Podcasts about GI

This week, Giovanna is joined by adventurer and explorer Steve Backshall Steve and Gi catch up on family life as he reflects on his childhood and how it shaped the person he is today. He also opens up about his wife Helen's inspiring journey training for the Tokyo Olympics just months after giving birth, and of course, there are plenty of tales from his iconic adventures along the way.LEGO® Education has launched four innovative STEM sets for young builders aged 7+, championed by explorer Steve Backshall. These sets turn children's big 'Why?' questions into hands-on, independent scientific discovery. Available today via select LEGO Stores and LEGO.com/LEGOEducation Hosted on Acast. See acast.com/privacy for more information.

This week we sit down with Dr. Claire Brandon, one of only a handful of GI psychiatrists in the country, to talk about something most of us learned in med school and then promptly never thought about again: the gut-brain axis. Why does stress wreck your stomach?Why do chronic GI conditions come with anxiety and depression attached?Why does “it's all in your head” miss the point entirely? We talk about serotonin living in your intestines, inflammation affecting mood, why doctors struggle with gray areas, and how radical acceptance might actually be more powerful than another test. We also get into what happens when medicine can't “see” the problem and why that makes everyone uncomfortable. Then, in true Knock Knock Hi fashion, we pivot from neuroscience to fecal transplants… and somehow land on a heated (but respectful) discussion about whether people should have kids. Takeaways: Your Brain and Gut Were Connected From Day One: Literally from embryology. This isn't a trendy concept. It's foundational biology we're finally paying attention to. Inflammation Doesn't Stop at the Intestines: Autoimmune conditions, chronic GI disease, and mood disorders are more intertwined than most patients (and doctors) realize. Invisible Symptoms Create Real Anxiety: When medicine can't “see” the pathology, everyone feels unsettled, including physicians. More Testing Isn't Always the Answer: Sometimes decreasing hyper-focus on symptoms can actually reduce suffering. The Gut Microbiome Is Just Getting Started: From depression to Parkinson's research, we're only beginning to understand how bacteria influence the brain. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Could an enzyme deficiency explain why you have food intolerances causing bloating, loose bowels, reflux, brain fog, joint pain, skin issues, and more? Namely, sucrase isomaltase.   This enzyme, known as the sucrase-isomaltase enzyme, may be deficient in many people dealing with chronic GI issues. One study found that 8% of people were at an increased genetic risk for this deficiency (https://jpedres.org/articles/frequency-of-congenital-sucrase-isomaltase-deficiency-by-whole-exome-sequencing-is-it-really-rare/doi/jpr.galenos.2024.65625?utm_). Another study found that 25% with chronic GI symptoms had issues breaking down sucrose (https://pubmed.ncbi.nlm.nih.gov/36304608/).   Thankfully, a diet exists for this which has been studied and shown to be very effective. In fact, it's been shown to be as or even more effective than some of the best diets we currently have for improving gut health – therefore maybe the best diet for gut health?   Let's break down what this enzyme deficiency is, what the diet is, SSRD, and how this diet applies and can be helpful even for those with underlying fungal or bacterial overgrowth and leaky gut.  

Why You Should Listen:  In this episode, you will learn about the role of Supportive Oligonucleotide Therapy, or SOT, in the treatment of Lyme disease and vector-borne infections. About My Guest: My guest for this episode is Dr. Clayton Bell.  Clayton Bell, MD is a leading integrative and functional medicine physician dedicated to helping patients achieve deep, lasting wellness.  Dr. Bell works with Lyme and vector-borne infections, integrative cancer support, environmental medicine including mold, mycotoxins, heavy metals, and detoxification; hormones, cardiometabolic and GI health, and mind-body balance.  Combining his Western medical training with functional, integrative, environmental, and Ayurvedic approaches, he focuses on uncovering the root causes of health concerns.  Patients benefit from personalized, whole-person treatment plans that empower the body's natural healing ability and support sustainable wellness from the inside out.  Dr. Bell provides online consultations that offer accessible, holistic care tailored to each individual's needs. Key Takeaways: What place does SOT have in the treatment arsenal for chronic Lyme disease? What is AOT or Antisense Oligonucleotide Therapy? What testing is acceptable for a practitioner to request an SOT for a patient? What testing is offered by Biocentaur? How does SOT work in the body? How does the practitioner determine which SOT to request when many infections may be positive? What SOTs are available for vector-borne infections and viruses? What are the foundational steps to prepare a patient for an SOT? Do certain therapies need to be stopped before testing and while doing SOT? How important is immune modulation or creating immune tolerance to the microbes? What is the SOT administration process? How are Herxheimer reactions addressed with using SOT? Can the SOT push back one infection and then lead to another becoming the dominant focus of the immune system and symptom presentation? How long should there be between SOTs?  Is there a maximum number of SOTs that can be done? Can SOT reach all potential reservoirs of infection in the body? What role do biofilms play in the context of SOT? Have any specific SOTs been helpful in the contents of EDS, PANS/PANDAS, or Long COVID? What role might SOT play in neurodegenerative conditions? Can SOT resolve autoimmunity, inflammation, or oxidative stress? When SOT does not appear to work, how does the practitioner troubleshoot potential reasons? - What is the cost of SOT? Connect With My Guest:  MetaMedical.life Related Resources: RGCC North America RGCC International RGCC Vector-Borne and Virus SOTs available RGCC Provider Map Interview Date: February 24, 2026 Transcript: To review a transcript of this show, visit https://BetterHealthGuy.com/Episode229. Support the Show: To support the show and Buy Me a Coffee, visit https://betterhealthguy.link/BuyMeACoffee. Additional Information: To learn more, visit https://BetterHealthGuy.com. Follow Me on Social Media: Facebook - https://facebook.com/betterhealthguy Instagram - https://instagram.com/betterhealthguy X - https://twitter.com/betterhealthguy TikTok - https://tiktok.com/@betterhealthguy Disclaimer:  The content of this show is for informational purposes only and is not intended to diagnose, treat, or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority. 

Contributor: Taylor Lynch MD Educational Pearls: Melatonin is an endogenous hormone released primarily by the pineal gland Also released by extrapineal regions in the retina, the GI tract, and some immune cells Peak secretion occurs at night and is suppressed during the day Secretion and production decrease with age Older patients experience the greatest improvement in sleep latency and sleep quality Mechanism of action in the suprachiasmatic nucleus of the hypothalamus MT1 receptor Reduces normal firing MT2 receptor Shifts the circadian rhythm FDA approved for insomnia Decreases sleep latency by 7 minutes Increases total sleep time by 8 minutes FDA approved for circadian sleep-wake disorders Jet lag Most effective in west-to-east travel Best if crossing at least 5 time zones Shift work A study examined ED physicians and nurses with rotating shifts Modest increase in deep sleep percentage No difference in cognition or reaction time the day after taking melatonin Nurses on rotating night shifts experienced increased total sleep time by 20 minutes Dosing 0.5 - 3 mg is the most evidence-based dosing Higher doses increase the risk of rebound grogginess but do not improve outcomes References Ahmad SB, Ali A, Bilal M, et al. Melatonin and Health: Insights of Melatonin Action, Biological Functions, and Associated Disorders. Cell Mol Neurobiol. 2023;43(6):2437-2458. doi:10.1007/s10571-023-01324-w Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;(2):CD001520. doi:10.1002/14651858.CD001520 Morgenthaler TI, Lee-Chiong T, Alessi C, Friedman L, Aurora RN, Boehlecke B, Brown T, Chesson AL Jr, Kapur V, Maganti R, Owens J, Pancer J, Swick TJ, Zak R; Standards of Practice Committee of the American Academy of Sleep Medicine. Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep. 2007 Nov;30(11):1445-59. doi: 10.1093/sleep/30.11.1445. Erratum in: Sleep. 2008 Jul 1;31(7):table of contents. PMID: 18041479; PMCID: PMC2082098. Thottakam BMVJ, Webster NR, Allen L, Columb MO, Galley HF. Melatonin Is a Feasible, Safe, and Acceptable Intervention in Doctors and Nurses Working Nightshifts: The MIDNIGHT Trial. Front Psychiatry. 2020;11:872. Published 2020 Aug 27. doi:10.3389/fpsyt.2020.00872 Summarized and edited by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

Hadde norske medier en hemmelig avtale om ikke å skrive om Torbjørn Jaglands helsetilstand? Hvorfor viderebringer mediene en ubekreftet påstand framsatt i åpen rett om at Marius Borg Høiby har et barn? Og hva skjer om NRK begynner å tenke som markedet? Ukas gjester er kringkastingssjef i NRK Vibeke Fürst Haugen og Svein Tore Bergestuen. Med Gard Steiro og Anders Giæver. Produsent Simon Lynau og Magne Antonsen. Ansvarlig redaktør Gard Steiro. Kontakt redaksjonen på giaeveroggjengen@vg.no. Giæver & gjengen gir deg de viktigste nyhetene hver dag på drøye 20 minutter når du skal hjem fra jobb. Hør «Mediebobler» hver lørdag om feilene pressen gjør og dilemmaer VG står i. Alltid på Podme.

MCAS. POTS. Hypermobility. GI symptoms that don't quite fit the usual boxes.   On this episode of The Gut Show, Dr. Alexis Cutchins joins us to unpack what cardiology has to do with GI—and why these systems are far more connected than most people realize.   We dive into the emerging overlap between cardiology, gastroenterology, and immune-driven conditions, exploring why these patterns so often show up together, what red flags clinicians should be watching for, and why GI symptoms may actually start far beyond the gut—especially when dysautonomia, heart palpitations, dizziness, and persistent fatigue are part of the picture.   Mentioned in this episode:  MASTER Method Membership FREE IBS Warrior Summit Take the quiz: What's your poop personality? MCAS episode   About our guest:  Dr. Alexis Cutchins is a board-certified Cardiologist and founder of Cutchins Cardiovascular Medicine. I began this work after years of caring for patients with POTS, MCAS, hypermobility, and other conditions that many doctors were not prepared to manage. My dedication to this patient community is what led me to build a practice centered on their needs. I wanted to create something different for people who are often under-recognized and left without answers. At Cutchins Cardiovascular Medicine, we provide inclusive, high quality support for those living with complex chronic illness. Follow on Instagram   Thank you to our partners:   @imodifyhealth is the leader in evidence-based, medically-tailored meal delivery offering Monash Certified low FODMAP, Gluten free, and Mediterranean meals - expertly crafted to help you achieve better symptom control AND improve overall health.    The best part? They make it easy by doing all prep work for you. Simply choose the meals you want, stock your fridge or freezer when meals arrive at your door, then heat and enjoy when you're ready. Delicious meals. Less stress. Complete peace of mind.   Check out modifyhealth.com and save 35% off your first order plus free shipping across the US with code: THEGUTSHOW.     @fodzyme is the world's first enzyme supplement specialized to target FODMAPs.   When sprinkled on or mixed with high-FODMAP meals, FODZYME's novel patent-pending enzyme blend breaks down fructan, GOS and lactose before they can trigger bloating, gas and other digestive issues.    With FODZYME, enjoy garlic, onion, wheat, brussels sprouts, beans, dairy and more — worry free! Discover the power of FODZYME's digestive enzyme blend and eat the foods you love and miss.   Visit fodzyme.com and save 20% off your first order with code THEGUTSHOW. One use per customer.   @mbiotaelemental is the next generation of the elemental diet. Developed with leading gastroenterologists and food scientists, it's the first formula that's both clinically effective AND genuinely easy to drink.   If you're looking for an option to support SIBO or your gut, mBIOTA Elemental may be one to consider. Learn more at mbiota.com and save 20% on their two-week protocol with code GUTIVATE.    

Kyle Jones is joined by Dr. Sabine Hazan and Dr. Hugh Beatty to explore the powerful connection between gut health and overall immunity. Dr. Hazan shares her journey from traditional GI practice and pharmaceutical clinical trials to becoming a leading voice in microbiome research during the COVID-19 pandemic.   They discuss the critical role of bifidobacteria — the beneficial gut bacteria she believes are central to immune resilience — and her "Save the Bif" movement to raise awareness about their dramatic decline in modern populations. The conversation covers microbiome diversity, immune response, severe COVID, autism, autoimmune disease, and long COVID, as well as the overuse of antibiotics, probiotics, and gut "cleanses."   This episode challenges conventional thinking and highlights the future of personalized, microbiome-centered medicine, and why protecting your gut, and "saving the bif," may be key to protecting your health.

What if the reason you’re not healing isn’t that you need another diagnosis? 0:08 It’s that your cells aren’t receiving the right signals. Because the body doesn’t run on diagnosis, it runs on 0:16 communication. And peptides are one of the most powerful, most misunderstood 0:21 tools we have for cellular signaling, immune balance, tissue repair, gut 0:27 lining support, metabolic control, brain signaling, sleep cycles, and even sexual 0:35 wellness. Today, I’m going to do what most people won’t. Define peptides in 0:41 plain English for you. break them into categories by what they’re best at and 0:47 tell you which ones are FDA approved on the list and which ones are commonly 0:53 used off label or investigational with the evidence that actually says these 1:00 work. This is going to be a powerful episode and if you’ve ever felt like you’re hearing hype without clarity, 1:07 this one’s for you. So, as usual, grab your cup of coffee or tea and settle in 1:13 as we talk about peptides that can fit into your healing journey. We’re going 1:19 to have a short word from our sponsor. You know, we got to do that. That’s how we stay on the air here. So, we will be 1:26 right back after this. Did you know sweating can literally heal your cells? 1:32I nfrared saunas don’t just relax you. They detox your body, balance hormones, 1:37 and boost mitochondrial energy. I’m obsessed with my health tech sauna. And 1:42 right now, you can save $500 with my code at healthtechalth.com/drmuthqen25. 1:54 All right, here we go, guys. I am excited to dive into peptides with you. 2:00 So understanding peptides is foundational, right? And I’ve been 2:06 studying peptides now for about nine years. Um, and I find that they are 2:13 incredible. Um, so I want to break down for you what peptides actually are, what 2:19 they do, and some of the top peptides that are available today, and how they 2:25 can be utilized. Because I think it’s really important. And I think it’s it’s there’s a lot of confusion out there about what these things actually are and 2:32 are they safe? Are they not? When do we use them? What’s the science behind them? So, we’re going to dive in and 2:38 we’re going to talk about all things peptides. So, let’s get ready here. Here we go. So, peptides are short chains of 2:45 amino acids and they typically range anywhere from 2 to 50 amino acids and 2:51 they’re linked by peptide bonds. So think of them as the superglue that holds the amino acids together. They sit 2:58 between the amino acids and they are full proteins in terms of their size and 3:04 their complex structure. And what makes peptides particularly interesting in 3:10 medicine is their role as signaling molecules. They’re essentially the 3:15 body’s text messages carrying specific instructions to cells and tissues. And 3:21 unlike our proteins which often serve as structural roles or act as enzymes, 3:28 peptides typically function as hormones, neurotransmitters and growth factors and 3:33 they bind to specific receptors on the cell’s surfaces or within the cells and 3:39 they trigger this effect. It’s like a cascade effect of a biochemical reaction 3:45 that ultimately changes the cellular behavior. So basically, it’s changing 3:50 the way the body’s cell structure acts. And this is why peptides can be so 3:56 incredibly powerful and therapeutic when you introduce the right peptide signal. 4:02 Now, you could theoretically redirect cellular processes toward healing, 4:07 towards metabolism, immune balance, tissue repair. Any of those things can 4:14 be manipulated to do a certain thing once we add the peptide. The challenge 4:19 in peptide medicine though lies in distinguishing between those peptides that have been rigorously studied, 4:26 proven safe and effective and approved by regulatory bodies like the FDA versus 4:31 those that exist in what we call the gray zone of a promising clinical data. 4:36 But they really lack human validation so far. And this distinction is critical because the presence of a plausible 4:43 mechanism does not guarantee safety or efficacy in living humans. So, this is 4:50 really important and we’re going to dive in and look at some of the research on all of these different peptides that are 4:56 available and I’m excited to say there’s some amazing peptides being studied right now that unfortunately are not 5:01 available. But I can’t wait to see them hit the market for us because it is going to be a gamecher as far as health 5:09 and longevity. So there is a quality control issue and there is a hidden 5:14 variable in peptide medicine with this and it’s one of the most underappreciated aspects of peptide 5:21 therapy particularly for non-FDA approved peptides. It’s quality control. 5:26 When we discuss pharmaceutical medicines, we take for granted that the pill contains what the label says. Not 5:32 always true depending on where it comes from. You guys, if you’ve heard my episodes before talk about how many of our medications are made in China and 5:41 have been contaminated with other things, you will realize that that is not always true. So, just because it has 5:48 the FDA stamp of approval on the medication, it still does not necessarily mean it’s safe and we still 5:54 need to do our homework on it. So, sorry for digressing on you guys, but you know, when we get a medication, we we 6:00 think that what the amount says is what is there, doesn’t have contaminants, it’s manufactured with good 6:06 manufacturing practices. You’ll see that listed as GMP on the bottle, and it’s been stored properly, it’s been 6:12 maintained stable, and with research peptides and compounded formulations, 6:17 none of this can be assumed. So, I will share a story with you. There was a gentleman that was purchasing these 6:24 peptides online from a research facility and um did not know that they were 6:30 coming from China and he was ordering a particular growth hormone peptide and 6:35 after a little while he had he had done fine for the few first few bottles. After a little while he started having 6:42 some complications. He started getting really irritable and angry and ragy and 6:47 he didn’t quite know what was going on. And so he decided to go get some testing done. He had some blood testing done and 6:53 his testosterone level was over 5,000. So for those of you who know what testosterone level should be for a guy, 7:00 they really shouldn’t be any higher than about 1,00200 would be absolute max that we’d want to see. Now he was taking 7:06 testosterone but not to that degree. And prior to adding this peptide, his 7:12 testosterone was very stable. What they ended up finding out was the peptide that he was getting, whoever was 7:18 manufacturing it added testosterone to the peptide. They felt like if if it had growth hormone, that was great, but if 7:25 it had growth hormone and tes testosterone, all the better. And he didn’t know that. And this is the 7:31 problem that we can have with peptides if you don’t source them properly. if you’re not working with somebody that 7:37 knows how to source them and can prove that they are what they say they are. Um, I’m sure there’s a whole bunch of 7:42 studies out there too of people getting these peptides and paying hundreds of thousands of dollars for them over their 7:48 lifetime and finding out they were nothing more than just sterile water. So, you really do need to be careful 7:53 with your quality control. Now, this kind of leads us right into the next topic that we’re going to talk about and that’s the manufacturing question, 8:00 right? The FDA approved peptides are manufactured in facilities subject to 8:05 the FDA inspection rules following our GMP regulations and these facilities 8:11 must validate their manufacturing process, demonstrate consistency batch to batch, test for purity and potency. 8:18 They need to test for bacterial endotoxins and sterility and they need to maintain detailed records. So, when a 8:25 pharmaceutical company submits a drug application, the FDA inspects the manufacturing facility as part of the 8:32 approval process. If you’re getting peptides from a different country, none of that is happening. And there are some 8:38 ways for us to determine if that is what you’re getting. Typically, the rule of thumb is if your peptides are coming 8:44 with a different colored top, every one of them has a different colored top. Those are typically being sourced out of 8:49 China. I wouldn’t say that’s 100% but that’s kind of the rule of thumb that people follow. So compoundingies these 8:56 are thearmacies that make our bio identical hormones. They can make medications in any dose or strength or 9:02 route. There are thousands of them in every not that not in every state but 9:08 there are thousands of them around the country right now. So these compoundingies are registered as 503A 9:15 facilities. They do traditional compounding for individual prescriptions, right? Like they can make 9:20 thyroid, they can make LDN, they can make estrogen. You can also have a 503b 9:27 facility, which is an outsourcing facility. And these companies produce larger batches of products. They’re they 9:34 have some oversight, but they’re less stringent than for FDA approved 9:40 manufacturers. And state boards of pharmacy regulate a 503A pharmacy. And 9:45 the FDA can inspect the 503b facility, but doesn’t preapprove any of their 9:52 compounding products. So, they can inspect it, but they don’t approve them. So, research chemicals and these 9:58 suppliers operate essentially with no oversight. They explicitly market products for research use only, not for 10:06 human consumption to avoid FDA regulation. If they put that on their 10:12 product, they don’t have to comply to what the FDA is saying. And there is no required manufacturing strategies or 10:19 standards, no required testing, no required sterility assurance, and no enforcement mechanisms if products are 10:26 mislabeled or contaminated. So basically, they don’t have the liability, but that doesn’t mean that 10:31 all of them are badies or bad suppliers. It just means they don’t have to comply 10:37 to the FDA rules. Now, there are many of these companies that I’ve seen and I’ve talked to that do do a lot of this. They 10:44 do test their product for sterility. They do test their product to make sure it is what it says it is. They don’t 10:51 have to, but they do. So, if you’re going to decide to use a company that 10:56 has research only, not for human consumption, at least ask for their 11:02 proof of testing so that you know that the product you’re getting is what it says it is and that it’s clean. Because 11:08 this is where we run into the problem is in purity. So in purity peptide 11:13 synthesis can produce not just the targeted peptide but also related 11:19 peptides with deletions, substitutions, truncations or truncations of amino 11:25 acids. Sorry. And this high performance liquid we call it uh chromatography can 11:30 separate these related impurities and quality and quantify the actual target 11:35 of the peptide content. So a certificate of analysis is what you want to ask these companies for. This shows the HPLC 11:44 the testing mechanism with greater than 95% or ideally 98% purity which 11:51 indicates a higher quality product. So this certificate of analysis can be fabricated may not represent the 11:57 specific batch being sold. It happens. We need to know not everybody is honest. Not everybody, you know, does what they 12:03 say and it does what’s right. But at least you at least they’re giving you something and you have some security. 12:10 and then choose a company that was referred to by someone else that has done some homework as well. In in 12:16 commercial research, there’s independent testing and they research peptides and this has been really shocking 12:23 variability that they’ve seen. Some products contain 50% or less of the 12:29 claimed peptide and some contained primarily degradation of the product or manufacturing impurities and some 12:36 contained bacterial endotoxins at levels that could cause fever and systemic 12:42 inflammation if it was truly injected. And I would also worry with some of those problems, you know, depending on 12:48 what impurity or bacterial endotoxin was there. If you’re using a product to boost your immune system and your immune 12:54 system is already compromised, these bacterial endotoxins can actually make you sicker instead of what you want it 13:02 to do, which is making you better. So, sterility is always an issue with anything that is manufactured, 13:08 especially things that we’re doing as an injection. Peptides are intended for injection. They must be sterile. They 13:16 must be kept safe. And pharmaceutical manufacturers conduct this sterility testing on every batch. 13:22 Compoundingarmacies should conduct sterility testing particularly for high-risisk compounded 13:28 sterile preparations and research chemical suppliers may or may not conduct any testing. So injecting 13:35 non-sterile material can cause local infections, abscesses at the injection 13:41 site and or if the bacteria enters the bloodstream could potentially be 13:46 life-threatening and you could have sepsis. Now, excuse me. We saw this 13:52 happen in a compounding pharmacy uh gosh, it’s probably been 10 years ago 13:57 now, I think. um they unfortunately had a strep uh contamination in their 14:03 product and they weren’t testing it. It was a large compounding pharmacy out of Florida and they were making products 14:08 that were being injected into the joints and um these people got very very sick 14:14 and some of them died and um some of them got very very injured by this uh 14:21 complication that happened. So it’s not like this doesn’t happen. It does, but it doesn’t happen often. And that’s what 14:28 we have to know about. And so, when we’re talking with you guys about storage and stability, it’s really 14:34 important to make sure you maintain your peptides well. So, many peptides are unstable at room temperature. They 14:41 require refrigeration or freezing. We tell everyone to make sure you’re refrigerating your peptides. That way, 14:48 there’s no question about it. when it stays cold um it prevents or slows down 14:54 the process of uh bacteria growing in it. So some of these peptides actually 14:59 degrade very rapidly in the solution and they must be reconstituted immediately before use and reconstitution of the 15:07 peptides really has limited stability often just days to weeks not months. So 15:13 improper storage, temperature, um changes during shipping or prolonged 15:19 storage of a reconstituted product can lead to degradation into inactivity or 15:25 potentially even a harmful breakdown of the product itself. So if you have a product that’s been sitting in your 15:30 refrigerator for a month or two months or 3 months or 6 months, just throw it away. It’s not going to be any good. 15:37 you’re not going to actually get the peptide and the uh potency that you’re looking for anyway out of it and the 15:44 potential of you introducing an endotoxin, a bacterial endotoxin is quite high at that point. So you just 15:50 really don’t want to take the risk, excuse me. So what practitioners, what 15:56 should we do and what should patients do? Well, for any peptide therapy, we 16:03 want to source our verification. know where the peptide product comes from. Is 16:08 it an FDA approved product? Is it a 503b compounding? A research chemical 16:14 supplier? Is there a certificate of analysis? Request and review this COA. 16:20 And you want it to show purity greater than 95% but ideally greater than 98%. 16:27 You want that identity be identity to be confirmed by mass spectromedy. Uh 16:33 sterility testing should be done. Bacterial endotoxin testing should be done. Batch number matching of the 16:39 product that you received should be done. Proper storage. You want to know that this has been refrigerated or 16:46 frozen as directed once it’s been mixed. Look at the expiration dates for reconstituting your peptides. Track that 16:53 reconstitution date and discarded accordingly like we just talked about. Monitor for your adverse effects. Even 17:01 with the perfect quality control, monitoring for adverse effects is essential with questionable quality and 17:08 vigilance is really critical here. I know it’s frustrating for a lot of patients when they have to get several 17:15 bottles and they only last a week or two. right here, you guys. This is why 17:21 they only last a short period of time because once they’re mixed, they start 17:26 to degrade and they won’t be good and you won’t get the benefit from it. So, 17:31 it’s really important with these research peptides specifically, practitioners should recognize that all 17:38 recommending products without quality assurance violates the fundamental medical principle of first do no harm. 17:45 If a patient is determined to use research peptides despite counseling, providing guidance on quality 17:52 verification, requesting those COAs, using pharmaceutical grade sources when available, proper testing, this all 17:59 reduces harm, but doesn’t constitute necessarily that recommendation. Now, 18:06 that being said, today it’s very difficult to find peptides by the compoundingies because of what the FDA 18:13 has done. So most of the peptides that are available to us have been labeled 18:18 not for human consumption, not because they’re not good products, but because 18:25 of what the FDA did. And this is how these companies have been able to 18:31 continue to provide peptides to the medical community. And if you know you 18:36 have a good company, then you’re, you know, you’re still taking the risk, right? But at the end of the day, the 18:42 reason they’re doing that is to protect themselves from the FDA, from liability. Um, so just kind of know that there is 18:50 some talk in the community with um Bobby Kennedy that this is going to change and 18:55 they are going to bring peptides back to the compounding pharmacies. Now, we don’t know which ones they’re going to 19:01 bring back. Uh, will it be all of them? Will it just be some of them? What’s going to happen here? Um, is it going to 19:07 go to the pharmaceutical companies like our GLP1s did? We don’t know what that’s going to look like quite yet. Um, but it 19:14 is coming and that is positive news. So, let’s talk now about FDA approved 19:21 peptide medications. So, this is the metabolic revolution, right? GLP1 19:28 and our dual increeting agonists. This is an exciting time. GLP-1s are amazing. 19:35 Um, a lot of people are skeptical, a lot of people love them, a lot of people hate them. Whichever side of the fence 19:42 that you’re on, I understand. But I want to talk about the science of it today 19:48 and what it actually means for people. So, the story of GLP1 glucagon like 19:54 peptide one represents one of the most significant advances in metabolic 19:59 medicine in the past several decades. GLP-1 is an accretin hormone. It’s 20:05 gutder derived peptide that potentiates insulin secretion in response to food 20:11 intake. And the body naturally produces GLP-1 in the intestinal L cells, but it 20:17 rapidly degraded by the enzyme DPP4 giving it a halflife of only about 2 20:24 minutes. So this rapid breakdown made in therapeutically impractical until 20:31 research was developed and modified the analoges that resist the enzyme degradation. So for those people who 20:39 never feel full when they’re eating, never feel satisfied when they’re done, this is because their body is either not 20:46 producing enough GLP1 or it’s not getting the signal right. And this is a 20:51 leptin issue. This is an insulin issue. It’s a GLP-1 issue. It’s a complicated 20:56 issue. This is not anything that the person is doing wrong. It’s what is happening to their body. And so GLP1s 21:03 have really revolutionized this. So one particular GLP-1 that we have is 21:09 semiglutide. And this GLP-1 agonist is what changed everything in the world of 21:16 metabolic medicine. Semiglutide is marketed as ompic for type 2 diabetes 21:23 and it’s marketed as WGOI for chronic weight management. It is a modified 21:29 GLP-1 analog with 95 or sorry 94% amino acid sequence uh homology to human 21:37 GLP-1. So it means that it’s it’s just like our own GLP-1 that we make. This 21:42 modification includes specific amino acid substitutions and the addition of C18 21:50 a fatty acid chain which allows the peptide to bind to albumin. Now this 21:56 albumin binding dramatically extends the half-life to approximately one week 22:01 enabling one weekly dosing which is a major advantage over the earlier GLP-1 22:07 agonists that require daily or twice daily injections. The mechanism by which 22:13 semiglutide works is multiaceted. At the pancreatin level, it binds to GLP-1 22:20 receptors on the pancreatic beta cells enhancing glucose depending sorry 22:27 enhancing glucose dependent insulin secretion. This glucose dependency is 22:33 crucial. It means the peptide only stimulates insulin release when blood glucose is elevated. This dramatically 22:41 reduces the hypoglycemic risk compared to insulin or even uh sulfuras. 22:47 Simultaneously semiglutide suppresses glucagon secretion from pancreatic alpha 22:53 cells further improving glycemic control. This is really amazing because 23:00 over the years when we’ve used insulin, which is also a peptide by the way, you 23:05 had to dose it just right because if you didn’t, you would produce so much insulin that it would crash the blood 23:12 sugar and then somebody would have too low of a blood sugar. They’d be hypoglycemic and they’d have to eat more 23:18 sugar and then they’d have to modify the insulin again and the person would be going up and down, up and down, up and 23:24 down all day long. And that created a lot of problems for people and so this 23:30 helps to stabilize that so it is not such an intense change. Now in the GI 23:36 tract semiglutide delays the gastric emptying particularly pronounced during 23:41 the initial weeks of therapy. This slowing of the gastric emptying contributes to the sensation of being 23:48 full and early satiety that patients often describe. However, this effect 23:54 tends to attend to weight over time as the body adapts through the appetite 24:00 suppressing effects generally persist through central mechanisms. So, when we 24:05 talk about what is actually happening, we’re slowing that digestive process down. That’s why people aren’t so 24:11 hungry. It’s why they’re not eating so much. This is why people can develop constipation with these products because 24:17 it’s slowing the body’s digestive tract down. Now some people will call this 24:22 gastroparesis. Um gastroparesis is actually different. 24:28 It is when we lose control over what’s happening in the in the colon like the 24:34 nerves and things like that just stop working. I have never seen that with the GLP1s that we prescribe in micro doing. 24:42 um it’s been documented. It can happen, but again it a lot of it is dosing and a 24:48 lot of it is staying on top of your client and what’s happening and what’s going on and what you’re doing and making sure that they do have good 24:54 motility still. So a lot of these things can be mitigated if you have problems 24:59 with them. Now one of the most profound effects of semiglutide occur in the 25:05 central nervous system. GLP-1 receptors are widely distributed in the brain 25:10 particularly in the hypothalamus and the brain stem area where we are involved in 25:15 appetite regulation. So when when wilding and colleagues published their 25:20 landmark step one trial in the New England Journal of Medicine in 2021, 25:25 they demonstrated that participants receiving 2.4 4 milligrams of semiglutide weekly achieved an average 25:32 weight loss of 14.9% of their body weight over 68 weeks. Now, I want you 25:39 guys to really understand this. We’re talking roughly 15% body weight loss 25:45 over a year, longer than a year. 52 weeks is a year, right? This is 68 25:50 weeks. So, it took longer for them to lose. We’re not talking about giving 25:55 somebody a dose to lose 15% of their body mass in a month or two. That that 26:01 is not healthy for any of us. That is not what we’re talking about doing here. Now, they compared this to placebo and 26:08 the placebo was only 2.4%. So, that is a significant difference. 26:14 And even beyond the numbers, patients reported something very qualitatively different, a reduction in what’s now 26:21 called food noise. Everybody knows what food noise is. We’ve talked about this long before GLP1. It’s that craving. 26:28 It’s that part of your brain that just keeps thinking about I want to eat something. You know, that was actually 26:34 reduced and they didn’t expect to see that happen. Now, this refers to the constant mental preoccupation with food, 26:42 the intrusive thoughts about eating, the difficulty in feeling satisfied. Semi-glutide appears to appears to 26:49 modulate reward pathways in the misolyic system reducing hedonic eating and food 26:57 cravings. Now there are also great cardiovascular effects of semiglutide 27:02 that extend beyond weight loss. Uh the sustained six and select trials 27:07 demonstrated significant reductions in major adverse cardiovascular events uh 27:14 mace in high-risisk populations. The select trial published in 2023 showed 27:20 that semiglutide reduced cardiovascular death, non-fatal myioardial inffection 27:25 and non-fatal stroke by 20% in adults with overweight or obesity and 27:31 established cardiovascular disease but without diabetes. So this suggests that 27:37 mechanisms beyond glucose control and weight loss possibly including 27:42 anti-inflammatory effects, improvements in endothelial function and favorable 27:47 changes to lipid profiles. Now I will tell you the clients that I work with that are on GLP1, 27:53 they will tell you that their inflammation has been significantly reduced. We are also seeing really 28:00 amazing results in lipid profiles. um part of its weight loss, but there is a 28:06 component to this that is lowering the triglyceride levels because it’s related to sugar and how the body’s processing 28:11 it. And we’re seeing better profiles, less need for statins as a result of 28:17 that. If if you want to listen to my episode on statins, I have one on that. Uh they are not my favorite medication. 28:24 I think it’s overprescribed and overused um and not really affecting or 28:29 addressing the problem. So these things can really be helpful. There’s also some 28:34 uh ramblings going on with GLP-1s saying that they may be able to help with 28:40 addiction in the future because of where they’re finding it affecting the brain and how it affects the food noise and 28:47 the cravings that we have for food and the addiction for food. Could it potentially help with other addictions 28:53 down the road? We’ll have to wait and see on that one. So semiglutide’s FDA prescribing information also includes a 29:00 box uh boxed warning about thyroid sea cell tumors. So in rodent studies 29:06 semiglutide caused dose dependent and treatment duration dependent sea cell 29:12 tumors at clinically relevant exposures. So while it’s unknown whether or not 29:17 semiglutide causes uh thyroid cancer tumors in humans and the rodent thyroid biology 29:26 differs significantly from humans, the drug is contraindicated in patients with a personal or family history of 29:33 medillary thyroid carcinoma or in patients with multiple endocrine neopl neoplasia syndrome type two. it is 29:42 uh contraindicated for safety effects with that. Um I have seen endocrinologists okay GLP1s to be used 29:50 in patients who’ve had other forms of thyroid cancer just not the meillary 29:55 thyroid cancer. So there is possibility there. Now the most common side effects 30:00 are gastrointestinal. It’s nausea affects about 20 to 44% of patients 30:06 depending on the formulation with diarrhea, vomiting, constipation, abdominal pain, and also frequently 30:13 reported in clinical trials. I see this in my clinic, too, especially dose dependent. Um, and it happens early on 30:20 when you’re first starting the medication, but seems to settle out over time. The one that I would add to this 30:26 that I don’t think they have on here is an increase in acid reflux. We also see that quite often uh especially in people 30:33 who suffer with acid reflux to begin with. Now these effects are typically most 30:40 pronounced during the escalation and they like I said often improve over time 30:45 but more serious but less common adverse effects include acute pancreatitis. 30:51 The medication needs to be discontinued immediately if this is confirmed. You can see some diabetic retinopathy 30:57 complications in patients with pre-existing retinopathy and acute kidney injury. Um, this usually happens 31:05 secondarily to dehydration from the GI effects. There are some gallbladder disease um that can occur and people who 31:13 have a sensitive gallbladder will describe uh discomfort with that. I’ve 31:18 even seen some people who’ve had their gallbladder out on GLP1s at the higher doses complain of similar pain that they 31:25 used to have when their gallbladder was in. So, really important to just kind of monitor these symptoms and work closely 31:32 with somebody that understands them and can be on top of them quite quickly if this happens. Excuse me. From an 31:39 integrative medicine perspective, semiglutide really represents a powerful tool, but it’s not a standalone 31:46 solution. Remember, the medication addresses one aspect of the metabolic dysfunction, the signaling systems 31:53 controlling appetite and glucose homeostasis, but it doesn’t address the root cause that led to the metabolic 32:00 disease in the first place. Patients who rely solely on the medication without addressing the ultrarocessed food 32:07 consumption, the ccadian disruptions, the chronic stress, the sleep apnea, or 32:12 underlying hormonal imbalances often experience weight regain when the medication is discontinued. 32:20 The drug is also not a substitute for addressing the emotional and psychological drivers of eating 32:26 behavior, including the unresolved trauma that may manifest as emotional eating. I think this is really important 32:33 because we don’t address the trauma issue enough with clients and we need to 32:38 be looking at that. There is a huge trauma effect out there these days that is I don’t want to say leading to or 32:45 causing but it is definitely contributing to chronic illness and it’s not being talked about enough. So we 32:52 really need to be talking about this and addressing this trauma aspect. Now the next GLP that one that I want to talk 32:59 about is trespathide. This is a dual agonist. It takes center stage. It is my 33:05 favorite GLP one. Trisepatide is marketed as Mangjaro for type 2 diabetes 33:11 and Zepbound for chronic weight management and it represents the next 33:16 evolution in increantbased therapy. This is a dual agonist a 39 amino acid 33:23 synthetic peptide structurally based on the human glucose dependent insulin tropic peptide so GIP sequence but 33:31 modified to activate both the GIP receptors and the GLP1 receptors. So the 33:37 addition of the GI GIP agonism to the GLP1 agonism appears to create this 33:46 synergistic effect that goes beyond simply adding the two mechanisms together. So the GIP like GLP-1 is an 33:55 increant hormone secreted by what is called the K cells in response to nutrient intake. It enhances glucose 34:02 dependent insulin secretion but it also effects on atapost tissue metabolism 34:09 potentially improving the insulin sensitivity in fat cells and influencing 34:14 how the body stores and metabolizes fat. So some research suggests that GIP may 34:20 also have effects on energy expenditure though this remains an area of 34:26 investigation. So basically what we’re saying is this drug may actually help 34:32 people who are insulin resistant or insulin sensitive, not just somebody who 34:38 has problems with glucose control. So, this is super exciting because it opens 34:43 up the door for all of these people for decades that we’ve been trying to manage with insulin resistance and trying to 34:50 prevent diabetes and honestly most of the time have been unsuccessful 34:56 unless you can keep your diet at 50 grams of carbs or less a day, which is extremely difficult. Um, and take some 35:04 supplements that may or may not work and or take some metformin that may or may not help. this drug actually really 35:11opens that up and helps in that capacity. So there was a clinical trial 35:17 called the surmount clinical trial which demonstrated that trespathide produces 35:22 even more substantial weight loss than semiglutide. In the surerount one trial published by uh J tree I might have said 35:31 that wrong. I apologize if I slaughtered your name and colleagues in the New York England Journal of Medicine in 2022. 35:38 Participants receiving the highest dose of trespide, which is 15 milligrams, achieved an average weight loss of 20.9% 35:47 of their body weight over 72 weeks, compared to 3.1% with placebo. This 35:54 level of weight loss approaches what’s typically only seen in beriatric surgery. So, this is amazing because if 36:02 this medication works and we don’t have to do beriatric surgery, stomach stapling basically, um, oh my gosh, it’s 36:11 amazing. There are so many complications and risks that go with stomach stapling and the different procedures that they 36:17 do these days. People don’t absorb their nutrients properly. They have to do liquid nutrients. It’s very complicated. 36:24 It’s very challenging. Many of these people gain their weight back. Um, and 36:30 this procedure is not fun to go through. So, if we could change that and change 36:35 the lives of people who’ve really been struggling, it is amazing. And I will tell you that I have seen this work. I 36:42 have seen people lose 100 150 pounds on these medications over a year or two 36:50 period of time. It is definitely slower than beriatric surgery on some standpoints, but that is okay. You don’t 36:56 want that rapid weight loss. It’s not good for you. It’s not healthy for you. It doesn’t look well. You know, we want 37:03 to do this safely and effectively in the best way that we can possibly do that for you. Now, the adverse effect profile 37:10 is similar to semiglutide. It’s dominated by gastrointestinal effects. 37:15 Nausea, diarrhea, decreased appetite, vomiting, constipation. These were all commonly reported in the surmount 37:22 trials. And like semiglutide, tricepide carries a blackbox warning regarding the 37:27 thyroid sea cell tumors based on the rodent data and it shares the same contra indications in patients with a 37:34 family history of thyroid cancer and men too. So the mechanism behind why 37:40 tepatide often produces more substantial weight loss than GLP-1. The agonism 37:45 alone remains under investigation, but it may relate to the complimentary effects on the different aspects of 37:51 energy homeostasis or to GIP’s effects on atapost tissue and potentially on 37:58 central central nervous system pathways that GLP1 alone doesn’t fully address. 38:03 Now patients often report even more profound reductions in food noise with tricepide compared to GLP1 and uh sorry 38:12 GLP1 the agonists through this is anecdotal and hasn’t been regularly 38:17 quantified in quality studies. So I’ve done both uh personally and in my 38:22 practice. I really like trespide better than semiglutide. For me I had too many side effects with semiglutide. uh I had 38:30 less side effects with trespathide. I also plateaued on semiglutide which I 38:35 didn’t really care for. And with Tresepide, I haven’t plateaued and I’ve been able 38:42 to lose about 25 pounds in um a year and a half and I’ve been able to maintain 38:49 that. Um and I continued to use it because I do have a strong family history of cardiovascular disease. And 38:56 if this could help me so that I don’t follow my family lineage with cardiovascular disease, I am all for 39:03 trying to do that. I’ve watched too many of my family members suffer from this. I’ve lost my dad at a very young age. I 39:09 lost my grandfather at a young age to it. All of their brothers to this. And I don’t want to be that same person. So 39:16 that is why I chose to do that. And I think it’s really important for us to take a look at that and understand that. 39:24 Now, I know this has been a really long podcast and I don’t typically do podcasts this long. I have a whole host 39:31 of information on additional peptides. So, I’m going to break this up for you 39:36 guys and I’m going to do another episode and we’re going to pick up where we left off here with these peptides so that we 39:43 can actually start to dive into different peptides as well. So, check 39:48 out my next podcast show when we’re going to dive into the peptides that 39:54 talk about sexual wellness, immune function, and all the other cool things 39:59 that we can do with peptides. So until then, remember to like, share, and 40:04 subscribe. It really helps us get out to other people and share our information, 40:10 and join us for our next episode as we continue the talk about peptides. 40:15 Welcome to Let’s Talk Wellness Now, where we bring expert insights directly to you. Please note that the views and 40:21 information shared by our guests are their own and do not necessarily reflect those of Let’s Talk Wellness Now, its 40:28 management, or our partners. Each affiliate, sponsor, and partner is an 40:34 independent entity with its own perspectives. Today’s content is provided forformational and educational 40:40 purposes only and should not be considered specific advice, whether financial, medical, or legal. While we 40:48 strive to present accurate and useful information, we cannot guarantee its completeness or relevance to your unique 40:56 circumstances. We encourage you to consult with a qualified professional to address your 41:01 individual needs. Your use of information from this broadcast is entirely at your own risk. By continuing 41:08 to listen, you agree to indemnify and hold Let’s Talk Wellness Now and its 41:14 associates harmless from any claims or damages arising from the use of this 41:20 content. We may update this disclaimer at any time and changes will take effect 41:26 immediately upon posting or broadcast. Thank you for tuning in. We hope you 41:31 find this episode both insightful and thought-provoking. Listener discretion 41:36 is advised.The post Episode 256 – How Peptides Work, Benefits, and FDA-Approved vs Off-Label Use Explained first appeared on Let's Talk Wellness Now.

Tựa Đề: Chỉ Một Mình Tôi Thoát; Kinh Thánh: Gióp 1:13-22; Tác Giả: Truyền Đạo Phạm Công Bình; Loạt Bài: Hội Thánh Tin Lành Orange

Giữa mùa hè rực nắng của nước Úc, khi Tết không còn là tiết xuân se lạnh như ở quê nhà, người Việt vẫn tìm cách giữ lại mùa xuân trong những chậu cây cảnh. Với nhiều gia đình, chơi bonsai và hoa Tết không chỉ là thú vui, mà là cách lưu giữ ký ức, gửi gắm lời chúc đầu năm và tìm lại sự bình an nội tâm. Từ câu chuyện của hai anh em Hiển và Hoàng tại Happy Bonsai Sydney, bài viết khám phá cách những loài cây đã thích nghi với khí hậu mới nhưng vẫn mang trọn tinh thần Tết Việt nơi đất khách.

Join My Private Group: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://theaxioncollective.manus.space/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Email List: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://huntershealthhacks.beehiiv.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Get My Book On Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://a.co/d/avbaV48Download⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Peptide Cheat Sheet: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://peptidecheatsheet.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Download The Bioregulator Cheat Sheet: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bioregulatorcheatsheet.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠1 On 1 Coaching Application: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamscoaching.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book A Call With Me: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamscall.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Supplement Sources: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamssupplements.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon Storefront: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/hunterwilliams/list/WE16G2223BXA?ref_=cm_sw_r_cp_ud_aipsflist_R7QWQC0P1RACB2ETY3DY⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Socials:Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/hunterwilliamscoaching/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Video Topic Request: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamsvideotopic.carrd.co/⁠⁠⁠⁠⁠In this episode, I'm diving deep into Mast Cell Activation Syndrome, or MCAS, and why it's such a big topic in the peptide world. If you've been around peptides long enough, you've probably seen it — certain people react strongly to compounds like CJC, ipamorelin, or other common peptides, and suddenly they're dealing with flushing, hives, GI distress, tachycardia, or brain fog.I break down what MCAS actually is, why some people are genetically predisposed, and why others develop it from environmental triggers, infections, autoimmune issues, or nervous system dysregulation. I also explain why traditional antihistamines often fall short — because they treat symptoms, not the upstream immune imbalance.Then I walk through my comprehensive MCAS stack: LDN, Thymosin Alpha-1, Thymalin, KPV, VIP, PEA, and even GLP-1 receptor agonists. I explain the mechanisms, dosing strategies, when to introduce each one, and how to think about this in phases instead of expecting a magic bullet.This isn't a cure-all, but it's what I've seen work coaching hundreds of people. If you're sensitive to peptides or trying to get back to baseline after reactions, this episode will give you a structured roadmap.

Det er åpen krig mellom Pakistan og Afghanistan, mens regjeringen her i Norge retter opp skattepolitikken. Med Hanne Skartveit, Shazia Majid og Frøy Gudbrandsen. Produsent Simon Lynau. Ansvarlig redaktør Gard Steiro. Kontakt redaksjonen på giaeveroggjengen@vg.no. Giæver & gjengen gir deg de viktigste nyhetene hver dag på drøye 20 minutter når du skal hjem fra jobb. Hør «Mediebobler» hver lørdag om feilene pressen gjør og dilemmaer VG står i. Alltid på Podme.

Costa Rica Camp Reflections and Beyond.Links and Resources Mentioned in this Episodewww.RollModelsWanted.com@dani_g_ina_gi@berimbozo@adelefornarino@jrizzinthehizz@ajclingerman@beautyandthegipodcast@rollmodelgrapplingIf you love the podcast, share it with a friend!You can also leave us a 5-star rating in Spotify or Apple Podcasts.

Drs. Cytryn, Foote, and Thummalapalli discuss recent data on HER2 testing modalities and the prevalence of HER2 positivity across hepatobiliary, upper GI, and colorectal cancers, highlighting implications for precision medicine. The conversation reviews the latest clinical trial findings and the evolving landscape of HER2-targeted therapies, with insights into optimal treatment sequencing for various GI cancer subtypes.

Dr. Lakshmi Rajdev and Dr. Manish Shah join the podcast to discuss the updated guideline on immunotherapy and targeted therapy in unresectable locally advanced, advanced, or metastatic gastroesophageal cancer. They share first-line and subsequent-line recommendations for both gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma based on actionable biomarkers including PD-L1 expression, MMR and/or MSI, CLDN18.2 expression, and HER2 status. They note the importance of the algorithms and tables in the guidelines that provide visual illustrations and quick reference guides of the evidence-based recommendations. They also comment on ongoing and recently presented trials that may impact future guidelines in this space. Read the full guideline, "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update" at www.asco.org/gastrointestinal-cancer-guidelines" TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/gastrointestinal-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02958      Timestamps ·       00:00 – 02:15 Introduction and Overview ·       02:16 - 08:20 First-line treatment for patients with pMMR/MSS, HER2-negative gastroesophageal adenocarcinoma ·       08:21 –10:29 First-line treatment for patients with pMMR/MSS, HER2-positive gastroesophageal adenocarcinoma ·       10:30 – 14:39 First-line treatment for patients with dMMR/MSI-H, gastroesophageal adenocarcinoma ·       14:40 – 18:03 First-line treatment for ESCC ·       18:04 – 22:04 Second- and third-line therapy for gastroesophageal adenocarcinoma and ESCC ·       22:05 – 24:38 Importance of guideline ·       24:39 – 27:45 Outstanding questions and future research   Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts.   My name is Brittany Harvey, and today I am interviewing Dr. Lakshmi Rajdev from the Icahn School of Medicine at Mount Sinai and Dr. Manish Shah from Weill Cornell Medicine, co-chairs on "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update." Thank you for being here today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you for having us. It is wonderful. Brittany Harvey: And then just before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Rajdev and Dr. Shah, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into what we are here today to talk about, Dr. Shah, I would like to start first with what prompted the update to this guideline, which was previously published in 2023, and what is the scope of this updated guideline? Dr. Manish Shah: Yes, terrific. So even in the last few years, the pace of drug development in gastroesophageal cancers has just been astounding. So, what prompted this guideline is actually the practice-changing results for a new biomarker, CLDN18.2 hat was based on the GLOW and SPOTLIGHT studies, as well as a practice-changing study in HER2-positive disease where we added pembrolizumab to trastuzumab and chemotherapy for tumors that are HER2-positive and PD-L1 CPS 1 or greater. And then there were also new studies and new approvals in esophageal squamous cell cancer that you will hear about as well. So there were several studies, overall more than 5,000 patients were reported on, and that led to several new therapies, new indications, and it really necessitated this guideline. Brittany Harvey: Excellent. It is great to hear about all of these exciting updates in this space. So then to next review the key recommendations of this guideline by clinical question that the expert panel addressed. So, Dr. Rajdev, what is the recommended first-line treatment for patients with proficient mismatch repair, microsatellite stable, HER2-negative gastroesophageal adenocarcinoma? Dr. Lakshmi Rajdev: Thank you for that question. So historically, we have sort of used fluoropyrimidine and platinum doublets, which yielded a survival of about one year. More recently, immunotherapy and targeted therapy options have improved outcomes in patients with advanced esophageal and gastric adenocarcinoma, as well as squamous cell carcinoma. Patients with gastric and GE junction adenocarcinoma have a high rate of actionable alterations, so it is imperative that physicians test the following biomarkers upfront so that it can help guide therapy. The markers recommended by the ASCO panel are HER2, MMR or MSI, CLDN18.2, and PD-L1. And also, it was recommended to use NGS if feasible in this patient population. HER2, as we know, is expressed in about 15% to 25% of patients; PD-L1 expression occurs in about 80% of patients; MSI-high, deficient MMR is present in about 5% to 8% of patients; and CLDN18.2 expression is present in about 40% of patients. There is, of course, biomarker overlap. About 13% to 22% of CLDN18.2 patients are also PD-L1 positive. For patients with pMMR or microsatellite stable HER2-negative disease with PD-L1 expression greater than 1 and absence of CLDN18.2, the panel recommended a first-line therapy with fluoropyrimidine and platinum-based therapy in combination with immunotherapy. These recommendations stem from large phase 3 trials, and the agents approved in the United States are pembrolizumab, nivolumab, and tislelizumab. It has been shown that immunotherapy benefit is greater in patients with higher PD-L1 expression, and it is not possible to comment on the individual PD-L1 cutoff scores and sort of identify the optimal PD-L1 cutoff score that sort of balances benefits and harms. But what is recommended is that immunotherapy-based treatments can be offered in patients with a CPS score of greater than 1. With regard to the choice of immunotherapy agents, that is pembrolizumab, nivolumab, or tislelizumab, these agents are considered to have similar efficacy, and the selection of an agent could be based on dosing schedule, cost considerations, toxicity, and the method of administration. Typically, clinicians should avoid withholding the start of chemotherapy while awaiting biomarker testing, depending on the clinical scenario. Now, for patients with pMMR microsatellite stable disease that is HER2-negative with PD-L1 expression less than 1 and positive CLDN18.2 expression, zolbetuximab-based treatments or in combination with chemotherapy is recommended, and this is based on two global phase III randomized controlled trials, the GLOW and the SPOTLIGHT. And across both studies, the hazard ratio for the overall survival was 0.78, and similarly, there was also an improvement in progression-free survival favoring the zolbetuximab group compared to the chemotherapy group alone. An important note is that nausea, vomiting is commonly associated with zolbetuximab-based treatments, and the panel recommended prophylactic antiemetics, adjusting zolbetuximab infusion rates, pausing infusion temporarily, using non-prophylactic antiemetics, and hydration intravenously prior to discontinuation of zolbetuximab-based chemotherapy. So effective handling of the GI-related symptoms with zolbetuximab is recommended prior to discontinuation of therapy. Now, for patients with pMMR microsatellite stable HER2-negative gastric, GE junction adenocarcinoma with PD-L1 expression greater than 1 and CLDN18.2 positivity, the ones with the dual expression with CLDN18.2 as well as PD-L1 chemotherapy, the choice of therapy can be based on the degree of PD-L1 expression, the toxicity profile, the burden of symptoms, and the anticipated improvement in symptoms associated with response to treatment, the patient comorbidities, the prior medical and treatment history. So this decision needs to be made on a case-by-case basis, and these are some of the factors that we suggested that could potentially influence the choice of therapy. For patients with pMMR microsatellite stable disease that is HER2-negative and a PD-L1 expression less than 1 and an absence of CLDN18.2 expression, first-line therapy with fluoropyrimidine and platinum-based chemotherapy is recommended. So you can see we have segmented out patients based on PD-L1 expression, pMMR and microsatellite stable disease expression, and also based on CLDN expression. Brittany Harvey: Absolutely. And that first point you noted, I think is really important, that biomarker testing is really critical for treatment decision-making in this space. So then the next subgroup of patients that the panel looked at, Dr. Shah, what first-line therapy is recommended for patients with proficient mismatch repair, microsatellite stable, HER2-positive gastroesophageal adenocarcinoma? Dr. Manish Shah: So this was an update from a few years ago. So we have known for 15 years now that if you are HER2-positive, you should get trastuzumab plus chemotherapy. That was based on the ToGA trial. And the update now is based on a trial called KEYNOTE-811, where it examined the addition of pembrolizumab to trastuzumab and chemotherapy versus trastuzumab and chemotherapy, and there was a progression-free and overall survival benefit. And again, here, the biomarkers are important. If your CPS PD-L1 is less than 1, we would not recommend Pembrolizumab in that setting, so you would still get trastuzumab and chemotherapy. But if it is 1 or greater, the PD-L1 CPS score, then we do recommend pembrolizumab unless there is a contraindication to immunotherapy. The take-home message really is from the onset of diagnosis, please check your biomarkers. And I will just, it is worth repeating, it is important to check your PD-L1 status, HER2 status, mismatch repair status, and CLDN18.2 status. And then the optimal therapy, and it is outlined in the publication, is really biomarker-driven. We know that if we are able to hit the target that is overexpressed, we are going to have a better outcome. And Dr. Rajdev did mention where there is overlap, there can be a lack of data, and that is where we are with both PD-L1 positive and CLDN positive. Here we do have data in HER2-positive cases where if you are both HER2-positive and PD-L1 positive, you would combine trastuzumab and pembrolizumab for the best outcomes. Brittany Harvey: Understood. I really appreciate you detailing what is most important for each individual biomarker combination that patients may have. So then following that, Dr. Rajdev, what does the expert panel recommend for first-line treatment for patients with esophageal squamous cell carcinoma that is not amenable to definitive chemoradiation? Dr. Lakshmi Rajdev: There are three phase III randomized clinical trials that have influenced practice in patients with esophageal squamous cell carcinoma examining the benefit of immunotherapy in this patient population. The RATIONALE-306 was a randomized trial of tislelizumab plus chemotherapy with platinum and fluoropyrimidine or paclitaxel versus placebo with chemotherapy. And then you have the KEYNOTE-590, which compared pembrolizumab plus chemotherapy versus chemotherapy alone. And then you have CheckMate-648, which included comparisons of nivolumab plus chemotherapy versus nivolumab plus ipilimumab or chemotherapy. And the primary endpoints for these studies were overall survival, and they did look at subgroups with PD-L1 expression. They used TPS score greater than 1% in CheckMate-648 and PD-L1 CPS greater than 10 in KEYNOTE-590. The bottom line is that the overall hazard ratio for overall survival across this patient population was 0.72. So clearly, there is benefit in patients that express PD-L1 CPS greater than 1 for benefit for the addition of immunotherapy. Now, the benefit again in patients with a PD-L1 expression less than 1 remains limited, and so the panel has made a recommendation for using immunotherapy in combination with platinum-based chemotherapy in patients with a PD-L1 greater than 1. Again, we know that it is hard to make recommendations on what PD-L1 cutoffs are recommended in this patient population, meaning that should it be limited to patients with a PD-L1 of 1 to 4 or greater than 10? I think that the general consensus that has been gleaned from the data is that the higher the PD-L1 expression, the greater the benefit. I do want to comment on another option that is available in patients with squamous cell carcinoma compared to adenocarcinoma, and that is the combination of nivolumab and ipilimumab. Now, in CheckMate-648, nivolumab with ipilimumab was also recommended as a treatment option in patients that have a PD-L1 score of greater than 1. There was a survival benefit demonstrated with this combination compared to chemotherapy alone. And an important observation in this study is that, although there was a slightly increased rate in early death, but there was really no significant difference in PFS and OS compared to chemotherapy alone. Importantly, the treatment appeared to be pretty well tolerated by the study population. There was a notable difference in the objective response rate, which was 35% in the nivolumab plus ipilimumab group compared to patients receiving nivolumab and chemotherapy, where it was 53%. So superiority is, so the importance of chemotherapy in patients with esophageal squamous cell carcinoma is to be noted. However, there is no difference in overall survival and progression-free survival when using the combination of nivolumab and ipilimumab, and thus it affords a chemotherapy-free option for this patient population with esophageal squamous cell carcinoma and a CPS with a score of greater than 1. Brittany Harvey: Understood. I appreciate you reviewing the evidence underpinning those recommendations as well. So then the next patient population that the guideline panel addressed, what first-line therapy is recommended for patients with deficient mismatch repair, microsatellite instability-high, gastroesophageal adenocarcinoma or esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: The rate of MSI-high expression is about 3% to 7% across different studies. Now, the KEYNOTE-158 was a tumor-agnostic study in patients with non-colorectal cancers, and again, the problem with the MSI-high population, given that it is so rare, the numbers in the individual studies are fairly small. But consistent outcomes do emerge, indicating high response to immunotherapy. So in KEYNOTE-158, a response rate of about 46% was noted. The number of patients was small, it was about 24. In CheckMate-649, which is a study of chemotherapy plus or minus nivolumab in patients with advanced gastric adenocarcinoma, there was again a very small number of patients, and patients that were MSI-high or deficient MMR did experience substantial benefits with the addition of immunotherapy, with hazard ratios in the order of about 0.38. In KEYNOTE-062, again, it was a very small number of patients, again about 6% or so, and similar to CheckMate-649, a substantial benefit was noted in combination with chemotherapy, but also there were benefits noted with pembrolizumab alone. The RATIONALE-305 again was a study of tislelizumab in combination with chemotherapy and similarly showed benefits to the combination of chemotherapy plus immunotherapy in this patient population. I think that we are all aware of the dramatic benefits of immunotherapy in this particular subset of patients, deficient MMR MSI-high, and also we have seen in CheckMate-649 they did have a subset of patients that received nivolumab and ipilimumab. And in this patient population, they noted unstratified hazard ratio of 0.28. So I think that the overall consensus is that immunotherapy is a very important treatment modality in patients with deficient MMR MSI-high disease, given that a lot of the trials in gastroesophageal adenocarcinoma have utilized chemotherapy-based options, that is certainly a recommendation of the panel to use chemotherapy in combination with immunotherapy. However, on a case-by-case basis, the panel recommended immunotherapy alone as well, and given the high response rates noted in trials across different diseases as well as noted in this disease as well. Brittany Harvey: Certainly. And I appreciate you both for reviewing these first-line recommendations. So moving to later lines of therapy, Dr. Rajdev, what recommendations did the expert panel make for second or third-line therapy for gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: So, I think that the RAINBOW trial that investigated the utility of the addition of ramucirumab as second-line therapy has been around since 2014, and those results have led to the addition of ramucirumab to taxane-based therapy in the second-line setting. Based on the utilization of oxaliplatin and platinum-based therapy in the front-line setting, there may be patients that have an underlying neuropathy, and so we wanted to really include treatment options for this patient population so that an agent that is less neurotoxic could also be recommended in combination with ramucirumab. The RAMIRIS trial is one such trial where ramucirumab was combined with FOLFIRI, and it demonstrated benefit in combination with ramucirumab. So we have listed that as a potential treatment option for patients in the second-line setting who may have an underlying neuropathy or even for whatever reason that based on the toxicity profile, that needs to be the preferred option by a physician, that recommendation is new from the older guidelines that we have. With regard to the utility of PD-1 inhibitors, there really has been no benefit noted in the second-line setting with regard to overall survival or progression-free survival, so no recommendation is made for that option. I think an important study that has been recently presented is the DESTINY-Gastric04 trial, which really has been practice-changing and has led to the recommendation for trastuzumab deruxtecan in patients that have HER2-positive metastatic gastric or GE junction adenocarcinoma. Now, this is a phase III trial in patients who retained HER2-positive disease after progressing on front-line trastuzumab-based treatments, and the comparator for this trial was trastuzumab deruxtecan versus ramucirumab plus paclitaxel. There was significant improvement and progression-free survival in patients that received trastuzumab deruxtecan. The patients that were excluded from the trial are patients that have pulmonary problems, interstitial lung disease; that is one of the toxicities of this particular agent, and close monitoring and prompt initiation of therapy such as glucocorticoid treatment in patients who develop this toxicity was also highlighted by the panel. So to summarize, the new guidelines highlight the possibility of FOLFIRI plus ramucirumab as a second-line option and then trastuzumab deruxtecan as a later-line option in patients that still retain HER2 expression. And that is very important because the trial did retest patients whether they expressed HER2. As we know, in a substantial number of patients, there is downregulation of HER2, and there is emerging data that the benefit for subsequent HER2-directed therapies is best noted in patients that still retain HER2 expression. Brittany Harvey: Great. So as our listeners have heard, there are many recommendations and new treatment options for advanced gastroesophageal cancer. Dr. Shah, earlier you highlighted the importance of biomarker testing, but I would like to hear in your view, what is the importance of this guideline and how will it impact both clinicians and patients with gastroesophageal carcinoma? Dr. Manish Shah: So as we have discussed throughout this podcast, the treatment for gastroesophageal cancer, both adenocarcinoma and squamous cell cancer, is increasingly complex, increasingly biomarker-driven. And I think the value of the guideline is to place all of that into context. So it provides the data for why certain biomarkers are important, what therapies should be indicated. Not only that, but if you are able to review the guideline, it provides the details of each of these studies and summarizes them in a meta-analysis fashion to sort of give you the context, because sometimes the individual studies can be maybe a little bit discordant or confusing and the guideline attempts to harmonize all that. And then also, I think the tables are very, very interesting because they give you actual numbers in terms of how many patients over a thousand would this benefit or how many patients over a thousand would this cause harm in terms of nausea, vomiting, or other things like that. So it gives you context for helping clinicians and patients weigh the potential benefits of the novel treatment strategies against the potential adverse events. And then finally, the guideline does also provide an algorithm that you are able to follow based on the biomarkers, and those are in figures 4 and 5. So I think overall, it is a very comprehensive guideline. It intends to make more manageable a very complex subject, and you know, I really encourage our listeners to review it after listening to the podcast. Dr. Lakshmi Rajdev: If I can add to that, I think that what is also really good about the guidelines is there are quick summaries. So if someone is busy in the clinic, of course, there is the opportunity to review the data supporting the guidelines in great depth in the manuscript, but what is also really good is that there are good summaries. In the event that you are very busy, you can easily identify what the recommendations should be for that particular patient based on these summaries. Brittany Harvey: Absolutely. Listeners are encouraged to review the full guideline, including those tables and figures that may be more helpful when they are looking for something quick to look at in the clinic as well. So, as you both mentioned, there have been a number of recent practice-changing trials in this area. So I imagine there is still a lot of ongoing research as well. So Dr. Shah, what are the outstanding questions regarding treatment options for patients with locally advanced unresectable, advanced, or metastatic gastroesophageal carcinoma? Dr. Manish Shah: I think we touched upon it a little bit. The guidelines are based on the data available, and they are primarily examining one novel therapy with chemotherapy in a specific biomarker population. But as you know, the biomarkers are not either/or; you are not either CLDN18.2 positive or PD-L1 positive. A portion of patients could have dual biomarkers, and you know, I think that we are generating data on how to manage those patients. At the recent GI Symposium in January this year, the ILUSTRO trial was presented by Dr. Shitara, which looked at combining zolbetuximab and chemotherapy with immunotherapy for dual-positive biomarkers, and that is leading to a phase III study that has begun to enroll. So unanswered questions are: how do we manage dual-positive biomarkers? The other thing that was mentioned is that the current data for mismatch repair deficiency involve chemotherapy plus immunotherapy. Only squamous cell cancer is there a study with a positive non-chemotherapy kind of backbone, that is CheckMate-648 that Dr. Rajdev mentioned. As we move forward, it will be good to get data on non-chemotherapy options in certain biomarker-positive populations. And then finally, another update, which is likely to be practice-changing, is the HERIZON-GEA-01 study that looked at zanidatamab, which is another biparatopic antibody that targets HER2, and that is likely to change practice. And as that data gets published, we may look to even do a rapid update for the current immunotherapy and targeted therapy guideline that is just being published. Dr. Lakshmi Rajdev: So, if I can add to that, there are numerous ADCs that look very interesting. There are bispecific antibodies; in fact, the zanidatamab is a bispecific antibody showing improved activity in patients with HER2-positive disease. So I think there are studies from Asia looking at CLDN CAR T-based therapies. So, I think that there are a lot of novel agents and a lot of excitement in the field. We know that the bemarituzumab study, unfortunately, the FGFR2 inhibitor failed to demonstrate any benefit, but I think that there are other agents that are being explored, so there are newer targets, newer agents, ADCs, bispecifics that could potentially change the field in the future. Brittany Harvey: Yes, we will look forward to the data to address these unanswered questions and new agents and inform future guideline updates. So, I would like to thank you both for all of your work to review the evidence here and update this important guideline, and for your time today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you. Brittany Harvey: And finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/gastrointestinal-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. 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.

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Mike and Molly just dropped a clear, test-focused breakdown of G protein coupled receptors that covers everything the AAMC expects you to know without the textbook overwhelm.Here's what we walk through:

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One huge milestone. One unforgettable twist

Send a text6 years. Hundreds of women physicians helped. Two books written. And it all started with one cracked MacBook.In this episode, Dr. Latifat sits down to share 5 raw, unfiltered truths she's learned from building MoneyFitMD from scratch as a full-time GI physician, mama of three, who never planned to be an entrepreneur a day in her life. No fluff, no highlight reel. Just the real talk about what it actually takes to build a business and wealth that lasts.If you're a woman physician with a calling, a business, or just a big dream you haven't acted on yet this one is for you.In this episode:Why feeling like it's hard means you're doing it rightHow investing, even imperfectly, is what separates those who build wealth from those who don'tThe #1 transformation you didn't know you were signing up for when you started your business "The future that is possible for you is big. And it doesn't matter if you're just starting out."You're making six or even seven figures—and still asking, “Where did all my money go?” The problem isn't your income—it's that you haven't learned how to have money left.The Money Left Over program gives women physicians the tools to uncover 4–5 figures in extra monthly cash and finally let your money start working for you.

Perplexed by patients with normal exams but persistent symptoms like recurrent UTIs or palpitations? It could be menopause. In this insightful episode of Succeed In Medicine podcast, host Dr. Bradley Block interviews Dr. Lauren Streicher. They explore commonly overlooked menopause symptoms beyond hot flashes: recurrent urinary tract infections tied to genitourinary syndrome of menopause (GSM), palpitations as "hot flashes of the heart" (often sinus tachycardia without EKG changes), GI microbiome shifts causing nebulous digestive issues, xerostomia (dry mouth) linked to oral health risks, and skin/hair changes like alopecia. Dr. Streicher emphasizes reassuring patients early, validating symptoms as hormonal, and tailoring treatments, vaginal estrogen, safe even for breast cancer patients, systemic hormones, or new non-hormonal NK3 receptor antagonists like fezolinetant. They discuss the SWAN study's findings on long-term risks from untreated hot flashes (e.g., cardiovascular disease, bone loss), the need to differentiate perimenopausal (temporary) vs. lifelong postmenopausal effects, and avoiding arbitrary hormone therapy stops after 5 years. The conversation also touches on sexual health gaps in medicine, with tips for better history-taking and resources like Dr. Stryker's "Come Again" course. Listeners, clinicians and patients alike, will gain tools to address menopause holistically, improving quality of life and preventing complications. Three Actionable Takeaways: Recognize GSM in Recurrent UTIs: For postmenopausal women with new-onset recurrent UTIs, suspect genitourinary syndrome of menopause, prescribe local vaginal estrogen (cream, suppository, or ring) to restore microbiome and tissue health; it's safe for most, including breast cancer survivors on aromatase inhibitors. Reassure on Palpitations First: When midlife women present with palpitations, lead with "This is common in perimenopause (up to 50% affected) likely autonomic dysfunction like a 'heart hot flash'"; order a Holter monitor, but emphasize it's often benign and tied to vasomotor symptoms, treatable with hormones or NK3 antagonists. Integrate Sexual History Properly: Ditch "Are you sexually active?",  ask "Many women in menopause experience low libido, pain with sex, or orgasm difficulty; are any of these issues for you?"; refer to resources like Dr. Streicher's course for evaluation scripts, screeners, and solutions to address 50% of patients' unspoken concerns. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Lauren Streicher is a clinical professor of OB-GYN at Northwestern University and founding director of its Center for Sexual Medicine and Menopause. A certified menopause practitioner, she serves on the Menopause journal's editorial board, is a Kinsey Institute fellow, and authors bestsellers like "Sex Rx" and "Hot Flash Hell." She hosts "Inside Information" podcast and created "Come Again" audio series on postmenopausal sexuality. Connect with Dr. Lauren Streicher: Website: https://www.drstreicher.com Email: info@drstreicher.com  About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This week on the show Maine and Miranda preview the 2026 IBJJF No-Gi GP we break down all of the big black belt, super fights, and every single athlete in the Grand Prix. In the preview section of the show, we discussed every single first round matchup in the IBJJF absolute No-Gi GP. We kick it off discussing the quarterfinal matchups that kickoff the event with the top seed Victor Hugo vs Marlon Tajik, we discussed the recent performances that we've seen from both athletes and how Marlons most recent ADCC European trials performance and brand new black belt will affect him going into this matchup against potential number one seed Victor Hugo.On the same side of the bracket we discussed Javier Barter vs Nick Hartman, with Hartman, coming off of an impressive ADCC trials performance of his own we talk about his guard work and how it may play a factor versus the Panamanian in Barter.In Pedro Marinho vs Diego Pato we discussed the stylistic matchup with Diego being by far the smallest competitor in the entire tournament. We discuss how Pedro will most likely play the Ranger game and leverage his wrestling and guillotine game versus the quick speed and leg locks of Pato. In the final quarterfinals matchup we discussed Michael Pixley vs Gustavo Batista, we talked about the guard work from Gustavo and how it may potentially play an issue with Pixley's passing game we also discussed some potential strategic avenues for Pixley and Gustavo to potentially leverage the IBJJF points in order to come out on top.We also preview the second round and potential finals matchups on each side of the bracket, discussing Victor Hugo's potential pathway to victory as the number one seed in the event. We preview the black belt, super fights on the card as well.With Cole Abate vs Will Wilson a rematch from an earlier event with both coming off of very strong performances at the Europeans will taking the lightweight division and Cole taking silver against Kennedy in the division below.We discussed Helena Crevar vs Aghata Rabelo another rematch that took place in the Gi at the colored belts we discuss Helena's argument for the slot as the number one No-Gi woman in the world.We briefly discuss Sarah Galvão vs Maria Vicentini, and how the recent Atos situation may play into the preparation that Sarah is able to do in the lead up to this match. We also discuss Leo Souza vs Mateo Cardona and Ashlee Funegra vs Yasmyn Castro.In the outro of the show, we discuss recent travel and the upcoming promotion for Corey of the Grappling Rewind later that night.  Recorded 2-23-2026

In Episode 125 of the BJJ Balance Podcast, Matt and Kenny go completely off the rails — and somehow still drop serious gems about Brazilian Jiu-Jitsu.We break down Sean Strickland's latest fight and betting lines, why Vegas might be behind on MMA analytics, and how personal life can affect fight performance. Then we dive into real BJJ talk:• Why wearing a t-shirt under your gi is controversial• The evolution of the 6AM class and gym culture• How to use points strategy to improve submission finishes• Why you shouldn't abandon your “money move”• Gi vs No-Gi growth trends• Student retention in modern academiesPlus sponsor talk, Level Black gear breakdown, and a few stories that probably shouldn't be clipped.If you train jiu-jitsu, run a gym, bet on MMA, or just enjoy unfiltered grappling conversations — this episode is for you.Please Follow BJJ Balance on all of our socials:IG: @BJJBalanceDiscord: discord.gg/bjjbalanceTik Tok: @BJJBalanceYouTube: YouTube.com/@BJJBalanceKenny IG: @FreakPartyBJJMatt IG: @oss_nation_bjj

Hành trình tìm lại công lý và sự gắn kết cho cộng đồng Do Thái tại Úc chính thức bước sang chương mới. Giữa những vết sẹo chưa lành sau thảm kịch Bondi, một Ủy ban hoàng gia đặc biệt đã được thành lập, đánh dấu cuộc điều tra ở cấp độ cao nhất. Không chỉ dừng lại ở việc bóc tách những góc khuất của chủ nghĩa bài Do Thái, đây còn là cuộc chiến pháp lý đầy quyết liệt nhằm củng cố an ninh quốc gia và hàn gắn những rạn nứt trong lòng xã hội.

Giữa bối cảnh lãi suất tại Úc rục rịch tăng nhiệt, một nghịch lý tài chính đang diễn ra: thay vì thắt lưng buộc bụng, người dân lại ồ ạt lao vào vòng xoáy nợ nần. Từ những khoản vay mua nhà chạm mốc kỷ lục trong 5 năm, đến sự bùng nổ thẻ tín dụng của thế hệ gen Z, làn sóng vay mượn đang dâng cao hơn bao giờ hết. Liệu đây là chiến thuật "chốt chặn" lãi suất khôn ngoan hay một canh bạc đầy rủi ro khi gánh nợ ngày càng phình to?

Send a textIf you've ever stared at your elimination diet food list thinking, “What on earth am I supposed to eat?”, this episode is for you. Alyssa sits down with professional chef Laurie Gauguin, author of Heal Simply: 1-2-3 Ingredient Recipes for Elimination Diets, to talk about the part of healing no one prepares you for: Actually implementing the elimination diet.Together, Alyssa and Laurie discuss:Why elimination diets often fail (and it's not lack of willpower)The biggest mistake people make when starting LEAP or low FODMAPHow to cook when your “safe food” list feels randomWhy simplicity (1-2-3 ingredient meals) can accelerate gut healingHow to stay motivated when food feels restrictiveMaking elimination diets work for familiesWhy mindset and support systems matter more than perfectionAbout Laurie Gauguin:Laurie Gauguin has cooked professionally for more than 20 years. For many years, she has cooked custom meals for clients following myriad special diets. She partners with dietitians to help patients succeed on their medically-prescribed diets and feel enthusiastic about mealtimes. Her first-hand experience with elimination diets informed her desire to write her book: Heal Simply: 1-2-3 Ingredient Recipes for Elimination Diets. Under the direction of her dietitian, Laurie completed a 3-month elimination diet and understands the challenges and rewards of the process. Her life's work is to help others regain their health.Connect with Laurie here: Instagram: @cheflauriegauguin Website: https://www.cheflauriegauguin.com/Heal Simply: 1-2-3 Ingredient Recipes for Elimination Diets: https://www.cheflauriegauguin.com/my-bookConnect with Alyssa here: Instagram, LinkedIn, Facebook, Pinterest   DM “GUT CHECK” on Alyssa's Instagram for a personalized quiz and free meal plans & resources to kickstart your gut healing journey.Check out Alyssa's FREE Masterclass “Why your gut still isn't better - the real reason you feel stuck. -If you're enduring uncomfortable, painful, and embarrassing GI symptoms and feel like you've tried everything, Alyssa uses a specialized approach to help people who've gone from doctor to doctor finally find relief. Book your 15-minute strategy call for FREE here.Looking for a supportive Gut Health community? Alyssa is building a community committed to helping people overcome their digestive symptoms by addressing the root cause using food and nutrition. Join Alyssa's FREE Facebook Community here.The Gut Health Dialogues drops new episodes weekly to help you uncover root causes, not just treat symptoms. Tune in for gut health insights, client transformation, and expert insights into gut health. Leave a review—Your support will help Alyssa empower more people with the knowledge and tools to take control of their gut health and reclaim their lives.

- Phó Thủ tướng Bùi Thanh Sơn thăm, làm việc với 4 Tập đoàn về công nghiệp, năng lượng.- Hoàn thiện dự thảo Nghị quyết của Bộ Chính trị về phát triển Thủ đô trong kỷ nguyên mới.- Trong chương trình có bình luận: Không có “tháng Giêng ăn chơi” trong mùa xuân khát vọng- Khai mạc Khóa họp lần thứ 61 của Hội đồng Nhân quyền Liên hợp quốc.- Mỹ rút nhân viên không thiết yếu khỏi Đại sứ quán ở Liban, trong bối cảnh lo ngại gia tăng về nguy cơ xung đột quân sự với Iran.

VOV1 - Trong làn sương mỏng của những ngày đầu Xuân, đỉnh Ngàn Nưa, tỉnh Thanh Hóa như chìm trong mây trắng. Con đường lên núi quanh co, uốn lượn giữa rừng xanh, đưa bước chân du khách tìm về chốn linh thiêng giữa đại ngàn xứ Thanh.Từ sáng sớm, từng đoàn người đã nối nhau lên núi. Người già, trẻ nhỏ, thanh niên… ai cũng mang theo trong lòng niềm háo hức của chuyến du xuân đầu năm. Gió núi mát lành, hương trầm thoảng nhẹ quyện trong không khí tạo nên một không gian vừa thanh tịnh, vừa ấm áp. Dừng chân trước “Cổng Trời”, nơi được người dân ví như “huyệt đạo thiêng” của đất trời xứ Thanh, bà Hoàng Thị Dự đến từ xã Hoằng Phụ, tỉnh Thanh Hóa cho biết: “Không khí ở đây quá tuyệt vời, vui. Đầu năm tôi lên cũng cầu cho con người khỏe mạnh, con của chăn nuôi bình an, cầu duyên cho cháu.

#943: Join us as we sit down with Dr. Karan Rajan – doctor, health educator, & bestselling author of This Book May Save Your Life & This is Vital Information. Known across social media for debunking viral health trends, he's become one of the most trusted voices in gut & general health. In this episode, Dr. Karan Rajan breaks down the alarming rise of colorectal cancer, how gut health impacts hormonal conditions like endometriosis, the truth about fiber intake, what your GI tract is really trying to tell you, & debunks today's biggest viral health trends.   To Watch the Show click HERE   For Detailed Show Notes visit TSCPODCAST.COM   To connect with Dr. Karan Rajan click HERE   To connect with Lauryn Bosstick click HERE   To connect with Michael Bosstick click HERE   Read More on The Skinny Confidential HERE   Head to our ShopMy page HERE and LTK page HERE to find all of the products mentioned in each episode.   Get your burning questions featured on the show! Leave the Him & Her Show a voicemail at +1 (512) 537-7194.   Shop LOAM at https://go.shopmy.us/p-43749215 and use code SKINNY20 for 20% off!    This episode is sponsored by The Skinny Confidential The beauty tool that started it all, redesigned to evolve with you. Shop Ice Roller at https://bit.ly/IceRollerSilver today.   This episode is sponsored by Beekeepers Natural's Go to http://beekeepersnaturals.com/SKINNY or enter code SKINNY to get 20% off your order!   This episode is sponsored by The American Beverage Association Visit http://goodtoknowfacts.org for more information.   This episode is sponsored by ARMRA Go to http://armra.com/SKINNY or enter SKINNY to get 30% off your first subscription order.   This episode is sponsored by The RealReal Get $25 off your first purchase when you go to http://TheRealReal.com/skinny.   This episode is sponsored by Ollie Go to http://ollie.com/skinny and use code skinny to get 60% off your first box!   This episode is sponsored by Just Thrive Get your health in check and save 20% on your first order at https://justthrivehealth.com/SKINNY.   This episode is sponsored by Bobbie If you want to feed with confidence too, head to http://hibobbie.com to find the formula trusted by parents and loved by their babies—700k and counting. Produced by Dear Media

The Gi crew return to discuss Phil Spencer & Sarah Bond suddenly stepping down from their positions at Xbox, the new Xbox CEO's plans, Sony's plan to rob YOU, Xenoverse 3, Skate getting worse and more.

In this episode, Drs. Jason Silverman and Jennifer Lee talk to Dr. Paul Wales all about the surgical management of short bowel syndrome, including decision-making based on initial presentation and important considerations for any autologous reconstruction procedure.Learning objectivesTo define intestinal failure, short bowel syndrome and ultrashort bowel syndrome as well as surgical subtypes of short bowel syndromeTo review surgical considerations in the staged management of short bowel syndromeTo discuss surgical approaches to autologous bowel reconstruction including their potential advantages and disadvantages LinksPapers mentioned:Surgical therapy for short bowel syndrome (review with images)Establishing norms for intestinal length in childrenPredicting Intestinal Adaptation in Pediatric Intestinal FailureAdvantages of the distal sigmoid colostomyDelayed primary STEP procedurePrevious episodes mentioned:Sue Protheroe - Enteral Nutrition in Intestinal FailureDanielle Wendel - Central Line Management in Intestinal Failure (Special JPGN Episode)Ruben Quiros-Tejeira - Multivisceral TransplantationSupport the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

The Gi crew return to discuss Phil Spencer & Sarah Bond suddenly stepping down from their positions at Xbox, the new Xbox CEO's plans, Sony's plan to rob YOU, Xenoverse 3, Skate getting worse and more.

Brad and Tyler envision how a Roman Reigns title run would look following WrestleMania and discuss Finn Balor's shift in presentation ahead of WWE Elimination Chamber. They also react to "Hangman" Adam Page's proposed stipulation for AEW Revolution before trading their hope for The Demand in 2026.Other topics include:At the Movies: "Anaconda"Netflix's "Star Search" FinaleRousey versus CaranoFollow the show for exclusive updates.Social: @gipod19Web: gimmickinfringementpod.com, 19mediagroup.comGoods: https://19-media-group.myspreadshop.com0:00 Intro3:31 WWE — Envisioning a Roman Title Reign 2.0, Finn's Change27:02 Gratitude — Perspective and the Spring Play31:44 AEW — Hangman's Offer, The Demand46:36 GI @ the Movies — Anaconda49:45 WDWM — Jesse Jackson, Olympics Coverage, and Rousey versus Carano1:01:40 ClosingFollow 19 Media Group:Twitter: @19MGroupInstagram: 19mediagrouphttps://www.19MediaGroup.comDiscover our favorite podcast gear and support the show—shop our studio must-haves on our Amazon Affiliate page! https://www.amazon.com/shop/19mediagroupWant to join the conversation or invite us to your platform? Connect with us and share your vision (budget-friendly collaborations welcome)!  https://bit.ly/19Guest

In this Jack Westin MCAT Podcast episode, Mike and Molly break down MCAT signaling cascades with a clear, test-focused walkthrough of G protein–coupled receptors (GPCRs). You'll learn the core GPCR structure, how GDP → GTP activation works , why signaling pathways create amplification, and how cells shut signals off with built-in termination steps.We cover the high-yield cAMP pathway in detail, including Gs vs Gi, adenylyl cyclase → cAMP → protein kinase A (PKA), plus the key ideas behind the Gq pathway (PLC and calcium signaling). We also connect GPCR signaling to common MCAT contexts like hormones, fast cellular responses, and a classic passage-style example (cholera toxin) to show how the AAMC tests cause-and-effect in pathways.In this episode, you'll learn:

Tựa Đề: Kinh Nghiệm Chúa Trong Đời Sống; Kinh Thánh: 1 Giăng 1:1-4; Tác Giả: Mục Sư Nguyễn Trọng Vinh; Loạt Bài: Hội Thánh Báp Tít Hy vọng Việt Nam Baton Rouge

Coach Donavin Britt on Building Las Vegas Combat Academy, Mental Toughness, and Protecting Gym Culture   Host Pete Deeley interviews Coach Donavin Britt on The Jiu Jitsu Mindset, discussing Britt's path from apprenticing under instructor Roger Donofrio into becoming a Krav Maga and self-defense-first gym owner who later added jiu-jitsu and MMA. He describes earning high-level training under figures including Sgt. Major Nir Maman (as the first American certified instructor), Darren Levine, and John Whitman, and discusses the importance of standards, mental toughness, and having a purpose bigger than oneself. Britt addresses misconceptions and quality-control issues in Krav Maga, his motivation to compete in jiu-jitsu (including winning at NAGA while representing Krav Maga on his rashguard), and how sparring and competition serve as stress tests while differing from real self-defense. He recounts a memorable fight from the 1990s loss-prevention work in Oakland involving a drug-impaired suspect who required a rear-naked choke to stop, using it to emphasize the need for a varied skill set. Britt also strongly condemns misconduct in martial arts settings, details removing a student with a troubling history involving women to protect members, and argues men and coaches must "guard the mat" and enforce clear consequences to keep women safe. He shares a transformative student story about a teenager, Angel, who was assaulted and regained confidence through training and sparring, connecting it to mentorship, accountability, and coaching built on consistent care and firm parameters. The episode ends with Deeley inviting Britt to return for further discussion.   00:00 Welcome Back + Coffee & Kids Program Plug 00:33 Meet Coach Donavin Britt 01:36 Life Without Martial Arts? From Student to Instructor via Apprenticeship 02:29 How Krav Maga Instructors Are Really Made (Not a Weekend Cert) 03:53 2008 Crash, Failed Smoothie Franchise, and Betting the Last $500 on a Gym 06:26 Building Las Vegas Combat Academy: Growth, Identity, and the 'Krav Guy' Label 08:38 Crossing Into Jiu-Jitsu: Competing at NAGA and Repping Krav on the Gi 13:36 Iron Will & Legacy: Training for Something Bigger Than Yourself 14:21 Work Ethic Roots: Poverty, Family Pressure, and Grandfather's Alaska Story 19:22 How Martial Arts Learning Differs: Physicality, Emotion, and Self-Defense Intent 22:44 Calling Out Toxic Gym Culture: Protecting Women and 'Guarding the Mat' 27:49 Gym Dating Drama: Standards, Respect, and Zero Tolerance for Fights 29:06 Most Memorable Fight: Loss Prevention Brawls in 90s Oakland 33:53 Competition vs Real Violence: Why Sparring Matters (and Its Limits) 37:58 "It's Just Pain": Teaching Kids Hurt vs Injured & Fighting vs Self-Defense 40:21 Cross-Training and Combat Sports Programming That Improves Self-Defense 42:48 Student Transformation Story: Angel's Sparring Breakthrough 49:52 Coaching, Accountability, and the "Rules of the Tribe" (Maximum Effort) 53:48 Final Thoughts: Self-Help Through Martial Arts & Closing the Conversation

Tựa Đề: Lời Cầu Xin Đầu Năm; Kinh Thánh: Thi-thiên 90:12; Tác Giả: Mục Sư Đoàn Trung Tín; Loạt Bài: Hội Thánh Truyền Giảng Phúc Âm, Năm Mới

Tựa Đề: Chúng Ta Có Cần Giúp Đỡ Việc Cầu Nguyện Không?; Tác Giả: Jeff Schreve; Loạt Bài: Gây Dựng Niềm Tin

Trong tập 246 của Have A Sip, chúng ta sẽ cùng gặp lại Dịch giả, Họa sĩ Trịnh Lữ - người đang bước vào tuổi già với sự bận rộn lạ lùng: từ tái bản cuốn sách Ghi Chép của chính mình, tổ chức triển lãm vinh danh người cha - cố họa sĩ Trịnh Hữu Ngọc, đến chứng kiến tư tưởng “thiết kế là thúc đẩy một nếp sống” của mình tiếp tục được thế hệ trẻ tiếp nhận.Từ câu chuyện về một không gian sống thấm đượm cảm xúc, cuộc trò chuyện mở rộng ra những không gian khác: mạng xã hội với văn hóa “trình diễn”, những “mồi giận dữ” khiến con người bị cuốn vào năng lượng độc hại, sự bủa vây của thông tin trong thời đại AI, và cảm giác thế giới đang đứng trước một chu kỳ thay đổi dữ dội. Giữa tất cả những xô lệch đó, bác Trịnh Lữ chọn một thái độ khác: nhớ rằng mình chỉ là một hạt cát trong vũ trụ, sống hết mình với điều mình yêu, không làm nửa vời, không biến các mối quan hệ thành công cụ, và học cách mở rộng tâm thức của chính mình.#HaveASip #Vietcetera #Vietcetera_Podcast #HAS246—Đừng quên có thể xem bản video của podcast này tại: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Và đọc những bài viết thú vị tại website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Vietcetera⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠—Yêu thích tập podcast này, bạn có thể donate tại:● Patreon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.patreon.com/vietcetera⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠● Buy me a coffee: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.buymeacoffee.com/vietcetera⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Nếu có bất cứ góp ý, phản hồi hay mong muốn hợp tác, bạn có thể gửi email về địa chỉ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠team@vietcetera.com

Ffion Davies joins James Smith to reveal the problem with women in jiu-jitsu, a sport often gatekept by a "sausage fest" mentality and dangerous myths about self-defense. Davies, a six-time world champion, exposes why the current narrative is failing women and how the lack of equal pay is a quiet crisis threatening the sport's growth. They confront the reality of the "big strong dude" syndrome, the biological discrepancies in training, and the high-stakes battle for financial respect in elite competition.

A fun, energetic exchange with GI on the Crucible on a wide range of topics. Be sure and follow Crucible here: Send Superchats at any time here: https://streamlabs.com/jaydyer/tip Join this channel to get access to perks: https://www.youtube.com/channel/UCnt7Iy8GlmdPwy_Tzyx93bA/join Order New Book Available here: https://jaysanalysis.com/product/esoteric-hollywood-3-sex-cults-apocalypse-in-films/ Get started with Bitcoin here: https://www.swanbitcoin.com/jaydyer/ The New Philosophy Course is here: https://marketplace.autonomyagora.com/philosophy101 Set up recurring Choq subscription with the discount code JAY60LIFE for 60% off now https://choq.com Subscribe to my site here: https://jaysanalysis.com/membership-account/membership-levels/ Follow me on R0kfin here: https://rokfin.com/jaydyer Music by Dr Evo the Producer, Jay Dyer and Amid the Ruins 1453 https://www.youtube.com/@amidtheruinsOVERHAULBecome a supporter of this podcast: https://www.spreaker.com/podcast/jay-sanalysis--1423846/support.

The Gi crew return to talk about the February 2026 Sony State of Play, Highguard & 2XKO layoffs, PS5 rental service, the FEDS trying to control gaming and more!