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Send us a textDr. Acosta returns to Causes or Cures to talk about the next big leap in obesity research: using genetics and machine learning to predict which patients will get side effects to popular GLP-1 weight-loss medications like Wegovy and Zepbound. Previously, he was on Causes or Cures to discuss your individual obesity type. He and his team are uncovering why some people experience major weight loss while others face tough side effects—especially nausea. The goal? True precision medicine for obesity: matching the right treatment to the right person before treatment even begins. (You can learn more about their available tests and company here.) Topics We DiscussDr. Acosta's background and what drew him to obesity researchWhy not all obesity is the same—and why that matters for patients and doctorsThe most common questions patients ask about GLP-1 drugs like Wegovy and ZepboundHow big a problem side effects like nausea really are in practiceNew research using genetic markers to predict who's more likely to experience side effectsWhether eating style affects nausea and how Dr. Acosta coaches patients on nutrition while using these medicationsThe possibility of genetic testing before prescribing GLP-1sWhat we know about rarer side effects, from vision to hearing changes, if he thinks more side effects will emergeWhat “satiation” (feeling full) means and why it varies so much between peopleHow genetic risk and satiation scores could determine which obesity treatment works bestDr. Acosta's thoughts on obesity prevention, especially on renewed energy to take on the unhealthy food industryThe persistence of stigma—why “willpower” doesn't tell the whole storyWhether the current obsession with obesity drugs distracts from prevention, nutrition, and community health Listen if you've ever wondered:Why GLP-1 drugs don't work the same for everyoneWhat your genes have to do with weight loss, feeling full and side effectsHow soon doctors could use genetic tests to personalize obesity treatmentWhether prevention is being overshadowed by the pharma spotlightWhy it mattersObesity isn't a one-size-fits-all condition—and neither should its treatment be. Dr. Acosta's research could mark a turning point in how we approach weight loss: scientifically, compassionately, and individually. Dr. Acosta is a Consultant of Gastroenterology and Hepatology at the Mayo Clinic, as well as an Associate Professor of Medicine. His research focus is on gastrointestinal physiology and the complexity of food intake regulation as it relates to obesity. You can learn more about his work here.You can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Or Facebook here.Or X.On Youtube.Or TikTok.SUBSCRIBE to her WEEKLY newsletter here! (Now featuring interviews with top experts on health you care about!)Support the show
Tune in to listen as expert faculty, Dr Christopher L. Bowlus and Dr Sonal Kumar, discuss recent developments in treating primary biliary cholangitis (PBC) with new and emerging agents, as well as strategies to integrate these advances into clinical practice.Topics covered include: Methods of Assessing PBC Disease ProgressionNewer Agents for Second-line Treatment of PBCPrioritizing Symptom Management and Quality of Life With PBC TreatmentPresenters:Christopher L. Bowlus, MDLena Valenta Professor and ChiefDivision of Gastroenterology and HepatologySchool of Medicine University of California Davis Sacramento, CaliforniaSonal Kumar, MD, MPHAssistant Professor of MedicineDivision of Gastroenterology and HepatologyWeill Cornell Medical CollegeNew York, New YorkLink to full program: https://bit.ly/43nHx6UGet access to all of our new podcasts by subscribing to the CCO Medical Specialties Podcast on Apple Podcasts, Google Podcasts, or Spotify. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Pediatrician Dr. Paul Bunch consults Dr. Kahleb Graham from the Division of Gastroenterology, Hepatology, and Nutrition and Dr. Megan Miller from the Division of Behavioral Medicine and Clinical Psychology on disorders of gut-brain interaction. Episode recorded on September 17, 2025. Resources discussed in this episode: Anxiety Assessment - Community Practice Support Tool Anxiety Management - Community Practice Support Tool Chronic Nausea and Vomiting - Community Practice Support Tool Functional Abdominal Pain - Community Practice Support Tool Financial Disclosure: The following relevant financial relationships have been disclosed: None All relevant financial relationships listed have been mitigated. Remaining persons in control of content have no relevant financial relationships. To Claim Credit: Click "Launch Activity." Click "Launch Website" to access and listen to the podcast. After listening to the entire podcast, click "Post Test" and complete. Accreditation In support of improving patient care, Cincinnati Children's Hospital Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Specific accreditation information will be provided for each activity. Physician: Cincinnati Children's designates this Enduring Material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing: This activity is approved for a maximum 0.75 continuing nursing education (CNE) contact hours. ABP MOCpt2: Completion of this CME activity, which includes learner assessment and feedback, enables the learner to earn up to 0.75 points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. Cincinnati Children's submits MOC/CC credit for board diplomates. Credits AMA PRA Category 1 Credits™ (0.75 hours), ABP MOC Part 2 (0.75 hours), CME - Non-Physician (Attendance) (0.75 hours), Nursing CE (0.75 hours)
Die Themen in den Wissensnachrichten: +++ Mann überlebt wochenlang mit Schweine-Leber +++ Frauen haben ein genetisch bedingt höheres Risiko für Depressionen +++ Durch den Schwarzwald streift ein Elch +++**********Weiterführende Quellen zu dieser Folge:Genetically engineered pig-to-human liver xenotransplantation, Journal of Hepatology, 08.10.2025Global Electricity Mid-Year Insights 2025, EMBER, 07.10.2025Global renewable capacity is set to grow strongly, driven by solar PV, IEA, 07.10.2025Sex-stratified genome-wide association meta-analysis of major depressive disorder, Nature Communications, 26.08.2025Sperm sequencing reveals extensive positive selection in the male germline, Nature, 8.10.2025Alle Quellen findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .
Send us a textThe original roundtable has three segments. Surfing the MASH Tsunami is preempting the third segment, which will be posted next week, to share our co-hosts' reactions to the positivity and energy they felt from a group of empowered SLD advocates. Immediately after the roundtable, Louise suggested to Roger that they record a separate conversation sharing their reactions to what they had just witnessed. They turned the recording equipment on and resumed their conversation.Roger starts by noting that this is the first SurfingMASH episode comprised entirely of patient advocates at a moment when advocates felt empowered and optimistic. (Also, the Fellows were the first advocates to appear on SurfingMASH who are not part of the Advocate KOL community.)For Louise, her overpowering reaction is to the passion, because passion breeds energy and empowerment. She notes that the SLD advocates came from an array of liver-related backgrounds and from HIV, the original sources of truly empowered patients some 30 years ago. Roger shares two thoughts. As he listened to the roundtable, he recalled earlier episodes, some four to five years ago, when it seemed that the physician KOL community was not in sync with the patient advocates' goals and needs. Continuing along this train of thought, he discusses the shift in identity from “MASH patient” to “person living with MASH.” To Roger, the term "MASH patient" suggests a person defined by the disease, whereas the term "patient living with MASH" empowers individual patients to manage the disease and its place in their lives in whatever way they choose. The advocates, he says, choose to learn and speak out confidently. During the roundtable, Elena mentioned Úna Keightly, a Harrison Fellow from Ireland, who spoke from the floor at Paris MASH to request that patients learn about the outcomes of the trials in which they participate, whether the outcome is deemed a success or a failure. For the "MASH patient," a failed trial feels like a personal failure, but for a "person living the MASH," even the failed trial becomes an opportunity to learn about the disease and contribute to a long-term solution. Louise mentions a comment from Harrison Fellow Pam Miller about her cardiologist giving her a potentially hepatotoxic medication without considering Pam's liver status. This reminded both Louise and Roger of a comment former Global Liver Institute President Donna Cryer made years ago to the effect of "it doesn't matter what kills me. If I'm dead, I'm dead." From here, the conversation shifts to other changes in disease description Louise and Roger foresee:Describing the disease itself in more accessible terms, such as "liver stiffness" vs. "fibrosis level."Increasing the groups of attendees at events to include not only patients, but also the APPs who will provide much of the actual patient-level care.Educating those who still mischaracterize MASLD as “a bit of fat” that requires no action. Focusing more attention on post-menopausal women, who Louise notes are most likely to exhibit advanced SLD and cirrhosis. Being more sensitive to issues that drive changes in patients' quality of life, which might be the impact of hepatic encephalopathy, but might also relate to lean mass wasting with incretin agonists. Both foresee a growing “army” of advocates that can drive earlier detection, smarter trial design, and better everyday care. They cite some specific examples from the Fellows in the roundtable and others from their own life experiences.Ultimately, Louise and Roger share their belief that this program is an excellent tribute to Stephen Harrison, who strongly believed in the importance of patient advocates and the messages they convey.
Send us a textWill AI make doctors and specialists less skilled—or even replace them?That's the question I explore in this episode of DigiPath Digest #29. As someone working where AI meets digital pathology, I'm both excited and cautious about how automation shapes our skills and professional identity.In this episode, I discuss two studies that ask tough questions about AI, expertise, and the future of medicine.What I Talk About:1️⃣ Endoscopist Deskilling After AI Exposure (Lancet, 2025)A multicenter Polish study found that after frequent AI-assisted colonoscopy use, endoscopists' adenoma detection rate dropped by ~6% when performing procedures without AI. It suggests overreliance on automation can subtly dull vigilance.It reminded me of how we depend on GPS instead of remembering routes—or how driving an automatic car changes focus. Could medicine be facing a similar shift?2️⃣ “Will My Expertise Be Devalued by Machines?” (Bangladesh, 2024)Healthcare professionals shared concerns about:Job security and evolving roles
Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Alexa Weingarden, MD PhD Probiotic use in gastroenterology remains a complex and evolving topic, shaped by variable evidence and growing patient demand. Dr. Peter Buch sits down with Dr. Alexa Weingarden to review current data, discuss distinctions between probiotic-related therapies, and explore the clinical utility of microbiome testing. Dr. Weingarden is an Assistant Professor of Gastroenterology, Hepatology, and Nutrition at the University of Minnesota Medical School.
Featuring: David T. Rubin, MD, University of Chicago MedicineThe GI Research Foundation was able to produce this podcast with sponsorships from Metro Infusion Center.David T. Rubin, MD, Joseph B. Kirsner Professor of Medicine and Chief of Gastroenterology, Hepatology and Nutrition at the University of Chicago Medicine, explores the top ten challenges faced by people with Crohn's disease and ulcerative colitis. He shares how health care providers and researchers are working to overcome these obstacles and improve patients' lives.To access other episodes of Visceral: Listen to Your Gut and learn more about the GI Research Foundation's support of clinical and laboratory research to treat, prevent, and cure digestive diseases, please visit https://www.giresearchfoundation.org/.Available on Apple Podcasts, Spotify, and everywhere else you listen.
Featuring: David T. Rubin, MD, University of Chicago MedicineThe GI Research Foundation was able to produce this podcast with sponsorships from Metro Infusion Center.David T. Rubin, MD, Joseph B. Kirsner Professor of Medicine and Chief of Gastroenterology, Hepatology and Nutrition at the University of Chicago Medicine, explores the top ten challenges faced by people with Crohn's disease and ulcerative colitis. He shares how health care providers and researchers are working to overcome these obstacles and improve patients' lives.To access other episodes of Visceral: Listen to Your Gut and learn more about the GI Research Foundation's support of clinical and laboratory research to treat, prevent, and cure digestive diseases, please visit https://www.giresearchfoundation.org/.Available on Apple Podcasts, Spotify, and everywhere else you listen.
Aujourd'hui, on parle médecine et intelligence artificielle, avec une étude qui soulève un sujet plutôt inattendu.L'IA pourrait, paradoxalement, réduire les compétences des médecins lors de certaines procédures.D'abord commençons par le contexte.La détection du cancer par l'IALe cancer colorectal est l'un des plus fréquents dans le monde, et la coloscopie reste l'examen de référence pour détecter les polypes précancéreux.Et ces dernières années, des systèmes d'IA ont été introduits pour aider les gastro-entérologues à repérer plus facilement ces lésions. Et en effet, avec l'IA, le taux de détection augmente.Mais comme souvent, existe le revers de la médaille.Un effet inattendu appelé « deskilling »Une équipe polonaise a publié dans The Lancet Gastroenterology & Hepatology une étude qui met en lumière un effet inattendu appelé « deskilling », autrement dit une perte de compétence des professionnels de santé qui utilisent des outils d'intelligence artificielle.En comparant les performances de 19 médecins avant et après l'introduction de l'IA, les chercheurs ont constaté que le taux de détection lors des coloscopies réalisées sans assistance avait baissé de 6 points en moyenne.Autrement dit, l'IA améliore les résultats quand elle est utilisée, mais semble réduire l'attention et la vigilance des médecins lorsqu'elle n'est pas là.La sur-confiance dans les outils automatisésAlors quelles sont les implications de cette découverte dérangeante. Ce phénomène pourrait refléter un biais humain bien connu, qui est la sur-confiance dans les outils automatisés.Si les médecins s'habituent trop à l'aide de l'IA, ils risquent d'être moins concentrés et moins performants seuls. Les chercheurs appellent donc à la prudence.Ces résultats doivent être confirmés, mais ils posent déjà un défi majeur pour l'intégration de l'IA en médecine, à savoir comment profiter de ses bénéfices sans fragiliser les compétences humaines ?Le ZD Tech est sur toutes les plateformes de podcast ! Abonnez-vous !Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.
In this episode of Bowel Sounds, hosts Dr. Peter Lu and Dr. Jason Silverman talk to Dr. Amber Hildreth, pediatric gastroenterologist and transplant hepatologist at Rady Children's Hospital and Assistant Professor at the University of California San Diego. She is also a clinician scientist at the Rady Children's Institute for Genomic Medicine. We discuss how genetic testing is transforming the way we care for children with rare GI and liver diseases.Learning objectivesRecognize key differences between various types of genetic testing.Discuss several applications of genetic testing in care for children with GI disorders.Understand the role of the genetic counselor in integrating genetic testing into GI practice.Support 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.
Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Yinghong Wang, MD, PhD, MS Immune checkpoint inhibitor (ICI) colitis comes with unique diagnostic and treatment challenges, which means that recognizing and managing it effectively is key to the best outcomes. Joining Dr. Peter Buch to share her insights on caring for patients with this complex condition is Dr. Yinghong Wang. Dr. Wang is a Professor in the Department of Gastroenterology, Hepatology, and Nutrition at MD Anderson Cancer Center in Houston, Texas, as well as Director of the Oncology-GI Toxicity Program, Director of Fecal Microbiota Transplantation, Deputy Division Head of Research in the Division of Internal Medicine, and Chair of the MD Anderson Cancer Center Immunotherapy Toxicity Working Group.
EPIsode 37 - Lauren Storch - Nutrition in Exocrine Pancreatic Insufficiency (EPI) and TPIAT (you see what we did there)In this episode of Nutrition Pearls: the Podcast, co-hosts Jen Smith and Nikki Misner speak with Lauren Storch on nutrition in patients with exocrine pancreatic insufficiency (EPI). Lauren works as a registered dietitian at Nationwide Children's Hospital, in Columbus Ohio, in the GI department working in both the inpatient and outpatient settings. She earned her undergraduate degree from Indiana University and her master's degree from The Ohio State University. Lauren has 11 years of experience in pediatric GI nutrition and is a Board Certified Specialist in Pediatric Nutrition. She has a wide variety of clinical interests all under the GI umbrella working with all the specialty centers within GI including the Pancreas and Liver centers. Lauren enjoys seeing patients with all different GI conditions and needs, however she has a special interest in nutrition and EPI. When she is not working, she enjoys spending time with her husband, 2.5 year old daughter and 12 year old Corgi. Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.Resources:Freeman et al. Medical Management of Chronic Pancreatitis in Children: A Position Paper by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee, JPGN. 2021;72(2):324-340.Taylor CJ et al.ESPGHAN and NASPGHAN Report on the Assessment of Exocrine Pancreatic Function and Pancreatitis in Children. JPGN. 2015;61(1):144-153.Sankararaman S et al. Exocrine Pancreatic Insufficiency in Children – Challenges in Management. Pediatric Health, Medicine and Therapeutics. 2023;14:361–378. Pancreatic enzyme replacement therapy for pancreatic exocrine insufficiency in the 21st centuryTrang T, Chan J, Graham DY. Pancreatic enzyme replacement therapy for pancreatic exocrine insufficiency in the 21st century. World J Gastroenterol 2014;20(33):11467-11485. -has photos of enzymes for size reference - Nathan JD, et al. The Role of Surgical Management in Chronic Pancreatitis in Children: A Position Paper From the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee. JPGN. 2022;74: 706–719.https://pancreasfoundation.org/patient-resources/camp-hope/Produced by: Corey IrwinNASPGHAN - Council for Pediatric Nutrition Professionalscpnp@naspghan.org
Featuring: David T. Rubin, MD, University of Chicago Medicine The GI Research Foundation was able to produce this podcast with sponsorships from Metro Infusion Center. David T. Rubin, MD, Joseph B. Kirsner Professor of Medicine and Chief of Gastroenterology, Hepatology and Nutrition at the University of Chicago Medicine, explores challenges 6-10 of the top ten faced by people with Crohn's disease and ulcerative colitis. He explains how providers and researchers are working to overcome these challenges and improve care for patients. To access other episodes of Visceral: Listen to Your Gut and learn more about the GI Research Foundation's support of clinical and laboratory research to treat, prevent, and cure digestive diseases, please visit https://www.giresearchfoundation.org/. Available on Apple Podcasts, Spotify, and everywhere else you listen.
What happens when alcohol use and metabolic factors collide? In Part 2, Stephanie Rutledge explains how alcohol-related liver disease develops, the challenges of holistic care, and the evolving role of liver transplantation. A must-listen for clinicians navigating the complexities of metabolic dysfunction and alcohol-related liver disease, and patient-centred management. Timestamps: 0:21 – Metabolic dysfunction and alcohol-related liver disease (MetALD) 3:45 – Treatments for liver disease 5:49 – Mental health considerations 6:36 – Family support 7:51 – Factors beyond clinical treatment
In the final instalment, Stephanie Rutledge explores alcoholic hepatitis and long-term mental wellness. Covering acute clinical crises, experimental therapies, and future treatment guidelines, she highlights how hepatology can better integrate mental health and substance use care to transform patient outcomes. Timestamps: 0:33 – Acute alcoholic hepatitis 3:08 – Patients with alcohol use disorder 4:32 – Medical advancements 6:25 – Prevention 10:45 – Current research 13:01 – Advice for young clinicians
Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Paul Kwo, MD While sometimes overlooked, minimally elevated liver tests may signal early liver disease or non-hepatic conditions like thyroid dysfunction. As a result, interpreting ALT and AST thresholds, assessing metabolic risk, and reviewing lifestyle factors can help shape a focused diagnostic approach and reduce liver-related complications. Joining Dr. Peter Buch to provide insights into the evaluation of minimally elevated liver tests is Dr. Paul Kwo, who's a Professor of Medicine and Director of Hepatology at Stanford University.
Send us a textThis discussion on ways to improve MASH patient management comes from the early July roundtable on "Major Issues of the First Six Months of 2025." As a reminder, that roundtable included the three co-hosts (Louise, Jörn Schattenberg and Roger Green) Louise drives this conversation based on two related issues she sees emerging: (i) increasing opportunities for motivated patients to manage their own health and (ii) managing the total patient in an environment where people may be taking incretin agonists as if they are consumer drugs. With increased access to scanning, providers can monitor patients (and patients can self-monitor) more closely. However, some of the issues a provider might find are tricky: patients who undertake what Louise describes as "the sneaky areas patients think are normal, but are probably contributing to disease" due to miseducation or no education on healthy eating and lifestyle, or patients purchasing and using incretin agonists through consumer channels, but possibly at subtherapeutic doses. Vigilance and probing are key here, but health systems will need to train more people on the types of probing that uncover underlying issues and behaviors that patients mistakenly believe to be healthy. The discussion also extends to the role of NITs in diagnosis and patient management, and how providers need to shift the paradigm away from describing a patient by fibrosis stage and instead focus on the amount of fat in the liver and its overall suppleness.
In this episode, hosts Drs. Peter Lu and Jason Silverman talk to Dr. Justine Turner about a non-biopsy approach to diagnosis for celiac disease in children. Dr. Turner is a Professor of Pediatrics and Divisional Director for the Division of Gastroenterology and Nutrition at the University of Alberta and also the medical lead for the Multidisciplinary Pediatric Celiac Disease Clinic at Stollery Children's Hospital in Edmonton. Learning Objectives:Review current clinical guidelines for the diagnosis of celiac disease in childrenUnderstand the potential pros and cons of a non-biopsy approach to diagnosis for celiac diseaseRecognize the potential impacts of serologic diagnosis for celiac disease on patients, their families and healthcare systemsLinks (to be added!!):Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and NutritionNASPGHAN Clinical Report on the Diagnosis and Treatment of Gluten-related DisordersEuropean Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020Positive Predictive Value of Tissue Transglutaminase IgA for Celiac DiseaseSupport 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.
Stephanie Rutledge joins host Saranya Ravindran to unpack the mental health dimensions of alcohol use disorder. From co-occurring conditions and behavioural strategies like motivational interviewing to the role of family and community support, this episode explores how integrated care can strengthen recovery. Timestamps: 1:44 – Why hepatology 3:25 – Genetic factors 4:18 – Alcohol use disorder interventions 5:58 – Motivational interviewing 7:25 – Motivational interviewing skills 8:34 – Beyond clinical settings 10:49 – Alcohol use disorder therapy
In this rapid-fire episode, Stephanie Rutledge answers key questions on alcohol in hepatology, from mental health challenges in alcohol use disorder to transplant misconceptions, emerging therapies, and the impact of lifestyle changes like Dry January. It provides a concise, insightful overview in just minutes. Timestamps: 1:08 – Treating alcohol use disorder 1:33 – Technique for alcohol use disorder recovery 1:50 – Misconceptions 2:14 – Psychosocial factors 2:32 – Alcohol use disorder and liver transplantation 2:50 – Experimental education 3:09 – Dry January and sober October 3:35 – Mental health 3:53 – Halting disease progression 4:14 – Liver transplantation 4:46 – Breakthrough therapies
Contributor: Alec Coston, MD Educational Pearls: Hepatic encephalopathy (HE) is defined as a disruption in brain function that results from impaired liver function or portosystemic shunting. Manifests as various neurologic and psychiatric symptoms such as confusion, inattention, and cognitive dysfunction Although ammonia levels have historically been recognized as important criteria for HE, the diagnosis is ultimately made clinically. An elevated ammonia level lacks sensitivity and specificity for HE Trends in ammonia levels do not correlate with disease improvement or resolution A 2020 study published in the American Journal of Gastroenterology evaluated 551 patients diagnosed with hepatic encephalopathy and treated with standard therapy Only 60% of patients had an elevated ammonia level, demonstrating the limitations of ammonia levels However, a normal ammonia level in a patient with concern for HE should raise suspicion for other pathology. In patients with cirrhosis presenting with neuropsychiatric symptoms, consider HE as the diagnosis after excluding other potential causes of altered mental status (i.e., Seizure, infection, intracranial hemorrhage) The primary treatment is lactulose Works by acidifying the gastrointestinal tract. Ammonia (NH₃) is converted into ammonium (NH₄⁺), which is poorly absorbed and subsequently eliminated from the body Also exerts a laxative effect, further enhancing elimination References: Haj M, Rockey DC. Ammonia Levels Do Not Guide Clinical Management of Patients With Hepatic Encephalopathy Caused by Cirrhosis. Am J Gastroenterol. 2020 May;115(5):723-728. doi: 10.14309/ajg.0000000000000343. PMID: 31658104. Lee F, Frederick RT. Hepatic Encephalopathy-A Guide to Laboratory Testing. Clin Liver Dis. 2024 May;28(2):225-236. doi: 10.1016/j.cld.2024.01.003. Epub 2024 Jan 30. PMID: 38548435. Vilstrup, Hendrik1; Amodio, Piero2; Bajaj, Jasmohan3,4; Cordoba, Juan1,5; Ferenci, Peter6; Mullen, Kevin D.7; Weissenborn, Karin8; Wong, Philip9. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study Of Liver Diseases and the European Association for the Study of the Liver. Hepatology 60(2):p 715-735, August 2014. | DOI: 10.1002/hep.27210 Weissenborn K. Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles. Drugs. 2019 Feb;79(Suppl 1):5-9. doi: 10.1007/s40265-018-1018-z. PMID: 30706420; PMCID: PMC6416238. Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4 Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/ Donate: https://emergencymedicalminute.org/donate/
Send us a textKey Opinion Leaders Manal Abdelmalek, Naim Alkhouri, Scott Isaacs and Zobair Younossi join Roger Green to discuss the FDA's approval of semaglutide for patients with non-cirrhotic MASH. This conversation centers on the roles that new technologies and an expanded APP population will play in MASLD and MASH management in the US, and concludes by exploring how care might look different 12 months from now, and then in subsequent years. As panelists identify some of the changes they foresee if we are to manage the tsunami of undiagnosed MASLD patients, many comments touch on themes discussed earlier in this episode. A couple are unique. Zobair and Scott discuss the increased role that artificial intelligence and big data analytics will play in identifying high-risk patients and improving clinical pathways. Additionally, Zobair notes that we must remember that the vast majority of MASLD patients will never develop MASH. Manal foresees a more sophisticated approach to selecting pharmacotherapies as prescribers have a broader set of options, each with its own benefits and drawbacks. Scott anticipates a "paradigm shift" in which endocrinologists view MASH similarly to how they view retinopathy, neuropathy and retinopathy. Naim suggests that one year will not look tremendously different from today, but that five years from now will be an entirely different picture, which he describes in some detail.
Send us a textKey Opinion Leaders Manal Abdelmalek, Naim Alkhouri, Scott Isaacs and Zobair Younossi join Roger Green to discuss FDA's approval of semaglutide for patients with non-cirrhotic MASH. This conversation focuses on benefits for patients and ways that having two drugs with different modes of action will change pharmacotherapy choices.This conversation starts with the group describing the sense of "enthusiasm" and "fulfillment" hepatology drug developers feel to see two drugs approved in the US and many other major changes to come (more drug approvals, FDA acceptance of a path to approval that is not based on liver biopsy). One interesting takeaway is that while the approval of semaglutide will likely change the number of patients treated with MASH pharmacotherapy, the greater impact of this approval will be on public awareness of MASH and the accompanying demand for treatment. In terms of actual drug use, the first major change will come among patients living with obesity but not Type 2 diabetes. Most of these patients previously saw their semaglutide prescriptions rejected for payment by health insurers. However, many of these patients will be living with MASH, and they are likely to see their prescriptions approved. Instead, the largest impact may involve increased education and awareness. Scott pointed out that endocrinologists, who frequently prescribe incretin agonists, will have reason to learn how to diagnose and manage MASH in patients they already treat. Zobair noted that an array of companies, starting with pharmaceutical manufacturers and scanning companies, will dramatically increase investments in prescriber and patient education. Another important benefit may come in terms of coverage. Scott points out that most patients living with obesity but not diabetes are unlikely to have their semaglutide prescriptions covered by commercial insurers. Those living with non-cirrhotic MASH are likely to have semaglutide covered. A separate but related point: Naim reports that ~30% of the MASH patients he sees are taking an incretin agonist at the time of initial visit.
Send us a textKey Opinion Leaders Manal Abdelmalek, Naim Alkhouri, Scott Isaacs and Zobair Younossi join Roger Green to discuss the FDA's approval of semaglutide for patients with non-cirrhotic MASH. This conversation focuses on how the US healthcare system must adapt to handle the growing number of MASH and MASLD patients who might seek treatment, given likely increases in publicity and education.The conversation starts with a focus on the implications of semaglutide approval for hepatologists. Naim states that many hepatologists are currently uncomfortable managing patients on GLP-1 agonists. This will need to change. Manal points out that providers must check for cirrhosis when testing for MASH and understand how to respond accordingly. An increase in the number of providers having access to in-office scanning devices will facilitate this process.Zobair shifts to a larger point: even if all related specialists integrate MASH into their practices, the actual patient care demand will require alternative pathways in which the responsibility for patient care will rest with specialist APPs. The number of APPs necessary to handle this load and trained to do so does not currently exist in the US. Increased APP training must, and will, become an area for increased investment and focus.After Naim Alkhouri describes some of the differences between resmetirom and semaglutide in terms of practical treatment decisions, the discussion focuses on why MASLD and MASH will create unique challenges for hepatology practices. Manal views the issue as a matter of time; practices cannot absorb large numbers of new, non-urgent patients. Naim suggests that the real issue is the business question: specialists today do not profit simply from treating patients. Zobair agrees with Naim and notes that the challenge is not unique to hepatology. He expresses the hope that AI and efficient database management will make it easier to target, screen, diagnose and treat patients...given sufficient providers (mostly APPs) to treat them.
Send us a text00:00:00 - Surf's Up, Season 6, Episode 12This week's episode is a special three-part roundtable on the implications of the FDA's recent approval of semaglutide. Naim Alkhouri, Manal Abdelmalek, Scott Isaacs and Zobair Younossi join Roger Green in a discussion that focuses less on specifics of pharmacotherapy and more on how having two drugs available will change MASH management in the US.00:08:45 - Part I: How Will The Semaglutide Approval Affect Patient Treatment and Pharmacotherapy?The group starts by describing the sense of "enthusiasm" and "fulfillment" hepatology drug developers feel to see two drugs approved in the US and many other major changes to come (more drug approvals, FDA acceptance of a path to approval that is not based on liver biopsy). One interesting takeaway is that while the approval of semaglutide will likely change the number of patients treated with MASH pharmacotherapy, the greater impact of this approval will be on public awareness of MASH and the accompanying demand for treatment. In terms of actual drug use, the first major change will come among patients living with obesity but not Type 2 diabetes. Most of these patients previously saw their semaglutide prescriptions rejected for payment by health insurers. However, many of these patients will be living with MASH, and they are likely to see their prescriptions approved. Instead, the largest impact may involve increased education and awareness. Scott pointed out that endocrinologists, who frequently prescribe incretin agonists, will have reason to learn how to diagnose and manage MASH in patients they already treat. Zobair noted that an array of companies, starting with pharmaceutical manufacturers and scanning companies, will dramatically increase investments in prescriber and patient education.00:25:30 - Part II: How the Structure of Medical Practice Is Likely To ChangeNaim states that many hepatologists are currently uncomfortable managing patients on GLP-1 agonists. This will need to change. Manal points out that providers must check for cirrhosis when testing for MASH and understand how to respond accordingly. An increase in the number of providers having access to in-office scanning devices will facilitate this process. Zobair states that even if all related specialists integrate MASH into their practices, the actual patient care demand will require alternative pathways in which the responsibility for patient care will rest with specialist APPs. After Naim Alkhouri describes some of the differences between resmetirom and semaglutide in terms of practical treatment decisions, the discussion focuses on why MASLD and MASH will create unique challenges for hepatology practices. Manal views the issue as a matter of time; practices cannot absorb large numbers of new, non-urgent patients. Naim suggests that the real issue is the business question: specialists today do not profit simply from treating patients. Zobair agrees with Naim and notes that the challenge is not unique to hepatology. He expresses the hope that AI and efficient database management will make it easier to target patients, screen, diagnose and treat them. 00:44:17 - Part III: What Happens Next?In this final section, panelists identify some of the changes they foresee if we are to manage the tsunami of undiagnosed MASLD patients. Many of the comments touch on themes discussed earlier in this episode, but a couple are unique. Zobair states we must remember that the vast majority of MASLD patients will never develop MASH. Manal foresees a more sophisticated approach to selecting pharmacotherapies as prescribers have a broader set of options, each with its own benefits and drawbacks. Scotts anticipates a "paradigm shift" in which providers come to view MASH similarly to how they view diabetic comorbidities.
Diverticulosis and diverticulitis sound alike but are very different conditions—and knowing the difference is key to protecting your digestive health. In this episode, host Jacqueline Gaulin welcomes Dr. Lisa Strate, Professor and Chief of Gastroenterology and Hepatology at the University of Wisconsin, and one of the nation's leading experts in diverticular disease. Together, they clear up common questions and misconceptions about diverticulosis and diverticulitis, including: What causes these conditions and who is most at risk The symptoms and warning signs patients should watch for Whether it's possible to have one without the other How diet and lifestyle affect treatment and prevention This episode is produced in collaboration with the American College of Gastroenterology's Patient Care Committee.
In today's episode, we spoke with Masatoshi Kudo, MD, about the evolving treatment landscape in hepatocellular carcinoma (HCC) and how recent comparative analyses are helping refine the use of first-line immunotherapy-based regimens. Dr Kudo is a professor and chairman in the Department of Gastroenterology and Hepatology at Kindai University Faculty of Medicine in Osaka, Japan.
Send us a textMulti-Metabolic Week focuses on the idea that MASLD and MASH are elements in a systemic set of Multi-Metabolic issues. This conversation is the first of two looking at the concept of the "Multi-Metabolic Clinic," a clinic that treats the entire spectrum of multi-metabolic diseases. The core of this episode starts during the weekly groundbreaker exercise, during which our guests began to describe the path that brought them from single-disease specialization to the broader multi-metabolic practice.. Immediately after the groundbreakers, participants describe their clinics today, including patient population and principles underlying their approach to treatment. For Karen, the path started in a conventional gastrointestinal practice. A decade ago, she gained certification in obesity medicine. While treating patients for obesity, she came to appreciate the interplay of obesity, diabetes and the other manifestations of multi-metabolic disease. Eventually, she divided her practice and time so that she spent half her time in the GI practice and the other half creating Trajectory Health Partners, a practice focused on overall metabolic health.For Dr. López, the initial goal was to "re-educate the hypothalamic problem," which he saw as the root cause of obesity and from which all other metabolic issues came. He describes this as "the auto-destruction button" of patients' lives, leading to two causes of death: (1) insulin resistance and related cardiovascular problems, and (2) short-telomere cancers. The rest of this conversation focuses on the tests that the two clinics use to confirm MASLD or MASH and their approaches to treating multi-metabolic patients.
In this hepatology episode, Dr. Hirsh Elhence presents a case to Dr. Elliot Tapper. They discuss the question: “Is the liver the driver or a bystander?” Facilitator: Dr. Madellena (Maddy) Conte Case Presenter: Dr. Hirsh Elhence, current resident at University of Colorado who has an interest in hepatology. Case Discussant: Dr. Elliot Tapper, Associate Professor… Read More »Episode 413: Rafael Medina Hepatology Episode with Dr. Tapper – Driver or Bystander
Featuring: David T. Rubin, MD, University of Chicago Medicine The GI Research Foundation was able to produce this podcast with sponsorships from Metro Infusion Center. David T. Rubin, MD, Joseph B. Kirsner Professor of Medicine and Chief of Gastroenterology, Hepatology and Nutrition at the University of Chicago Medicine, explores challenges 1–5 of the top ten faced by people with Crohn's disease and ulcerative colitis. He shares how health care providers and researchers are working to overcome these obstacles and improve patients' lives. To access other episodes of Visceral: Listen to Your Gut and learn more about the GI Research Foundation's support of clinical and laboratory research to treat, prevent, and cure digestive diseases, please visit https://www.giresearchfoundation.org/. Available on Apple Podcasts, Spotify, and everywhere else you listen.
Send us a text00:00:00 - Surf's Up: Season 6, Episode 11 This week, we modify our usual episode structure to focus on multi-metabolic practices and constructs. The multi-metabolic practices covered this week are run by non-hepatologists who have chosen to focus on the liver in a broader cardiometabolic context. They include two practices discussed during a two-part roundtable, one run by US gastroenterologist Dr. Karen Jerome-Zapadka and the EDOM practice in Spain, run by endocrinologists. The expert interview is with Dr. Emily Andaya, an internist who helms a cardiometabolic practice in Indiana, US, that focuses on the liver. 00:14:23 - Roundtable Part I: Groundbreaker and introductionThe core of the episodes started during the weekly groundbreakers, as guests began to describe the path that brought them from single-disease specialization to the broader multi-metabolic practice.. Immediately after the groundbreakers, participants describe their clinics today, including patient population and principles underlying their approach to treatment.00:26:15 - Roundtable Part II: Tools they useGuided by Louise, the specialists discuss the devices they use to screen and stage patients and the drugs they use to treat them. One interesting item that emerges is that EDOM relies on a 0-to-4 disease severity classification, but it does not align point-by-point with the 4-point fibrosis scale common in MASH. 00:40:28 - Roundtable Part III: Training Providers in the ClinicsLouise starts this segment by asking the EDOM team how they train practitioners in their clinic. EDOM trains practitioners in nutrition and technologists in the proper use of scanning devices. Karen comments that one big issue in re-training involves the length of visits: 15 minutes for a typical GI visit vs. 60 minutes for an initial multi-metabolic session and 30 minutes for follow-ups. Along with this, the information gathering technique are different.00:50:57 - Roundtable Part IV: Patient Health and Wrap-upLouise asks participants whether and how they have measured the impact the multi-metabolic approach has on patients' health (profound in both cases) and whether they are seeing an increase in HCC. Karen sees a difference among her long-term patients, while EDOM refers patients before their fibrosis reaches cirrhosis stage. In the last part of the episode, panelists share perspectives on how their initial specialties fit with the broader multi-metabolic practice and the kinds of impact they can have on patients.01:12:50 - Expert: Dr. Emily Andaya discusses US initiatives in multi-metabolic healthThis week's expert is Dr. Emily Andaya, an Indiana (US)-based internist whose practice has expanded to take on a multi-metabolic focus. She begins by discussing her recent attendance at the American Society for Preventive Cardiology (SPC) meeting in Boston, where she heard a talk by Dr. Christos Montzoros, an endocrinologist and multi-metabolic advocate, who emphasized the importance of incorporating the liver into preventive cardiology's focus. Louise and Emily agree that cardiometabolic focus involves evaluating general, overall health, but Emily discusses how this might require a deeper or broader testing protocol for each target organ. Emily describes the 4-point CKM scale and Louise asks how fibrosis or NAS scoring, as deployed in the MASH CRN system, might be valuable here. This is a far-ranging conversation, but one special point of interest involves the psychological benefit of telling a patient they need to treat one (multi-metabolic) condition, instead of separate heart, kidney, endocrinological and liver conditions, which might feel far more overwhelming. 01:48:48 - ConclusionBecause Roger is on vacation, there is no business report this week.
Send us a textRoger Green talks with LiverRight CEO Brandon Tudor and Chief Medical Officer Alexander Lalos about the launch of LiverRight, America's first virtual hepatology clinic, which has recently begun treating patients.Brandon starts the conversation by telling the story of how he and his partner, Pete Celano, started LiverRight: they saw liver disease as a growing disease in a medical system that was ill-equipped to provide front-line care. When the two men "secret shopped" getting doctor's appointments, they found extremely long waits (3-5 months in examples provided throughout this conversation) for appointments that put stress on the patients and their schedules (days off from work, hours of travel to the clinic). Brandon gave one example in Arizona, where LiverRight could get a hepatologist certified and accepted by insurance months faster than the patient could get an appointment at a local hepatology center. Al amplifies the issue by noting that when the patient in Arizona was scheduled to see a transplant hepatologist, who certainly could treat the patient but was "not really appropriately matched to [the patient's] condition. To Al, who is a transplant hepatologist himself, the virtual approach provides three benefits: convenience, speed and a better match between provider and disease. As Al notes, transplant hepatologists spend their time doing transplants, an important and highly specialized skill. A far broader swath of providers could treat a patient seeking testing for MASLD. Al notes two more benefits he sees with virtual clinics. After online triage during the initial visit, the patient is routed to the level and type of provider best matched to that individual's need for care. The second benefit, which Al says "may sound crazy," is that an online visit, where the provider is looking directly at the computer (and patient) while entering information, feels far more personal than an in-person visit where the provider is looking at the computer monitor instead of the patient. The rest of the discussion covers various advantages that the LiverRight executives believe accrue from virtual care. The most important, in Brandon's words, is that virtual "allows us to move to a preventive world instead of a reactive world." One that Al mentions is that the quality and breadth of knowledge of the virtual providers is higher than he expected and leads to both guidelines that are appropriate to task and special knowledge in key areas such as nutrition.NOTE: Roger Green is a paid advisor to LiverRight
Send us a text00:00 - Surf's Up 6.10.1This conversation covers three topics. Jörn Schattenberg discusses two papers that suggest an exciting role NITs might play in future prescribing decisions, two executives from LiverRight describe the U.S.'s first virtual liver clinic, and Tom Jobson of Predictive Health Intelligence updates us on how simple analyses of large data bases can identify and motivate high-risk liver patients to visit their doctors. 00:17:30 - Roundtable: NITs might help physicians determine the value of metabolic vs. specific anti-fibrotic effects for individual patientsThe overall theme of this roundtable is "Major Stories and Events of the First Half, 2025." Jörn's contribution is to discuss two papers that use proteomic analyses to determine the degree to which a patient's MASH is driven by metabolic issues as compared to direct fibrotic challenges. Today, when we have only a few drugs, limited NITs and no proteomic tests available for use in practice, these findings point to directions for future research and test development. Over time, providers may be able to prescribe based on the knowledge of h0w much benefit metabolic agents might provide as compared to anti-fibrotics. This may point to step therapy or multi-agent first line therapy, but it is an exciting idea.00:29:50 - Newsmakers: LiverRight opens America's first virtual liver clinic LIverRIght CEO Brandon Tudor and Chief Medical Officer Alexander Lalos join Roger Green to discuss the launch of America's first virtual hepatology clinic. Brandon shares his personal history to explain why providing fast access is so important to him. Alex describes his original motivation to go into Transplant Hepatology and how, over time, his focus has shifted from healing the sick to preventing disease in the first place. They describe how LiverRight works and their successes to date in reducing patients' time from first contact to visit, often from months to days. NOTE: Roger Green is a paid advisor to LiverRight.00:56:44 - Expert: Tim Jobson describes how Hepatoscope is helping the NHS identify untreated high-risk liver patients and bring them to the office for screening. Tim describes hepatoSIGHT, a tool that "allows clinicians to get their hands on the data and to find patients both for treatment and for clinical trials." He describes it as standard in Somerset, UK, now, and proceeds to share new data about the patient experience. This is a unique program in that providers reach out to tell individual patients they should visit the physician based on information found in their medical records. Interestingly, patient response is overwhelmingly positive. Six in ten respondents rated their satisfaction with the process, giving it a mean of 4.8 on a 5-point scale. Tim also shared some preliminary modeling suggesting that sustained use of hepatoSIGHT could increase clinical trial participation as much as 50-fold if trial sites had the capacity to take all these patients. In all, this is a warming, affirming look at whether and how patients know they benefit from what we ask them to do and share. 01:29:58 - ConclusionThe business report discusses the next few episodes and asks who would like to meet Roger at Paris MASH.
ARFID is an eating disorder that often presents as extremely picky eating, but that can quickly turn serious. Caitlin Moscatello, author and contributor to New York Magazine, and William Sharp, director, Children's Multidisciplinary Feeding Program at Children's Healthcare of Atlanta; and associate Professor, Division of Autism and Related Disorders & Division of Pediatric Gastroenterology, Hepatology, and Nutrition in the Department of Pediatrics, Emory University School of Medicine, explain how to recognize signs and how treatment is evolving.
Send us a textThis conversation is the third segment of SurfingMASH's April discussion of drug development in memory of Stephen A. Harrison. In addition to co-hosts Jörn Schattenberg, Louise Campbell and Roger Green, panelists include hepatologists and key opinion leaders Sven Francque and Naim Alkhouri. Louise starts the discussion by asking when a patient is metabolically and hepatically healthy instead of merely driving weight loss. She notes that basing therapy entirely on weight loss goals will breed failure and frustration while failing to address the actual pivotal goal of metabolic health. Sven agrees and notes how important this point is. Roger suggests that the benefit of weight loss is likely to become limited over time, which is why there is such excitement about GLP-glucagon combination therapies. Again, Sven concurs, noting that such knowledge and increasing drug class diversity will allow researchers to look at true, basic differences between agents instead of "small numerical differences."Jörn notes the importance of NITs in addressing these kinds of issues. Scanning is an effective method for measuring changes in liver fat; however, the academic community has developed surrogate NITs for specific physiological activities. As Sven notes, there is still a great deal of work to do here. That said, Jörn cites examples of large, NIT-based projects like the VCTE Study Group that have sufficient sample size to start building definitions around kilopascal levels. Louise shares her strong concern that many TE operators are not trained adequately to appreciate subtle clues that would tell an expert how an individual scan was providing misleading results. She notes that the increased demand for scanning, in this case TE, is going to drive a watering down of the qualifications and the skill of the user and the supervision level..." The discussion winds down with Sven agreeing with Louise and stating the need for sequential testing and Jörn citing EASL guidelines in stating that practices should provide and manage high-quality care to the best of their abilities.
Host: Darryl S. Chutka, M.D. Guest: Sunanda V. Kane, M.D. Most people who develop inflammatory bowel disease are diagnosed before the age of 30. In women, this often occurs during the middle of their reproductive years. Some with inflammatory bowel disease choose to avoid pregnancy, usually due to misconceptions about pregnancy risks. Yet if properly managed, women can experience a normal, uneventful pregnancy and deliver a healthy child. What effect does inflammatory bowel disease have on fertility? Do patients have a greater chance of a normal pregnancy if the bowel disease is in remission? How can patients minimize the risk of inflammatory bowel disease flares during pregnancy and are the pharmacologic therapies commonly used to treat inflammatory bowel disease safe to use during pregnancy? These are some of the questions I'll ask my guest, Sunanda V. Kane, M.D., from the Division of Gastroenterology and Hepatology at the Mayo Clinic as we discuss “Inflammatory Bowel Disease and Pregnancy”. https://ce.mayo.edu/content/mayo-clinic-talks-inflammatory-bowel-disease Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts
ReferencesFront Immunol. 2017 Jun 9;8:643JAMA. 2021;325(16):1640-1649Journal of Hepatology 2012 56, 704-713DOI:(10.1016/j.Annual Review of Food Science and Technology.2022. Volume 13:263-286Annual Review of Pathological Mechanisms of Disease 2010. 5:99-118.Nature.2013 Jul 4;499(7456):97-101 Nature Reviews Gastroenterology and Hepatology 26 April 2019Cell Metabolism 2019. [29] 4:886-900Lamm, R. 1972. "While the City Sleeps" Chicago Vhttps://music.youtube.com/watch?v=qCrgrGsBlr0&si=oGMvJDfCrd2BU7_ICetera and Seraphine . "Lowdown" Chicago IIIhttps://music.youtube.com/watch?v=6LlZCBbeZTk&si=DrSyAp9lCzhZyqfWLamm, R. 1969. "Questions 67 and 68" CTAhttps://music.youtube.com/watch?v=0TKaFqhmmg4&si=_W-MMatKBBQ0cBF9
In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/4lKaO2HFollow along with the slides: https://bit.ly/44PPBysGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/44ySoL3Follow along with the slides: https://bit.ly/3IvwQrjGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.
Host: Darryl S. Chutka, M.D. Guest: Edward V. Loftus JR, M.D. Inflammatory Bowel Disease is somewhat of an umbrella term for a group of chronic inflammatory conditions of the GI tract. The most common types include ulcerative colitis and Crohn's Disease. While there are similarities between the two, there are also differences. For many individuals with inflammatory bowel disease, it's only a mild illness. Unfortunately for some, it can lead to severe disability and potentially life-threatening complications. What are the similarities and differences between ulcerative colitis and Crohn's? When should we suspect a patient has an inflammatory bowel disease? What's the best way to establish a diagnosis and finally, what treatment options do we have? These are just some of the questions I'll be asking my guest, Edward V. Loftus JR, M.D., from the Division of Gastroenterology and Hepatology at the Mayo Clinic as we discuss “Inflammatory Bowel Disease and Its Treatment”. https://ce.mayo.edu/content/mayo-clinic-talks-inflammatory-bowel-disease Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts
Host: Darryl S. Chutka, M.D. Guests: David H. Bruining, M.D., and Nayantara Coelho-Prabhu, M.B.B.S. An early diagnosis of inflammatory bowel disease is important in preventing long-term complications. Prompt treatment can improve quality of life, reduce the likelihood of hospitalizations, and help maintain remissions. However, establishing a diagnosis is often challenging due to the nonspecific and fluctuating nature of symptoms. Inflammatory bowel disease can also mimic other GI conditions. In addition, diagnostic confirmation usually requires a combination of blood tests, imaging, endoscopy, and histological analysis, making the process both time consuming and complex. The topic for today's podcast is “Diagnosing Inflammatory Bowel Disease and Monitoring Modalities” and my guests are David H. Bruining, M.D., and Nayantara Coelho-Prabhu, M.B.B.S., from the Division of Gastroenterology and Hepatology at the Rochester campus of the Mayo Clinic. https://ce.mayo.edu/content/mayo-clinic-talks-inflammatory-bowel-disease Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field. This issue will review: 1. Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes 2. Lorundrostat Efficacy and Safety in Patients with Uncontrolled Hypertension Meta-Analysis 3. The Diabetes Prevention Program and Its Outcomes Study: NIDDK's Journey Into the Prevention of Type 2 Diabetes and Its Public Health Impact 4. Comparative effectiveness of alternative second‐line oral glucose‐lowering therapies for type 2 diabetes: a precision medicine approach applied to routine data 5. Phase 3 Trial of Semaglutide in Metabolic Dysfunction– Associated Steatohepatitis For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health
Welcome to the Choosing Wisely Campaign series! This is the third episode of a 6-part series exploring the ABIM Foundation's Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures. Our second case-based episode presents an infant with diarrhea and diaper dermatitis. After a clear discussion of the case and thoughtful consideration of the etiology and treatment strategies, we use the AAP's Choosing Wisely dermatology and gastroenterology, hepatology, and nutrition lists to create a resource-conscious care plan that is safe and patient-centered. In the coming episodes, we'll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics. Series Learning Objectives: Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed. Modified rMETRIQ Score: 15/15 Competencies: AACN Essentials: 1: 1.1 g, 1.2f, 1.3de 2: 2.1 de, 2.2g, 2.4fg, 2.5 hijk 7: 7.2 ghk 9: 9.1ij, 9.2ij, 9.3ik NONPF NP Core Competencies: 1: NP1.1h, NP 1.2km, NP 1.3fjh 2: NP2.1jg, NP2.2kn, NP 2.4hi, NP2.5 klmno 7: NP7.2m 9: NP9.1mn, NP9.2n, NP9.3p References ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf AAP Section on Dermatology. (2021). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWDermatology.pdf AAP Section on Gastroenterology, Hepatology, and Nutrition. (2023). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWGastroenterology.pdf Harriet Lane Service (Johns Hopkins Hospital), Anderson, C. C., Kapoor, S., & Mark, T. E. (2024). The Harriet Lane handbook: a manual for pediatric house officers (23rd ed.). Elsevier. Jauregui, J., Nelson, D., Choo, E., Stearns, B., Levine, A. C., Liebmann, O., & Shah, S. P. (2014). External validation and comparison of three pediatric clinical dehydration scales. PloS one, 9(5), e95739. https://doi.org/10.1371/journal.pone.0095739 Johnson, H., & Yu, J. (2022). Current and Emerging Therapies in Pediatric Atopic Dermatitis. Dermatology and therapy, 12(12), 2691–2703. https://doi.org/10.1007/s13555-022-00829-4 Semon, A. K., Keenan, O., & Zackular, J. P. (2021). Clostridioides difficile and the Microbiota Early in Life. Journal of the Pediatric Infectious Diseases Society, 10(Supplement_3), S3–S7. https://doi.org/10.1093/jpids/piab063
Better Edge : A Northwestern Medicine podcast for physicians
In this episode of Better Edge, Sean W. P. Koppe, MD, moderates a panel of hepatologist, featuring Laura M. Kulik, MD, Andres Duarte, MD, Sarang B. Thaker, MD and Amanda C. Cheung, MD, as they discuss recent advances and challenges in liver research. The conversation addresses such key issues as the timing of immunotherapy in relation to transplants, the role of albumin management and the implications of these factors on patient outcomes. This discussion offers valuable insights to fellow researchers and clinicians navigating the complexities of liver medicine.
Host Roz is joined by new co-host Alberto Sanchez-Fueyo, MD, PhD to discuss the key articles of the June issue of the American Journal of Transplantation. Dr. Sanchez-Fueyo is a Professor of Hepatology, and the Academic Director of the Institute of Liver Studies, King's College, London. [02:51] Recipient toll-like receptor 4 determines the outcome of ischemia-reperfusion injury in steatotic liver transplantation in mice [10:47] Association between everolimus combination therapy and cancer risk after liver transplantation: A nationwide population-based quasi-cohort study [21:35] Balancing equity and human leukocyte antigen matching in deceased-donor kidney allocation with eplet mismatch Editorial: Equitable allocation through human leukocyte antigen eplet matching: A promising strategy with several challenges [32:51] Impact of the lung allocation system score modification by blood type on US lung transplant candidates Editorial: From flawed to fairer: Reducing blood type bias in lung transplant allocation Recommended article: The economic value of a transplant nephrologist: The case for improving compensation models
Join Andrew Warmington, Manufacturing Editor at Citeline, in conversation with Tom Hickey, Director of Therapeutic Strategy at Novotech, a global full-service clinical CRO dedicated to accelerating the development of advanced and novel therapeutics. In this episode, recorded live at the European Association for the Study of the Liver Congress (EASL) in Amsterdam, Tom shares invaluable insights into the evolving landscape of hepatology clinical trials and the unique challenges and opportunities shaping the field today. Listen now to stay ahead in the dynamic world of clinical trials.
You can text us here with any comments, questions, or thoughts!In this episode, Kemi welcomes Dr. Allison Wu. Dr. Wu is Principal Investigator of the Wunderfull Lab. She is a clinician-researcher board certified in pediatric gastroenterology and nutrition as well as obesity medicine. Her research focuses on epidemiology and health services research in pediatric nutrition and obesity. She completed her fellowship in Pediatric Gastroenterology, Hepatology & Nutrition at Boston Children's Hospital and the Harvard-wide Pediatric Health Services Research Fellowship at Mass General Hospital for Children. She is also an alumnus of our Get That Grant® coaching program! Together, they explore Dr. Wu's unique journey that intertwines her love for science, nutrition, and working with children, shaped by her family's background in academia and the restaurant business. Join the conversation as Dr. Wu shares her experiences with coaching, her insights on how supportive environments can foster growth, confidence, and collaboration and the importance of grant writing in creating meaningful change. Conversation Highlights: Navigating maternity leave and career transitions The role of coaching in professional growth Building community and collaboration in academia The importance of intentionality in career development Loved this convo? Please go find Dr. Wu on LinkedIn to show her some love!
In this episode, hosts Drs. Peter Lu and Jason Silverman talk to Dr. Cary Sauer about Competency-Based Medical Education (CBME) to break down this concept and all the related terminology that is part of this approach to medical training. If you're confused about CBME, EPAs, milestones and competencies, this episode is for you! Dr. Sauer is a Pediatric Gastroenterologist specializing in the care of children with IBD and Division Chief at Children's Healthcare of Atlanta and Emory University.Learning Objectives:Understand what Competency-Based Medical Education (CBME) means and how it differs from traditional time-based models of medical trainingUnderstand how milestones, competencies and EPAs relate to one another within the CBME frameworkRecognize the central role of entrustment and how that can is incorporated into workplace-based assessments of traineesLinks:Pediatric GI Milestones (v2.0)NASPGHAN EPA resourcesABP EPAs for subspecialtiesNorth American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on Entrustable Professional Activities: Development of Pediatric Gastroenterology, Hepatology, and Nutrition Entrustable Professional ActivitiesEducating pediatric gastroenterology fellows: milestones, EPAs, & their application within a new educational curriculumImplementing entrustable professional activities in pediatric fellowships: facilitating the processSupport 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.
Dr. Vivian Abenaa Asamoah discusses H. Pylori with Dr. Ben Weitz. [If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] Podcast Highlights ________________________________________________________________________________________________________ Dr Vivian Abenaa Asamoah is a board-certified Gastroenterologist who combines conventional and Integrative Medicine. She went to the University of Geneva Medical School and did a residency and fellowship in Gastroenterology, Hepatology and Nutrition at John's Hopkins. You can find out more about her on the HoustonGastroInstitute.com Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.