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In this episode, we review the high-yield topic of Gastric Secretion from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
The PIVOTAL trial is the world’s first PIC specific Platform trial. It comes hot on the heels of some brilliant UK PIC research, like OxyPICU (PicPod77), and GASTRIC (not published yet, but will definitely have a PicPod soon!). It’s a platform which aims to reduce the life cycle of PIC research from about 10 years from idea to publication, down towards one half, or one third. All UK PICUs have signed up to this. We discuss the ethics, methodology, and statistics (spoiler alert: PicPod65 will help). We go through the aims, and hoped for end points. We discuss each of the three starting arms, (restrictive vs standard fluids, midazolam vs dexmedetomidine or clonidine, and various transfusion thresholds). It’s a study of ambition and huge scope, with an aim of recruiting as many PIC admissions as possible. For UK listeners it’s a must: for those in other countries it’s an example of how PICUs can work together to build a platform like this. Enjoy!
Send us Fan MailWhy are pathology vendors still speaking different image languages when radiology solved that problem decades ago?In this episode of DigiPath Digest #46, I talk through four papers that all point to a bigger issue in digital pathology: we are not only dealing with better algorithms. We are dealing with interoperability, workflow design, explainability, and whether the field is actually ready to use these tools well.I start with DICOM in digital pathology, because I think this is still one of the most important infrastructure questions in the field. Digital pathology has clear value for consultation, image analysis, archival, and workflow, but vendor-specific whole slide image formats still create silos. In the episode, I explain why DICOM matters, why adoption is still low, how the multi-resolution pyramid works, and why this is really about enterprise imaging and future-proofing, not just file conversion. Then I move into kidney transplant rejection, where the paper makes a strong case for multimodal precision diagnostics. Creatinine is late. Antibody testing can miss important biology. Biopsies can miss the area that matters. So the opportunity is not to replace pathology, but to combine biomarkers, biopsy, and machine learning in a way that is more useful than any one signal alone. I also talk about explainability here, because if a model gives a risk score, we need to know what contributed to it. The third paper focuses on perineural invasion in solid tumors, and I liked this one a lot because it shows how AI can help standardize something that is clinically important but still inconsistently detected and reported. Perineural invasion is not just a passive pathway of spread. The biology is more active than that, and the quantification can go far beyond a simple yes-or-no answer. This is a good example of where digital pathology can do something humans cannot realistically do by eye at scale. The last paper is on gastric cancer immunohistochemistry biomarkers and advanced quantification, including HER2, PD-L1, mismatch repair, and CLDN18.2. This section is really about complexity. We are now asking pathologists to visually score biology that is getting harder and harder to summarize consistently, especially when markers, spatial context, and multiplexing all start to matter at once. I make the case that computational pathology is becoming necessary here, not because pathologists are failing, but because the biology is outgrowing purely visual workflows. What ties these four papers together is simple: digital pathology is not only about remote reading anymore. It is about interoperability, quantification, explainable AI, and making pathology more precise in places where the old workflow is reaching its limit. If you are a pathologist, lab leader, or digital pathology trailblazer trying to figure out what actually matters right now, this episode will help you connect the dots.Episode Highlights 07:41 – Why DICOM still matters if we want digital pathology systems to work together. 14:39 – Current adoption of SVS, MRXS, and DICOM, and why DICOM is still lagging. 16:44 – How the DICOM whole slide image pyramid works and why it matters for workflow. 24:29 – Why kidney transplant rejection is still difficult to diagnose with any single marker. 29:18 – Why perineural invasion is clinically important and still inconsistently reported. 34:44 – How AI can quantify tumor-nerve relationships more consistently than visual review alone. 46:39 – Why gastric cancer biomarker scoring is getting too complex for purely visual workflows. 54:55 – Multiplexing, spatial biology, and why explainable AI matters in biomarker interpretation. 01:04:01 – What is really blocking digital pathology adoption: cost, workflow, regulation, or mindset? Resources mentionedDICOM / digital pathology interoperability paper https://pubmed.ncbi.nlm.nih.gov/42093730/Kidney transplant rejection, biomarkers, and artificial intelligence https://pubmed.ncbi.nlm.nih.gov/42073482/Perineural invasion in solid tumors with AI and machine learning applications https://pubmed.ncbi.nlm.nih.gov/42100436/Gastric cancer IHC biomarkers, advanced detection methods, and perspectives https://pubmed.ncbi.nlm.nih.gov/42075555/Digital Pathology Place https://digitalpathologyplace.comDigital Pathology 101 Free PDF book mentioned at the end of the episode through Digital Pathology Place.Support the showGet the "Digital Pathology 101" FREE E-book and join us!
On today's episode, Josh and Michael "advance" in their ongoing GI journey, as Michael continuously insists on saying, to discuss advanced gastric and GOJ cancer. Historically, an orphan disease with a very poor prognosis, perhaps the first rays of light are beginning to shine on this difficult-to-treat cancer type. Immunotherapy has been well established as standard of care, but are there any new agents that are emerging in this space? As always, the answer to that question is "yes," and as usual, the agent in question is trastuzumab deruxtecan. Listen on for all the surprising details, even more awful puns, and a strange tangent about the difference between a "good" and "effective" dictator.Studies discussed in this episode:Checkmate 648/649Destiny-Gastric01For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content. Hosted on Acast. See acast.com/privacy for more information.
From Dialysis to VSG Success | Bariatric Surgery After Kidney Transplant
This week, as we enter our 200th episode, Michael and Josh continue their journey through the alimentary canal, exploring the world of stomach cancer. Gastric cancer has been notoriously difficult to treat, with a thirty-year grace period of multiple trials seeking an appropriate regimen that reduces recurrences while remaining effective. This episode gives you all the answers, and just when we thought everything was settled, immunotherapy enters the fray with MATTERHORN.Studies discussed in this episode:FLOT4-AIOMATTERHORN For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content. Hosted on Acast. See acast.com/privacy for more information.
Gastric health plays a major role in your horse's comfort, behavior, and performance. In this episode, we break down common risk factors, signs of stomach stress, and how management, supplements, and veterinary care all work together to support a healthy horse. Links: Giveaway BlogGiveaway FormHost: Ashlee Lecompte LazicHost: Jenna BoscardinSmartGut Ultra SmartGut SmartGut Ultra Research Feeding Forage Before Exercise Research SmartGI Ultra Slow Feed Hay Bag Slow Feed Round Hay Bag SmartPak Small Hole Hay Net Shires Ball FeederJolly Hay BallLeMeiux Hay BallUlcer Gard
Gut Check: Jacqueline Squire, MD, on Gastric Impacts of MCAS by Gastroenterology Learning Network
Detta är ett fullspäckat frågeavsnitt där vi går igenom allt från magoperationer och näringsupptag till löparknä och hur du egentligen bör hantera smärta i träningen. Vi diskuterar morgonträning och om du verkligen behöver äta innan intervaller – eller om koffein räcker. Dessutom djupdyker vi i kosttillskott: protein, kreatin och vad som faktiskt gör skillnad för en vanlig motionär. Vi tar också upp en aktuell studie kring kolhydratintag under maraton och varför 120 gram per timme kan vara en game changer. Avsnittet rundas av med en viktig diskussion om stress, balans och hur du får ihop träning med livet i stort. Ett praktiskt och nyanserat avsnitt för dig som vill optimera utan att tappa helheten. Tidsschema: 00:00 Intro & snack om OS och maraton 03:25 Fråga: Gastric bypass & näringsupptag 08:00 Fråga: Löparknä – vad göra? 13:40 Fråga: Morgonträning & energiintag 19:15 Fråga: Protein & kreatin för motionärer 24:00 Fråga: Protein före läggdags 30:30 Studie: 60 vs 90 vs 120 g kolhydrater/h 36:15 Fråga: Stress, träning & livspussel 43:00 Praktiska råd: balans, intensitet & hälsa 45:15 Avslutning Mer poddar och artiklar hittar du på Prestera Mera Har du frågor till podden? ställ din fråga på vårt instagramkonto: @presteramerabyumara Värdar Tommy Ivarsson, Fil.mag Biomedicin (M.Sc.)–Specialisering mot mänsklig prestation. tommy@umara.se Simon Gustavsson, Fil.kand Biomedicin (B.Sc.)–Specialisering mot områdena kost och träning. simon@umara.se
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/YYF865. CME/MOC/AAPA/IPCE credit will be available until April 5, 2027.Unifying Surgical-Oncology Expertise in Resectable Gastric/GEJ Malignancies: Leveraging the Evidence on Perioperative Immunotherapy Platforms to Deliver Personalized Care In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
Gastric cancer is often described as a disease in decline, yet it remains one of the deadliest malignancies worldwide. For many GPs, it is a diagnosis that still arrives late, cloaked in vague symptoms and missed opportunities for early intervention. In this episode, Dr Roger Henderson takes a deep, clinically focused look at gastric cancer, from its evolving epidemiology and underlying biology to modern approaches in diagnosis, staging and treatment. He also explores why outcomes differ so dramatically across regions, how molecular insights are reshaping its therapy and what this disease continues to teach us about prevention and early detection.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-199-gastric-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
Featuring perspectives from Dr Haley Ellis, Prof Eric Van Cutsem and Dr Zev Wainberg, moderated by Dr Lionel A Kankeu Fonkoua, including the following topics: Novel immune checkpoint inhibitors (0:00) Gastroesophageal junction cancer (7:36) Gastric cancer (14:52) CME information and select publications
Please visit answersincme.com/HAC860 to participate, download slides and supporting materials, complete the post test, and get a certificate. Presented by Kohei Shitara, MD, PhD. In this activity, an expert in gastrointestinal oncology discusses the latest data for the treatment of gastric and gastroesophageal junction (GEJ) adenocarcinoma. Upon completion of this activity, participants should be better able to: Discuss the latest efficacy and safety data for HER2-directed antibody-drug conjugates in the treatment of gastric and gastroesophageal junction (GEJ) adenocarcinoma; and Translate the latest data for the treatment of gastric and GEJ adenocarcinoma within the context of the current treatment landscape.
In this podcast, experts Manish A. Shah, MD, FASCO; Syma Iqbal, MD; and Haeseong Park, MD, MPH; discuss novel combinations of targeted therapy, immunotherapy, and chemotherapy to treat resectable and unresectable gastroesophageal adenocarcinomas.
In this special episode of The Pet Food Science Podcast Show Equine, celebrating International Women's Month, Dr. Marie-Céline Hottat, Teaching Assistant and Research Associate at Ghent University, explains how gastric ulcers develop in horses and how nutrition and management influence risk and recovery. She clarifies differences between squamous and glandular ulcers, key dietary risk factors, and practical feeding strategies for prevention and support. Learn clear, science-based guidance to improve equine gastric health. Listen now on all major platforms!“The equine stomach has a squamous and a glandular part, and ulcers can occur in both locations, but nutritional management differs depending on where lesions develop.”Meet the guest: Dr. Marie-Céline Hottat is a Diplomate of the European College of Veterinary and Comparative Nutrition and a Teaching Assistant and Research Associate in Animal Nutrition at Ghent University. Her work focuses on equine and companion animal nutrition, with strong expertise in gastric health, obesity, and diet formulation. Liked this one? Don't stop now — Here's what we think you'll love!Don't miss the chance to be part of the Pet Food Inner Circle!Join now and connect with leading experts in pet nutrition: https://petfoodinnercircle.com/What will you learn:(00:00) Highlight(01:15) Introduction(05:15) Ulcer causes(10:32) Feeding risks(16:29) Stress effects(22:09) Diet management(38:26) Final QuestionsThe Pet Food Science Podcast Show is trusted and supported by innovative companies like:* Kemin* Trouw Nutrition- DietForge- Rangen Group- Biorigin
Send us Fan MailPaper Discussed in this AI Journal Club: "Transforming Gastric Biopsy Diagnostics: Integrating Omics Technologies and Artificial Intelligence" by Nasar Alwahaibi, published in the journal Biomedicines.Episode Summary: In this episode, we explore how traditional gastric biopsies are getting a massive, sci-fi-level upgrade. For over a century, diagnostic practice has relied heavily on visual pattern recognition via histomorphology—essentially looking at stained tissue under a brightfield microscope. Today, we discuss the paradigm shift toward data-driven "precision gastroenterology," made possible by merging high-resolution multi-omics technologies with the computational power of artificial intelligence (AI).Key Topics Covered:The Limits of the Status Quo: Traditional microscopic evaluation is foundational but limited. It suffers from interobserver variability (human disagreement), sampling limitations, and an inability to fully capture a tumor's biological complexity or predict how a disease will progress and respond to treatment.The Multi-Omics Revolution: Moving beyond basic static genomics to include transcriptomics, epigenomics, proteomics, and metabolomics provides a comprehensive map of cellular activity—what we call the "active construction site". We highlight a pivotal study by Kamio et al., which demonstrated that knowing a patient's specific TP53 mutation profile (such as the R175H mutation) in early-onset gastric cancer can predict a significantly longer time-to-treatment failure (17.3 months vs. 7.0 months) using oxaliplatin chemotherapy.AI as the Medical Co-Pilot: Deep learning models and convolutional neural networks (CNNs) are transforming both endoscopy and histopathology. For example, an AI-assisted tandem study showed a reduction in gastric neoplasm miss rates from 27.3% to an incredible 6.1%. Furthermore, AI tools have demonstrated the ability to outperform human experts in objectively scoring gastritis severity. However, it is crucial to remember that AI is currently a decision-support tool that still requires human oversight, especially in complex clinical realities.The "Endo-Histo-Omics" Paradigm: We dive into the future of integrated diagnostics, such as the HTML (Highly Trustworthy Multi-omics Learning) framework. This self-adaptive model dynamically tailors its computational architecture to prioritize the most reliable data from a specific sample's unique multi-omics and visual profile.Real-World Roadblocks: Before this becomes the standard of care at your local clinic, the medical field must overcome four main pillars of limitations: AI hurdles (data annotation burdens, black-box models), omics constraints (high costs, tiny biopsy sizes), integration complexity (lack of standardized software frameworks), and ethical/regulatory challenges (data privacy, algorithmic bias, and accountability).Conclusion: The traditional intuition of the pathologist is evolving as we transition toward personalized, multi-omics management. Keep questioning the data, exploring the mechanics of the science, and we will see you on the next episode!Support the showGet the "Digital Pathology 101" FREE E-book and join us!
Glenmark to launch the first generic version of Flovent HFA, expanding affordable access; achondroplasia treatment granted accelerated approval; Dupixent approved for allergic fungal rhinosinusitis; and a swallowable balloon offers a unique outpatient alternative for weight management.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GGF865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2027.Synchronizing Success in Resectable Gastric/GEJ Cancer: Merging Expertise to Effectively Deliver Immunotherapy Platforms in the Surgical Setting In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GGF865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2027.Synchronizing Success in Resectable Gastric/GEJ Cancer: Merging Expertise to Effectively Deliver Immunotherapy Platforms in the Surgical Setting In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GGF865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2027.Synchronizing Success in Resectable Gastric/GEJ Cancer: Merging Expertise to Effectively Deliver Immunotherapy Platforms in the Surgical Setting In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GGF865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2027.Synchronizing Success in Resectable Gastric/GEJ Cancer: Merging Expertise to Effectively Deliver Immunotherapy Platforms in the Surgical Setting In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GGF865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2027.Synchronizing Success in Resectable Gastric/GEJ Cancer: Merging Expertise to Effectively Deliver Immunotherapy Platforms in the Surgical Setting In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/GGF865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2027.Synchronizing Success in Resectable Gastric/GEJ Cancer: Merging Expertise to Effectively Deliver Immunotherapy Platforms in the Surgical Setting In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.
In this episode, Jonathan Yardley, DVM, of The Ohio State University in Columbus, explains what barn managers and horse owners need to know about how veterinarians diagnose and treat gastric ulcers in horses. He describes the difference between squamous and glandular ulcers, the importance of an accurate diagnosis, and how management and feeding tactics can support gastric ulcer treatment.GUESTS AND LINKS - EPISODE 42:Host: Hailey Pfeffer (Kerstetter)Guest: Jonathan Yardley, DVM, of The Ohio State University in ColumbusPlease visit our sponsors, who makes all this possible: Ask TheHorse Live, USRider Equestrian
Dr. Pedro Barata and Dr. Ugwuji Maduekwe discuss the evolving treatment landscape in gastroesophageal junction and gastric cancers, including the emergence of organ preservation as a selective therapeutic goal, as well as strategies to mitigate disparities in care. Dr. Maduekwe is the senior author of the article, "Organ Preservation for Gastroesophageal Junction and Gastric Cancers: Ready for Primetime?" in the 2026 ASCO Educational Book. TRANSCRIPT Dr. Pedro Barata: Hello, and welcome to By the Book, a podcast series from ASCO that features compelling perspectives from authors and editors of the ASCO Educational Book. I'm Dr. Pedro Barata. I'm a medical oncologist at University Hospitals Seidman Cancer Center and an associate professor of medicine at Case Western Reserve University in Cleveland, Ohio. I'm also the deputy editor of the ASCO Educational Book. Gastric and gastroesophageal cancers are the fifth most common cancer worldwide and the fourth leading cause of cancer-related mortality. Over the last decade, the treatment landscape has evolved tremendously, and today, organ preservation is emerging as an attainable but still selective therapeutic goal. Today, I'm delighted to be speaking with Dr. Ugwuji Maduekwe, an associate professor of surgery and the director of regional therapies in the Division of Surgical Oncology at the Medical College of Wisconsin. Dr. Maduekwe is also the last author of a fantastic paper in the 2026 ASCO Educational Book titled "Organ Preservation for Gastroesophageal Junction and Gastric Cancers: Ready for Prime Time?" We explore these questions in our conversations today. Our full disclosures are available in the transcript of this episode as well. Welcome. Thank you for joining us today. Dr. Ugwuji Maduekwe: Thank you, Dr. Barata. I'm really, really glad to be here. Dr. Pedro Barata: There's been a lot of progress in the treatment of gastric and gastroesophageal cancers. But before we actually dive into some of the key take-home points from your paper, can you just walk us through how systemic therapy has emerged and actually allowed you to start thinking about a curative framework and really informing surgery decision-making? Dr. Ugwuji Maduekwe: Great, thank you. I'm really excited to be here and I love this topic because, I'm terrified to think of how long ago it was, but I remember in medical school, one of my formative experiences and why I got so interested in oncology was when the very first trials about imatinib were coming through, right? Looking at the effect, I remember so vividly having a lecture as a first-year or second-year medical student, and the professor saying, "This data about this particular kind of cancer is no longer accurate. They don't need bone marrow transplants anymore, they can just take a pill." And that just sounded insane. And we don't have that yet for GI malignancies. But part of what is the promise of precision oncology has always been to me that framework. That framework we have for people with CML who don't have a bone marrow transplant, they take a pill. For people with GIST. And so when we talk about gastric cancers and gastroesophageal cancers, I think the short answer is that systemic therapy has forced surgeons to rethink what "necessary" really means, right? We have the old age saying, "a chance to cut is a chance to cure." And when I started out, the conversation was simple. We diagnose the cancer, we take it out. Surgery's the default. But what's changed really over the last decade and really over the last five years is that systemic therapy has gotten good enough to do what is probably real curative work before we ever enter the operating room. So now when you see a patient whose tumor has essentially melted away on restaging, the question has to shift, right? It's no longer just, "Can I take this out?" It's "Has the biology already done the heavy lifting? Have we already given them systemic therapy, and can we prove it safely so that maybe we don't have to do what is a relatively morbid procedure?" And that shift is what has opened the door to organ preservation. Surgery doesn't disappear, but it becomes more discretionary. Necessary for the patients who need it, and within systems that can allow us to make sure that we're giving it to the right patients. Dr. Pedro Barata: Right, no, that makes total sense. And going back to the outcomes that you get with these systemic therapies, I mean, big efforts to find effective regimens or cocktails of therapies that allow us to go to what we call "complete response," right? Pathologic complete response, or clinical complete response, or even molecular complete response. We're having these conversations across different tumors, hematologic malignancies as well as solid tumors, right? I certainly have those conversations in the GU arena as well. So, when we think of pathologic CRs for GI malignancies, right? If I were to summarize the data, and please correct me if I'm wrong, because I'm not an expert in this area, the traditional perioperative chemo gives you pCRs, pathologic complete response, in the single digits. But then when you start getting smarter at identifying biologically distinct tumors such as microsatellite instability, for instance, now you start talking about pCRs over 50%. In other words, half of the patients' cancer goes away, it melts down by offering, in this case, immunotherapy as a backbone of that neoadjuvant. But first of all, this shift, right, from going from these traditional, "not smart" chemotherapy approaches to kind of biologically-driven approaches, and how important is pCR in the context of "Do I really need surgery afterwards?" Dr. Ugwuji Maduekwe: That's really the crux of the entire conversation, right? We can't proceed and we wouldn't be able to have the conversation about whether organ preservation is even plausible if we hadn't been seeing these rates of pathologic complete response. If there's no viable tumor left at resection, did surgery add something? Are we sure? The challenge before this was how frequently that happened. And then the next one is, as you've already raised, "Can we figure that out without operating?" In the traditional perioperative chemo era, pathologic complete response was relatively rare, like maybe one in twenty patients. When we go to more modern regimens like FLOT, it got closer to one in six. When you add immunotherapy in recent trials like MATTERHORN, it's nearly triple that rate. And it's worth noting here, I'm a health services-health disparities researcher, so we'll just pause here and note that those all sound great, but these landmark trials have significant representation gaps that limit and should inform how confidently we generalize these findings. But back to what you just said, right, the real inflection point is MSI-high disease where, with neoadjuvant dual-checkpoint blockade, trials like NEONIPIGAS and INFINITY show pCR rates that are approaching 50% to 60%. That's not incremental progress, that's a whole new different biological reality. What does that mean? If we're saying that 50% to 60% of the people we take to the OR at the time of surgery will end up having no viable tumor, man, did we need to do a really big surgery? But the problem right now is the gold standard, I think we would mostly agree, the gold standard is pathologic complete response, and we only know that after surgery. I currently tell my patients, right, because I don't want them to be like, "Wait, we did this whole thing." I'm like, "We're going to do this surgery, and my hope is that we're going to do the surgery and there will be no cancer left in your stomach after we take out your stomach." And they're like, "But we took out my stomach and you're saying it's a good thing that there's no cancer." And yes, right now that is true because it's a measure of the efficacy of their systemic therapy. It's a measure of the biology of the disease. But should we be acting on this non-operatively? To do that, we have to find a surrogate. And the surrogate that we have to figure out is complete clinical response. And that's where we have issues with the stomach. In esophageal cancer, the preSANO protocol, which we'll talk about a little bit, validated a structured clinical response evaluation. People got really high-quality endoscopies with bite-on biopsies. They got endoscopic ultrasounds. They got fine-needle aspirations and PET-CT, and adding all of those things together, the miss rate for substantial residual disease was about 10% to 15%. That's a number we can work with. In the stomach, it's a lot more difficult anatomically just given the shape of people's stomachs. There's fibrosis, there's ulceration. A fair number of stomach and GEJ cancers have diffuse histology which makes it difficult to localize and they also have submucosal spread. Those all conceal residual disease. I had a recent case where I scoped the patient during the case, and this person had had a 4 cm ulcer prior to surgery, and I scoped and there was nothing visible. And I was elated. And on the final pathology they had a 7 cm tumor still in place. It was just all submucosal. That's the problem. I'm not a gastroenterologist, but I would have said this was a great clinical response, but because it's gastric, there was a fair amount of submucosal disease that was still there. And our imaging loses accuracy after treatment. So the gap between what looks clean clinically and what's actually there pathologically remains very wide. So I think that's why we're trying to figure it out and make it cleaner. And outside of biomarker-selected settings like MSI-high disease, in general, I'm going to skip to the end and our upshot for the paper, which is that organ preservation, I would say for gastric cancer particularly, should remain investigational. I think we're at the point where the biology is increasingly favorable, but our means of measurement is not there yet. Dr. Pedro Barata: Gotcha. So, this is a perfect segue because you did mention the SANO, just to spell it out, "Surgery As Needed for Oesophageal" trial, so SANO, perfect, I love the abbreviation. It's really catchy. It's fantastic, it's actually a well-put-together perspective effort or program applying to patients. And can you tell us how was that put together and how does that work out for patients? Dr. Ugwuji Maduekwe: Yeah, I think for those of us in the GI space, we have SANO and then we also have the OPRA for rectum. SANO for the upper GI is what takes organ preservation from theory to something that's clinically credible. The trial asked a very simple question. If a patient with a GEJ adenocarcinoma or esophageal adenocarcinoma achieved what was felt to be a clinical complete response after chemoradiation, would they actually benefit from immediate surgery? And the question was, "Can you safely observe?" And the answer was 'yes'. You could safely observe, but only if you do it right. And what does that mean? At two years, survival with active surveillance was not inferior to those who received an immediate esophagectomy. And those patients had a better early quality of life. Makes sense, right? Your quality of life with an esophagectomy versus not is going to be different. That matters a lot when you consider what the long-term metabolic and functional consequences of an esophagectomy are. The weight loss, nutritional deficiencies that can persist for years. But SANO worked because it was very, very disciplined and not permissive. You mentioned rigor. They were very elegant in their approach and there was a fair amount of rigor. So there were two main principles. The first was that surveillance was front-loaded and intentional. So they had endoscopies with biopsies and imaging every three to four months in the first year and then they progressively spaced it out with explicit criteria for what constituted failure. And then salvage surgery was pre-planned. So, the return-to-surgery pathway was already rehearsed ahead of time. If disease reappeared, take the patient to the OR within weeks. Not sit, figure out what that means, think about it a little bit and debate next steps. They were very clear about what the plan was going to be. So they've given us this blueprint for, like, watching people safely. I think what's remarkable is that if you don't do that, if you don't have that infrastructure, then organ preservation isn't really careful. It's really hopeful. And that's what I really liked about the SANO trial, aside from, I agree, the name is pretty cool. Dr. Pedro Barata: Yeah, no, that's a fantastic point. And that description is spot on. I am thinking as we go through this, where can this be adopted, right? Because, not surprisingly, patients are telling you they're doing a lot better, right, when you don't get the esophagus out or the stomach out. I mean, that makes total sense. So the question is, you know, how do you see those issues related to the logistics, right? Getting the multi-disciplinary team, getting the different assessments of CR. I guess PETs, a lot of people are getting access to imaging these days. How close do you think this is, this kind of program, to be implemented? And maybe I would assume it might need to be validated in different settings, right, including the community. How close or how far do you think you see that being applied out there versus continuing to be a niche program, watch and wait program, in dedicated academic centers? Dr. Ugwuji Maduekwe: I love this question. So I said at the top of this, I'm a health equity/health disparities researcher, and this is where I worry the most. I love the science of this. I'm really excited about the science. I'm very optimistic. I don't think this is a question of "if," I think it's a question of "when." We are going to get to a point where these conversations will be very, very reasonable and will be options. One of the things I worry about is: who is it going to be an option for? Organ preservation is not just a treatment choice, and I think what you're pointing out very rightly is it's a systems-level intervention. Look at what we just said for SANO. Someone needs to be able to do advanced endoscopy, get the patients back. We have to have the time and space to come back every three to four months. We have to do molecular testing. There needs to be multi-disciplinary review. There needs to be intensive surveillance, and you need to have rapid access to salvage surgery. Where is that infrastructure? In this country, it's mostly in academic centers. I think about the panel we had at ASCO GI, which was fantastic. And as we were having the conversation, you know, we set it up as a debate. So folks were debating either pro-surveillance or pro-surgery. But both groups, both people, were presenting outcomes based on their centers. And it was folks who were fantastic. Dr. Molena, for example, from Memorial Sloan Kettering was talking about their outcomes in esophagectomies [during our session at GI26], but they do hundreds of these cases there per year. What's the reality in this country? 70% to 80% to 90%, depending on which data you look at, of the gastrectomies in the United States occur at low-volume hospitals. Most of the patients at those hospitals are disproportionately uninsured or on government insurance, have lower income and from racial and ethnic minority groups. So if we diffuse organ preservations without the system to support it, we're going to create a two-tiered system of care where whether you have the ability to preserve your organs, to preserve bodily integrity, depends on where you live and where you're treated. The other piece of this is the biomarker testing gap. One of the things that, as you pointed out at the beginning, that's really exciting is for MSI-high tumors. Those are the patients that are most likely to benefit from immunotherapy-based organ preservation. But here's the problem. If the patient isn't tested at time of initial diagnosis before they ever see me as a surgeon, the door to organ preservation is closed before it's ever open. And testing access remains very inconsistent across academic networks. And then there's the financial toxicity piece where, for gastrectomy, pancreatectomy, I do peritoneal malignancies, more than half of those patients experience significant financial toxicity related to their cancer treatment. We're now proposing adding at least two years, that's the preliminary information, right? It's probably going to be longer. At least a couple of years of surveillance visits, repeated endoscopies, immunotherapy costs. How are we going to support patients through that? We're going to have to think about setting up navigation support, geographic solutions, what financial counseling looks like. My patient for clinic yesterday was driving to see me, and they were talking about how they were sliding because it was snowing. And they were sliding for the entire three-hour drive down here. Are we going to tell people like that that they need to drive down to, right, I work at a high-volume center, they're going to need to come here every three months, come rain or snow, to get scoped as opposed to the one-time having a surgery and not needing to have the scopes as frequently? My concern, like I said, I'm an optimist, I think it is going to work. I think we're going to figure out how to make it work. I'm worried about whether when we deploy it, we widen the already existing disparities. Dr. Pedro Barata: Gotcha, and that's a fantastic summary. And as I'm thinking also of what we've been talking in other solid tumors, which one of the following do you think is going to evolve first? So we are starting to use more MRD-based assays, which are based on blood test, whether it's a tumor-informed ctDNA or non-informed. We are also trying to get around or trying to get more information response to systemic therapies out of RNA-seq through gene expression signatures, or development of novel therapeutics which also can help you there. Which one of these areas you think you're going to help this SANO-like approach move forward, or you actually think it's actually all of the above, which makes it even more complicated perhaps? Dr. Ugwuji Maduekwe: I think it's going to be all of the above for a couple of reasons. I would say if I had to pick just one right now, I think ctDNA is probably the most promising and potentially the missing piece that can help us close the gap between clinical and pathologic response. If you achieve clinical complete response and your ctDNA is negative, so you have clinical and molecular evidence of clearance, maybe that's a low-risk patient for surveillance. If you have clinical complete response but your ctDNA remains positive, I would say you have occult molecular disease and we probably need intensified therapy, closer monitoring, not observation. I think the INFINITY trial is already incorporating ctDNA into its algorithm, so we'll know. I don't think we're at the point where it alone can drive surgical decisions. I think it's going to be a good complement to clinical response evaluation, not a replacement. The issue of where I think it's probably going to be multi-dimensional is the evidence base: who are we testing? Like, what is the diversity, what is the ancestral diversity of these databases that we're using for all of these tests? How do we know that ctDNA levels and RNA-seq expression arrays are the same across different ancestral groups, across different disease types? So I think it's probably going to be an amalgam and we're going to have to figure out some sort of algorithm to help us define it based on the patient characteristics. Like, I think it's probably different, some of this stuff is going to be a little bit different depending on where in the stomach the cancer is. And it's going to be a little bit more difficult to figure out if you have a complete clinical response in the antrum and closer to the pylorus, for example. That might be a little bit more difficult. So maybe the threshold for defining what a clinical complete response needs to be is higher because the therapeutic approach there is not quite as onerous as for something at the GE-junction. Dr. Pedro Barata: Wonderful. And I'm sure AI, whether it's digitization of the pathology from the biopsies and putting all this together, probably might play a role as well in the future. Dr. Maduekwe, it's been fantastic. Thank you so much for sharing your insights with us and also congrats again for the really well-done review published. For our listeners, thank you for staying with us. Thank you for your time. We will post a link to this fantastic article we discussed today in the transcript of this episode. And of course, please join us again next month on the By the Book Podcast for more insights on key advances and innovations that are shaping modern oncology. Thank you, everyone. Dr. Ugwuji Maduekwe: Thank you. Thank you for having me. Watch the ASCO GI26 session: Organ Preservation for Gastroesophageal and Gastric Cancers: Ready for Primetime? Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Pedro Barata @PBarataMD Dr. Ugwuji Maduekwe @umaduekwemd Follow ASCO on social media: @ASCO on X (formerly Twitter) ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Pedro Barata: Stock and Other Ownership Interests: Luminate Medical Honoraria: UroToday Consulting or Advisory Role: Bayer, BMS, Pfizer, EMD Serono, Eisai, Caris Life Sciences, AstraZeneca, Exelixis, AVEO, Merck, Ipson, Astellas Medivation, Novartis, Dendreon Speakers' Bureau: AstraZeneca, Merck, Caris Life Sciences, Bayer, Pfizer/Astellas Research Funding (Inst.): Exelixis, Blue Earth, AVEO, Pfizer, Merck Dr. Ugwuji Maduekwe: Leadership: Medica Health Research Funding: Cigna
This new mini-series on Behind the Knife will delve into the technical aspects of the Operative Standards for Cancer Surgery, developed through the American College of Surgeons Cancer Research Program. This second episode highlights the thyroid cancer operative standard.Hosts:Tracy Wang, MD, MPH, FACS is a Professor of Surgery and Vice-Chair of Strategic and Professional Development at the Medical College of Wisconsin with a clinical focus on endocrine surgical oncology. Vladmir Neychev, MD, PhD is a Professor of Surgery at the University of Central Florida College of Medicine with a clinical focus on endocrine surgical oncology.Jack Sample, MD (@JackWSample) is a General Surgery Resident at Mayo Clinic Rochester.Guests:Elizabeth Grubbs, MD (@EGrubbsMD) is a Professor of Surgical Oncology at MD Anderson where she specializes in endocrine tumors, with expertise in cancer of the thyroid.David Hughes, MD is a Clinical Associate Professor of Surgery at University of Michigan, where he focuses on surgical diseases of the endocrine system, including a particular focus on the diagnosis and management of papillary thyroid cancer.Learning Objectives: Understand key preoperative and intraoperative aspects of the evaluation and treatment of patients with biopsy-proven papillary thyroid carcinoma (PTC) greater than or equal to 1 cm. Define factors that guide decision making regarding the extent of surgical resection (lobectomy versus total thyroidectomy) for PTC.Links to Papers Referenced in this EpisodeOperative Standards for Cancer Surgery, Volume 2: Thyroid, Gastric, Rectum, Esophagus, Melanomahttps://www.facs.org/quality-programs/cancer-programs/cancer-surgery-standards-program/operative-standards-for-cancer-surgery/purchase/Kindle edition:Amazon.com: Operative Standards for Cancer Surgery: Volume 2, Section 1: Thyroid eBook : Program, American College of Surgeons Clinical Research, Katz, Matthew HG: Kindle StoreImpact of Extent of Surgery on Survival for Papillary Thyroid Cancer Patients Younger Than 45 years. https://pubmed.ncbi.nlm.nih.gov/25337927/ Extent of Surgery Affects Survival for Papillary Thyroid Cancer. https://pubmed.ncbi.nlm.nih.gov/17717441/Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
Oprah Winfrey shared striking insights this week on her experience with Ozempic, a popular drug known as semaglutide for type two diabetes and weight management. On the Today Show on January 21, 2026, the media icon revealed she gained 20 pounds after stopping the medication for nearly a year. She wanted to prove she could maintain her weight through discipline alone, including hiking regularly and exercising up to two hours a day, six days a week. But the weight returned quickly, leading her to resume the injections. Oprah compared it to lifelong blood pressure medicine, saying she has proven to herself that she needs it. A new BMJ study mentioned in the discussion found that people quitting GLP-one drugs like Ozempic regain about four kilograms every month and can recover all lost weight within two years.This personal story aligns with warnings from experts this week. Doctor Andre Teixeira, a bariatric surgeon, told Scripps News that without lifestyle changes, most people regain 67 percent of their weight within two years after stopping these drugs. The medications slow digestion and reduce cravings, but effects fade 30 to 90 days after discontinuation, often worsening prior metabolic issues. Gina Leinninger, a physiology professor at Michigan State University, called them forever drugs in an MSUToday article, noting the body fights to defend higher weights once gained, making sustained loss challenging even with diet and exercise.Meanwhile, legal concerns mount over Ozempic side effects. Lawsuit Information Center reported on January 17, 2026, that Novo Nordisk faces potential mass torts in New Jersey for claims of gastroparesis, or stomach paralysis, and NAION, a vision loss condition. The GLP-one multidistrict litigation now includes over 3,000 cases, with predictions of high value for severe NAION injuries. Gastric emptying studies are key to proving these claims, as symptoms like nausea, vomiting, and bloating can persist without cure.These developments highlight Ozempic's dual role as a powerful weight loss tool and a medication demanding long-term commitment amid emerging risks.Thanks for tuning in, listeners. Please subscribe, come back next week for more, and remember this episode was brought to you by Quiet Please podcast networks. For more content like this, please go to Quiet Please dot Ai.Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.aiThis content was created in partnership and with the help of Artificial Intelligence AI
In this encore episode, we detail connections between H. pylori and hypochlorhydria, while highlighting possible downstream effects on nutrient absorption. We examine how reduced gastric acidity can impair the liberation and assimilation of certain micronutrients, including iron, calcium, vitamin B12, and more; and we further discuss the impact of low stomach acid upon downstream digestive enzyme activation and gut microbial balance. Topics:1. Hypochlorhydria - Low stomach acid.2. H. pylori 3. Gastric Anatomy & Layers- The stomach: hollow, muscular organ for mechanical and chemical digestion.- Regions: Cardia, fundus, body, and pylorus.- Layers: Mucosa, Submucosa, Muscularis externa, Serosa4. Mucosal Layer - Surface mucous cells secrete a thick bicarbonate-rich, protective mucus.- Gastric pits lead to gastric glands, which contain specialized secretory cells.5. Specialized Gastric Cells- Parietal Cells: Secrete hydrochloric acid (HCl) and intrinsic factor (IF).- Chief Cells: Secrete pepsinogen (converted to pepsin by HCl) and gastric lipase.- Role of HCl: Activates pepsin, denatures proteins, and contributes to nutrient absorption.- Intrinsic factor and vitamin B12 absorption.6. Vitamin B12 Absorption- Essential for DNA synthesis, RBC formation, neurological function.- Released from food proteins by gastric acid and pepsin.- Impaired absorption.7. Role of Gastric Acid in Broader Micronutrient Absorption- Absorption of minerals.- Soluble, ionized state.- Iron: HCl aids in preventing insoluble precipitates and supports iron absorption.8. Protective Role of Gastric Acid- Acts as a line of defense against ingested pathogens.- Maintains low microbial diversity in the stomach.- Low HCl and Small Intestinal Bacterial Overgrowth.9. Symptoms of Low Stomach Acid- Bloating, early satiety, excessive belching.- Undigested food in stool, chronic constipation.- May reflect impaired enzymatic activation and digestive insufficiency.10. Conclusion- Multifactorial causes and downstream effects.- Optimal range, neither high nor low.Thank you to our episode sponsor: 1. "Longevity" with Protein, Probiotics, Bovine Colostrum, Collagen, and More. Use code CHLOE for 25% off.*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.Thanks for tuning in!Follow Chloe on Instagram @synthesisofwellnessVisit synthesisofwellness.com
Send us a textShantanu Gaur, CEO of Allurion, returns to the podcast to break down their swallowable inflatable weight loss balloon, how it works, who it is for, how much it is expected to cost, and when patients can realistically expect access.We talk real world weight loss results, safety, availability in the US, and how Allurion fits into the broader obesity treatment conversation alongside GLP-1 medications and bariatric options.This is a clear, no hype discussion for patients who want more tools and better choices in obesity care.More Info:OTPLinks.com
Dr. Ben Sykes is a world leading expert on Equine Gastric Ulcer Syndrome and is actively changing the way we think, talk about, treat, prevent, and manage gastric ulcers in our horses. He has pioneered research on gastric ulcers with a focus on Equine Glandular Gastric Disease and is a well-recognised speaker at numerous conferences around the world on subjects relating to equine health and Equine Gastric Ulcer Syndrome. Dr. Sykes is also a veterinarian with over 28 years of clinical experience and is boarded with the American College of Veterinary Internal Medicine. He graduated from Murdoch University in 1997 before completing an internship at Randwick Equine Centre followed by a residency in Equine Internal Medicine in Virginia, gaining his Diplomate Registration in Large Animal Internal Medicine in 2004. He then spent 7 years in Finland as head of the Equine Hospital at Helsinki University, in private practice, and as a visiting Professor in Equine Medicine and Surgery in Estonia. He has a special interest in equine gastric ulcers, with many peer-reviewed publications to his credit, including being the lead author on the 2015 European College of Equine Internal Medicine Consensus Statement on Equine Gastric Ulcer Syndrome in adult horses. Throughout his career Dr. Sykes has worked with a wide range of horses, focusing on high performance horses in racetrack, breeding, and sport horse settings. In this episode, we discuss - you guessed it - ulcers. Our discussion includes what they are, signs to look for, treatment, prevention, and so much more Connect with Dr. Ben Sykes: Facebook: https://www.facebook.com/benjamin.sykes.5095 Email: b.sykes@protekgi.us
We mock the Victorians for their corsets. The fainting. The deformed ribs. The compressed organs.How barbaric, we think. Thank God we've evolved.And then we strap on a waist trainer and call it “shaping.”In this episode, I'm walking through the modern torture devices—the wraps, the trainers, the vibration plates, and yes, the surgeries that remove organs rather than examine thoughts. Nothing has changed. We just have better marketing.In this episode:* Waist trainers: corsets with Instagram accounts* Body wraps and the lie of “melting inches”* Vibration plates: the $500 illusion of effort* Gastric surgery: when we'd rather remove organs than examine beliefs* Why surgery doesn't reset the thermostat eitherIf this resonates:If you've ever considered an extreme intervention, this episode might save you from a painful mistake. Share it with someone who needs perspective. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit news.weightlossmindset.co
Dr Charlie Andrews talks to Dr Jan Bornschein. Chapters (00:00:02) - Invent(00:00:32) - H. Pylori management(00:01:54) - H. Pylori and stomach cancer(00:07:47) - Diabetes dyspepsia: tests available for non-in(00:15:37) - H. Pylori test in peptic ulcer disease(00:21:58) - H. Pylori in gastroesophageal reflux(00:23:04) - Does helicobacter have a positive effect on reflux?(00:25:11) - H. Pylori disease 7, Parents and children(00:28:36) - H. Pylori management, first line treatment(00:37:25) - Bismuth based quadruple therapy(00:46:32) - Gastric cancer retesting
In this episode, we review the high-yield topic of Esophageal/Gastric Varices from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this video we cover Gastric Cancer / Stomach Cancer, looking at risk factors for it as well as what are the signs and symptoms of Gastric Cancer (with Troisier's sign!). Also includes the most common locations of gastric cancer, how gastric cancer is diagnosed (including staging), and how is gastric cancer treated. PDFs available at: https://rhesusmedicine.com/pages/gastroenterologyFor more medicine videos consider subscribing (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Buy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineVideo Timestamps:0:00 How common is Gastric Cancer0:10 Risk Factors for Gastric Cancer1:07 Where is Gastric Cancer most common? 1:19 Types of Gastric Cancer1:35 Most Common Site of Gastric Cancer (Which part of the stomach is most commonly affected)1:49 Signs and Symptoms of Gastric Cancer (Gastric Cancer Symptoms) 2:39 What is Troisier's Sign? (Virchows Node)2:51 Gastric Cancer Diagnosis3:10 Gastric Cancer Staging4:03 Gastric Cancer Prognosis4:35 Gastric Cancer TreatmentLINK TO SOCIAL MEDIA: https://www.instagram.com/rhesusmedicine/ReferencesWorld Journal of Gastroenterology, 2008. Role of symptoms in diagnosis and outcome of gastric cancer. World Journal of Gastroenterology, 14(8), pp.1149–1155. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690660/. PMCMachlowska, J., Baj, J., Sitarz, M., Maciejewski, R. & Sitarz, R., 2020. Gastric Cancer: Epidemiology, Risk Factors, Classification, Genomic Characteristics and Treatment Strategies. International Journal of Molecular Sciences, 21(11):4012. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312039/. PubMedWikipedia, 2025. Stomach carcinoma / Gastric cancer. [online] Available at: https://en.wikipedia.org/wiki/Stomach_carcinoma.ScienceDirect Topics, 2025. Stomach carcinoma – Medicine and Dentistry. [online] Available at: https://www.sciencedirect.com/topics/medicine-and-dentistry/stomach-carcinoma. ScienceDirectWorld Health Organization (WHO), 2025. Cancer fact sheet. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/cancer.Disclaimer: Please remember this podcast and all content from Rhesus Medicine is for educational and entertainment purposes only and is not a guide to diagnose or to treat any form of condition. The content is not to be used to guide clinical practice and is not medical advice. Please consult a healthcare professional for medical advice.
Safety for children under anesthesia shouldn't depend on luck or location. We walk through 100+ years of progress in pediatric anesthesia and focus on the next wave of innovations that can make first attempts safer, dosing smarter, and systems more reliable—especially for neonates and infants who face the highest risk.We start with the historical milestones that changed outcomes: pulse oximetry, capnography, standardized monitoring, and the rise of pediatric training and ICUs. Then we examine where progress must accelerate. Video laryngoscopy is improving first-pass success and reducing desaturation by giving teams a brighter, shared view of the airway. Ultrasound enhanced by AI promises needle guidance, better vascular access, and more consistent regional anesthesia. Gastric ultrasound could reshape fasting practices, reducing hypotension, nausea, and anxiety while safeguarding against aspiration. Alongside these tools, processed EEG helps tailor volatile agents and propofol to the developing brain, pushing practice from population averages to precision dosing.We also look ahead to artificial intelligence as a connective layer across perioperative care. Think risk stratification in the EHR, early-warning analytics for intraoperative instability, and smarter OR management that reduces cancellations and costs. With expert insights from pediatric anesthesiologist, Dr. Elizabeth Malinzak, we name the real barriers—training, cost, bias, regulation—and stake a claim for proactive safety science over reactive fixes. The goal is equitable, high-quality anesthesia care for every child, in every setting.If this conversation resonates, follow the show, share it with a colleague, and leave a quick review. Your support helps spread practical tools and ideas that keep our smallest patients safe.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/286-pediatric-anesthesia-safety-past-gains-next-frontiers/© 2025, The Anesthesia Patient Safety Foundation
Welcome to the Oncology Brothers podcast! In this episode, we were joined by Dr. Rutika Mehta, a GI medical oncologist from Weill Cornell. Together, we dived into the current treatment landscape for advanced metastatic gastroesophageal junction (GEJ) and gastrointestinal carcinoma, with a special focus on HER2-positive disease. Episode Highlights: • Overview of recent advancements in the treatment of resectable disease, including the approval of Durvalumab in perioperative settings. • Discussion on the importance of biomarker testing, including HER2, PD-L1, MMR, and Claudin 18.2, in determining treatment options. • Insights into frontline treatment strategies for HER2-positive patients, including the role of trastuzumab and the addition of pembrolizumab based on PD-L1 status. • The significance of retesting HER2 expression upon disease progression and the implications for treatment decisions. • Exploration of emerging therapies like TDXd and Zanidatamab, and their potential impact on the treatment landscape. • Considerations for managing side effects and the importance of treatment sequencing in palliative care. Join us for an informative discussion that aims to keep community oncologists up to date in this ever-evolving field of cancer treatment. Follow us on social media: • X/Twitter: https://twitter.com/oncbrothers • Instagram: https://www.instagram.com/oncbrothers • Website: https://oncbrothers.com/ Don't forget to subscribe for more episodes covering treatment algorithms, FDA approvals, and conference highlights! Accreditation/Credit Designation Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Physicians' Education Resource®, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Acknowledgment of Commercial Support This activity is supported by an educational grant from Jazz Pharmaceuticals, Inc. Link to gain CME credits from this activity: https://www.gotoper.com/courses/biomarker-testing-in-her2-gea-diagnosis-and-treatment-implications #HER2GastricCancer #GastricCancer #BiomarkerTesting #OncologyBrothers #GIOncology #CME
*The Texas grain harvest is almost done. *Highly Pathogenic Avian Influenza is showing up in wild birds. *The Texas Wheat Producers Board presented the Texas Wheat Legacy Award to wheat breeder Dr. Jackie Rudd. *Regaining access to China is good news for Texas sorghum growers. *High input costs continue, with fertilizer playing a major role. *Regenerative agriculture is getting a funding boost. *Many Texas soils are acidic. *Gastric ulcers are a major problem in horses.
In this episode of The Oncology Brothers, we dived into the pivotal study of MATTERHORN, which explored the addition of Durvalumab to perioperative FLOT chemotherapy for patients with resectable gastric and gastroesophageal junction adenocarcinoma. Join us as we welcome Dr. Yelena Y. Janjigian, a medical oncologist from Memorial Sloan Kettering and the lead author of the MATTERHORN study. Dr. Janjigian shared insights on the study's design, findings, and the implications for clinical practice, including: • The significance of the study in the context of recent FDA approvals and treatment advancements. • Key survival data, including a three-year overall survival rate of 68.6% with Durvalumab. • The feasibility of combining immunotherapy with chemotherapy and impact on surgical outcomes. • Management of side effects and clinical pearls for practitioners. We also discussed the potential for extrapolating this data to esophageal adenocarcinoma and the role of PD-L1 status in treatment decisions. Whether you're a seasoned oncologist or just starting in the field, this episode is packed with valuable information to help you provide the best care for your patients. Follow us on social media: • X/Twitter: https://twitter.com/oncbrothers • Instagram: https://www.instagram.com/oncbrothers • Website: https://oncbrothers.com/ Don't forget to like, share, and subscribe for more practice-changing updates in oncology! #MATTERHORN #GastricCancer #Immunotherapy #Durvalumab #OncologyBrothers #GIOncology
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/ZSR865. CME/AAPA credit will be available until October 29, 2026.To Glycemia and Beyond: Managing Cardiovascular Risk in People With Type 2 Diabetes Using Incretin-Based Therapies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/ZSR865. CME/AAPA credit will be available until October 29, 2026.To Glycemia and Beyond: Managing Cardiovascular Risk in People With Type 2 Diabetes Using Incretin-Based Therapies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/ZSR865. CME/AAPA credit will be available until October 29, 2026.To Glycemia and Beyond: Managing Cardiovascular Risk in People With Type 2 Diabetes Using Incretin-Based Therapies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.
Fibroblast growth factor receptor 2 isoform IIIb (FGFR2b) is an emerging biomarker present in about 38% of patients with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma. In this episode, CANCER BUZZ speaks with Nataliya Uboha, MD, PhD, a medical oncologist at University of Wisconsin Health, about current recommendations for biomarker testing in this population, emerging biomarkers such as FGFR2b, and how multidisciplinary collaboration can ensure patients receive timely biomarker testing. CANCER BUZZ also interviews Wendi Waugh, BS, RT(R)(T), CMD, ODS, FACCC, administrative director of cancer services and ambulatory infusion at Southern Ohio Medical Center, about care coordination strategies and lessons learned from her team's experience administering biomarker testing. Finally, Kristina A. Matkowskyj, MD, PhD, pathologist at Mayo Clinic, explains the vital role of pathologists in identifying biomarkers and strategies for success in biopsies. "We have to work closely with our pathology colleagues to make sure that all of the tests are done quickly and so that they are readily available by the time the patient is seen in clinic." - Nataliya Uboha, MD, PhD "Tracking, knowing what and when new things come out, being able to mine your data to find those things, I think is going to be uber critical." - Wendi Waugh, BS, RT(R)(T), CMD, ODS, FACCC "I believe that the precision medicine testing that we're doing today... is going to change the face of cancer care." - Wendi Waugh, BS, RT(R)(T), CMD, ODS, FACCC "As a pathologist, if I was able to stress one thing, it would be to collect as many biopsies as is safely possible for that particular patient." - Kristina A. Matkowskyj, MD, PhD Guests: Nataliya Uboha, MD, PhD Medical Oncology University of Wisconsin Health Madison, WI Wendi Waugh, BS, RT(R)(T), CMD, ODS, FACCC Administrative Director of Cancer Services & Ambulatory Infusion Southern Ohio Medical Center Portsmouth, OH Kristina A. Matkowskyj, MD, PhD Pathologist Mayo Clinic Rochester, MN