severe indirect hyperbilirubinemia in neonates by itself, but it may have a summative effect on rising bilirubin when combined with other factors, for example in the presence of increased red blood cell destruction due to diseases such as G6PD deficiency. This situation can be especially dangerous if not quickly treated, as the high serum bilirubin can cause irreversible neurological disability in the form of kernicterus. Detoxification of certain drugs The enzymes that are defective in GS – UDP glucuronosyltransferase 1 family, polypeptide A1 (UGT1A1) – are also responsible for some of the liver's ability to detoxify certain drugs. For example, Gilbert syndrome is associated with severe diarrhea and neutropenia in patients who are treated with irinotecan, which is metabolized by UGT1A1. While paracetamol (acetaminophen) is not metabolized by UGT1A1, it is metabolized by one of the other enzymes also deficient in some people with GS. A subset of people with GS may have an increased risk of paracetamol toxicity. Cardiovascular effects The mild increase in unconjugated bilirubin due to Gilbert syndrome is closely related to the reduction in the prevalence of chronic diseases, especially cardiovascular disease and type 2 diabetes, related risk factors, and all-cause mortality. Observational studies emphasize that the antioxidant effects of unconjugated bilirubin may bring survival benefits to patients. Several analyses have found a significantly decreased risk of coronary artery disease (CAD) in individuals with GS. Specifically, people with mildly elevated levels of bilirubin (1.1 mg/dl to 2.7 mg/dl) were at lower risk for CAD and at lower risk for future heart disease. These researchers went on to perform a meta-analysis of data available up to 2002, and confirmed the incidence of atherosclerotic disease (hardening of the arteries) in subjects with GS had a close and inverse relationship to the serum bilirubin. This beneficial effect was attributed to bilirubin IXα which is recognized as a potent antioxidant, rather than confounding factors such as high-density lipoprotein levels. This association was also seen in long-term data from the Framingham Heart Study. Moderately elevated levels of bilirubin in people with GS and the (TA)7/(TA)7 genotype were associated with one-third the risk for both coronary heart disease and cardiovascular disease as compared to those with the (TA)6/(TA)6 genotype (i.e. a normal, nonmutated gene locus). Platelet counts and MPV (mean platelet volume) are decreased in patients with Gilbert's syndrome. The elevated levels of bilirubin and decreasing levels of MPV and CRP in Gilbert's syndrome patients may have an effect on the slowing down of the atherosclerotic process. Other Symptoms, whether connected or not to GS, have been reported in a subset of those affected: fatigue (feeling tired all the time), difficulty maintaining concentration, unusual patterns of anxiety, loss of appetite, nausea, abdominal pain, loss of weight, itching (with no rash), and others, such as humor change or depression. But scientific studies found no clear pattern of adverse symptoms related to the elevated levels of unconjugated bilirubin in adults. However, other substances glucuronidized by the affected enzymes in those with Gilbert's syndrome could theoretically, at their toxic levels, cause these symptoms. Consequently, debate exists about whether GS should be classified as a disease. However, Gilbert syndrome has been linked to an increased risk of gallstones. Cause Mutations in the UGT1A1 gene lead to Gilbert Syndrome. The gene provides instructions for making the bilirubin uridine diphosphate glucuronosyltransferase (bilirubin-UGT) enzyme, which can be found in the liver cells and is responsible for preparing bilirubin for removal from the body. The bilirubin-UGT enzyme performs a chemical reaction called glucuronidation. Glucuronic acid is transferred to unconjugated bilirubin, which is a yellowish pigment made when your body breaks down old red blood cells, and then being converted to conjugated bilirubin during the reaction. Conjugated bilirubin passes from the liver into the intestines with bile. It's then excreted in stool. People with Gilbert syndrome have approximately 30 percent of normal bilirubin-UGT enzyme function, which contributes to a lower rate of glucuronidation of unconjugated bilirubin. This substance then accumulates in the body, causing mild hyperbilirubinemia. Genetics Gilbert syndrome is a phenotypic effect, mostly associated with increased blood bilirubin levels, but also sometimes characterized by mild jaundice due to increased unconjugated bilirubin, that arises from several different genotypic variants of the gene for the enzyme responsible for changing bilirubin to the conjugated form. Gilbert's syndrome is characterized by a 70–80% reduction in the glucuronidation activity of the enzyme (UGT1A1). The UGT1A1 gene is located on human chromosome 2. More than 100 polymorphisms of the UGT1A1 gene are known, designated as UGT1A1*n (where n is the general chronological order of discovery), either of the gene itself or of its promoter region. UGT1A1 is associated with a TATA box pr.... Discover the Michele Gilbert popular books. Find the top 100 most popular Michele Gilbert books.
Best Seller Michele Gilbert Books of 2024
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How to Choose a Guy in 10 Days
Lila MonroeThe only thing more hilarious than the movies is… real life?! Fall in love with the sizzling grumpysunshine romantic comedy perfect for fans of Sophie Kinsella and Ali Hazlewood! ...
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Pride and Prejudice
Jane AustenAn Apple Books Classic edition. Jane Austen’s beloved classic opens with this witty and very memorable line: “It is a truth universally acknowledged, that a single man in possessio...
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Hard Love
Peyton BanksHe was football royalty. Legendary quarterback. A champion.  Reiner Strickland had led his team to three national championships and playing a knight in shining armor was a...
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Silver Santa
Lacey SilksTrapped together on Christmas, their unintended onenight stand becomes a lifechanging encounter amidst the snow. Laura Young's professional role as a security guard at the Sil...
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Bewitching a Highlander
Roma CordonDefying all for the love of a bewitching lass. Breena MacRae, a healer from Skye with a touch of witchery in her blood, embarks on a dangerous search for her missing father. She ar...
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Little Women
Louisa May AlcottAn Apple Books Classic edition. Meet the Marches! Louisa May Alcott’s classic introduces us to four unforgettable sisters: beautiful Meg, tomboyish Jo, delicate Beth, and Amy, the ...
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The Honeymoon Homicide
J. R. Mathis & Susan MathisEnjoy this SmallTown Murder Mystery Featuring A Unique Sleuthing Couple I'm Father Tom Greer, a Catholic Priest in a smalltown parish who never expected this . . . When I came...
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The Odyssey
HomerAn Apple Books Classic edition. Homer’s eighthcentury epic poem is a companion to The Iliad . It tells the story of Odysseus, who journeys by ship for 10 years after the Trojan War...
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Once Upon A One-Night Stand
Zoey LockeAt first sight, there was electrifying chemistry.  So why not go for it? After all, Lynx Grove, the city's most eligible bachelor, wants to claim her, at least for th...
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The Art of War
Sun TzuAn Apple Books Classic edition. It’s believed that Sun Tzu wrote this Chinese military primer during the 5th century BChundreds of years before the Bible. The book’s 13 chapters ex...
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Holy Bible
The Church of Jesus Christ of Latter-day SaintsThe 2013 edition of the Holy Bible contains all of the study aids contained in the 1979 edition and includes revisions to the study aids, several new photos, updated maps, and adju...
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Assisting the Bosshole
Kristin MacQueenNo hot water? Check Missed the train? Check Broke my heel? Check Dropped my coffee? Check My first day of my new job can’t possibly go worse, right? Wrong. When I meet Parker Scott...
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Man In The Water
Jon HillAn attempted murder. A missing spouse. And an international conspiracy that could change the world. Jack Green has always been skeptical of socalled facts. Though he's forced ...
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Silenced Girls
Roger Stelljes“ Wow wow wow!  Grips you in a choke hold and  does not let go … Oozes suspense and  bonechilling twists and turns .  Astonishing … One of those...
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Dark Psychology and Manipulation
Margaret MorrisonTHE MENTAL MANIPULATOR WILL NO LONGER KEEP SECRETS FROM YOU! Are you fed up with the wool being pulled over your eyes?Are you prepared to stand up to those who believe they can man...
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The Count of Monte Cristo
Alexandre DumasAn Apple Books Classic edition. Alexandre Dumas’ classic paints a portrait of Edmond Dantès, a dark and calculating man who is willing to wait years to exact his perfect plan for r...
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The Holy Bible - King James Version
King JamesHoly Bible King James Version Few Sample Paragraphs from The Holy Bible eBook, Genesis (OT) 1 Gen. 1 IN the beginning God created the heaven and the earth. 2 And the earth was with...
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Wuthering Heights
Emily BrontëAn Apple Books Classic edition. If you’ve only ever seen Wuthering Heights on screen, you may have an image of Catherine and Heathcliff as the ultimate starcrossed lovers. But that...
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Get Lucky
Lila MonroeFall for the hot and hilarious romcom spin on 'The Hangover', perfect for fans of Tessa Bailey, Ali Hazelwood, and Emily Henry! What happens when you wake up in a hotel s...
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His Own Heaven
Jennie KewWinner of the 2021 Passionate Plume Award for BDSM Romance Finalist in the 2021 Stiletto Contest for Contemporary Romance He taught her to trust, she taught him to love. Lucy Bar...
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Become A Better Version of Yourself
Ben LeightonThis ebook contains golden nuggets on how to motivate, inspire and improve your current situation. It encompasses the holistic view of self improvement from mental& emotion...
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Alpha
Sybil BartelBillionaire. Mercenary. Navy SEAL. The Teams trained me to be a killer. War taught me to be ruthless. Then an illfated mission proved I was human. Combat wounded, cut loose by the ...
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Christmas in Sweetbriar Cove
Melody GraceCelebrate the holidays in Sweetbriar Cove with this festive romance collection, containing two sizzling smalltown holiday stories perfect for fans of Tessa Bailey, Sophie Kinsella...
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Becoming Lady Dalton
Carrie LomaxA dance of desire and deceit... In the glittering world of London's ton, Mrs. Viola Cartwright revels in her newfound freedom as a lady of leisureuntil a series of jewel theft...
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A Bookshop to Die For
M.P. BlackDitching her fiancé at the altar, Alice Hartford bolts to her childhood hometown to reconnect with the last, happy remnant of her past: her mom's old bookstore. But the bookst...
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Nothing to Hide
Scarlett FinnPrize of a lifetime: travel the world with a celebrity billionaire. Come to LA with us, Roxie… It will be so much fun! We have tickets for a latenight talk show! What could possibl...
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Good Guy
Kate MeaderHe's a Special Forces veteran making his pro hockey debut. She's a dogged sports reporter determined to get a scoop. She's also his best friend's widow . . . Fa...
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Always Yours
Claire RayeSome things are just meant to be... Ellen Somerville and Will McIntyre met by accident and under unusual circumstances. Getting sprayed by a skunk in a parking lot wouldn’t normall...
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Escape, A New Life
David J AntocciTo save herself, she had to lose everything. Trapped in a tropical paradise with no memory of how she got there, Abby is thrust into a fight for her life. Hunted by a madman, and c...
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Pretty Little Lies
Ivy ThornFour years ago, Nicolo Marchetti took my innocence. But he left me with something else Nicolo almost took everything from me. My virginity, my reputation, and very nearly my future...
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Salvation
Meghan O'FlynnIf you like mouthy detectives, serial killers, and suspenseful mysteries that don't quit, this chilling and actionpacked hardboiled detective series has you covered! Try this ...
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Saltwater Cove
Amelia AddlerSecond chances...and the secrets that sabotage them. At 48 years old, Margie Clifton never expected to be starting her life all over again. But when her brother gifts her a propert...
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A Green Kind of Witch
Sierra CrossCinderella crossed with Mean Girls.   That's what Hazel's daily existence feels like. Born to a family of elegant yet shallow Beige Witches, seventeen y...
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The Great Gatsby
F. Scott FitzgeraldAn Apple Books Classics edition. The Roaring Twenties are in full effect in F. Scott Fitzgerald’s riveting classic. Manabouttown Jay Gatsby seems to have it all, including loads of...
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Law of Attraction
Jordan HollisHow to Finally Overcome the Hurdles of Manifesting Proven, effective and enjoyable ways to help you manifest faster… Right now, think of something that makes you successful. If you...
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The Seduction Series Boxset
Roxy Sloane“Sensual, thrilling and wild!”   Discover the bestselling series in one collection: THE SEDUCTION, THE BARGAIN, and THE INVITATION. Perfect for fans of Ana Huang, Sierra S...
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School of Potential
W.J. MayUSA Today Bestselling author, W.J. May brings you a continuation of the international bestselling series, The Chronicles of Kerrigan! Come back and enjoy the famous characters, or ...
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Coffee Girl
Sophie SinclairMackenzie "Kiki" Forbes finds herself in a pickle. Either become her snarky sister's nanny, or move halfway across the country to work as assistanttothestylist of a ...
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Peace on Earth
Maia RossCrime never takes a holiday. Why should Irma? Irma Abercrombie is an energetic retiree with a shadowy past, a mean right hook, and a profound love of Christmas. Surrounded by seaso...
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Eternal
W.J. MayShe will fight for what is hers. When the king is murdered, Katerina, his only daughter, must flee for her life. She finds herself on a strange and dangerous path. Alone for the fi...
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My Paper Heart
Magan VernonOne piece of paper can change everything After my parents received the letter I failed out of college, they didn't ask questions. They just sent me to work for my great aunt i...
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Finding Cinderella
Colleen Hoover#1 New York Times bestselling author of It Starts with Us and It Ends With Us writes a free novella about the search for happily ever after. A chance encounter in the dark leads ei...
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Rogue Alpha
Kimber WhiteOne touch made her crave him. But the pull of fate could be the path to ruin. College student Laura Prince lands a plum internship deep in the Michigan wilderness. When she discove...
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The Adventures of Sherlock Holmes
Arthur Conan DoyleAn Apple Books Classic You get not one, not two, but 25 gripping mysteries in Arthur Conan Doyle’s first of five collections of Sherlock Holmes short stories. Follow the brilliant ...
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The Wonderful Wizard of Oz
L. Frank BaumAn Apple Books Classic edition. You’ve seen the iconic 1939 movie, but do you know about the talking field mice, the Winkies, and the Witch of the North that appear in the original...
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Dracula
Bram StokerAn Apple Books Classic edition. Few characters have seized readers’ imaginations quite like Count Dracula of Transylvania, the hero of Bram Stoker’s classic. The 1897 novel put vam...
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Just Me
Lexy TimmsWe all need somewhere where we feel safe… After leaving her abusive husband, Katherine Marshall is out on her own for the first time. She's hopped from city to city to avoid t...
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You Are Kind
Michael GordonA little kindness goes a long way. How can you help encourage your kids to be kind from a young age? Teach kindness to preschoolers Acts of kindness can be fun, easy, and make a ...
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Dream Psychology
Sigmund FreudAn Apple Books Classic edition. Written by the founding father of psychoanalysis, Sigmund Freud’s 1899 book is the definitive text on learning to interpret dreams. Freud’s groundbr...
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The Next Girl
Carla KovachIF YOU ONLY READ ONE BOOK THIS YEAR, MAKE IT THE NEXT GIRL... You thought he’d come to save you. You were wrong. ‘ Absolutely the best thriller I’ve read this year! ’ Goodreads Rev...