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In this powerful podcast, virologist Dr Basu Dev Pandey breaks down the science behind the Nipah Virus, its symptoms, transmission, and whether there is any cure for Nipah Virus today. We explore the growing concern around a potential Nipah Virus pandemic, why bats are considered a major carrier, and how virus mutation increases global health risks. Dr Pandey explains the difference between Encephalitis Virus, Japanese Encephalitis Virus, and Dengue Virus, clarifying how these infections impact the brain and immune system. The discussion also covers the 100 Days Vaccine Mission and how rapid vaccine development, including mRNA vaccine technology, could prevent the next pandemic. Learn how mRNA vaccines work, how viruses mutate, and how PCR machines are used to detect infections early. We also examine the current Nepal virus situation, the availability of Dengue treatment, and the present encephalitis outbreak risks. Most importantly, we ask the big question: Are we ready for the next pandemic? This in-depth virologist interview provides expert insights into pandemic preparedness, vaccine development, and global health threats. If you want to understand Nipah Virus symptoms, emerging virus risks, and the science behind future outbreak prevention, this episode is a must-watch.
Dans cet épisode de Cheminements, nous plongeons au cœur de l'urgence absolue : la méningite. Cette infection foudroyante, qui peut toucher n'importe qui sans prévenir, impose une course contre la montre où le diagnostic précoce est la seule clé pour éviter le décès ou des séquelles irréversibles. À travers le récit bouleversant d'une mère devenue présidente d'association et l'expertise d'un infectiologue, nous explorons comment la collaboration entre patients et soignants sauve des vies et comment les nouvelles technologies diagnostiques transforment la prise en charge à l'hôpital.Les intervenants :Patricia Merhant-Sorel : Présidente de l'association Petit Ange (Ensemble contre la méningite). Après avoir perdu sa fille Gwendoline en 2003, elle consacre son action à l'accompagnement des familles et à la sensibilisation du public et des professionnels de santé.Docteur Nicolas Ettahar : Infectiologue au Centre Hospitalier de Valenciennes. Expert de la réalité clinique des maladies infectieuses, il apporte son regard sur les enjeux de diagnostic et de prévention.Les sujets abordés dans l'épisode :Le témoignage de Patricia sur la perte brutale de sa fille et la création de l'association Petit Ange.Les formes fulgurantes de la maladie : pourquoi l'évolution peut être fatale en moins de 12 heures.L'importance capitale du diagnostic différentiel face à des symptômes parfois trompeurs (fièvre, maux de tête).L'apport des tests rapides (PCR) pour cibler immédiatement le bon traitement antibiotique.Le rôle de la vaccination et des mesures barrières dans la prévention collective.La nécessité d'un dialogue permanent entre les familles, les cliniciens et les industriels du diagnostic.Écriture : Marguerite de RodellecProduction : MedShake StudioCet épisode est enregistré dans le cadre de la première édition de la Journée Patients & Pharma, un événement pour créer un véritable espace de dialogue entre représentants de patients et industrie qui aura lieu le 4 décembre 2025, à la Maison A. Trocadéro. Chers auditeurs, je vous informe que cette journée s'écoutera aussi ! Des épisodes exclusifs du podcast Cheminements seront enregistrés en direct, pour donner la parole à des binômes patients / laboratoires qui viendront raconter leurs collaborations, leurs défis, et parfois même… leurs histoires d'amour professionnelles. Alors si ce sujet vous parle, rejoignez-nous.Ressources :https://patientspharma.com/En ouvrant le dictionnaire, on apprend que "cheminement" désigne une progression graduelle, un mouvement, une avance graduelle.➡ Retrouvez tous les épisodes sur https://www.cheminements.co/❤️ Soutenez-nous gratuitement :Abonnez-vous !Laissez 5 étoiles et un avis sur Apple Podcasts ou Spotify ⭐Cheminements, le podcast santé des femmes, dans vos oreilles chaque semaine.Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.
Liz Gunn sits down with Dr David Cartland, a respected and deeply caring, ethical family doctor with impeccable qualifications (BMedSci 1st class, MBChB, MRCGP).David bravely spoke out against lockdowns, masks, PCR 'over-cycling', and mRNA COVID injections.The Hounds of Hell were unleashed upon him for his deep courage and personal integrity.This is a story of institutional bullying, loss of livelihood, and one man's unyielding commitment to his patients, to humanity's better future and above all, to Truth.Twitter/X Post: Masks the ultimate IQ test! Hypoxia, hypercapnia, a Petri dish and a Cochrane review shows Meta-analysis that they don't work!: https://x.com/cartlanddavid/status/1827609950761189697?s=46Sign the Dr David Cartland Petition: https://www.change.org/p/demand-justice-for-dr-david-cartlandTwitter/X: https://x.com/cartlanddavidInstagram: https://www.instagram.com/dr_david_cartlandYouTube https://youtube.com/@davidcartlandSubstack: https://substack.com/@drdavidcartlandWebsite: https://www.drdavidcartland.com/GiveSendGo Campaign: https://www.givesendgo.com/davidlegalBooks:Do No Harm: Diaries of a 'Vaccinated' Antivaxxer (Amazon): https://amzn.eu/d/0czQQIB3A Doctor's Despair: Second Edition (Amazon): https://amzn.eu/d/05NMEIXUSupport FreeNZ:Substack: https://freenz.substack.com/Locals: https://freenz.locals.comBuy Me A Coffee: www.buymeacoffee.com/supportfreenzKo-fi: https://ko-fi.com/freenzhttps://freenz.carrd.coAffiliates:Dioxi Care - Chlorine Dioxide based Oral Care, Skin Care & Veterinary & Wound Care: https://frontierpharm.com/?sca_ref=9717384.brQladA5pgSnoot Spray - Chlorine Dioxide based Nasal Cleaner: https://www.snootspray.com/?sca_ref=9667634.AV2NJQvGlTNavigate the matrix with this 2026 Year of the Fire Horse Numerology & Astrology Calendar: https://gumroad.com/a/809846675/itcfmgWide Awake Media - Freedom T-Shirts: https://wideawake.clothing/en-nz?sca_ref=9458851.1aXfjvGDqL
UNAM realiza la prueba de detección del Virus de Papiloma Humano por PCR Edomex rescata a turista con mal de montaña en el Iztaccíhuatl Carlos Castellanos cambia de horario desde el lunes 16 de febreroMás información en nuestro podcast
In this episode of the Tails From the Lab podcast, co-host Dr. Brad Ryan sits down with Dr. Michelle Evason (BSc, DVM, DACVIM, MRCVS), Director of Veterinary Education & Outreach at Antech and MARS Science and Diagnostics. Dive into the fascinating world of gastrointestinal parasites with Dr. Evason, a leading expert and educator in small animal internal medicine, infectious disease, and One Health. Discover how data from millions of fecal PCR tests are transforming veterinary clinical decision-making, revealing emerging multidrug parasite resistance, and reshaping our understanding of One Health risks that impact pets, people, and wildlife alike. From the importance of One Health and zoonotic concern messaging to the nuances of fecal screening in cats and dogs, listen in for more about: The power of collaboration and data sharing in veterinary parasitology Landmark cases of Echinococcus multilocularis in the US and Canada The rise of hookworm drug resistance and what it means for treatment Broader trends affecting parasite prevalence, including climate change and pet travel Practical advice for veterinarians on fecal testing and antimicrobial stewardship Future directions in parasite research and diagnosticsOur guest today is Dr. Michelle Evason who is employed by Antech. We're sharing this so you have full transparency about the relationships involved. Tails From the Lab is a production of Antech Diagnostics. The intent of this podcast is to provide education and guidance with the understanding that any diagnostic testing and treatment decisions are ultimately at the discretion of the attending veterinarian within the established veterinarian-patient-client relationship.
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Dr. Pedro Barata and Dr. Ugwuji Maduekwe discuss the evolving treatment landscape in gastroesophageal junction and gastric cancers, including the emergence of organ preservation as a selective therapeutic goal, as well as strategies to mitigate disparities in care. Dr. Maduekwe is the senior author of the article, "Organ Preservation for Gastroesophageal Junction and Gastric Cancers: Ready for Primetime?" in the 2026 ASCO Educational Book. TRANSCRIPT Dr. Pedro Barata: Hello, and welcome to By the Book, a podcast series from ASCO that features compelling perspectives from authors and editors of the ASCO Educational Book. I'm Dr. Pedro Barata. I'm a medical oncologist at University Hospitals Seidman Cancer Center and an associate professor of medicine at Case Western Reserve University in Cleveland, Ohio. I'm also the deputy editor of the ASCO Educational Book. Gastric and gastroesophageal cancers are the fifth most common cancer worldwide and the fourth leading cause of cancer-related mortality. Over the last decade, the treatment landscape has evolved tremendously, and today, organ preservation is emerging as an attainable but still selective therapeutic goal. Today, I'm delighted to be speaking with Dr. Ugwuji Maduekwe, an associate professor of surgery and the director of regional therapies in the Division of Surgical Oncology at the Medical College of Wisconsin. Dr. Maduekwe is also the last author of a fantastic paper in the 2026 ASCO Educational Book titled "Organ Preservation for Gastroesophageal Junction and Gastric Cancers: Ready for Prime Time?" We explore these questions in our conversations today. Our full disclosures are available in the transcript of this episode as well. Welcome. Thank you for joining us today. Dr. Ugwuji Maduekwe: Thank you, Dr. Barata. I'm really, really glad to be here. Dr. Pedro Barata: There's been a lot of progress in the treatment of gastric and gastroesophageal cancers. But before we actually dive into some of the key take-home points from your paper, can you just walk us through how systemic therapy has emerged and actually allowed you to start thinking about a curative framework and really informing surgery decision-making? Dr. Ugwuji Maduekwe: Great, thank you. I'm really excited to be here and I love this topic because, I'm terrified to think of how long ago it was, but I remember in medical school, one of my formative experiences and why I got so interested in oncology was when the very first trials about imatinib were coming through, right? Looking at the effect, I remember so vividly having a lecture as a first-year or second-year medical student, and the professor saying, "This data about this particular kind of cancer is no longer accurate. They don't need bone marrow transplants anymore, they can just take a pill." And that just sounded insane. And we don't have that yet for GI malignancies. But part of what is the promise of precision oncology has always been to me that framework. That framework we have for people with CML who don't have a bone marrow transplant, they take a pill. For people with GIST. And so when we talk about gastric cancers and gastroesophageal cancers, I think the short answer is that systemic therapy has forced surgeons to rethink what "necessary" really means, right? We have the old age saying, "a chance to cut is a chance to cure." And when I started out, the conversation was simple. We diagnose the cancer, we take it out. Surgery's the default. But what's changed really over the last decade and really over the last five years is that systemic therapy has gotten good enough to do what is probably real curative work before we ever enter the operating room. So now when you see a patient whose tumor has essentially melted away on restaging, the question has to shift, right? It's no longer just, "Can I take this out?" It's "Has the biology already done the heavy lifting? Have we already given them systemic therapy, and can we prove it safely so that maybe we don't have to do what is a relatively morbid procedure?" And that shift is what has opened the door to organ preservation. Surgery doesn't disappear, but it becomes more discretionary. Necessary for the patients who need it, and within systems that can allow us to make sure that we're giving it to the right patients. Dr. Pedro Barata: Right, no, that makes total sense. And going back to the outcomes that you get with these systemic therapies, I mean, big efforts to find effective regimens or cocktails of therapies that allow us to go to what we call "complete response," right? Pathologic complete response, or clinical complete response, or even molecular complete response. We're having these conversations across different tumors, hematologic malignancies as well as solid tumors, right? I certainly have those conversations in the GU arena as well. So, when we think of pathologic CRs for GI malignancies, right? If I were to summarize the data, and please correct me if I'm wrong, because I'm not an expert in this area, the traditional perioperative chemo gives you pCRs, pathologic complete response, in the single digits. But then when you start getting smarter at identifying biologically distinct tumors such as microsatellite instability, for instance, now you start talking about pCRs over 50%. In other words, half of the patients' cancer goes away, it melts down by offering, in this case, immunotherapy as a backbone of that neoadjuvant. But first of all, this shift, right, from going from these traditional, "not smart" chemotherapy approaches to kind of biologically-driven approaches, and how important is pCR in the context of "Do I really need surgery afterwards?" Dr. Ugwuji Maduekwe: That's really the crux of the entire conversation, right? We can't proceed and we wouldn't be able to have the conversation about whether organ preservation is even plausible if we hadn't been seeing these rates of pathologic complete response. If there's no viable tumor left at resection, did surgery add something? Are we sure? The challenge before this was how frequently that happened. And then the next one is, as you've already raised, "Can we figure that out without operating?" In the traditional perioperative chemo era, pathologic complete response was relatively rare, like maybe one in twenty patients. When we go to more modern regimens like FLOT, it got closer to one in six. When you add immunotherapy in recent trials like MATTERHORN, it's nearly triple that rate. And it's worth noting here, I'm a health services-health disparities researcher, so we'll just pause here and note that those all sound great, but these landmark trials have significant representation gaps that limit and should inform how confidently we generalize these findings. But back to what you just said, right, the real inflection point is MSI-high disease where, with neoadjuvant dual-checkpoint blockade, trials like NEONIPIGAS and INFINITY show pCR rates that are approaching 50% to 60%. That's not incremental progress, that's a whole new different biological reality. What does that mean? If we're saying that 50% to 60% of the people we take to the OR at the time of surgery will end up having no viable tumor, man, did we need to do a really big surgery? But the problem right now is the gold standard, I think we would mostly agree, the gold standard is pathologic complete response, and we only know that after surgery. I currently tell my patients, right, because I don't want them to be like, "Wait, we did this whole thing." I'm like, "We're going to do this surgery, and my hope is that we're going to do the surgery and there will be no cancer left in your stomach after we take out your stomach." And they're like, "But we took out my stomach and you're saying it's a good thing that there's no cancer." And yes, right now that is true because it's a measure of the efficacy of their systemic therapy. It's a measure of the biology of the disease. But should we be acting on this non-operatively? To do that, we have to find a surrogate. And the surrogate that we have to figure out is complete clinical response. And that's where we have issues with the stomach. In esophageal cancer, the preSANO protocol, which we'll talk about a little bit, validated a structured clinical response evaluation. People got really high-quality endoscopies with bite-on biopsies. They got endoscopic ultrasounds. They got fine-needle aspirations and PET-CT, and adding all of those things together, the miss rate for substantial residual disease was about 10% to 15%. That's a number we can work with. In the stomach, it's a lot more difficult anatomically just given the shape of people's stomachs. There's fibrosis, there's ulceration. A fair number of stomach and GEJ cancers have diffuse histology which makes it difficult to localize and they also have submucosal spread. Those all conceal residual disease. I had a recent case where I scoped the patient during the case, and this person had had a 4 cm ulcer prior to surgery, and I scoped and there was nothing visible. And I was elated. And on the final pathology they had a 7 cm tumor still in place. It was just all submucosal. That's the problem. I'm not a gastroenterologist, but I would have said this was a great clinical response, but because it's gastric, there was a fair amount of submucosal disease that was still there. And our imaging loses accuracy after treatment. So the gap between what looks clean clinically and what's actually there pathologically remains very wide. So I think that's why we're trying to figure it out and make it cleaner. And outside of biomarker-selected settings like MSI-high disease, in general, I'm going to skip to the end and our upshot for the paper, which is that organ preservation, I would say for gastric cancer particularly, should remain investigational. I think we're at the point where the biology is increasingly favorable, but our means of measurement is not there yet. Dr. Pedro Barata: Gotcha. So, this is a perfect segue because you did mention the SANO, just to spell it out, "Surgery As Needed for Oesophageal" trial, so SANO, perfect, I love the abbreviation. It's really catchy. It's fantastic, it's actually a well-put-together perspective effort or program applying to patients. And can you tell us how was that put together and how does that work out for patients? Dr. Ugwuji Maduekwe: Yeah, I think for those of us in the GI space, we have SANO and then we also have the OPRA for rectum. SANO for the upper GI is what takes organ preservation from theory to something that's clinically credible. The trial asked a very simple question. If a patient with a GEJ adenocarcinoma or esophageal adenocarcinoma achieved what was felt to be a clinical complete response after chemoradiation, would they actually benefit from immediate surgery? And the question was, "Can you safely observe?" And the answer was 'yes'. You could safely observe, but only if you do it right. And what does that mean? At two years, survival with active surveillance was not inferior to those who received an immediate esophagectomy. And those patients had a better early quality of life. Makes sense, right? Your quality of life with an esophagectomy versus not is going to be different. That matters a lot when you consider what the long-term metabolic and functional consequences of an esophagectomy are. The weight loss, nutritional deficiencies that can persist for years. But SANO worked because it was very, very disciplined and not permissive. You mentioned rigor. They were very elegant in their approach and there was a fair amount of rigor. So there were two main principles. The first was that surveillance was front-loaded and intentional. So they had endoscopies with biopsies and imaging every three to four months in the first year and then they progressively spaced it out with explicit criteria for what constituted failure. And then salvage surgery was pre-planned. So, the return-to-surgery pathway was already rehearsed ahead of time. If disease reappeared, take the patient to the OR within weeks. Not sit, figure out what that means, think about it a little bit and debate next steps. They were very clear about what the plan was going to be. So they've given us this blueprint for, like, watching people safely. I think what's remarkable is that if you don't do that, if you don't have that infrastructure, then organ preservation isn't really careful. It's really hopeful. And that's what I really liked about the SANO trial, aside from, I agree, the name is pretty cool. Dr. Pedro Barata: Yeah, no, that's a fantastic point. And that description is spot on. I am thinking as we go through this, where can this be adopted, right? Because, not surprisingly, patients are telling you they're doing a lot better, right, when you don't get the esophagus out or the stomach out. I mean, that makes total sense. So the question is, you know, how do you see those issues related to the logistics, right? Getting the multi-disciplinary team, getting the different assessments of CR. I guess PETs, a lot of people are getting access to imaging these days. How close do you think this is, this kind of program, to be implemented? And maybe I would assume it might need to be validated in different settings, right, including the community. How close or how far do you think you see that being applied out there versus continuing to be a niche program, watch and wait program, in dedicated academic centers? Dr. Ugwuji Maduekwe: I love this question. So I said at the top of this, I'm a health equity/health disparities researcher, and this is where I worry the most. I love the science of this. I'm really excited about the science. I'm very optimistic. I don't think this is a question of "if," I think it's a question of "when." We are going to get to a point where these conversations will be very, very reasonable and will be options. One of the things I worry about is: who is it going to be an option for? Organ preservation is not just a treatment choice, and I think what you're pointing out very rightly is it's a systems-level intervention. Look at what we just said for SANO. Someone needs to be able to do advanced endoscopy, get the patients back. We have to have the time and space to come back every three to four months. We have to do molecular testing. There needs to be multi-disciplinary review. There needs to be intensive surveillance, and you need to have rapid access to salvage surgery. Where is that infrastructure? In this country, it's mostly in academic centers. I think about the panel we had at ASCO GI, which was fantastic. And as we were having the conversation, you know, we set it up as a debate. So folks were debating either pro-surveillance or pro-surgery. But both groups, both people, were presenting outcomes based on their centers. And it was folks who were fantastic. Dr. Molena, for example, from Memorial Sloan Kettering was talking about their outcomes in esophagectomies [during our session at GI26], but they do hundreds of these cases there per year. What's the reality in this country? 70% to 80% to 90%, depending on which data you look at, of the gastrectomies in the United States occur at low-volume hospitals. Most of the patients at those hospitals are disproportionately uninsured or on government insurance, have lower income and from racial and ethnic minority groups. So if we diffuse organ preservations without the system to support it, we're going to create a two-tiered system of care where whether you have the ability to preserve your organs, to preserve bodily integrity, depends on where you live and where you're treated. The other piece of this is the biomarker testing gap. One of the things that, as you pointed out at the beginning, that's really exciting is for MSI-high tumors. Those are the patients that are most likely to benefit from immunotherapy-based organ preservation. But here's the problem. If the patient isn't tested at time of initial diagnosis before they ever see me as a surgeon, the door to organ preservation is closed before it's ever open. And testing access remains very inconsistent across academic networks. And then there's the financial toxicity piece where, for gastrectomy, pancreatectomy, I do peritoneal malignancies, more than half of those patients experience significant financial toxicity related to their cancer treatment. We're now proposing adding at least two years, that's the preliminary information, right? It's probably going to be longer. At least a couple of years of surveillance visits, repeated endoscopies, immunotherapy costs. How are we going to support patients through that? We're going to have to think about setting up navigation support, geographic solutions, what financial counseling looks like. My patient for clinic yesterday was driving to see me, and they were talking about how they were sliding because it was snowing. And they were sliding for the entire three-hour drive down here. Are we going to tell people like that that they need to drive down to, right, I work at a high-volume center, they're going to need to come here every three months, come rain or snow, to get scoped as opposed to the one-time having a surgery and not needing to have the scopes as frequently? My concern, like I said, I'm an optimist, I think it is going to work. I think we're going to figure out how to make it work. I'm worried about whether when we deploy it, we widen the already existing disparities. Dr. Pedro Barata: Gotcha, and that's a fantastic summary. And as I'm thinking also of what we've been talking in other solid tumors, which one of the following do you think is going to evolve first? So we are starting to use more MRD-based assays, which are based on blood test, whether it's a tumor-informed ctDNA or non-informed. We are also trying to get around or trying to get more information response to systemic therapies out of RNA-seq through gene expression signatures, or development of novel therapeutics which also can help you there. Which one of these areas you think you're going to help this SANO-like approach move forward, or you actually think it's actually all of the above, which makes it even more complicated perhaps? Dr. Ugwuji Maduekwe: I think it's going to be all of the above for a couple of reasons. I would say if I had to pick just one right now, I think ctDNA is probably the most promising and potentially the missing piece that can help us close the gap between clinical and pathologic response. If you achieve clinical complete response and your ctDNA is negative, so you have clinical and molecular evidence of clearance, maybe that's a low-risk patient for surveillance. If you have clinical complete response but your ctDNA remains positive, I would say you have occult molecular disease and we probably need intensified therapy, closer monitoring, not observation. I think the INFINITY trial is already incorporating ctDNA into its algorithm, so we'll know. I don't think we're at the point where it alone can drive surgical decisions. I think it's going to be a good complement to clinical response evaluation, not a replacement. The issue of where I think it's probably going to be multi-dimensional is the evidence base: who are we testing? Like, what is the diversity, what is the ancestral diversity of these databases that we're using for all of these tests? How do we know that ctDNA levels and RNA-seq expression arrays are the same across different ancestral groups, across different disease types? So I think it's probably going to be an amalgam and we're going to have to figure out some sort of algorithm to help us define it based on the patient characteristics. Like, I think it's probably different, some of this stuff is going to be a little bit different depending on where in the stomach the cancer is. And it's going to be a little bit more difficult to figure out if you have a complete clinical response in the antrum and closer to the pylorus, for example. That might be a little bit more difficult. So maybe the threshold for defining what a clinical complete response needs to be is higher because the therapeutic approach there is not quite as onerous as for something at the GE-junction. Dr. Pedro Barata: Wonderful. And I'm sure AI, whether it's digitization of the pathology from the biopsies and putting all this together, probably might play a role as well in the future. Dr. Maduekwe, it's been fantastic. Thank you so much for sharing your insights with us and also congrats again for the really well-done review published. For our listeners, thank you for staying with us. Thank you for your time. We will post a link to this fantastic article we discussed today in the transcript of this episode. And of course, please join us again next month on the By the Book Podcast for more insights on key advances and innovations that are shaping modern oncology. Thank you, everyone. Dr. Ugwuji Maduekwe: Thank you. Thank you for having me. Watch the ASCO GI26 session: Organ Preservation for Gastroesophageal and Gastric Cancers: Ready for Primetime? Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Pedro Barata @PBarataMD Dr. Ugwuji Maduekwe @umaduekwemd Follow ASCO on social media: @ASCO on X (formerly Twitter) ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Pedro Barata: Stock and Other Ownership Interests: Luminate Medical Honoraria: UroToday Consulting or Advisory Role: Bayer, BMS, Pfizer, EMD Serono, Eisai, Caris Life Sciences, AstraZeneca, Exelixis, AVEO, Merck, Ipson, Astellas Medivation, Novartis, Dendreon Speakers' Bureau: AstraZeneca, Merck, Caris Life Sciences, Bayer, Pfizer/Astellas Research Funding (Inst.): Exelixis, Blue Earth, AVEO, Pfizer, Merck Dr. Ugwuji Maduekwe: Leadership: Medica Health Research Funding: Cigna
5748 風とあそぶ：） 20260209MON 今日のCOVID-19・・・1912回目検査を・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
5744 風とあそぶ：） 20260208SUN 今日のCOVID-19・・・1911回目寒波・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
5740 風とあそぶ：） 20260207SAT 今日のCOVID-19・・・1910回目脆弱化する公衆衛生・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
🧭 REBEL Rundown 📌 Key Points 💨 HFNC met criteria for non-inferiority to BPAP for preventing intubation or death within 7 days in four of the five ARF subgroups.🧪 Bayesian dynamic borrowing increased power across subgroups but created variable certainty, especially in smaller groups such as COPD.🫁 The immunocompromised hypoxemia subgroup did not meet non-inferiority, leading to early trial stopping for futility.️ Rescue BPAP use, subgroup-specific exclusion criteria, and non-standardized BPAP delivery are important contextual factors that influence how subgroup results should be interpreted. Click here for Direct Download of the Podcast. 📝 Introduction Bilevel Positive Airway Pressure (BPAP) has long been a foundational modality in the management of acute respiratory failure (ARF), particularly in COPD exacerbations and cardiogenic pulmonary edema, where it can rapidly reduce work of breathing and improve gas exchange. It remains a core tool in our respiratory support arsenal.High-flow nasal cannula (HFNC), however, has expanded what we can offer patients by delivering many of the same physiologic benefits through a far more comfortable interface. With high flows, modest PEEP, and effective dead-space washout, HFNC can improve oxygenation and decrease work of breathing while preserving the ability to talk, cough, eat, and interact with staff and family. This combination of physiologic support and tolerability makes HFNC especially attractive in patients where comfort, anxiety, or cardiovascular stability are key considerations, and in settings where prolonged noninvasive support may be needed. Rather than competing with BPAP, HFNC broadens our options in ARF and allows us to better match the modality to the patient and their underlying disease process.The RENOVATE trial set out to answer a high-impact question across five distinct etiologic groups: Is HFNC non-inferior to BPAP (NIV) for preventing intubation or death in acute respiratory failure? 🧾 Paper Azoulay É, et al. High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial. JAMA. 2025 PMID: 39657981 🔙Previously Covered On REBEL: HFNC: Part 1 – How It WorksHFNC: Part 2 – Adult and Pediatric IndicationsFLORALI and AVOID TrialFLORALI-2: NIV vs HFNC as Pre-Oxygenation Prior to IntubationThe Pre-AeRATE Trial – HFNC vs NC for RSI ️ What They Did CLINICAL QUESTION Is HFNC non-inferior to BPAP for rate of endotracheal intubation or death at 7 days in patients with acute respiratory failure due to a variety of causes? STUDY DESIGN Multicenter, randomized non-inferiority trial33 Brazilian hospitalsNov 2019 – Nov 2023Adaptive Bayesian hierarchical modeling with dynamic borrowingOpen label, outcome adjudicators blindedPatients were classified into 5 subgroups SUBGROUPS 1. Non-immunocompromised hypoxemiaSpO₂ < 90% on room air orPaO₂ < 60 mm Hg on room air plusIncreased respiratory effort (accessory muscle use, paradoxical breathing, thoracoabdominal asynchrony) orRespiratory rate > 25 breaths/min2. Immunocompromised hypoxemiaDefined as:Use of immunosuppressive drugs for >3 monthsOR high-dose steroids >0.5 mg/kg/dayOR solid organ transplantOR solid tumors or hematologic malignancies (past 5 years)OR HIV with AIDS / primary immunodeficiency3. COPD exacerbation with acidosisHigh clinical suspicion of COPD as primary diagnosisRR >25 with accessory muscle use, paradoxical breathing, and/or thoracoabdominal asynchronyABG: pH 454. Acute cardiogenic pulmonary edema (ACPE)Sudden onset dyspnea and rales± S3 heart soundNo evidence of aspiration, infection, or pulmonary fibrosisCXR consistent with pulmonary edema5. Hypoxemic COVID-19 (added June 2023)Added due to deviations between expected and observed outcome proportionsAny patient across the other 4 groups with PCR-confirmed SARS-CoV-2 infection in any of the above groups POPULATION Inclusion Criteria:≥18 yrs with ARF* in one of 5 pre-defined subgroups excluding COPD was defined by the following:Hypoxemia with SpO₂
Dr. Monty Pal and Dr. Atul Batra discuss the PLANeT study from India, which evaluated low-dose pembrolizumab in addition to neoadjuvant chemotherapy for triple-negative breast cancer, and its place among a growing body of international research on improving efficacy while reducing costs and toxicity with lower doses of immunotherapy. TRANSCRIPT Dr. Monty Pal: Hello and welcome to the ASCO Daily News Podcast. I'm your host, Dr. Monty Pal. I'm a medical oncologist, professor, and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center, Los Angeles. My guest today, I think, is going to be a really riveting one. It's Dr. Atul Batra, who is an additional professor of medical oncology at the All India Institute of Medical Sciences, or AIIMS, in New Delhi. And he's also the senior author of the PLANeT study. It's a very compelling study that evaluated low-dose pembrolizumab in addition to neoadjuvant chemotherapy for triple-negative breast cancer. And it's really a big part of a growing body of research that's showing balanced efficacy when we use lower doses of immunotherapy instead of standard doses to reduce cost, as well as potentially toxicity. I think this has huge implications for our global audience, and I'm so thrilled to have you on the podcast today, Dr. Atul Batra, welcome. Dr. Atul Batra: Thank you, Dr. Pal. Dr. Monty Pal: And we'll just take it with first names from here since we're both friends. I have to give the audience some context. Atul, I had the great honor of visiting AIIMS New Delhi. For those that don't know, this is really, you know, the Harvard Medical School of India. It's the most competitive institution for medical training. And on the back end of that, there's also incredible resources when it comes to clinical trials and infrastructure. I just wanted to have you give the audience sort of a scope of the types of trials that you've been able to do at AIIMS New Delhi. Dr. Atul Batra: Thank you, Monty. So, I work at the All India Institute of Medical Sciences, and we had the honor and pleasure of having Monty here this month. And people are still in awe of his lectures that he delivered there. Coming back to our institute, so it's kind of a medical college. It's one of the oldest ones, it was built in 1956. We are lucky enough that we get the best of the residents and fellows because they have to go through an exam, a competitive exam, and mostly it's them who come to us and we're able to do some good work out here. Regarding the trials that we have conducted, we do conduct some investigator-initiated studies, and we try to answer the questions where we can help our own patients. Like, for example, this PLANeT study. Every other patient in the clinic was almost not able to afford Keytruda at the full dose, pembrolizumab, and we had a lot of evidence creeping in that a lower dose might be helpful. And that's how we planned this study. Before that, there are certain cancers that are peculiar to India, like gallbladder cancer, head and neck cancers. These are much more common in India as compared to the U.S., and there are some good studies that have been conducted from our own institute by our senior colleagues which have been presented at ASCO and published in the JCO. We also did the capecitabine hand-foot syndrome study that was known as the D-ToRCH study: 1% diclofenac gel that became the standard of care to prevent hand-foot syndrome. So, that's kind of a brief overview of investigator-initiated studies. India is slowly and steadily becoming a partner of the global registration trials. And it's more recently, the last five years or so, we have seen that the number of phase 2 and phase 3 trials are increasing and we are able to offer now these trials as well to our patients. Dr. Monty Pal: That was a terrific overview. I just want to highlight for the audience, as we go through some of your discussions today around specific trials, the speed at which this can be done. Just for context, for me to accrue a clinical trial of 30 patients – I think many people have probably come across some of the work that I've done in the microbiome space – at a single institution, 30 patients, right, takes me about a year and a half, two years. We're going to go through some trials today where Dr. Batra and his team have actually, in fact, accrued close to 200 patients over a span of just a year, which is just remarkable by, I would say, any American standard. So, I see a real need for partnership and Atul, I'll kind of get back to that at the end. But without further ado, the focus of this podcast today, I think, is really this terrific presentation you gave in an oral session at ESMO and subsequently published in Annals of Oncology related to the PLANeT study. Would you give the listeners some context around what the study entailed and population and so forth? Dr. Atul Batra: So, we know the KEYNOTE-522 became the standard of care for triple-negative breast cancer, where Keytruda, when added at 200 mg, the standard dose every three weeks with neoadjuvant, increases the pCR from around 51% to 64% by a magnitude of around 13%. However, in India and other low-middle income countries, less than 5% of the patients actually have access to this dose of pembrolizumab. So, our standard of care was actually just chemotherapy till now. And this kind of led us to design this trial. There are data that come from previous trials conducted in India, from the Tata Memorial, done in head and neck space, some other studies done in Hodgkin's lymphoma, that a much lower dose, probably around one-tenth of the dose, works well in these cancers. So, that's where we designed the PLANeT study, where we gave the standard neoadjuvant chemotherapy in the control arm, and in the experimental arm we added 50 mg of pembrolizumab. This was given every six weeks for three doses. So, that's a total of 150 mg over the neoadjuvant period as compared to 1,600 mg that was given in the KEYNOTE-522 study. So, this was almost one-tenth of the study. Dr. Monty Pal: So, a tenth of the dose, which is just remarkable. I mean, that's just such an interesting concept. Dr. Atul Batra: And the results, when we – the primary outcome, this was a phase 2 study. We just wanted to see, is there a signal of activity? And to even our surprise, when we looked at the pathological complete response rates, in the control arm this was 40.5%, and in the experimental arm this was 53.8%. So, a difference came to around 13.3%; it was numerically, I mean, so much similar to what KEYNOTE-522 had with just these many doses. So, this was around 160 patients randomized over one year. We could randomize them in one year because of the load that we see. And the primary endpoint was met, and we could see that the path complete response did show a remarkable increase. We are still following these patients to see whether there is a difference in event-free survival at a longer follow-up. Until now, it's a small follow-up, so the number of events absolute, are different: four events in the experimental arm and 11 events in the control arm. So, we are seeing some signal even in this much short follow-up period as well. But we need to see more of what happens in the longer term. Dr. Monty Pal: That's so impressive. I wonder, with this lower dose, do you attenuate toxicity at all as far as you can gather? Dr. Atul Batra: So, although we shouldn't be doing kind of cross-trial comparisons, but if you look at thyroid dysfunction, we saw that around 10% of our patients had this thyroid dysfunction. This was compared to 15% in the KEYNOTE-522, that was a larger sample size though. But we're seeing that all the toxicities are somewhat less as compared to those in the standard dose. So, the exposure is less, but I mean, I can't really commit definitely on this. For this we would need much more data to say this with more confidence. Dr. Monty Pal: Yeah. I'm going to ask you a really tough question to follow up, and this is probably something that's on everyone's mind after reading a study like this. Is this something that is disease-specific that needs to be replicated across other histologies? The reason I ask this is, you know, you think about paradigms like, for instance, in the States we're toying between intravenous versus subcutaneous delivery of checkpoint inhibitors, and we have studies focused in specific histologies that might justify use across all histologies. With this particular phenomenon, do you think we need to do dedicated studies in renal cell or in colon cancer and other places where, you know, in selected settings we might use checkpoint inhibitors and then decide whether or not there's this dose equivalence, if you will? Dr. Atul Batra: That's a real tough one, though. But I'm happy to share that there are several ongoing studies within India currently. At our institute, my colleagues are leading studies in lung cancer space, cervical cancer. There was already a publication from Tata Memorial Hospital in head and neck cancers and we see that the signal has been consistent throughout. Regarding renal cancer, there was one study that was presented for sure at ASCO from CMC Vellore, that's again a center in South India. That was in RCC at a much lower dose. And for patients who cannot take the full dose, we actually are offering lower dose nivolumab in such patients and we are seeing responses. I mean, we haven't done those randomized trials again because the numbers are much lower in kidney cancers, we know. We could do this trial in triple-negative ones because we had support and we had numbers to conduct this trial. But I'm sure this should be a class effect. I mean, when we can get tumor-agnostic approvals, then some real-world data has come up in almost all tumors, we have seen that consistent effect across tumors. And as we speak of today, I'm also delighted to share that in India, yesterday, we had the first biosimilar of nivolumab and that's now available at a much, much lower price than the original patent product. There was a long ongoing lawsuit that was there, that's over now, and from yesterday onwards, I'm so happy to share here that we would have the first biosimilar of nivolumab that's available. That's going to bring the cost to almost like one-tenth already. Dr. Monty Pal: Wow. That's huge. I'm going to be very selfish here for a second and focus on a study that is in the renal cell space that your group has done. You know, when it came out, I was really sort of intrigued by this study as well and it reflects sort of a different capability, I think, of AIIMS New Delhi, and that's in the, what I'm going to call, biomarker space. This, for the audience, was a prospective effort to characterize germline variants in patients with advanced kidney cancer. And it's something that we talk about a lot in the kidney cancer literature, whether or not we're missing a lot of these so-called hereditary patterns of RCC. Can you tell us a little bit about that study too? Dr. Atul Batra: Yeah, so that was led by one of our fellows, Chitrakshi Nagpal, and she's just completed her fellowship. And two years back we published that. So, that was done in almost 160 consecutive patients that we recruited over the span of just one year and we saw, apart from the common known mutations in RCC, that was around 5% or so, but a lot of other mutations were also seen that we don't generally see in kidney cancers and we see in other cancers like BRCA1, BRCA2 and others. We are still, I mean, doing those analyses to see whether we get more things out of there in the somatic: is there a loss of heterozygosity or was it just present and in there? Dr. Monty Pal: I thought it was a terrific study and again, I was just so blown away at the pace. I mean, as I look at 140 patients accrued over a span of one year, this is something that would take us perhaps three times as long at City of Hope, and that's with a very sort of, what I consider to be large and dedicated kidney cancer program. So, it really underscores, I think, the need for collaboration. And ever since I came back from my visit to you at AIIMS Delhi, I think I've just been sort of transformed in the sense of trying to think of better ways for us to collaborate. One tangible thing that I'm going to get cracking on is seeing whether or not perhaps we can form some partnerships through SWOG or what we call the NCTN, the National Clinical Trials Network here within the U.S. Talk to me about collaboration. I mean, you've been really terrific at this. How do you sort of envision collaboration enhancing the global landscape of oncology? Dr. Atul Batra: That's really amazing, Monty. That's what we need. We have the infrastructure, we have the manpower, we have patients. I mean, these are all high-volume centers. Unfortunately, we are a little less in numbers, so we are more clinically occupied as well. So, sometimes it's kind of tougher, but again, when it comes to helping out the patients, global collaboration, we need to kind of take you guys along with us and have our patients finish trials earlier. This is a win-win situation for patients, one, because they also get exposure or an option to participate in the clinical trials, and second, we can answer all these scientific questions that we have at a much faster pace. All those things can be done within a much shorter span of time for sure. We are so happy to hear that, and with open hands we are ready to collaborate for all these efforts. Dr. Monty Pal: That's awesome. You know, I came back thinking, gosh, this would be so ideal for some of these rare subtypes of kidney cancer. Prospective clinical trials that I'm running in that space where really we're threatened with closure all the time. And if we just sort of extended a hand to, you know, our partners in India and other countries, you know, I'm sure we could get this research done in a meaningful way and that's got to be a win for patients. Atul, I had such a terrific time chatting with you today. I'm looking forward to seeing lots more productivity from your group there. By the way, for our viewership here, take a look and see what AIIMS New Delhi is doing under the leadership of Dr. Batra and others. It is just a real powerhouse and I think that after doing so, you'll be enticed to collaborate as well. I'm hoping this is the first of many times that we have you on the podcast. Thank you so much for joining. Dr. Atul Batra: Thank you so much for having me here, Monty. It was a pleasure as always speaking to you. And thank you again. Dr. Monty Pal: You got it. Well, and thanks to our listeners. I encourage you to check out Dr. Batra's paper. We'll actually have a link to the study in the transcript of this episode. Finally, if you value the insights that you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. More on today's speakers: Dr. Monty Pal @montypal Dr. Atul Batra @batraatulonc Follow ASCO on social media: ASCO on X ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Monty Pal: Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis Dr. Atul Batra: Stock and Other Ownership Interests: Zydus Pharmaceuticals, Glenmark, Caplin Point Laboratories, Laurus Research Funding: AstraZeneca, Astellas Pharma, Alkem Laboratories
5736 風とあそぶ：） 20260206FRI 今日のCOVID-19・・・1909回目インフルB型猛威・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
5732 風とあそぶ：） 20260205THU 今日のCOVID-19・・・1908回目集団風・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
Dr. Sonam Puri discusses the full update to the living guideline on stage IV NSCLC with driver alterations. She shares a new overarching recommendation on biomarking testing and explains the new recommendations and the supporting evidence for first-line and subsequent therapies for patients with stage IV NSCLC and driver alterations including EGFR, MET, ROS1, and HER2. Dr. Puri talks about the importance of this guideline and rapidly evolving areas of research that will impact future updates. Read the full living guideline update "Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2026.3.0" at www.asco.org/thoracic-cancer-guidelines TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/thoracic-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-25-02822 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'm interviewing Dr. Sonam Puri from Moffitt Cancer Center, co-chair on "Therapy for Stage IV Non-Small Cell Lung Cancer with Driver Alterations: ASCO Living Guideline, Version 2026.3.0." It's great to have you here today, Dr. Puri. Dr. Sonam Puri: Thanks, Brittany. Brittany Harvey: And then just before we discuss this guideline, I'd 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. Puri, who has 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 the content that we're here today to talk about, Dr. Puri, this living clinical practice guideline for systemic therapy for patients with stage IV non-small cell lung cancer with driver alterations is updated on an ongoing basis. So, what data prompted this latest update to the recommendations? Dr. Sonam Puri: So Brittany, non-small cell lung cancer is one of the fastest-moving areas in oncology right now, particularly when it comes to targeted therapy for driver alterations. New data are emerging continuously from clinical trials, regulatory approvals, real-world experience, which is exactly why these are living guidelines. The goal is to rapidly integrate important advances as they happen, rather than waiting for years for a traditional update. Since the last full update of the ASCO Stage IV Non-small Cell Lung Cancer Guideline with Driver Alterations published in 2024, there have been seven new regulatory approvals and changes in first-line therapy for some driver alterations. [This version] of the "Stage IV Non-small Cell Lung Cancer Guidelines with Driver Alterations" represents a full update, which means that the panel reviewed and refreshed every applicable section of the guideline to reflect the most current evidence across therapies including sequencing and clinical decision-making. This is to ensure that clinicians have up-to-date practical guidelines that keep pace with how quickly the field is evolving. Brittany Harvey: Absolutely. As you mentioned, this is a very fast-moving space and this full update helps condense all of those versions that the panel reviewed before into one document, along with additional approvals and new trials that you reviewed during this time period. So then, the first aspect of the guideline is there's a new overarching recommendation on biomarker testing. Could you speak a little bit to that updated recommendation? Dr. Sonam Puri: Yeah, definitely. So the panel has discussed and provided recommendations on comprehensive biomarker testing and its importance in all patients diagnosed with non-small cell lung cancer. Ideally, biomarker testing should include a broad-based next-generation sequencing panel, rather than single-gene tests, along with immunohistochemistry for important markers such as PD-L1, HER2, and MET. These results really drive treatment decisions, both in frontline settings for all patients diagnosed with non-small cell lung cancer and in subsequent line settings for patients with non-small cell lung cancer harboring certain targetable alterations. Specifically in the frontline setting, it helps determine whether a patient should receive upfront targeted therapy or immunotherapy-based approach. We now have strong data that shows that complete molecular profiling results before starting first-line therapy is associated with better overall survival and actually more cost-effective care. Using both tissue and blood-based testing can improve likelihood of getting actionable results in a timely way, and we've also provided guidance on platforms that include RNA sequencing, which are specifically helpful for identifying gene fusions that might be otherwise missed with other platforms. On the flip side, outside of a truly resource-limited setting, single-gene PCR testing really should not be routine anymore. This is what the panel recommends. It's less sensitive and inefficient and increases the risk of missing important actionable alterations. Brittany Harvey: Understood. I appreciate you reviewing that recommendation. It really helps identify critical individual factors to match the best treatment option to each individual patient. So then, following that recommendation, what are the updated recommendations on first-line therapy for patients with stage IV non-small cell lung cancer with a driver alteration? Dr. Sonam Puri: Since the last full update in 2024, there have been four additional interim updates which were published across 2024 and 2025. Compared to the last version, there have been several updates which have been included in this full update. One of the most important shifts has been in first-line treatment of patients with non-small cell lung cancer harboring the classical, or what we call as typical, EGFR mutation. The current version of the recommendation is based on the updated survival data from the phase III FLAURA2 and MARIPOSA studies, based on which the panel recommended to offer either osimertinib combined with platinum-pemetrexed chemotherapy or the combination of amivantamab plus lazertinib in the first-line treatment of classical EGFR mutations. And these recommendations, as I mentioned, are grounded in the results of the FLAURA2 and MARIPOSA trials, both of which demonstrated improvement in progression-free survival and overall survival compared to osimertinib alone in patients with common EGFR mutations. That being said, the panel actually spent significant time discussing the toxicities associated with these treatments as well. These combination approaches come with higher toxicity, longer infusion time, increased treatment frequency. So while combination therapy is now recommended as preferred, the panel has recommended that osimertinib monotherapy remains a reasonable option, particularly for patients with poor performance status and for those who are not interested in treatment intensification after knowing the risks and benefits. Brittany Harvey: Absolutely. It's important to consider both those benefits and risks of those adverse events that you mentioned to match appropriately individualized patient care. So then, beyond those recommendations for first-line therapy, what is new for second-line and subsequent therapies? Dr. Sonam Puri: So this is a section that saw several major updates, particularly again in the EGFR space. The first was an update on treatment after progression on osimertinib for patients with classical EGFR mutation. Here the panel recommends the combination of amivantamab plus chemotherapy, and this recommendation was based on the phase III MARIPOSA-2 trial, which compared amivantamab plus chemotherapy with chemotherapy alone with progression-free survival as the primary endpoint. The study met its primary endpoint, showing an improvement in median PFS with the combination of amivantamab plus chemotherapy compared to chemotherapy alone. And as expected, the combination was associated with higher toxicity. So, although the panel recommends this regimen, the panel emphasizes that patients should be counseled on the side effects which may be moderate to severe with the combination therapy approach. In addition, a new recommendation was added for patients who are not candidates for amivantamab plus chemotherapy. In those cases, platinum-based chemotherapy with or without continuation of osimertinib may be offered, and the option of continuing osimertinib with chemotherapy was recommended and supported by data from a recently presented phase III COMPEL study, which randomized 98 patients with EGFR exon 19 deletion or L858R-mutated advanced non-small cell lung cancer who had experienced no CNS progression on first-line osimertinib, and these patients were randomized to receive platinum-pemetrexed chemotherapy with osimertinib or placebo. Although this study was small, it demonstrated a PFS benefit with continuation of osimertinib with chemotherapy, and this approach may be appropriate for patients without CNS progression who prefer or require alternatives to more intensive treatment strategies. Next was an update on options for patients with EGFR-mutated lung cancer after progression on osimertinib and platinum-based chemotherapy. Here the panel recommended that for patients whose disease has progressed after both osimertinib and platinum-based chemotherapy, a new drug known as datopotamab deruxtecan can be offered as a treatment option. And this treatment recommendation was based on evaluation of pooled data from the TROPION-Lung01 and TROPION-Lung05 study, in which in the pooled analysis about 114 patients with EGFR-mutant non-small cell lung cancer were treated with Dato-DXd, 57% of whom had received three or more prior lines of treatment, and what was observed was an overall response rate of 45% with a median duration of response of 6.5 months. So definitely promising results. Next, we focused on updates to subsequent therapy options for patients with another type of EGFR mutation known as EGFR exon 20 insertion mutations. In this section, the panel added sunvozertinib as a subsequent line option after progression on platinum-based chemotherapy with or without amivantamab. Sunvozertinib is an oral, irreversible, and selective EGFR tyrosine kinase inhibitor with efficacy demonstrated in the phase II WU-KONG6 study conducted in Chinese patient population. In this study, amongst 104 patients with platinum-pretreated EGFR exon 20 mutated non-small cell lung cancer, the observed response rate was 61%. Staying in the EGFR space, the panel added a recommendation for patients with acquired MET amplification following progression on EGFR TKI therapy. In these situations, the panel recommended that treatment may be offered with osimertinib in combination with either tepotinib or savolitinib. As our listeners may know, MET amplification occurs in approximately 10% to 15% of patients with EGFR-mutated non-small cell lung cancer when they progress on third-generation EGFR TKIs, and detection of MET amplification is done with various methods, such as tissue-based methods like FISH, NGS, and IHC, as well as ctDNA-based NGS with variable cut-offs. Over the last few years, several studies have informed this recommendation. I'm going to be discussing some of them. In the phase II ORCHARD trial, 32 patients with MET-amplified non-small cell lung cancer after progression on first-line osimertinib were evaluated, where the combination of osimertinib plus savolitinib achieved an overall response rate of 47% with a duration of response of 14.5 months. More recently, the phase II SAVANNAH trial reported outcomes in 80 patients with MET-amplified tumors after progression on osimertinib, and in this patient population, the combination of savolitinib and osimertinib achieved an overall response rate of 56% with a median PFS of 7.4 months. And lastly, the phase II single-arm INSIGHT 2 trial assessed the efficacy of osimertinib plus tepotinib in patients with advanced EGFR-mutant non-small cell lung cancer who had disease progression following first-line osimertinib therapy. And in this study, in a cohort of 98 patients with MET-amplified tumors confirmed by central testing, the overall response rate with the combination was 50% with a duration of response of 8.5 months. So definitely informing this guideline recommendation. Next, we had an update on recommendation in patients with ROS1-rearranged non-small cell lung cancer. For patients with ROS1-rearranged non-small cell lung cancer, the panel recommended specifically for patients who progressed after first-line ROS1 TKIs, the addition of taletrectinib as a new option alongside repotrectinib. And this recommendation was based on analysis of the results of the TRUST-I and TRUST-II studies, which showed that amongst 113 tyrosine kinase inhibitor-pretreated patients, taletrectinib achieved a confirmed overall response rate of 55.8% with a median duration of response of 16.6 months and a median PFS of 9.7 months, a very promising agent. Finally, for patients with HER2 exon 20 mutated non-small cell lung cancer, the panel added two new oral HER2 tyrosine kinase inhibitors, zongertinib and sevabertinib, as options in addition to T-DXd and after exposure to T-DXd. These recommendations are based on early phase data from two trials: the phase I Beamion LUNG-01 study, which evaluated zongertinib, and the phase I/II SOHO-01 study that evaluated sevabertinib. In this study, zongertinib demonstrated an overall response rate of 71% in previously treated patients, with an overall response rate of 48% amongst patients who had received prior HER2-directed ADCs including T-DXd. Sevabertinib in its early phase study showed an overall response rate of 64% in previously treated but HER2 therapy-naive patients, and an overall response rate of 38% in patients previously exposed to HER2-directed therapy. The panel believes that both agents had manageable toxicity profile and represent meaningful new options for this patient population. Brittany Harvey: Certainly, it's an active space of research, and I appreciate you reviewing the evidence underpinning all of these recommendations for our listeners. So, it's great to have these new options for patients in the later-line settings. And given all of these updates in both the first and the later-line settings, what should clinicians know as they implement this latest living guideline update, and how do these changes impact patients with non-small cell lung cancer? Dr. Sonam Puri: Some great questions, Brittany. I think for clinicians when implementing this update, I think about two practical steps. First is reiterating the importance of comprehensive biomarker testing. That is the only way to identify key drivers and resistance mechanisms that we are now targeting. And second, picking a first-line strategy that balances efficacy and toxicity and patient preference for your specific patient. I think informed decision-making, shared decision-making is more important than any time right now. It has always been important, but definitely very important now. For patients, this guideline brings recommendations on more personalized treatment options for both first-line and post-progression settings, which potentially means better outcomes. But it is also very important for our patients to continue to have informed conversations about side effects, time commitment, and what matters most to them with their providers. The panel in this version of the guideline specifically acknowledges the real-world barriers that prevent patients from receiving guideline-concordant therapy, including challenges with access to comprehensive molecular testing and treatment availability, and the panel emphasizes on the importance of shared decision-making, and we provide practical discussion points to help clinicians navigate these conversations with the patient. In addition, the panel has also addressed common real-world clinical complexities, such as treating elderly or frail patients, managing multiple chronic conditions, considerations around pregnancy and fertility, and certain disease scenarios such as oligoprogression or oligometastatic disease. And where available, the guideline summarizes this existing data to support informed individual decision-making in these complex situations. Brittany Harvey: Shared decision-making is really paramount, especially with all of the options and weighing the risks and benefits and considering the individual circumstances of each patient that comes before a clinician. We've talked a lot about all of the new studies that the panel has reviewed, but what other studies or areas of research is the panel examining for future updates to this living guideline as it continues to be updated on an ongoing basis? Dr. Sonam Puri: Yes, definitely, so much to look forward to, right? Looking ahead, the panel is closely monitoring several rapidly evolving areas that are likely to shape future updates of the guideline. This includes emerging data from ongoing later-phase studies, particularly the studies that are evaluating these new targeted agents moving to earlier lines of therapy, alongside studies evaluating additional combination strategies or more refined approaches to treatment sequencing. We're also closely watching advances in biomarker testing, the evolving understanding of resistance mechanisms, development of new targets, and promising therapeutic agents. I think ultimately the living guideline exists to help clinicians and patients navigate this rapidly evolving field, and we would like to ensure that scientific advances are rapidly translated into better, more personalized patient care. Brittany Harvey: Definitely. We'll look forward to those updates from those ongoing trials and future areas of research that you mentioned to provide better options for patients with non-small cell lung cancer and a driver alteration. So I want to thank you so much for your work to rapidly and continuously update this guideline, and thank you for your time today, Dr. Puri. Dr. Sonam Puri: Thanks so much. Thanks so much for the opportunity. 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/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. There's also a companion episode with Dr. Reuss on the related living guideline on stage IV non-small cell lung cancer without driver alterations that listeners can find in their feeds as well. And if you've enjoyed what you've 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.
5728 風とあそぶ：） 20260204WED 今日のCOVID-19・・・1907回目五輪開催へ・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
Fuel Her Awesome: Food Freedom, Body Love, Intuitive Eating & Nutrition Coaching
If you've ever thought, “I'm eating healthy… so why do I feel worse?” — this episode is for you. In today's conversation, we're breaking down GI-MAP testing in clear, human language. No fear-mongering. No over-promising. Just honest insight into what this popular gut health tool can and can't tell us—and how it can help bring clarity when symptoms feel confusing. You'll learn why more data doesn't always mean better outcomes, how gut testing fits into an empowered, food-first approach, and why the solution is almost never cutting more foods—but understanding which foods your body is ready for right now. Connect with us HERE. Learn more about working with the Empowered Eating team here! In This Episode, We Cover: What a GI-MAP actually is (and how PCR stool testing works—in plain English) What defines a “healthy gut” beyond perfect lab numbers What dysbiosis means—and why it's not a diagnosis or a life sentence The pros of GI-MAP testing and how it can help identify possible contributors to symptoms The limitations of GI-MAPs, including: Lack of regulation Cost considerations Emerging (but incomplete) microbiome science The risk of over-restriction without proper guidance A personal story of eating “healthier” and feeling worse—and how gut data helped explain why Why whole foods are always the foundation, but which whole foods matter Who GI-MAP testing is best suited for—and who it's not Key Takeaway GI-MAP testing isn't about controlling your gut or chasing perfect results. It's about listening to your body with better context, reducing guesswork, and choosing support strategies that actually align with where your gut is today. Data doesn't heal—but informed care does. Interested in GI-MAP Testing? If you're curious whether GI-MAP testing could be a helpful tool for your health journey, I offer guided GI-MAP testing with personalized interpretation and a food-first plan—so the data supports your life instead of overwhelming it.
5724 風とあそぶ：） 20260203TUE 今日のCOVID-19・・・1906回目脆弱さの中で・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
5720 風とあそぶ：） 20260202MON 今日のCOVID-19・・・1905回目人の動きについてくる・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
5716 風とあそぶ：） 20260201SUN 今日のCOVID-19・・・1904回目危機・脅威に向き合うと言うこと・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
5712 風とあそぶ：） 2026031SAT 今日のCOVID-19・・・1903回目報告者数増加・・・■Ground News：アラキが利用しているニュースリソースです：）https://ground.news/downloaduse this referral code 4424782 to get 1 month of free Premium.■COVID Incubation Period: Facts You Should Knowhttps://www.health.com/covid-incubation-period-11704405■PCR nowhttps://pcrnow.jp■コロナ早期診断・治療｜新型コロナは終わっていない｜ 塩野義製薬https://bit.ly/4kLQEV6■検証なきコロナ禍 ～いまこそ「下水サーベイランス」（北島正章さん・兪炳匡さん）【山岡純一郎のニッポンの崖っぷち】20250716https://youtu.be/jqPogTrB56Y?si=aJkT66VcHjKcCGpz■札幌市下水サーベイランスhttps://www.city.sapporo.jp/gesui/surveillance.html■新型コロナ・季節性インフルエンザの流行状況速報値の活用例監修モデルナhttps://moderna-epi-report.jp/■全員が安全になるまで、誰も安全ではないNobody is safe until everybody is safe■◇■ 予防は治療に勝る!!! ■◇■●WHOコロナ後遺症の方のためのガイドラインhttp://bit.ly/3kteZFv 日本語●職場復帰に関するガイドラインー英国産業衛生学会http://bit.ly/3ZWmipo 日本語■Flowflex フロウフレックス 抗原検査キットhttps://amzn.to/46LQ3wY■株式会社 CLEAIRhttps://cleair-w.com/■ゲノムに聞け 最先端のウイルスとワクチンの科学https://amzn.to/42pt7DH気合・気愛で555!!!アラキ：）KOJI ARAKI Art WorksCopyright KOJI ARAKI Art Works All Rights Reserved
In this episode of Let's Talk Micro, Luis is joined by faculty and collaborators from the University of Florida to discuss their new Clinical Laboratory Microbiologist (CLM) program — the first NAACLS-approved, microbiology-only certification pathway in the United States. They share how the program was created to address the growing shortage of clinical microbiologists and provide a direct pathway for microbiology graduates and working professionals to enter the clinical laboratory. The conversation covers: Gaps in the current workforce and training pipeline The hybrid model combining online coursework, hands-on bootcamp labs, and local clinical internships Real-world training with clinical lab technology such as MALDI-TOF, PCR, and blood culture systems Preparation for the ASCP categorical microbiology certification exam The strong nationwide interest in the program The episode closes with a fun discussion on everyone's favorite microbes. Whether you're a student, lab professional, or educator, this episode offers insight into the future of clinical microbiology training. Additional resources: ASCP Categorical Certification (Microbiology) https://www.ascp.org/boc/explore-credentials/view-all-credentials/M University of Florida Clinical Laboratory Microbiologist (CLM) Program https://microbiologyonline.ifas.ufl.edu/programs/clinical-laboratory-microbiologist/ GIDEON (Global Infectious Diseases and Epidemiology Network) https://www.gideononline.com/ Stay connected with Let's Talk Micro: Website: letstalkmicro.com Questions or feedback? Email me at letstalkmicro@outlook.com Interested in being a guest on Let's Talk Micro? Fill out the form here: https://forms.gle/V2fT3asjfyusmqyi8 Support the podcast: Venmo Buy me a Ko-fi
In this JCO Precision Oncology Article Insights episode, host Dr. Jiasen He summaries the article, "Longitudinal Evaluation of Circulating Tumor DNA as a Prognostic Biomarker to Detect Molecular Residual Disease in Germ Cell Tumors," by Hassoun et al. TRANSCRIPT Jiasen He: Hello, and welcome to the JCO Precision Oncology Article Insights. I'm your host, Jiasen He, and today, we'll be discussing the JCO Precision Oncology article, "Longitudinal Evaluation of Circulating Tumor DNA as a Prognostic Biomarker to Detect Molecular Residual Disease in Germ Cell Tumors," by Dr. Rebecca Hassoun and colleagues. Traditionally, treatment response for solid tumors has relied on imaging, which focuses on visible anatomic changes in the tumor. However, imaging does not always reflect molecular or cellular changes and cannot detect microscopic disease, which is clinically important and often linked to relapse. Liquid biopsy, on the other hand, is minimally invasive and can be used for cancer monitoring by analyzing circulating biomarkers in biofluids such as blood. One type of liquid biopsy is circulating tumor DNA, or ctDNA, which measures small fragments of DNA released by tumor cells into the bloodstream. ctDNA can allow precise monitoring of tumor-specific mutations and be a powerful tool for assessing treatment responses. ctDNA has already been applied in clinical settings for cancers such as non-small cell lung cancer and breast cancer, etcetera. However, there is still limited data on the use of ctDNA for germ cell tumors. Germ cell tumors are the most common malignancy affecting men aged 15 to 35 years. Accurate risk stratification and disease monitoring is key to risk-adapted therapy, maximizing the chance of cure while minimizing side effects. One unique tool we use currently for diagnosis, staging, and monitoring is serum tumor markers, such as AFP, beta-hCG, and LDH. However, these markers have limitations, including false elevation in certain clinical scenarios, and studies have shown that they can be normal in up to 40 percent of patients with germ cell tumor. This creates an unmet need for other sensitive and specific biomarkers to improve patient care. In this paper, the authors investigated the use of ctDNA in a cohort of patients with germ cell tumor at various disease time points. They compared ctDNA results with traditional serum tumor markers to evaluate whether ctDNA can predict relapse and survival outcomes. This multi-institutional retrospective study included patients with stage I, II, and III germ cell tumors, primarily testicular cancer, who had at least one ctDNA test result. ctDNA was evaluated longitudinally at different time points, including pre-orchiectomy, during the molecular residual disease, or MRD, window, defined as 1 to 12 weeks post-orchiectomy but before primary therapy, and during the surveillance window, defined as more than 12 weeks post-orchiectomy or follow retroperitoneal lymph node dissection or post-chemotherapy. ctDNA analysis was performed using a tumor-informed 16 multiplex PCR next-generation sequencing assay. A total of 324 plasma samples were analyzed from 74 patients in this cohort. The majority had stage I disease, around 40 percent, and nonseminomatous histology, around 70 percent. 15 patients were evaluated in the pre-orchiectomy window, and only one patient tested negative for ctDNA. This patient had stage I disease. The authors further assessed ctDNA positivity in both the MRD window and surveillance window, evaluating its association with event-free survival. They found that ctDNA outperformed serum tumor markers in both settings. ctDNA positivity was associated with significantly worse event-free survival compared with ctDNA-negative patients. Among the 14 patients with stage II to III disease who had ctDNA assessed in both the MRD window and surveillance window, nine patients consistently had a negative ctDNA or converted from positive to negative over time. In contrast, five patients demonstrated persistent ctDNA positivity, and all of these patients subsequently relapsed. Among the 38 patients who had both ctDNA and serum tumor marker tests during the MRD window, nine patients showed discordant biomarker results. Of these, 6 patients were ctDNA-negative but serum tumor marker-positive, and one of them experienced recurrence. Three patients were ctDNA-positive but serum tumor marker-negative, and one of these patients also recurred. During the surveillance window, 46 patients had both biomarkers available, and 10 showed discordant results. Three patients were ctDNA-negative but serum tumor marker-positive, and none of them recurred. In contrast, all seven patients who were ctDNA-positive but serum tumor marker-negative experienced recurrence. This intriguing data strongly support the potential role of ctDNA in patients with stage I, II, and III germ cell tumors. However, as the authors noted, the retrospective nature of the study presents limitations, as treatment approaches, imaging schedules, and the timing of testing were not standardized, and ctDNA testing varies among participating institutions. Larger prospective trials with standardized protocols and long-term follow-up will be essential to validate these findings and determine how ctDNA can be reliably integrated into clinical practice. Thank you for tuning in to JCO Precision Oncology Article Insights. Don't forget to subscribe and join us next time as we explore more groundbreaking research shaping the future of oncology. 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.
In this episode of Let's Talk Micro, we break down metagenomic next-generation sequencing (mNGS) and how it's changing the way we diagnose complex infectious diseases. I'm joined by Steve Miller, MD, PhD—Chief Medical Officer at Delve Bio—to discuss how unbiased metagenomics moved from research labs into real-world clinical practice. We cover what metagenomics is, how it differs from targeted PCR and sequencing, and where it adds the most value—especially in meningitis and encephalitis, immunocompromised patients, and cases where routine testing comes back negative. Dr. Miller shares insights from years of clinical experience, including how mNGS can improve diagnostic yield, shorten time to diagnosis, guide targeted therapy, and reduce unnecessary testing and hospital stays. We also touch on challenges like cost, result interpretation, diagnostic stewardship, and where metagenomics is headed next—including its role in public health and emerging infections. Links & Resources Clinical metagenomics for meningitis and encephalitis (Nature Medicine) https://www.nature.com/articles/s41591-024-03275-1 Stay connected with Let's Talk Micro: Website: letstalkmicro.com Questions or feedback? Email me at letstalkmicro@outlook.com Interested in being a guest on Let's Talk Micro? Fill out the form here: https://forms.gle/V2fT3asjfyusmqyi8 Support the podcast: Venmo Buy me a Ko-fi
We're back and better than ever. Season 4 of Absolute Gene-ius is officially here, and this teaser gives you a front-row seat to what's coming. From scientific puns to sneak peeks of the upcoming guest lineup, co-hosts Jordan Ruggieri and new addition Lisa Crawford set the tone for another season of engaging, educational, and entertaining molecular biology content.This season, the show expands its scope beyond digital PCR to include real-time PCR and other tools that are working together to move research forward in fields like oncology, agriculture, behavioral psychiatry, and more. Lisa brings a non-scientist's view to the show along with a deep passion for translating complex science into compelling stories. Whether it's microvesicles, stem cells, or high-containment biosafety labs, the upcoming episodes promise to be both technically informative and very human.And in classic Absolute Gene-ius fashion, we keep it fun. From how guests got into science, to what thy love most about it, and lab fail stories, the Career Corner returns with fresh energy and laughs. Expect bad puns, big discoveries, and the beautiful chaos of real-world research. Visit the Absolute Gene-ius page to learn more about the guests, the hosts, and the science we explore. Discover the Applied Biosystems QuantStudio Digital and Real-Time PCR Systems powering real-world research across neuroscience, oncology, agriculture, and more.
The current landscape of testing for NSCLC is complex, with many new biomarkers emerging rapidly, more points during which testing is possible, and precision drug treatments available on the basis of findings from biomarker testing. While promising for patients, the result of this rapidly changing landscape is confusion from interdisciplinary care teams as to what testing is necessary and when, who in multidisciplinary care teams should be ordering new tests and when, and what workflows are necessary for labs. Host David Ritter, MA is joined by Dr. Ying-Chun Lo and Dr. Mamatha Chivuluka to discuss what things pathologists and lab professionals need to know about emerging biomarkers for NSCLC. In this conversation, the panel reflects on how NSCLC biomarker testing has evolved over the past decade, highlighting the shift from limited, sequential testing to guideline-recommended broad molecular profiling. Drs. Lo and Chivuluka explore the clinical relevance of emerging biomarkers such as HER2, TROP2, and HER3, and discuss how new targeted therapies are influencing testing strategies in real-world practice. They also examine practical considerations for laboratories, including platform selection across IHC, PCR, and NGS, approaches to tissue stewardship in small lung biopsies, and the growing leadership role of pathologists in multidisciplinary teams to ensure timely, guideline-concordant, and equitable access to biomarker testing for patients with NSCLC.
Dr. Deb 0:01Welcome back to another episode of Let’s Talk Wellness Now, and I’m your host, Dr. Deb, and today we’re pulling back the curtain on a topic that barely gets a whisper in conventional medicine. Chronic bladder symptoms, biofilms, and the hidden genetic drivers that keep so many women stuck in a cycle of pain, urgency, and infection that never truly resolves. My guest today is someone who is not only brilliant, but battle-tested, like myself. Dr. Kristen Ryman is a physician, a mom, and the author of Life After Lyme, a book and blueprint that has helped countless people reclaim health after complex chronic illness. After healing herself from advanced Lyme, she has spent her career helping patients recover their most vibrant, resilient selves through her Inner Flow program. Her Healing Grove podcast, her membership community, and her deep dive work on bladder biofilms and stealth pathogens. And what I love about Kristen is that she teaches from lived experience. In 2022, she suffered a stroke. And not only survived it, but rebuilt her brain, resolved lateral strabismus, restored balance, and regained her ability to multitask That journey uncovered her own genetic predisposition to clotting, the very same patterns she sees in her chronic bladder patients. And that personal revelation ultimately led to her Introducing this groundbreaking work that we’re talking about today. So let’s get into it, because bladder biofilms, clotting genetics, stealth pathogens, and real recovery is the conversation women have been needing for decades. And we’ll get started. Where did this one go? There we go. Alright, so welcome back to Let’s Talk Wellness Now. I have Dr. Kristen with me, and I am so excited to talk to her for multiple reasons. A, she’s got a fabulous story, and B, she’s an expert in a topic that nobody’s talking about, and I want to learn from her, too. So, welcome to the show. Kristin Reihman 3:07Thank you! I’m so happy to be here, Dr. Deb. Dr. Deb 3:10Thank you. Well, let’s dive right in, because we have so much to talk about, and you and I could probably talk for hours. So, let’s dive into this conversation, and tell us a little bit about yourself and how you got involved in this. Kristin Reihman 3:23Well, I mean, like so many people, I think, on this path, I had, had to learn it the hard way. You know, I had to find my way into a mystery illness, a complex, mysterious set of symptoms that sort of didn’t fit the… the sort of description of what, you know, normal doctors do, and even though I was a normal doctor for many years, nothing I’d been trained in could help me when I was really debilitated from Lyme disease back in 2011, 20212, 2023. And so I kind of had to crawl my way out of that, using all the resources at my disposal, which, you know, started out with a lot of ILADS stuff, you know, a lot of the International Lyme and Associated Diseases Society, resources online, found some Lyme doctors, and then my journey really quickly evolved to sort of, like, way far afield of normal Western medicine, which is what my training is in you know, I think within a year of my diagnosis, I was, like, you know, at a Klingheart conference, and learning all sort of, you know, the naturopathic approach to Lyme, and really trying to heal my body and terrain, and heal the process that had led me to become so, so ill from, you know. A little bacteria. Dr. Deb 4:29Yeah. Yeah, same here. Like, I’ve been an ILADS practitioner for over 20 years, and when I got sick with Lyme, I was like… how did I not realize this? And I knew I had Lyme before I even was ILADS trained, but when I got really sick and got diagnosed with MS, I never thought about Lyme or mycotoxins or any of that, because I was too busy, head down, doing what I’m doing, helping people. And I, too, had to take that step back, not just physically, but more spiritually and emotionally, and say, how did my body get this sick? Like, what was I doing, and what was I not doing? That allowed this to happen, and now look at this from a healing aspect of not just the physical side, but that spiritual-emotional side as well. Kristin Reihman 5:13Totally. I have the same… I have the same realization as I was coming out of it. I was like, wow, this wasn’t just about, sort of, physically what I was doing and not doing. There was something spiritual here as well for me, and I… I feel like it really was a wake-up call for me to get on the path that I’m supposed to be on, the path that I’m on now, really, which is stepping away from the whole medicine matrix model and moving into, you know, working with really complex people. Listening to their bodies, understanding intuition, understanding energy, understanding all these different pieces that doctors just aren’t trained to look at. Dr. Deb 5:46Right? We don’t have time to learn everything, right? Like, you have time to learn the body and the medical side of things, and that’s a whole prism of itself, but then learning the spiritual energy medicine, that’s a completely different paradigm. That’s a full-time learning aspect, and it’s so different than what we learn in conventional medicine. Kristin Reihman 6:04Yeah, it’s a complete health system. Like, it’s a complete healthcare system. Dr. Deb 6:10Yes, and nobody takes it that seriously, but I, for myself, I’ve been spiritual healing for decades, and it wasn’t until I got really sick that I dived deeper into that and looked at what is it in this world that I’m owning, what belongs to generational things that were brought to me from childbirth and other generations in my family that I’m carrying their old wounds. And how do I clear some of that so that it’s not still following me? And then how do I help my kids so that they don’t have to carry what I brought forth? And it’s just… a lot of people, that may sound crazy, but that’s the kind of stuff that we need to be looking at if we want to truly heal. Kristin Reihman 6:54Yeah, and I think it’s also, it’s inspiring, you know, because when people… and I would tell this to my patients with Lyme and these sort of mystery illnesses, like, look, you are on this path for a reason, and this is going to teach you so much that you didn’t necessarily want to learn, but you need to learn. And this… nothing that you learn or change about your lifestyle or the way in which you move through the world is gonna make you a worse person. Like, it’s only gonna sort of up-level you. You know, it’s gonna up-level your diet, and your sleep habits, and your relationships, and your toxic thinking, like, it’s all gonna change for you to get better, and that’s… that’s a gift, really. Dr. Deb 7:27It really is, and I tell people the same thing. Like, we can look at this as… something that’s happening to us, or we can look at this as something that’s happening for us. And that’s how I looked at my MS diagnosis. This was happening for me, not to me. I wasn’t going to be the victim. And you have a very similar story, so tell us a little bit about your story and what kind of catapulted you into this in 2022. Kristin Reihman 7:52Well, by 2022, I was, like, 10 years out of my Lyme hole, and I had been seeing patients, you know, I had opened my own practice, and I was working for another company, seeing, families who have brain-injured children. I was their medical director, still am, actually. And so I was doing a patchwork of things, all of which really fed my soul. You know, all of which felt like this is, like, me, aligned with my purpose on the planet. And so, based on a lot of my thinking, I sort of figured, okay, well, I’m good now, right? Like, I’m on my path now, like, the universe is not going to send another 2×4. And then the universe sent another 2×4. And in 2022, I had an elective neck surgery. You kind of still see the little scar here for my two-level ACDF. Because I had crazy off-the-hook arm pain for, like, a year and a half that I just finally became, like, almost like it felt like I was developing fasciculations and fiery, fiery pain, and I just got the surgery, and the pain went away. But when I woke up, I was different. I didn’t have a voice. Which is a common side effect, actually, of that surgery that resolves after a few months, and in many cases, and mine did. But I also didn’t have, normal balance anymore, and my right eye turned out a little bit, and I couldn’t multitask. And my job is all about multitasking. As you know, with very complex people in front of you, you’re hearing all these pieces of their story, and you’re kind of categorizing it, and thinking about where they fit, and you’re making a plan for what to work up, and you’re making a plan for what to wait until next time. It’s like all these pieces, right? You’re in the matrix. And I… I couldn’t hold those pieces anymore. And I didn’t realize that until I went back to work a couple months after my, surgery, because my voice came back and was like, okay, well, now I’m going back to work. And then I realized, I can’t do simple math. In fact, I can’t remember what this person just said to me, unless I read my note, and I can’t remember taking that note. What is going on? And so I had a full workup, and indeed, I had some neurological deficits that didn’t show up on an MRI, so they must have been quite tiny. Possibly were even low-flow, you know, episodes during my surgery when my blood pressure drops really low with the medicines that you’re on for surgery. But I, basically had, like, a few mini strokes, and needed to recover from that. So that was sort of the… that was the 2×4 in 2022. Dr. Deb 10:09Wow. So, what are, what are some of the things that you learned during that process of that mini-stroke? Kristin Reihman 10:17Well, the first thing I learned is that, something that I already knew from working with the Family Hope Center, which is that organization I mentioned that helps families heal their kids’ brains, I know that motivation lives in the ponds, and if you have a ding or a hit to the ponds, like, you don’t want to get out of bed in the morning, you don’t want to do the work it takes to heal your brain, in my case. And I remember spending several months in the fall of 2022 just sort of walking around my yard. With my puppies, being like, This is enough. I don’t really need to work anymore, right? Like, I don’t… why do I need my brain back? Like, I don’t need to have my brain back to enjoy life. You know, I’ll have a garden, I have people I love and who love me, like, why do I need to work? Like, my whole, like, passion, purpose-driven mentality and motivation to kind of do and be all the things I always strive to do and be in the world, was, like, gone. It was really interesting, slash very alarming to those who knew me, but being inside the brain that wasn’t really working, it wasn’t alarming to me. I was just sort of like, oh, ho-hum, this is my new me.Well, luckily I have some people around me, I like to call them my healing team, who sort of held up a mirror, and they’re like, this is not you, and we’re gonna take you to a functional neurologist now. And so, I ended up seeing a functional neurologist who, you know, within… within, like probably 6 visits. I had all these, like, stacked visits with him. Within 6 visits, my brain just turned on. I was like, oh! Right! I need my brain back! I gotta fix this eyesight, I gotta get my balance back, and I gotta learn how to do simple math again and multitask. So, after that sort of jumpstart, I actually did the program that I, you know, know very well inside and out from the Family Hope Center, where I’d been medical director for 10 years. And, it’s a hard program, it’s not… not for wimps, and it’s certainly… I wasn’t about to do it when I had no motivation, so I’m really grateful to the functional neurologist who helped me kind of, like get my brain… get my pawns back, and my motivation back, my mojo. And then I’m really grateful to the Family Hope Center, because if I didn’t have that set of tools in my back pocket, I would still have an eye that turns out to the side, I would still have a positive Romberg, you know, closing my eyes, falling over backwards, and I would still have, a lot of trouble seeing patients, and probably wouldn’t be working anymore. Dr. Deb 12:32I can totally relate to that. When I got my MS diagnosis, you know, there’s a period of time where you go, okay reality kicks in, and I’m thinking, okay, how long am I going to be able to work? How long am I going to be able to play with my kids and my grandkids and be able to be me? And I started looking at, how do I sell my practice, just in case I need to do this? How do I step back? And I spent probably about 9 or 10 months in that place of, this is gonna be my life, and it’s not gonna be what I’m used to, and, you know, how are we gonna redesign my house, and do this, and that, and… Finally, my husband looked at me one day, and he’s like, what the hell is wrong with you? And I was like, what are you talking about? He’s like, this is ridiculous. He’s like, you fix everybody else. He’s like you can fix yourself. Why do you think you can’t fix yourself, or you don’t know the people that can fix you? You need to get out of this, and pick yourself up, and start doing what you tell your patients. And… and I sat there, and at first I was like just did he know that I’m sick? Like, I have MS. I took that victim mode for a little bit, and then I went, no, he’s right. Like, this is my wake-up call to say, I can reverse this, I can fix this, and total, total turnaround, too. Like, I started reaching out to my friends and colleagues, because I kept myself in this huge bubble, like, I didn’t want anyone to know what was going on with me, because I was afraid my patients wouldn’t see me, what are my staff going to say? My staff are going to leave, and if I lose my business, what am I going to do? And da-da-da-da, all those fears. And then… when I finally started opening up and sharing with people, people started bringing me other people, and you need to talk to this person, you need to talk to this person. They connected me here and there, and this place, and 18 months later, I was totally back to normal again. And now my practice is growing, and we’re adding on, and it’s bigger, and I’m taking on more projects than I feel like myself, and… and I was a lot like you, too. Like, I couldn’t remember my protocols that I’ve done for 20 years. I had to depend on what was in the EHR to pull forward, because I always had them in my notes, so I didn’t have to type them all the time, but I was like I have to pull that forward, because I don’t remember the name of the supplement that I’ve used for 15 years. I don’t remember what laps I’m ordering. I don’t remember the normal values of this stuff. And now it’s back on the tip of my tongue, but at the time, it was a little scary, for sure. Kristin Reihman 14:47Wow, so scary. Well, that’s a remarkable story, and why I can’t wait to have you on my podcast, but I’m really… I’m really happy that you had a healing team around you, too, who was like, yeah, nope, that’s not your… that’s not the train we’re on. Get off that train. Come back on your usual train. What are you doing over there? Dr. Deb 15:03Yeah, and you know, I hope that a lot of patients have that, or people that are experiencing this have that, but there’s so many people who don’t have that. And they need somebody, they need somebody in their corner, like we had in our corners, to help pick them up and say, this doesn’t have to be your reality. It can change, but it is a lot of work, like you said. It’s a lot of work. It’s not… Kristin Reihman 15:25Yeah, no, it’s a lot of work. So when I started off. I was work… I was doing probably 4 hours a morning, like, 4… basically, my entire morning was devoted to brain training and healing my brain through the ref… you know, we… I mean, I can get into the details of it, but basically it’s a lot of, like, crawling on the floor. On your belly, creeping on your hands and knees, doing reflex bags to stimulate, you know, more blood flow to the brain, doing a lot of smells. You know, and just staying with it, you know? And I remember balking, even in the beginning, I was, like, seeing some changes, I was feeling more motivated. I remember feeling this… I started noticing it was changing about 2 weeks in, when I would get up in the morning. And I would… I noticed I would start… I would do my, like, beginnings of the day, I would get the kids on the bus, I would do everyone’s breakfast, I’d do the dishes, and I’d be, like, sitting down and being like, hmm, like, what am I supposed to be doing now? Like, where… What is my purpose today? And because I had this plan, I was just like, well, I know that has to happen, so I may as well do that now. And I would get on the floor, and I would start crawling down the length of our hallway. And within about 8 laps, I would feel my brain, like. I felt like it integrating. I would feel things, like, just coming online, and I’d be like, oh, right. I know who I am, I know what I’m doing today, I have these other things this afternoon, I gotta get this done before noon, and I would do it. But it was really interesting, and I’ve never been a coffee drinker, but when I thought of what that felt like, to me, that’s how people often describe, like, my brain doesn’t wake up until I have coffee. I never needed coffee to have… my brain woke up before I’d wake up, and I’d be like, bing, and I’m ready to go. But when I had the brain injury for those 9 months, it wasn’t that way the whole time. In the beginning, it was very hard to get my brain back in the morning, and it was creeping and crawling that would pull it in. Dr. Deb 17:08Wow. Is there one particular thing that you did that you felt made the biggest difference to rebuilding your brain? Kristin Reihman 17:15Crawling on my belly like a commando, wearing elbow pads, knee pads, actually two sets of knee pads, wearing toe shoes, and just ripping laps on my floor. Dr. Deb 17:26Oh, and that’s so simple to do. So why does that work? Kristin Reihman 17:31So interesting, and I… this is the kind of… this is the… the story of this is something that I think is bigger than all of us, and I wish everybody knew how to optimize your brain using just the simple hallway in your house. But essentially, if you take a newborn baby. And you put them on mom’s belly, and they’re neurologically intact, and maybe you’ve seen videos of this. There used to be a video circulating about a baby born onto mom’s belly, nobody touches the baby, and in about 2 minutes and 34 seconds, that baby crawls on its belly, like, uses arms, uses its toe dig with its little babinsky, and pushes its way up to mom’s breast. Latches on with its reflexes, and there you go. That baby keeps itself alive through its primitive reflexes. So it’s essentially telling its brain, every time it runs those reflexes, every time it does a little toe dig, every time it, like, swings its arm across in a cross-later, hetero… what do we call, a homolateral pattern. That little baby is getting a message to its brain that says, grow and heal and organize. And because all the reflexes come out of the middle and lower brain stem. That’s the part of the brain that’s organizing as a baby. And as a baby grows and does the various things a baby does using its reflexes, like eventually on its belly, crawling across the floor, and then popping up to hands and knees, and creeping across the floor, and eventually standing and walking, all of those things are invoking a different set of reflexes that tell the brain to grow and heal and organize. So it’s almost like the function creates the structure, and if you run those pathways again and again and again your brain will get the message to basically invoke its own neuroplasticity, and that’s how a baby’s brain grows. And it turns out, any brain of any age, if you put it through those same pathways, it will send a message of neuroplasticity to the brain, and the brain will grow and heal and organize. Dr. Deb 19:16That was going to be my question, is why aren’t we using this for elderly people with dementia, or Alzheimer’s, or stroke, or Parkinson’s, or things like that, to help them regrow their brain? Kristin Reihman 19:28Well, because number one, nobody knows about it. Number two, even when people do know about it, nobody likes to be on the floor like a baby, creepy and crawling. And least of all the stubborn old people with dementia who are, like, who don’t even think they have a problem. I mean, the problem with the brain not working, as I discovered, and it sounds like you discovered, too, is the brain that’s not working doesn’t know it’s not working, or worse, doesn’t care. You know, and so it’s tricky with adults. With kids who, you know, you have some sort of power over, you can often make your kids do things that they don’t want to do, like eat their vegetables, or creep and crawl on the floor for 80, you know, 80 laps before they get to go, you know, do their thing. But adults are a little trickier. Dr. Deb 20:10Is there another way for us to be able to do that same thing without the crawling on the floor? Like, could they do it in a sitting motion, or do they need that whole connection to happen? Kristin Reihman 20:21Well, they need to be moving in a cross pattern, and they need to be moving their arms and their legs in such a way that stimulates the reflexes. But you can do that on your bed, you can do it face down on your bed by getting into a pattern, and switching sides and, you know, moving your legs and your arms in the opposite… in the, you know, an opposite cross pattern, and that will get you some of the benefit. And we, in fact, we have… we work with kids who are paralyzed and who don’t… aren’t able to independently move forward in a crawling pattern, who have people coordinating their movements so that they get the same movement, and the brain registers it, and they do make progress, and some of them eventually. Crawl, and then creep, and then walk. Dr. Deb 20:59Wow, that’s so… and it’s so simple and easy for people to do. Kristin Reihman 21:04Well, it’s simple. I don’t know that it’s easy. I do… I do… having done it myself, I will say it’s probably the hardest thing I’ve ever done, was literally crawl my way out of that brain injury. And I’m so glad that I knew what to do, and I’m so glad I had people push me to remind me that it was important, because… I’ll even… I’ll share another story of my own resistance. So, about 2 or 3 weeks into it, I was up to 300 meters of crawling on my belly. And 600 meters of creeping on hands and knees, which was really killing my knees, which was why I was wearing two knee pads. And, I started to get this feeling that maybe I wasn’t doing enough. Like, even though I was noticing changes, and even though I was feeling more purpose, and I was getting organized in the morning, I could tell it was making a difference. I… I knew, I remembered that usually the kids on our program are doing a lot more than that, including my own… my youngest kids, but I made them creep and crawl, even though they didn’t have serious brain injuries, I just thought, we’re gonna optimize everyone, get on the floor, get on the floor. Lord so I was… I was nervous about not doing enough, so I… I reached out to the member… one of the members of the team, and I said, you know, hey, Maria, what’s… what do you think about my numbers? And here’s a… here’s a video of me creeping and crawling, what do you think? Am I doing it right? And she said, you’re doing it right, but how many, how many meters are you doing? And I said, I’m doing 300 meters of crawling on my belly, and 600 meters of creeping, and she’s like, oh. Yeah, that’s not nearly enough for an adult. She’s like, Matthew probably gave you those numbers because he felt bad for you and thought you were going to be still working. He didn’t know you were going to take off from patients. Now that you’re… since you’re not working, you need to do more. I was like, okay, tell me… tell me how much I’m supposed to do. And she goes, you need 900 meters of crawling on your belly, and 3,600 meters, 3.6 kilometers of basically crawling on my hands and knees. Dr. Deb 22:51Oh my gosh. Kristin Reihman 22:52And I just shut down. Dr. Deb 22:54Yeah. Kristin Reihman 22:55I was like, okay, screw it. I’m not doing it. Dr. Deb 22:58And I spent a day or two just not doing it and feeling petulant, and then I was like, you know what? Kristin Reihman 23:01Forget that, I was noticing some benefit. I’m gonna do my 300-600. So, the next day, I went and did 300 and 600 while my daughter was at physical therapy, and we got back in the car, and I said, hey, I’m so excited, I finished my… all my creepy and crawling, and it’s only 10 a.m. on a Saturday, I’m done for the weekend. And she did this. She’s sitting in the car, she looks at me, she goes. Was that your whole program, or was that a third of your program? Dr. Deb 23:28How old is she? Kristin Reihman 23:01Well, she’s, like, 20 now, but she was 18 at the time, and she… she had my number, and I was like, Tula! How can you say that? I’m working so hard! And she’s like, Mom? You need to stop seeing patients completely, and do what they tell you at the Family Hope Center. Because we’re your family, and this is your brain we’re talking about, and we need you to have all your brain back. And I must have looked terrible, because she goes, too much? Dr. Deb 23:54You raised a good daughter. Kristin Reihman 23:58And I was like, well, let me tell… let me ask you, do you mean that? She goes, yeah, I really mean that. I’m like, then it’s not too much. I needed to hear that. Thank you. And I went home, and I finished another 600 of crawls. I didn’t… I never got up to 3,600 of creeps. It was just too much for my knees. I got to 900 and 900, but that was the end of my resistance, and I just did it. Dr. Deb 24:17I just did it. Yeah, your family needed you, right? I mean, when somebody in your family that you love tells you they need you, that’s a huge motivating factor. Kristin Reihman 24:27Yeah, yeah, I’m so grateful for that. So, I did that for 9 months, and at the end of 9 months, my eye was straight and stayed straight, my balance was back, I was multitasking again, and I could take, you know, days and days off of creeping and crawling and not notice a dip. I was like, I’m done. Dr. Deb 24:45Wow, that’s awesome. Kristin Reihman 24:46Yeah. Dr. Deb 24:47During this process, you also discovered that you’re part of 20% of the people with clotting genetics. Tell us a little bit about that. What’s your understanding in that? Kristin Reihman 24:58Well, so, I’ll back up. So, before I had my stroke, I had already been seeing patients with really complex, you know, patients like yours, really complex stories, lots of different things going on, kind of the perfect storm for if they got a tick bite, they tanked. Dr. Deb 25:12and… Kristin Reihman 25:13And I’m one of those people, and my patients were those people. And about 7 years ago, I had one of these patients who said to me, you know, I’ve never told you this, but when I was in my 20s, I had so many bladder infections, so much, like, you know, kind of interstitial cystitis, they said it was, and they said it wasn’t an infection, but it felt like one. And I’ve been doing a little research, and I’ve learned about this woman whose name’s Ruth Kriz, she’s a nurse practitioner, and she sees Patients, and she has… she works with practitioners, and she basically heals interstitial cystitis. And I want you to work with her, I want you to learn from her. And I was like, I’m game. That sounds really interesting, I have no idea what she’s doing, and you don’t usually hear the words cure and interstitial cystitis in the same sentence, so, like, I’m in. So I reached out to Ruth, and long story short, I’ve been working with her for the last 5 or 7 years basically increasing the number of patients who I’m diagnosing now with these hidden bladder infections that are really often what’s at the root of these interstitial cystitis symptoms, meaning, you know, you go to the doctor, you pee in a cup, they look for something, they say there’s no infection here, so, you know, you’re probably crazy, or, you know, you probably have just a pain syndrome, we can’t help you. And actually, if you look with a much more sensitive test, and if you break down the biofilms where these bugs kind of are living in the bladder, you find them. And then you can treat them, and then people get well. So I knew about this, and I, didn’t have any bladder infections that I knew about, and what I did start to think about after my stroke was, well, maybe, since these people who have these bladder infections often have issues breaking down biofilms, the same genetics that lead you to have trouble breaking down biofilms, which are these places where the bugs are kind of hiding in your body, have trouble breaking down clots. And I just had some strokes. I wonder if I have maybe some of these clotting genetics that I’m looking for in all my bladder people. And so I looked, and surprise, surprise, I had not one, not two, but, like, six of them. Ruth said to me, Ruth said, Darlin, I don’t know how you’re standing up. This is more than I’ve ever seen in any of my patients. And she’s been doing this for, like, 4 years now. I was like, oh boy, that’s not good. But in retrospect, it made a lot of sense to me, because having the clotting genetics I have. puts me at risk for severe, you know, chronic Lyme that’s intractable, which I had. It puts me at risk for trouble with, you know, having surgery and clotting and, you know, low blood pressure and low flow states. It puts me at risk for the cold hands and cold feet that I had my entire life until I started treating the clotting issues by taking an enzyme that breaks down little microclots. I mean, I was the person in med school who’d put my hands on people, be like, I’m so sorry. My hands are ice. Warm heart, cold hands, warm heart. Yeah, not anymore, because I’ve treated it. But yeah, so I was surprised slash not surprised to find that I’m one of the people in my community who is a setup for chronic infections and, strokes and bladder infections. Dr. Deb 28:22So you just had that predisposition that took you down that path. Kristin Reihman 28:28Yeah, I think so. Dr. Deb 28:30What are some of the layers of biofilm and the stealth pathogens, like tick-borne diseases and things like that, hiding inside us that… what are some of the symptoms look like, and how do they look different in people with clotting disorders versus the common tick-borne disease? Kristin Reihman 28:47I would say they’re very similar, so it tends to be poor peripheral circulation, so if you put your hands on your neck, and your hands feel cold to your neck difference in the heat, right? The amount of blood flow in your sort of axial skeleton and area as compared to the periphery. And that can indicate a biofilm kind of predisposition or a clotting disposition. It doesn’t necessarily mean it’s there, but it’s a clue, right? Another clue is a family history of any kind of clotting disorders. So, miscarriages, heart attacks, especially early heart attacks, strokes, especially strokes in young people. These things are… are clues that we should probably look for some kind of clotting issue. And of course, in my population, I’m always thinking about it now, because if you have not been able to get well with the usual things for Lyme disease, for example, or Babesia or Bartonella, all of which, by the way, can form biofilms or, you know, love to live and hide in biofilms, then chances are your body’s having a hard time addressing those biofilms. And it turns out, so the connection between the clotting and the biofilm piece is that the same proteins that our body uses to break down Biofilms are used to break down microclots, blood clots, and soluble fibrin, which are the sort of precursors to those clots. And so, if we have an issue kind of grinding up those just normal flotsam and jetsam in our blood flow, then our blood flow is going to become sticky, and our blood will become sort of stagnant and sludgy, and that’s sort of a setup for not being able to heal from infections. Dr. Deb 30:25Is one of the genetic markers you look at MTHFR? Kristin Reihman 30:28I look at that, but I don’t consider that a clotting issue, unless it leads to high homocysteine. So, homocysteine can be either high or low, they’re both problematic. And MTHFR can create either an over-methylation situation, and sometimes if people have low homocysteine, it’s almost worse, because they’re such poor detoxers that they can’t actually get anything out of their system, and they get sludgy for that reason. But I think in terms of the clotting, the bigger issue is high homocysteine, which, you know, typically the MTHFRs, the 1298 would be more implicated for that. Dr. Deb 31:02Yeah, it kind of sets you up. Dr. Deb 31:04Yeah, yeah. Kristin Reihman 31:05I’m curious what you’re seeing. I know since the pandemic, we see a lot of people with elevated D-dimer levels.Are you seeing some of that in your practice, too? Like, we’re seeing more of it, and now that you’re talking about this, I’m wondering if some of those people are predisposed to some of these genetic makeups, and that’s why we’re seeing such a high rise in that.It… and this is connected, and it’s a piece we’re missing. Kristin Reihman31:29Yes, I do think it’s a piece we’re missing. There was a very interesting study that came out of South Africa. A physician in his office did a clinical study on his patients using 3 blood thinners. So he put people on Plavix, and Eliquis, and aspirin, all at once. It… yeah, you’d be hard-pressed to find a doctor in the States to, like, you know, kind of risk that, because most people don’t even want people on aspirin and Flavix at the same time. Dr. Deb 31:55But Kristin Reihman 31:56They put them on 3 different blood thinners, people with long COVID, and in 6 months, 80% of those people were completely free of symptoms. Dr. Deb 32:04Wow. Kristin Reihman 32:05Yeah, yeah. Now, my question is, what about that 20%? Like, what’s going on with them? And I suspect, they weren’t looking at the other half of the pathway, because when you give a blood thinner, you’re not doing anything to help the body break down clot. You’re simply stopping the body from making more of it. And you rely on the body’s own mechanisms, you know, plasminogen activating inhibitor, for example to kind of grind up those clots and take them out. But when people have a mutation, say, in that protein, they’re not going to be able to grind up the clots, and so my suspicion is the 20% of people who didn’t get well in that study were people who had issues on the other side of the pathway. Dr. Deb 32:44Yeah, they weren’t able to excrete that out and maybe have some fiber and issues and things like that, and that wasn’t being addressed. Kristin Reihman 32:50Yeah Dr. Deb 32:51Yeah Kristin Reihman 32:52Of course, COVID makes its own biofilm. There’s a whole… there’s a whole new, you know, arm of research looking at sort of the different proteins that get folded in the body when COVID spike proteins are in there, kind of creating these almost, like, little amyloid plaque situations in your blood vessels. So, I do think that people who can’t break those down are really at risk for both COVID and the shots. You know, the spike protein comes at you for both of those, right? Dr. Deb 33:17Yeah. Did you use any lumbrokinase or natokinase in your situation? Kristin Reihman 33:22So lumbar kinase is what I use. It’s my main player. I use the Canada RNA one, which is, you know, I think, you know, more studied than any of the other ones, and because of its formulation, it’s about 12 times more potent than anything else out there. So that’s what I’m pretty much on for life. You know, that’s… I consider that kind of my…My… my main game. Dr. Deb 33:44Yeah, I agree, I love Limerocheinase for that, that’s really good. So you recently hosted a retreat around this topic. What were some of your biggest aha moments for the participants as they started unraveling some of these biofilm layers? Kristin Reihman 34:00Yeah, no, it was so fun. My sister and I host retreats together. She came out from California and did the yoga, and I did the teaching about biofilms and bladder issues, and it was really fabulous, because a lot of these folks are people already in my community. A few of them were new, and so we had this wonderful Kind of connection, and learning together, and just validation of what it is to live with symptoms that are super inconvenient, you know? Like, one of the… one of the members even, or participants even brought a big bag of, like, pads, and she’s like, listen, ladies. This is what I’m going to use to get through the week. If you want to borrow, I’ll put my little stash over there, and I think they all went by the end of the week. So we… my aha moment was just how powerful it is to be, hosting community and facilitating conversations where people really feel seen and heard, and just how important that is, especially post-COVID, right? When we, you know, so many people just really missed that piece of other humans. And, yeah, I love… I love being able to help people connect around stuff like that. Dr. Deb 35:00That’s awesome. So, for people who are listening that have that mystery, quote-unquote bladder issue, frequent UTIs, interstitial cystitis symptoms, or pelvic pain, or bladder spasms. Where should they start, and what are the first clues that tell you this is biofilm-driven? Kristin Reihman 35:20So, I think it’s always a good idea to… to do a test, you know, to take a microgen test. There’s a couple companies out there, I think Microgen’s the one that I rely on more than any of the others, and it requires, you know, not only doing a very sensitive test like Microgen, but breaking down biofilm before you take it. So, I always encourage people to take a biofilm breaker like lumbrokinase for 5 days leading up to the test, so you’re really grinding into the bladder wall and opening up those biofilms so that when you catch whatever comes out of your bladder, there’s something in there. If you don’t have bladder biofilm, nothing will come out, and you’ll have a negative test, and that’s usually confirmatory. If you’ve done a good provoking with BLUC or, you know, lumbrokinase for 5 days, and nothing comes out then I usually say mischief managed. That’s… that’s a great… that’s great news for you, right? And most people in my community, when they look, they find something, because, you know, not for nothing, but you’re in my community for a reason, right? Dr. Deb 36:17And so… Kristin Reihman 36:18So, yeah, and typically then we need to get into the ring with those bladder biofilms, and it doesn’t… it doesn’t usually take one or two tests, it’s many tests, because the layers are deep. I’m working with children, too, and even in small kids, they… if they have the right genetics, and if they’re living in an environment that is… that kind of can also push them to make more biofilms, like living in mold, for example, is a huge instigator of inflammation and biofilms, and also, you know, microclots and fibrin in the body. then those layers can go deep. And so, we’re peeling the layers one at a time, and we’re treating what comes out, and supporting people along the way. Dr. Deb 36:57With these microgen tests, can you find biofilms in other parts of the body as well, or is it primarily bladder? Kristin Reihman 37:03No, you can find… you can culture… and you can send a microgen PCR for any… any, you know, secretion you want. So they have a semen test, they have a vaginal test, they have a nasal test, you can send sputum, you can culture out what… you can stick a swab in your ear. There’s all sorts of… anything that you can put a swab in, you can… you can send in there. Oh, that’s awesome, that’s amazing. Yeah. Dr. Deb 37:26So, once you identify the drivers, genetics, environment, stealth infections, what does an effective treatment or reversal process look like for people? Kristin Reihman 37:36For the… for the bladder in particular? Well, I wish I could say it was herbs or oxidation, which are my favorite things for Lyme. I haven’t found those to work for the bladder, and so I’m using antibiotics. Which, even though I’m a Western-trained MD, it was not my bag of tricks. You know, when I left, sort of, the matrix medicine model, I really stopped using those things as much as possible, and I’ve had to come back to them, because they really, really work, and they’re really, really needed. So I love it if someone else out there is getting results with something other than antibiotics, please contact me and let me know, because I have plenty of patients who are like, really? Another antibiotic? I’m like, I know. But they work. We also do a really careful job, you know, I work with Ruth Kriz on every case, and we do a very careful job in finding the drug that’s going to be the least broad spectrum, and that’s really only going to tackle the highest percentage bug there. So, MicroGen does this really cool thing. It’s a PCR, next-gen sequencing, they’re looking at genetics, so you don’t have to have it on ice, it can sit on your countertop for a month, and you can still send it in. And they, they, they categorize by percentage, like, what’s there. And they’re not just looking for the 26 or 28 different bacteria that you would get if you were looking at a culture in your doctor’s office. They’re looking for 57,000 different organisms. Fungal and bacterial, yeah? And so, this is why I say, if there’s something there, and you’ve broken down the biofilm, microgen will find it. Dr. Deb 39:06That’s really great. That was going to be my question, is does it pick up fungal biofilms as well? So I’m so glad you mentioned that, because a lot of times with bladder stuff, it’s fungal in that bladder, too, and then we’re throwing an antibiotic at it and just making it worse if it’s fungal in there. Kristin Reihman 39:21Yeah, yeah, that’s… they… and I recently saw one, I had a little Amish girl who came back with 5 different fungal organisms in her bladder. And a whole flurry, a slurry of bacteria, too. Yeah, pretty sick. And that’s usually an indication that you’re living in mold, honestly. Dr. Deb 39:37Now, conventional medicine treats the bladder as a sterile organ, and rarely looks at biofilms. Why do we believe that this has been overlooked for so long, and what are they missing? Kristin Reihman 39:53Dr. Dr. Deb 39:53I’m loaded up. Kristin Reihman 39:54One of the many mysteries of medicine. I have no idea why people are like, la la la, biofilms. I mean, we know, so when I say we know, so when I trained, you know, I trained at Stanford for my medical school, I trained at Lehigh Valley for residency. Great programs, and I learned that, oh yes, biofilms, they exist in catheters of bladders. When people have an indwelling catheter for more than a month and they spike a fever, it’s a biofilm, but it’s only in the catheter. Really? Why does it stop at the catheter? Dr. Deb 40:23Yeah. Kristin Reihman 40:25Or, you know, now chronic sinusitis, people are recognizing this is a bladder… this is not a bladder, this is a biofilm infection in your sinuses. But we’re really reluctant to kind of admit that there’s, you know, that we’re teeming with microorganisms, that they might be setting up shop, and for good, right? Like, it’d be great if they were in biofilms as opposed to our bloodstream. Like, we don’t want them in our bloodstream, so thankfully they wall themselves off. But yeah, I think they’re everywhere. I mean, they found a microbiome in the brain, in the breast, in the, you know, the lung. There’s microbiome, there’s bugs everywhere. And the question is, are they friend or foe? And the bladder really shouldn’t have anybody in it. Because, think about it, you’re flushing it out, you know, 6 times a day. You know, most people who can break down biofilm because their clotting genetics are normal, and because they’re peeing adequately, will never set up an organism shop in their bladder. Even though things are always crawling up, we’re always peeing them out. Dr. Deb 41:23Yeah. Kristin Reihman 41:23And then there’s the 20% of us who… Who aren’t that way. Dr. Deb 41:30Oh, so you run the Interflow program and a number of healing communities. What tools and teachings have been the most transformational for people going through this journey? And tell us a little bit about the Interflow program, too, please. Kristin Reihman 41:44Okay, maybe I’ll start there, because honestly, I have to think about the which tools are most transformational. The Interflow program is my newest offering, and we developed it because my team and I were looking around at the patients we had, and so many folks were needing to go down this… we call it the microgen journey, like, get on the microgen train and just start that process. And there was just a lot of hand-holding and support, and… education that they were requiring. And by the way, their brains aren’t working that great, because when you have these infections, you know, you’re dealing with, like, downloads of ammonia from time to time from the bladder organisms, you’re dealing with a lot of brain fog, overwhelm, you know, there’s just a lot of… you know how our patients are, they… they… they’re struggling, and they really need a lot of hand-holding, and so we were providing that. But we kept thinking, like, gosh, it would be great to get these guys in community, like you know, we can say all we want, like, you know, it’s important to check your pH, it’s important to, like, stay on top of the whatever, but it’d be great to have them hear that from one another, and to have them also hear, sort of, that they’re not alone. So, because we had some experience running communities online, which we started during the pandemic and has been super successful, we said, let’s do this, let’s create a little online community of our inner… of our, you know, call them… informally, we call them our bladder babes. But, like, let’s create a community of people who are looking to really heal and get to this deep, deep root that no one else is doing. And that was really the key for me, that nobody else is really doing this. Very few people are doing it or aware of it. I wish that weren’t the case, but as it stands now, it’s pretty hard to find someone to take this seriously. Most doctors, if you even take a microgen to them, they’ll say, oh, there’s 10 organisms on here, that’s a contamination. That must be contaminated. Well, yeah, buy your biofilms, but they don’t know about biofilms, so they think it just comes from the lab. Dr. Deb 43:31Something. Kristin Reihman 43:32I don’t know. But, yeah, basically it was because I felt called to do this service that no one else is providing, and I wanted to do it in a way that was going to be really optimally supportive for people. So we created a membership, basically. Dr. Deb 43:44Do you see a difference in men and women? Obviously, women have this problem more than men, but do you see a difference in how many men that have these self-infections or live in mold compared to women? Kristin Reihman 43:57I… it’s hard to know, really, what the, sort of, prevalence is out there, I will say, in terms of who calls our office. Dr. Deb 43:03It’s, you know, 95% women call our office. Kristin Reihman 44:08And occasionally, we’ve had someone call our office on behalf of a husband or a son. I just saw a woman whose 2-year-old son is in our Bladder Babes community. But typically, it’s the women who are seeking care around this, and I don’t know if that’s a function of their having more of the issues. I suspect it is, because as you said before, so many more women deal with these complex mystery illnesses than men.But there certainly are men who have them. Dr. Deb 44:33Yeah. So, you’ve lived through Lyme, chronic illness, stroke, and now biofilm-driven bladder issues, and you’ve come out stronger. What mind shifts helped you stay resilient through all of these chapters? Kristin Reihman 44:50I think there have been many. I think the first one I had to really, Really accept and lean into and kind of internalize. Was this idea that, I… I couldn’t… I didn’t have to do the work that I was doing. Dr. Deb 45:09You know? Kristin Reihman 45:09In order to be of value to the world. You know, I’d trained in a certain way, I had, you know, I had this beautiful practice. I was working in the inner city, I was working with my best friend, we were seeing really needy people who had no money, and it felt really, like, you know, I felt very sort of service-driven and connected to a purpose. And I think the hardest thing in the beginning for me was realizing, I can’t do that work anymore. That’s not the work that I’m… needing to do, and to make a leap into the unknown. It felt like, you know, having a baby at 45 and not doing any ultrasounds, or any tests, and just being like, I’m birthing something here. I don’t know what it is, it’s me, but who knows what she’s gonna look like, or… what this doctor is going to be, you know, what, you know, peddling in terms of her tools. That was a big leap of faith, and I think letting go of the kind of control of needing to be… needing to look a certain way and be a certain kind of doctor was a big step for me, my big initial step. Dr. Deb 46:05That’s really hard, because you’re taught and ingrained in who you’re supposed to be as a doctor, and what that person’s supposed to be, what your persona’s supposed to be. And doing a lot of the Klinghart work and some of those things, and I’m sure on the days crawling through the floor, you’re like, this is not what I was trained to do. If my colleagues could only see me now, they’d… they’d… Commit me, right? But like you said, just giving that leap of faith and saying, I’m gonna turn this over to your higher power, and you’re gonna bring me out on the other side, and trusting that, that is a vulnerability for us that is huge. Kristin Reihman 46:43Yeah, and I mean, I’d like to say it’s because I’m some sort of strong person, but truthfully, I feel like there was no other choice. Like, I had to surrender because there was… the alternative was death or something. I didn’t… I don’t know, right? There was no other choice. Dr. Deb 46:56Yeah. Kristin Reihman 46:56I couldn’t move. I was in so much pain. I couldn’t move. Couldn’t get out of bed. Dr. Deb 47:01Thank you so much for sharing all of this and being vulnerable with our audience. Where can people find you? Find your book, your podcast, your programs, if they want to go deeper with you? Kristin Reihman 47:12Yeah, thanks for asking. So, I have a website, it’s my name, kristenRymanMD.com, and all my programs are listed there. I have several, you know, I have a, sort of, a wellness… I have an online membership for well people who want to stay well and pick my brain every week around, sort of, healthy, holistic tools. It’s called The Healing Grove.I have a podcast that people can listen to for free, where I interview people like you, and you’re gonna be on it, right? She’s gonna be on it soon. Dr. Deb 47:38I’d love to. Kristin Reihman 47:39So I can share stories of hope and transformational tools with people. I also have a Life After Lyme coaching program, which is kind of the place where I invite people who are dealing with a mystery illness to come get some support, community, and guidance from someone like me, and also just from the other people in the room. There’s a lot of wisdom in those groups. And that’s… I guess that’s the answer I’ll share for what you asked earlier, like, what’s the main tool they take away? I think they take away an understanding that community really matters, and that they’re not alone. You know, I think it can be very lonely to be stuck in these… to feel stuck in these illnesses, and people need to be reminded that they’re… that they’re human, you know, and that they’re worthy of love and acceptance. I think that’s what people get from my… from my community, is kind of like, that’s the common thread. Dr. Deb 48:23They definitely need that. Kristin Reihman 48:25Man. Dr. Deb 48:26Kirsten, thank you so much for sharing your powerful story. Your work is so needed, and your ability to weave personal experience and advanced clinical insight is exactly what our community craves. And this kind of conversation helps women finally be seen and heard, which is my motto too, and gives them just the real tools to get their life back. And for everyone listening, if you’re struggling with unexplained bladder pain, frequent UTIs, pelvic discomfort, or symptoms that never match your labs, because they never quite do. You are not crazy, you are not alone. You need to find the answers, you need to be with community, and there are solutions, and conversations like this is how we bring them forward. So, thank you all for tuning in to Let’s Talk Wellness Now. I’m your host.And until next time… Kristin Reihman 49:15Thanks, Dr. Dove. Dr. Deb 49:16Thank you. This was awesome. Thank you so much. This was… Kristin Reihman 49:21You’re so welcome, you’re such a great interviewer.The post Episode 251 – Chronic Bladder Symptoms, Biofilms, and the Hidden Genetic Drivers first appeared on Let's Talk Wellness Now.
Are you a parent at the end of your rope dealing with your child's complex neurological challenges like tics, Tourette's, ADHD or anxiety?Today, we welcome pioneering functional health expert Dr Piper Gibson, founder of the Regenerating Health and Tic Disorder Institute. Dr Gibson shares her powerful, research-backed journey of helping her own son overcome a transient neurological tic disorder and how she now empowers families globally with a holistic, root-cause approach. Discover why symptoms like tics and anxiety are not random and how underlying issues like gut dysfunction, a dysregulated immune system, environmental toxins and genetics are the true drivers.Key Information 02:33 Discover why neurological symptoms like tics, ADHD and anxiety are not random and how these issues are linked to a dysregulated immune system and root causes beyond typical neurological labels.03:44 Parents often miss the underlying issues (like gut problems, genetics and toxicity) that conventional research overlooks. Learn why treatments must go beyond simple probiotics to address parasites, leaky gut and chronic inflammation.04:51 Understand the powerful and often-overlooked gut-brain axis. Dr Gibson explains how inflammation and leaky gut allow pathogens into the bloodstream, triggering immune cells in the brain and driving neurological symptoms.06:45 Dr Gibson outlines her protocol: first, clean up the environment and change the diet. She emphasizes that detoxing too early on an unsupported gut and body can actually worsen symptoms.10:19 Learn about the specific lab tests used to uncover root causes, including PCR stool pathogen tests, organic acids testing, tests for environmental toxins/heavy metals/mycotoxins (mold) and detailed genetic panels (MTHFR, methylation). 13:09 Genetics are not set in stone. Dr Gibson explains epigenetics, showing how parents can manipulate the child's environment (diet, toxins, supplements) to influence gene expression and effectively "turn off" symptomatic neurological genes. 27:16 #1 Tip: Dr Gibson's top initial tip is to drastically reduce inflammatory sugar and processed foods to immediately support the gut-brain connection and begin the healing process. Piper's Bio Dr Piper Gibson, PhD is a pioneering voice in functional and natural health, specializing in complex neurological conditions like tic disorders, ADHD, and anxiety in children. As the founder of Regenerating Health and the Tic Disorder Institute, she empowers families who are at the end of their rope, offering a research-backed, holistic approach that goes far beyond symptom management. Through advanced lab testing, genetics, and personalized nutrition, she helps uncover the root causes of children's health challenges. Dr Gibson's work blends deep scientific understanding with a compassionate, supportive framework, giving parents a roadmap to help their kids thrive—naturally.Connect with Piper https://www.regenerating.health/Facebook: https://www.facebook.com/RegeneratingHealthInstagram: https://www.instagram.com/regeneratinghealth/LinkedIn: https://www.linkedin.com/in/drpipergibson/YouTube: https://www.youtube.com/@ticdisordersecretsWho am I?Sarah Dawkins is a passionate Holistic Health and Healing Coach, international speaker and author of Heal Yourself. She's also a multi-award-winning entrepreneur and the award-winning host of the uplifting podcast Heal Yourself with Sarah Dawkins.With over 20 years' experience as a Registered Nurse, Sarah combines her deep understanding of conventional medicine with her own powerful self-healing journey to create a truly integrative approach. Having overcome multiple chronic health challenges herself, she now supports others in uncovering and addressing the root causes of their symptoms, helping them restore balance, reclaim their energy and create lasting, vibrant wellness.www.sarahdawkins.com#NeurologicalDisorders #Tics #TourettesSyndrome #ADHD #OCD
EHV-1 has dominated online conversation in recent weeks—but not all the information circulating reflects the science. In this episode of Equine Innovators, we step back from the noise to focus on what researchers and clinicians know about how equine herpesvirus infects horses, how it spreads, why latency matters, and what drives the neurologic form of the disease.Host Stephanie Church, editorial director at The Horse, speaks with Dr. Abby Sage, equine technical services veterinarian for Zoetis and a former state veterinary official, and Dr. Lutz Goehring, professor of equine infectious diseases at the University of Kentucky's Gluck Equine Research Center. Sage and Goehring explain what testing can—and cannot—tell us during an outbreak, clarify common misconceptions, and outline how vaccination and biosecurity fit into a thoughtful response.The conversation also looks ahead, exploring emerging diagnostic tools, vaccine research, and unanswered questions about viral reactivation and neurologic risk. Whether you're a veterinarian or a horse owner navigating heightened concern, this episode offers grounded perspective and practical context.In this episode, Dr. Lutz Goehring and Dr. Abby Sage discuss:How EHV-1 spreads and why outbreaks occur regularly, even when they don't make headlinesWhat differentiates respiratory infection from equine herpesvirus myeloencephalopathyHow veterinarians interpret PCR testing and where stall-side tools fitWhat vaccination can realistically achieve, and what it cannotWhich biosecurity measures matter most at home and on the roadWhere current research on EHV-1 is headed nextTune in to hear how two equine veterinarians break down equine herpesvirus-1 transmission, testing, neurologic disease, and prevention.GUESTS AND LINKS – EPISODE 24:Host: Stephanie L. Church, editorial director at The Horse: Your Guide to Equine Health Care/TheHorse.com | @stephlchurch on Instagram | Email Stephanie (schurch@thehorse.com)Links: (EHV-1 and other resources from TheHorse.com) Special Feature: Everything You Need To Know About EHV-1 | Discussion of the Valencia, Spain, EHV outbreak: EHV-1 in 2022 | Biosecurity Tips to Protect Your HorseLinks: (EHV-1 and other infectious disease information from the AAEP's
Send us a textIn this episode of WTR Small-Cap Spotlight, host Tim Gerdeman and analyst Robert Sassoon speak with Dwight Egan, CEO of Co-Diagnostics Inc. (NASDAQ: CODX), about the company's evolution from a pandemic-era PCR testing provider to a diversified molecular diagnostics leader. In our discussion, Egan highlights the Co-DX PCR Pro, a portable, cost-effective device that delivers gold-standard PCR testing outside the lab and explains how its patented Co-Primer multiplexing technology sets it apart from competitors. Our conversation also covers Co-Diagnostics' “razor-and-blade” business model, its pipeline of testing capabilities targeting high-impact infectious diseases, the role of AI in manufacturing and diagnostic optimization, and the commercial strategies needed to achieve long-term financial success.
EHV-1 has dominated online conversation in recent weeks—but not all the information circulating reflects the science. In this episode of Equine Innovators, we step back from the noise to focus on what researchers and clinicians know about how equine herpesvirus infects horses, how it spreads, why latency matters, and what drives the neurologic form of the disease.Host Stephanie Church, editorial director at The Horse, speaks with Dr. Abby Sage, equine technical services veterinarian for Zoetis and a former state veterinary official, and Dr. Lutz Goehring, professor of equine infectious diseases at the University of Kentucky's Gluck Equine Research Center. Sage and Goehring explain what testing can—and cannot—tell us during an outbreak, clarify common misconceptions, and outline how vaccination and biosecurity fit into a thoughtful response.The conversation also looks ahead, exploring emerging diagnostic tools, vaccine research, and unanswered questions about viral reactivation and neurologic risk. Whether you're a veterinarian or a horse owner navigating heightened concern, this episode offers grounded perspective and practical context.In this episode, Dr. Lutz Goehring and Dr. Abby Sage discuss:How EHV-1 spreads and why outbreaks occur regularly, even when they don't make headlinesWhat differentiates respiratory infection from equine herpesvirus myeloencephalopathyHow veterinarians interpret PCR testing and where stall-side tools fitWhat vaccination can realistically achieve, and what it cannotWhich biosecurity measures matter most at home and on the roadWhere current research on EHV-1 is headed nextTune in to hear how two equine veterinarians break down equine herpesvirus-1 transmission, testing, neurologic disease, and prevention.GUESTS AND LINKS – EPISODE 24:Host: Stephanie L. Church, editorial director at The Horse: Your Guide to Equine Health Care/TheHorse.com | @stephlchurch on Instagram | Email Stephanie (schurch@thehorse.com)Links: (EHV-1 and other resources from TheHorse.com) Special Feature: Everything You Need To Know About EHV-1 | Discussion of the Valencia, Spain, EHV outbreak: EHV-1 in 2022 | Biosecurity Tips to Protect Your HorseLinks: (EHV-1 and other infectious disease information from the AAEP's
GET YOUR APRICOT SEEDS at the life-saving Richardson Nutritional Center HERE: https://rncstore.com/r?id=bg8qc1 Use code JOSH to save money! Get Your SUPER-SUPPLIMENTS HERE: https://vni.life/wam Use Code WAM15 & Save 15%! Life changing formulas you can't find anywhere else! DITCH YOUR DOCTOR! https://www.livelongerformula.com/wam Get a natural health practitioner and work with Christian Yordanov! Mention WAM and get a FREE masterclass! You will ALSO get a FREE metabolic function assessment! GET YOUR WAV WATCH HERE: https://buy.wavwatch.com/WAM Use Code WAM to save $100 and purchase amazing healing frequency technology! Josh Sigurdson reports on the mass fear mongering campaign by the media regarding the so-called "Super Flu" which like most years is "an illness no one has seen before." Every year, we find out about an illness and it seems everyone claims they've never been so sick before. The reality is, this is just the latest pandemic hoax based on fraudulent PCR tests. As the United States records its first child flu death of the year, the so-called "Super Flu" aptly named to terrify the public is one of the most talked about issues in the media currently. So what is it? Well, first of all, publications like The Daily Mail insist on writing step by step guides to help you "tell the difference" between the Super Flu and Covid. The irony of this is that a PCR test will come up positive for pretty much anything and in 2020, doctors would blindly say "it must be positive for Covid." Now, if a doctor gives someone a PCR test, they will blindly say "it must be positive for the Super Flu." Realistically, that's how you tell the difference. No actual science is involved. There is no doubt that people's immune systems are shot these days. This is due to many contributing factors such as fluoridated tap water, processed foods, industrial chemicals in the air, heavy metals falling from the sky and obviously mass vaccination which according to countless studies shows a direct correlation with autoimmune function. Are people getting more sick these days? Yes. Is it due to some scary pandemic? No. It's due to people being more unhealthy. Meanwhile we are simultaneously seeing fear mongering in the media over Measles and Bird Flu. In fact, multiple types of Bird Flu are being pushed for maximum fear as countless chickens and cows are culled. H1N1, H5N9 and H2N9. It's convenient that the largest ever pandemic exercise just happened in the fall, named Project Polaris. In France, there is a mass culling of cows as the army is called in to mass inject cattle under the guise of stopping "Lumpy Skin Disease." This has lead to thousands of farmers protesting. If people don't yet read between the lines, they will be fodder in the next global pandemic scam. Stay tuned for more from WAM! BUY TICKETS HERE! https://anarchapulco.com/ Use Code WAM & Save 10%! HELP SUPPORT US AS WE DOCUMENT HISTORY HERE: https://gogetfunding.com/help-keep-wam-alive/# GET HEIRLOOM SEEDS & NON GMO SURVIVAL FOOD HERE: https://heavensharvest.com/ USE Code WAM to save 25% plus free shipping! BUY GOLD HERE: https://firstnationalbullion.com/schedule-consult/ FIND OUR CoinTree page here: https://cointr.ee/joshsigurdson PURCHASE MERECHANDISE HERE: https://world-alternative-media.creator-spring.com/ PayPal: ancientwonderstelevision@gmail.com JOIN US on SubscribeStar here: https://www.subscribestar.com/world-alternative-media For subscriber only content! Pledge here! Just a dollar a month can help us alive! https://www.patreon.com/user?u=2652072&ty=h&u=2652072 BITCOIN ADDRESS: 18d1WEnYYhBRgZVbeyLr6UfiJhrQygcgNU World Alternative Media 2025
From day one of COVID, guest James Lyons-Weiler, Phd, has been saying that using PCR tests "as the primary driver of pandemic policy would guarantee a tidal wave of false positives, distort epidemiology, and weaponize diagnostic noise as public fear." He was absolutely right, and yet "public health" has not yet learned its lesson and threatens to make a mess of it again with avian flu. Luckily, Dr. Lyons-Weiler has a plan. Tune in!Reference Linkshttps://informedchoicewa.substack.com/https://popularrationalism.substack.com/p/avian-flu-pandemic-or-pandemoniumhttps://ipak-edu.org/https://ipaknowledge.org/https://publichealthpolicyjournal.com/See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
I almost can't believe that we are wrapping up yet another year on the podcast this month, which has been going strong for 6 years now! And it has been another exciting year in the world of Clin Micro as well with improvements and new assays available for some of our bread and butter tests, but the year also brought about significant developments in the application of AI and digital imaging, use of NGS methods, and probably some cool AST stuff in there too among other things, with many of these advancements published in JCM. And so, as has become customary for the last 6 years, for this episode, we will be sharing some of our favorite papers or more intriguing manuscripts published in the Journal this year. And I have to say, this is probably one of the hardest episodes to prep for because picking just on paper to talk about is an incredible difficult task! But, we are up to the challenge and we'll share those with you over the next half hour or so, all the while wearing ridiculous holiday sweaters and/or holiday headgear, as is now tradition. So, if you are not watching, you may want to switch and find a video option for your viewing pleasure. Watch this episode: https://youtu.be/taqcjqeQQBE Paper Links: Interlaboratory assays from the fungal PCR Initiative and the Modimucor Study Group to improve qPCR detection of Mucorales DNA in serum: one more step toward standardization | Journal of Clinical Microbiology https://journals.asm.org/doi/10.1128/jcm.01525-24 Detection of protozoan and helminth parasites in concentrated wet mounts of stool using a deep convolutional neural network | Journal of Clinical Microbiology https://journals.asm.org/doi/10.1128/jcm.01062-25 Prediction of antimicrobial susceptibility of pneumococci based on whole-genome sequencing data: a direct comparison of two genomic tools to conventional antimicrobial susceptibility testing | Journal of Clinical Microbiology https://journals.asm.org/doi/10.1128/jcm.01079-24 a. Bonus: Rapid detection of gram-negative antimicrobial resistance determinants directly from positive blood culture broths using a multiplex PCR system | Journal of Clinical Microbiology https://journals.asm.org/doi/10.1128/jcm.00384-25 A novel single-tier serologic test to diagnose all stages of Lyme disease | Journal of Clinical Microbiology https://journals.asm.org/doi/10.1128/jcm.00483-25 This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Romney Humphries, Ph.D., D(ABMM) and Elitza (Elli) Theel, Ph.D., D(ABMM). Editors in conversation is supported by the American Society for Microbiology, which publishes JCM. Become an ASM member to receive up to 50% off publishing fees when you publish in JCM or any of the ASM journals. Sign up at https://asm.org/joinasm. Visit https://journals.asm.org/journal/jcm to read articles and/or submit a manuscript. Get the audio only podcast at https://asm.org/eic.
00:00:55 — War With Venezuela Begins as Congress AbdicatesKnight warns that a U.S. naval blockade of Venezuela is already underway, while Congress refuses to restrain executive war-making. 00:07:37 — Trump Admits the War Is About OilHe dissects Trump's demand that Venezuela “return our oil,” exposing naked colonialism behind regime-change rhetoric. 00:14:02 — The CIA as the World's Largest Drug CartelKnight argues the “narco-terrorism” narrative masks the CIA's historic role in trafficking, coups, and covert wars. 00:22:44 — Ukraine as a Doomed Proxy WarCiting John Mearsheimer, Knight argues diplomacy is impossible because Ukraine exists as a battering ram against Russia. 01:00:54 — France Begins Mass Cattle Slaughter Under Police GuardKnight describes armed escorts and tear gas as veterinarians euthanize entire herds in the name of disease control, echoing COVID-era coercion. 01:03:19 — Vaccines Without Challenge Tests Are a Scientific FraudHe claims authorities never test vaccines against real exposure, calling modern virology a controlled sham. 01:08:13 — PCR Tests Justify Wiping Out Entire HerdsKnight explains how a single PCR “case” is used to exterminate valuable livestock with no sick animals present. 01:11:06 — The Three Pillars of Tyranny: Depopulation, Vaccination, Movement ControlHe links livestock policy directly to COVID lockdown logic, calling it rehearsal for population control. 02:01:05 — Banks Quietly Debanked Individuals and IndustriesKnight explains how major banks restricted services not just to industries but to individuals, using financial power as political enforcement. 02:05:12 — Usury Replaces Law as Credit Card Rates ExplodeHe argues modern interest rates are criminal usury made legal by repealing consumer protections. 02:35:15 — Adelson's $250 Million Offer Exposes Political ProstitutionKnight details allegations that Trump was offered massive funding to pursue a third term, framing it as open corruption. 02:46:38 — The $18 Trillion Tariff LieHe proves Trump's repeated tariff revenue claims are mathematically impossible and deliberately deceptive. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHT Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.
00:00:55 — War With Venezuela Begins as Congress AbdicatesKnight warns that a U.S. naval blockade of Venezuela is already underway, while Congress refuses to restrain executive war-making. 00:07:37 — Trump Admits the War Is About OilHe dissects Trump's demand that Venezuela “return our oil,” exposing naked colonialism behind regime-change rhetoric. 00:14:02 — The CIA as the World's Largest Drug CartelKnight argues the “narco-terrorism” narrative masks the CIA's historic role in trafficking, coups, and covert wars. 00:22:44 — Ukraine as a Doomed Proxy WarCiting John Mearsheimer, Knight argues diplomacy is impossible because Ukraine exists as a battering ram against Russia. 01:00:54 — France Begins Mass Cattle Slaughter Under Police GuardKnight describes armed escorts and tear gas as veterinarians euthanize entire herds in the name of disease control, echoing COVID-era coercion. 01:03:19 — Vaccines Without Challenge Tests Are a Scientific FraudHe claims authorities never test vaccines against real exposure, calling modern virology a controlled sham. 01:08:13 — PCR Tests Justify Wiping Out Entire HerdsKnight explains how a single PCR “case” is used to exterminate valuable livestock with no sick animals present. 01:11:06 — The Three Pillars of Tyranny: Depopulation, Vaccination, Movement ControlHe links livestock policy directly to COVID lockdown logic, calling it rehearsal for population control. 02:01:05 — Banks Quietly Debanked Individuals and IndustriesKnight explains how major banks restricted services not just to industries but to individuals, using financial power as political enforcement. 02:05:12 — Usury Replaces Law as Credit Card Rates ExplodeHe argues modern interest rates are criminal usury made legal by repealing consumer protections. 02:35:15 — Adelson's $250 Million Offer Exposes Political ProstitutionKnight details allegations that Trump was offered massive funding to pursue a third term, framing it as open corruption. 02:46:38 — The $18 Trillion Tariff LieHe proves Trump's repeated tariff revenue claims are mathematically impossible and deliberately deceptive. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHT Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.
Osteomyelitis in children is common enough to miss and serious enough to matter. In this episode of PEM Currents, we review a practical, evidence-based approach to pediatric acute hematogenous osteomyelitis, focusing on diagnostic strategy, imaging decisions including FAST MRI, and modern antibiotic management. Topics include age-based microbiology, empiric and pathogen-directed antibiotic selection with dosing, criteria for early transition to oral therapy, and indications for orthopedic and infectious diseases consultation. Special considerations such as MRSA, Kingella kingae, daycare clustering, and shortened treatment durations are discussed with an emphasis on safe, high-value care. Learning Objectives After listening to this episode, learners will be able to: Identify the key clinical, laboratory, and imaging findings that support the diagnosis of acute hematogenous osteomyelitis in children, including indications for FAST MRI and contrast-enhanced MRI. Select and dose appropriate empiric and pathogen-directed antibiotic regimens for pediatric osteomyelitis based on patient age, illness severity, and local MRSA prevalence, and determine when early transition to oral therapy is appropriate. Determine when consultation with orthopedics and infectious diseases is indicated, and recognize clinical features that warrant prolonged therapy or more conservative management. References Woods CR, Bradley JS, Chatterjee A, et al. Clinical practice guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2021 guideline on diagnosis and management of acute hematogenous osteomyelitis in pediatrics. J Pediatric Infect Dis Soc. 2021;10(8):801-844. doi:10.1093/jpids/piab027 Woods CR, Bradley JS, Chatterjee A, et al. Clinical practice guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2023 guideline on diagnosis and management of acute bacterial arthritis in pediatrics. J Pediatric Infect Dis Soc. 2024;13(1):1-59. doi:10.1093/jpids/piad089 Stephan AM, Platt S, Levine DA, et al. A novel risk score to guide the evaluation of acute hematogenous osteomyelitis in children. Pediatrics. 2024;153(1):e2023063153. doi:10.1542/peds.2023-063153 Alhinai Z, Elahi M, Park S, et al. Prediction of adverse outcomes in pediatric acute hematogenous osteomyelitis. Clin Infect Dis. 2020;71(9):e454-e464. doi:10.1093/cid/ciaa211 Burns JD, Upasani VV, Bastrom TP, et al. Age and C-reactive protein associated with improved tissue pathogen identification in children with blood culture-negative osteomyelitis: results from the CORTICES multicenter database. J Pediatr Orthop. 2023;43(8):e603-e607. doi:10.1097/BPO.0000000000002448 Peltola H, Pääkkönen M. Acute osteomyelitis in children. N Engl J Med. 2014;370(4):352-360. doi:10.1056/NEJMra1213956 Transcript This transcript was provided via use of the Descript AI application Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast. As always, I'm your host, Brad Sobolewski, and today we're covering osteomyelitis in children. We're going to talk about diagnosis and imaging, and then spend most of our time where practice variation still exists: antibiotic selection, dosing, duration, and the evidence supporting early transition to oral therapy. We'll also talk about when to involve orthopedics, infectious diseases, and whether daycare outbreaks of osteomyelitis are actually a thing. So what do I mean by pediatric osteomyelitis? In children, osteomyelitis is most commonly acute hematogenous osteomyelitis. That means bacteria seed the bone via the bloodstream. The metaphysis of long bones is particularly vulnerable due to vascular anatomy that favors bacterial deposition. Age matters. In neonates, transphyseal vessels allow infection to cross into joints, increasing the risk of concomitant septic arthritis. In older children, those vessels involute, and infection tends to remain metaphyseal and confined to bone rather than spreading into the joint. For children three months of age and older, empiric therapy must primarily cover Staphylococcus aureus, which remains the dominant pathogen. Other common organisms include group A streptococcus and Streptococcus pneumoniae. In children six to 36 months of age, especially those in daycare, Kingella kingae is an important and often underrecognized pathogen. Kingella infections are typically milder, may present with lower inflammatory markers, and frequently yield negative routine cultures. Kingella is usually susceptible to beta-lactams like cefazolin, but is consistently resistant to vancomycin and often resistant to clindamycin and antistaphylococcal penicillins. This has direct implications for empiric antibiotic selection. Common clinical features of osteomyelitis include fever, localized bone pain, refusal to bear weight, and pain with movement of an adjacent joint. Fever may be absent early, particularly with less virulent organisms like Kingella. A normal white blood cell count does not exclude osteomyelitis. Only about one-third of children present with leukocytosis. CRP and ESR are generally more useful, particularly CRP for monitoring response to therapy. No single CRP cutoff reliably diagnoses or excludes osteomyelitis in children. While CRP is elevated in most cases of acute hematogenous osteomyelitis, the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America note that high-quality data defining diagnostic thresholds are limited. A CRP above 20 milligrams per liter is commonly used to support clinical suspicion, with pooled sensitivity estimates around 80 to 85 percent, but no definitive value mandates the diagnosis. Lower values do not exclude disease, particularly in young children, as CRP is normal in up to 40 percent of Kingella kingae infections. CRP values tend to be higher in Staphylococcus aureus infections, especially MRSA, and higher levels are associated with complications such as abscess, bacteremia, and thrombosis, though specific cutoffs are not absolute. In summary, CRP is most useful for monitoring treatment response. It typically peaks two to four days after therapy initiation and declines rapidly with effective treatment, with a 50 percent reduction within four days seen in the majority of uncomplicated cases. Blood cultures should be obtained in all children with suspected osteomyelitis, ideally before starting antibiotics when feasible. In children, blood cultures alone can sometimes identify the pathogen. Plain radiographs are still recommended early, not because they're sensitive for acute osteomyelitis, but because they help exclude fracture, malignancy, or foreign body and establish a baseline. MRI with and without contrast is the preferred advanced imaging modality. MRI confirms the diagnosis, defines the extent of disease, and identifies complications such as subperiosteal abscess, physeal involvement, and concomitant septic arthritis. MRI findings can also guide the need for surgical consultation. Many pediatric centers now use FAST MRI protocols for suspected osteomyelitis, particularly from the emergency department. FAST MRI uses a limited sequence set, typically fluid-sensitive sequences like STIR or T2 with fat suppression, without contrast. These studies significantly reduce scan time, often avoid the need for sedation, and retain high sensitivity for bone marrow edema and soft tissue inflammation. FAST MRI is particularly useful when the clinical question is binary: is there osteomyelitis or not? It's most appropriate in stable children without high concern for abscess, multifocal disease, or surgical complications. If FAST MRI is positive, a full contrast-enhanced MRI may still be needed to delineate abscesses, growth plate involvement, or adjacent septic arthritis. If FAST MRI is negative but clinical suspicion remains high, further imaging may still be necessary. The Pediatric Infectious Diseases Society and the Infectious Diseases Society of America recommend empiric antibiotic selection based on regional MRSA prevalence, patient age, and illness severity, with definitive therapy guided by culture results and susceptibilities. Empiric therapy should never be delayed in an ill-appearing or septic child. In well-appearing, stable children, antibiotics may be briefly delayed to obtain imaging or tissue sampling, but this requires close inpatient observation. For children three months and older with non–life-threatening disease, empiric therapy hinges on local MRSA rates. In regions with low community-acquired MRSA prevalence, generally under 10 percent, reasonable empiric options include cefazolin, oxacillin, or nafcillin. When MRSA prevalence exceeds 10 to 20 percent, empiric therapy should include an MRSA-active agent. Clindamycin is appropriate when local resistance rates are low, while vancomycin is preferred when clindamycin resistance is common or the child has had significant healthcare exposure. For children with severe disease or sepsis, vancomycin is generally preferred regardless of local MRSA prevalence. Some experts recommend combining vancomycin with oxacillin or nafcillin to ensure optimal coverage for MSSA, group A streptococcus, and MRSA. In toxin-mediated or high-inoculum infections, the addition of clindamycin may be beneficial due to protein synthesis inhibition. Typical IV dosing includes cefazolin 100 to 150 milligrams per kilogram per day divided every eight hours; oxacillin or nafcillin 150 to 200 milligrams per kilogram per day divided every six hours; clindamycin 30 to 40 milligrams per kilogram per day divided every six to eight hours; and vancomycin 15 milligrams per kilogram every six hours for serious infections, with appropriate monitoring. Ceftaroline or daptomycin may be considered in select MRSA cases when first-line agents are unsuitable. For methicillin-susceptible Staphylococcus aureus, first-generation cephalosporins or antistaphylococcal penicillins remain the preferred parenteral agents. For oral therapy, high-dose cephalexin, 75 to 100 milligrams per kilogram per day divided every six hours, is preferred. Clindamycin is an alternative when beta-lactams cannot be used. For clindamycin-susceptible MRSA, clindamycin is the preferred IV and oral agent due to excellent bioavailability and bone penetration, and it avoids the renal toxicity associated with vancomycin. For clindamycin-resistant MRSA, vancomycin or ceftaroline are preferred IV agents. Oral options are limited, and linezolid is generally the preferred oral agent when transition is possible. Daptomycin may be used parenterally in children older than one year without pulmonary involvement, typically with infectious diseases and pharmacy input. Beta-lactams remain the drugs of choice for Kingella kingae, Streptococcus pyogenes, and Streptococcus pneumoniae. Vancomycin has no activity against Kingella, and clindamycin is often ineffective. For Salmonella osteomyelitis, typically seen in children with sickle cell disease, third-generation cephalosporins or fluoroquinolones are used. In underimmunized children under four years, consider Haemophilus influenzae type b, with therapy guided by beta-lactamase production. Doxycycline has not been prospectively studied in pediatric acute hematogenous osteomyelitis. There are theoretical concerns about reduced activity in infected bone and risks related to prolonged therapy. While short courses are safe for certain infections, the longer durations required for osteomyelitis increase the risk of adverse effects. Doxycycline should be considered only when no other active oral option is available, typically in older children, and with infectious diseases consultation. It is not appropriate for routine treatment. Many hospitals automatically consult orthopedics when children are admitted with osteomyelitis, and this is appropriate. Early orthopedic consultation should be viewed as team-based care, not failure of medical management. Consult orthopedics when MRI shows abscess or extensive disease, there is concern for septic arthritis, the child fails to improve within 48 to 72 hours, imaging suggests devitalized bone or growth plate involvement, there is a pathologic fracture, the patient is a neonate, or diagnostic bone sampling or operative drainage is being considered. Routine surgical debridement is not required for uncomplicated cases. Infectious diseases consultation is also often automatic and supported by guidelines. ID is particularly valuable for antibiotic selection, dosing, IV-to-oral transition, duration decisions, bacteremia management, adverse reactions, and salvage regimens. Even in straightforward cases, ID involvement often facilitates shorter IV courses and earlier oral transition. Osteomyelitis is generally not contagious, and clustering is uncommon for Staphylococcus aureus. Kingella kingae is the key exception. It colonizes the oropharynx of young children and spreads via close contact. Clusters of invasive Kingelladisease have been documented in daycare settings. Suspicion should be higher in children six to 36 months from the same daycare, with recent viral illness, mild systemic symptoms, refusal to bear weight, modest CRP elevation, and negative routine cultures unless PCR testing is used. Public health intervention is not typically required, but awareness is critical. There is no minimum required duration of IV therapy for uncomplicated acute hematogenous osteomyelitis. Transition to oral therapy should be based on clinical improvement plus CRP decline. Many children meet criteria within two to six days. Oral antibiotics must be dosed higher than standard outpatient regimens to ensure adequate bone penetration. Common regimens include high-dose cephalexin, clindamycin, or linezolid in select cases. The oral agent should mirror the IV agent that produced clinical improvement. Total duration is typically three to four weeks, and in many cases 15 to 20 days is sufficient. MRSA infections or complicated cases usually require four to six weeks. Early oral transition yields outcomes comparable to prolonged IV therapy with fewer complications. Most treatment-related complications occur during parenteral therapy, largely due to catheter-related issues. Take-home points: osteomyelitis in children is a clinical diagnosis supported by labs and MRI. Empiric antibiotics should be guided by age, illness severity, and local MRSA prevalence. Early transition to high-dose oral therapy is safe and effective when clinical response and CRP support it. Orthopedics and infectious diseases consultation improve care and reduce variation. FAST MRI is changing how we diagnose osteomyelitis. Daycare clustering is uncommon except with Kingella kingae. That's all for this episode. If there are other topics you'd like us to cover, let me know. If you have the time, leave a review on your favorite podcast platform. It helps more people find the show and learn from it. For PEM Currents, this has been Brad Sobolewski. See you next time.
In this podcast, featuring audio from an expert roundtable video module, listen as 3 multidisciplinary faculty, Tracey Q. Davidoff, MD, FCUCM; Carina Marquez, MD, MPH; and Jeffrey D. Whitman, MD, MS, discuss the benefits of diagnosing respiratory syncytial virus (RSV) and optimal testing strategies. Topics covered include:The annual burden of RSV and the benefits of diagnosisWhom to test and what diagnostic techniques to useLogistical considerations for implementationPotential benefits of RSV testingFor the full video module and to download the accompanying slides, visit the program page for this episode:https://bit.ly/3MrXTpIPresenters:Tracey Q. Davidoff, MD, FCUCMAttending PhysicianBaycare Urgent CareAssistant Professor, Family MedicineFlorida State University College of MedicineTallahassee, FloridaCarina Marquez, MD, MPHAssociate Professor of MedicineDivision of HIV, Infectious Diseases and Global MedicineUniversity of California, San FranciscoSan Francisco, CaliforniaJeffrey D. Whitman, MD, MSCo-Director of Clinical MicrobiologyAssociate ProfessorDepartment of Laboratory MedicineUniversity of California, San FranciscoSan Francisco, CaliforniaGet access to all of our new podcasts by subscribing to the Decera Clinical Education Infectious Disease Podcast on Apple Podcasts, YouTube Music, or Spotify. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
00:00:00 – Tech gremlins, show finally goes live, and Mike defends OBDM's mix of silliness and niche stories against "cover important news" commenters. 00:04:09 – Alex Jones Clips of the Week: AI-mangled transcripts, goofy soundboard noises, French hit-squad rumors around Candace Owens, and dreams of a 24/7 Jones megamix stream. 00:13:50 – Deep dive into Tim Pool "crashing out" on-air over security, alleged drive-by shots at his house, his feud with Candace Owens, and whether the meltdown is genuine or radio-war kayfabe. 00:18:14 – Article walk-through on leaked China–Taiwan war games: hypersonic missiles, US carriers and F-35s getting wiped, Pentagon overspending on complex gear, and CFR scenarios where America basically backs away from Taiwan. 00:28:02 – Gaming out a Taiwan invasion: chip-fab self-destruct plans, Taiwan striking Chinese dams and industry, how fast things could go nuclear, and a long "china china china" Trump soundboard riff. 00:37:48 – Russia and China run joint bomber patrols near Japan; hosts frame it as ominous saber-rattling that conveniently justifies even more Western military spending. 00:42:49 – Reason/Atlantic story on elite university students claiming disabilities: explosion of ADHD/anxiety accommodations, TikTok-diagnosed "neurodivergence," and how grifted extra time hurts students with real needs. 00:52:13 – Rapid-fire: Trump UFO/Roswell betting-market hype, speculation he's been "talked to" about disclosure, Ohio Republicans endlessly re-tweaking the voter-approved weed law, and a tease for an AI-generated police suspect image. 00:57:09 – AI-generated mugshot of a Phoenix shooting suspect that looks eerily like Tim Pool; worries about lazy prompt-based "sketches," misidentification, and cops arresting whoever matches the AI face. 01:06:10 – COVID, vaccines, and excess-death anger: UK data allegedly withheld, false-positive PCR testing, "turbo cancer" anecdotes, and a long rant (plus influencer clip) about total lack of accountability for mandates and pharma. 01:10:57 – Marco Rubio orders State to ditch Calibri; typography nerd-out on why serif fonts suit long documents, plus a heartfelt status update on Joe's recovery, bike-accident aftereffects, and the door being open for his return. 01:15:54 – Spanish delivery worker fired for repeatedly clocking in too early; court calls it "serious misconduct," prompting horror stories about hyper-strict time clocks and quitting over minute-by-minute overtime policing. 01:24:45 – Trump "no tax on tips" meets OnlyFans: IRS agents theoretically forced to watch spicy content to classify incomes, porn vs lifestyle creators, and jokes about this mess landing in the Supreme Court's lap. 01:34:30 – Red "jellyfish" sprite lightning above storms: NASA's high-altitude discharge explanation versus the show's playful theories about alien biology, portals, or off-gassing mystery tech. 01:39:34 – Trump bumping an Air Force One bathroom door mid-press gaggle, imagined awkwardness for whoever's inside, then a UK saga where a council paints a disabled bay around a parked car and slaps it with tickets. 01:47:48 – Florida man claims he teleported into a stolen BMW before a 140-mph crash; hosts compare it to real teleport/time-slip lore, pitch better "I'm from the year 5000" alibis, and suggest cops should ticket illegal teleporting. 01:55:58 – In-N-Out bans order number 67 (after 69) to stop meme-yelling kids, audio-leveller gremlins creep into the show, and they close with Patreon/Discord plugs, schedule notes, Joe shout-outs, and one last "watch the sky for sprite lightning" sign-off. Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research ▀▄▀▄▀ CONTACT LINKS ▀▄▀▄▀ ► Website: http://obdmpod.com ► Twitch: https://www.twitch.tv/obdmpod ► Full Videos at Odysee: https://odysee.com/@obdm:0 ► Twitter: https://twitter.com/obdmpod ► Instagram: obdmpod ► Email: ourbigdumbmouth at gmail ► RSS: http://ourbigdumbmouth.libsyn.com/rss ► iTunes: https://itunes.apple.com/us/podcast/our-big-dumb-mouth/id261189509?mt=2
In this episode, Allison Carey, VP of Marketing at Raw Sugar Living, talks about the brand's mission to provide better-for-you hair and body products at an affordable price, while also lifting spirits through positive messages, images, and experiences. She touches on the Gen Z consumer's desire for authenticity, education, and values-alignment in the brands they support, and how the brand appeals to that generation through their raw voice and integrity. Allison sheds insights into their product development guardrails, and the importance of creating products that are safe for sensitive skin, kids, and even fur kids (dogs). We discuss the brand's commitment to us 100% post consumer recycled (PCR) content in their bottles by 2030, their give back program that has donated over 20 million bars of soap and other clean essentials to families in need, and what the future looks like for Raw Sugar Living. We wrap up by hearing Allison's personal vision for a better world.Takeaways:The Clean Beauty Movement is a significant trend.Gen Z prefers authenticity, education, and values alignment over big splashy campaigns.Raw Sugar Living is dedicated to making clean beauty accessible and affordable. The brand avoids harmful ingredients and prioritizes safe formulations. Fragrance is carefully selected to enhance the consumer experience without compromising safety. Consumer insights drive innovation, particularly in catering to younger generations.Understanding consumer preferences is essential for marketing.Consistency in messaging is crucial for brand loyalty.Brands need to adapt to changing consumer expectations.Authenticity can differentiate brands in a crowded market.Sound bites:“Gen Z really is not as interested in the big splashy campaigns and trends. They want more authenticity, more education, and they want brands that live into those values.”“We don't just say Clean For All because we're an affordable brand. It also means that we have something for your whole family.”“We formulate without phthalates, without silicones, and we also have a very strict policy on fragrance. So you can be rest assured that everything you're putting on your skin, not only is it safe and better for you, but it's also effective.”“The post consumer recycled (PCR) plastic initiative was one that was started from the brand's inception.”“We believe it's like a full immersive 360 experience. So it's good for you, it smells good, and you walk out of the shower feeling better.”“We put sugar notes on the back of everything and it's always like a positive uplifting message.”“We also have something for your fur kids too, because we have a line called Fur Kids and that is for your dogs.”“A better world, to me, is definitely one where we all strive to make each other feel grateful and happier for what we have and how we use it.”Links:Allison Carey on LinkedIn - https://www.linkedin.com/in/allison-carey-23942849/Raw Sugar Living - https://rawsugarliving.com/Raw Sugar Living on LinkedIn - https://www.linkedin.com/company/raw-sugar-living/Raw Sugar Living on Facebook - https://www.facebook.com/rawsugarliving/Raw Sugar Living on Instagram - https://www.instagram.com/rawsugarliving/Raw Sugar Living on TikTok - https://www.tiktok.com/@rawsugarliving_…Joyful (Book) by Ingrid Fetell Lee - https://www.goodreads.com/book/show/43300050…Brands for a Better World Episode Archive - http://brandsforabetterworld.com/Brands for a Better World on LinkedIn - https://www.linkedin.com/company/brand-for-a-better-world/Modern Species - https://modernspecies.com/Modern Species on LinkedIn - https://www.linkedin.com/company/modern-species/Gage Mitchell on LinkedIn - https://www.linkedin.com/in/gagemitchell/…Print Magazine Design Podcasts - https://www.printmag.com/categories/printcast/…Heritage Radio Network - https://heritageradionetwork.org/Heritage Radio Network on LinkedIn - https://www.linkedin.com/company/heritage-radio-network/posts/Heritage Radio Network on Facebook - https://www.facebook.com/HeritageRadioNetworkHeritage Radio Network on X - https://x.com/Heritage_RadioHeritage Radio Network on Instagram - https://www.instagram.com/heritage_radio/Heritage Radio Network on Youtube - https://www.youtube.com/@heritage_radioSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
This episode was recorded for my UK Column show.Mike Yeadon is a former Vice President and Chief Scientific Officer for allergy and respiratory research at Pfizer, where he spent 16 years developing new medicines before founding his own biotech company, Ziarco.With a PhD in pharmacology and over 30 years in pharmaceutical research, Mike became one of the most prominent voices challenging the official Covid narrative. He was amongst the first credentialed scientists to call out the government's 'lethally incompetent' scientific advice, arguing that lockdowns were based on flawed PCR testing that produced massive numbers of false positives.Mike consistently warned that the so-called 'second wave' was fabricated through dodgy testing protocols, pointing out that respiratory deaths in late 2020 were actually lower than in previous years. His outspoken criticism of the experimental Covid injections—which he argued were 'toxic by design' and failed to prevent illness or transmission—led to widespread censorship across social media platforms.➡️ Mike's Substack
00:11:55 — The Silicon Goliath: Tech as a Global Ruling Power Knight warns that AI and data monopolies have become a new ruling class, forming a global architecture of control more intrusive than any past empire. 00:19:11 — Intelligence Agencies Built Big Tech's Infrastructure Knight describes how CIA and NSA venture networks seeded the modern tech ecosystem, creating a surveillance-optimized internet disguised as a public marketplace. 00:28:26 — AI Collapse: Not Enough Humans to Build the System Knight highlights panic inside the tech sector over the labor required to construct AI data centers, noting the irony that humans must build the system designed to replace them. 00:31:11 — UK Man Arrested for a Legal Gun Photo in America Knight covers the arrest of a British man for posting a lawful U.S. gun photo, illustrating how Western nations criminalize harmless online expression. 00:41:11 — TSA Imposes Real-ID Penalties to Expand Control Knight frames the TSA's new $45 Real-ID fine as another bureaucratic tool for coercive compliance rather than a genuine safety measure. 00:49:56 — Tariff Chaos Leaves Americans Paying Surprise Bills Knight details how Trump's sudden tariff exemption repeal blindsided Americans with unexpected charges, creating financial traps and supply-chain volatility. 01:18:13 — Somali Fraud Ring Looted a Billion Dollars From Minnesota Knight explains how massive welfare fraud siphoned over a billion dollars overseas while the state ignored red flags to protect a politically useful voting bloc. 01:20:03 — Pentagon Allows Only Approved Trump-Aligned Media Knight exposes how the Pentagon restricted access to Trump-friendly influencers while excluding independent journalists, institutionalizing partisan propaganda. 01:32:13 — Bureaucracies Replace Congress With Rule-By-Decree Knight argues that agencies now govern through regulation, fines, and automated enforcement, proving Congress has effectively surrendered its lawmaking role. 02:03:34 — Killing Incapacitated Survivors Is Murder, Not Warfare Knight breaks down why the second boat strike constitutes murder under both wartime and peacetime legal standards, destroying Trump's justification narrative. 02:33:48 — COVID, PCR Tests, and the Manufactured Pandemic Narrative Knight explains how PCR misuse and virological pseudoscience constructed the illusion of a deadly pandemic, enabling lockdowns, lies, and technocratic biomedical control. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHT Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.
00:11:55 — The Silicon Goliath: Tech as a Global Ruling Power Knight warns that AI and data monopolies have become a new ruling class, forming a global architecture of control more intrusive than any past empire. 00:19:11 — Intelligence Agencies Built Big Tech's Infrastructure Knight describes how CIA and NSA venture networks seeded the modern tech ecosystem, creating a surveillance-optimized internet disguised as a public marketplace. 00:28:26 — AI Collapse: Not Enough Humans to Build the System Knight highlights panic inside the tech sector over the labor required to construct AI data centers, noting the irony that humans must build the system designed to replace them. 00:31:11 — UK Man Arrested for a Legal Gun Photo in America Knight covers the arrest of a British man for posting a lawful U.S. gun photo, illustrating how Western nations criminalize harmless online expression. 00:41:11 — TSA Imposes Real-ID Penalties to Expand Control Knight frames the TSA's new $45 Real-ID fine as another bureaucratic tool for coercive compliance rather than a genuine safety measure. 00:49:56 — Tariff Chaos Leaves Americans Paying Surprise Bills Knight details how Trump's sudden tariff exemption repeal blindsided Americans with unexpected charges, creating financial traps and supply-chain volatility. 01:18:13 — Somali Fraud Ring Looted a Billion Dollars From Minnesota Knight explains how massive welfare fraud siphoned over a billion dollars overseas while the state ignored red flags to protect a politically useful voting bloc. 01:20:03 — Pentagon Allows Only Approved Trump-Aligned Media Knight exposes how the Pentagon restricted access to Trump-friendly influencers while excluding independent journalists, institutionalizing partisan propaganda. 01:32:13 — Bureaucracies Replace Congress With Rule-By-Decree Knight argues that agencies now govern through regulation, fines, and automated enforcement, proving Congress has effectively surrendered its lawmaking role. 02:03:34 — Killing Incapacitated Survivors Is Murder, Not Warfare Knight breaks down why the second boat strike constitutes murder under both wartime and peacetime legal standards, destroying Trump's justification narrative. 02:33:48 — COVID, PCR Tests, and the Manufactured Pandemic Narrative Knight explains how PCR misuse and virological pseudoscience constructed the illusion of a deadly pandemic, enabling lockdowns, lies, and technocratic biomedical control. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHT Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.
00:00:39 — Trump's Genesis Act Hands Treasury to AI Knight exposes Trump's “Genesis Act” as a massive transfer of financial authority and surveillance power to artificial intelligence, bypassing constitutional structures. 00:01:22 — FBI Director Cash Patel Threatens Thomas Massey Knight reveals that FBI leadership attempted to intimidate Rep. Massey into supporting Israel policy, demonstrating the bureau's role as a foreign-aligned political weapon. 00:06:23 — TSA's Real Mission: Conditioning Americans to Obey Physical Control Knight argues that TSA's invasive procedures aren't about security but about training citizens to accept bodily control and warrantless government intrusion. 00:10:41 — McDonald's Inflation Exposes the Collapse of Living Standards Knight highlights runaway food inflation as proof that lockdowns and fiscal manipulation under Trump and Biden have permanently degraded American living standards. 00:13:43 — USDA's Fake Bird Flu Testing Drives Food Shortages Knight details how PCR-driven poultry culling is artificially tightening meat supplies, worsening price spikes and creating government-manufactured scarcity. 00:23:23 — U.S. Military Cancels Christmas Leave for Venezuela War Prep Knight reports that the Trump administration has put troops on wartime footing for a Venezuela operation that lacks congressional approval and constitutional justification. 01:01:56 — Speaker Johnson Moves to Silence Rank-and-File Knight outlines Johnson's plan to change House rules to block discharge petitions, consolidating power and suppressing internal dissent within Congress. 01:04:17 — FBI Threatens Massey's Staff Over Foreign Policy Knight reveals that Cash Patel's office threatened Massey's staff with prosecution to force alignment on Israel and Ukraine, underscoring federal coercion. 01:20:16 — Gaza, War, and Manufactured Popularity for World Leaders Knight argues that foreign conflicts are routinely used by failing leaders—such as Netanyahu—to revive approval ratings through war sentiment. 01:39:45 — Tether, Stablecoins, and the Coming Digital Dollar Takeover Knight warns that Tether and Trump-aligned financiers are constructing a private-sector CBDC system, backed by gold, that would centralize digital money under corporate control. 02:00:39 — Christians Must Reject Zionist Propaganda Knight explains that modern Christian Zionism is a 19th-century theological invention that distorts scripture and pressures believers into supporting state violence. 02:21:41 — Trump's Genesis Mission Hands America to Technocrats Knight says the broader Genesis Mission will give AI systems unprecedented power over communication, authentication, and governance, forming the backbone of a permanent technocracy. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.
00:00:39 — Trump's Genesis Act Hands Treasury to AI Knight exposes Trump's “Genesis Act” as a massive transfer of financial authority and surveillance power to artificial intelligence, bypassing constitutional structures. 00:01:22 — FBI Director Cash Patel Threatens Thomas Massey Knight reveals that FBI leadership attempted to intimidate Rep. Massey into supporting Israel policy, demonstrating the bureau's role as a foreign-aligned political weapon. 00:06:23 — TSA's Real Mission: Conditioning Americans to Obey Physical Control Knight argues that TSA's invasive procedures aren't about security but about training citizens to accept bodily control and warrantless government intrusion. 00:10:41 — McDonald's Inflation Exposes the Collapse of Living Standards Knight highlights runaway food inflation as proof that lockdowns and fiscal manipulation under Trump and Biden have permanently degraded American living standards. 00:13:43 — USDA's Fake Bird Flu Testing Drives Food Shortages Knight details how PCR-driven poultry culling is artificially tightening meat supplies, worsening price spikes and creating government-manufactured scarcity. 00:23:23 — U.S. Military Cancels Christmas Leave for Venezuela War Prep Knight reports that the Trump administration has put troops on wartime footing for a Venezuela operation that lacks congressional approval and constitutional justification. 01:01:56 — Speaker Johnson Moves to Silence Rank-and-File Knight outlines Johnson's plan to change House rules to block discharge petitions, consolidating power and suppressing internal dissent within Congress. 01:04:17 — FBI Threatens Massey's Staff Over Foreign Policy Knight reveals that Cash Patel's office threatened Massey's staff with prosecution to force alignment on Israel and Ukraine, underscoring federal coercion. 01:20:16 — Gaza, War, and Manufactured Popularity for World Leaders Knight argues that foreign conflicts are routinely used by failing leaders—such as Netanyahu—to revive approval ratings through war sentiment. 01:39:45 — Tether, Stablecoins, and the Coming Digital Dollar Takeover Knight warns that Tether and Trump-aligned financiers are constructing a private-sector CBDC system, backed by gold, that would centralize digital money under corporate control. 02:00:39 — Christians Must Reject Zionist Propaganda Knight explains that modern Christian Zionism is a 19th-century theological invention that distorts scripture and pressures believers into supporting state violence. 02:21:41 — Trump's Genesis Mission Hands America to Technocrats Knight says the broader Genesis Mission will give AI systems unprecedented power over communication, authentication, and governance, forming the backbone of a permanent technocracy. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.
00:01:25 — China's First Cryogenic Wife Knight opens with the story of a man freezing his deceased wife, framing it as a warning about the growing obsession with technological immortality and the moral vacuum behind it. 00:52:28 — Hollywood Panics Over AI Actors Knight highlights how digital performers threaten the traditional film industry, exposing how fragile and artificial celebrity identity really is. 01:14:30 — Bitcoin Flash-Crash Exposes Crypto Fragility Bitcoin's sudden collapse with no clear trigger demonstrates how unstable and speculative the crypto ecosystem remains despite mainstream hype. 01:30:16 — Pompeo Joins Corrupt Ukraine Arms Firm Knight reveals Mike Pompeo's new advisory role in a scandal-plagued Ukrainian weapons company, illustrating how political insiders cash in on endless-war networks. 02:06:44 — Hospitals Paid to Kill Patients Zoe describes how federal COVID incentives rewarded deadly protocols — ventilators, remdesivir, and inflated diagnoses — turning hospitals into profit-driven death machines. 02:10:05 — COVID Diagnosed Without Tests or Exams Official coding rules allowed doctors to declare COVID based purely on opinion, bypassing examinations and PCR testing, guaranteeing inflated case numbers. 02:18:37 — COVID Protocols Created the Deaths Zoe explains that most fatalities were caused by hospital protocols — organ shutdown, sedation, remdesivir toxicity — not the virus itself. 02:21:01 — Vaccine Injuries Exploded Immediately She recounts severe neurological, cardiovascular, and clotting disorders occurring right after vaccination, all dismissed or unreported by medical staff. 02:34:38 — PCR Was a DNA Data-Mining Operation Zoe details how PCR samples were routed to global gene banks, turning COVID testing into a worldwide DNA-harvesting and sequencing program. 02:49:44 — Palantir & Tiberius Used to Track Vaccine Compliance Operation Warp Speed used Palantir's real-time data systems to monitor ICU beds, ventilators, demographics, and vaccination rates, creating a national surveillance infrastructure. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.
00:01:25 — China's First Cryogenic Wife Knight opens with the story of a man freezing his deceased wife, framing it as a warning about the growing obsession with technological immortality and the moral vacuum behind it. 00:52:28 — Hollywood Panics Over AI Actors Knight highlights how digital performers threaten the traditional film industry, exposing how fragile and artificial celebrity identity really is. 01:14:30 — Bitcoin Flash-Crash Exposes Crypto Fragility Bitcoin's sudden collapse with no clear trigger demonstrates how unstable and speculative the crypto ecosystem remains despite mainstream hype. 01:30:16 — Pompeo Joins Corrupt Ukraine Arms Firm Knight reveals Mike Pompeo's new advisory role in a scandal-plagued Ukrainian weapons company, illustrating how political insiders cash in on endless-war networks. 02:06:44 — Hospitals Paid to Kill Patients Zoe describes how federal COVID incentives rewarded deadly protocols — ventilators, remdesivir, and inflated diagnoses — turning hospitals into profit-driven death machines. 02:10:05 — COVID Diagnosed Without Tests or Exams Official coding rules allowed doctors to declare COVID based purely on opinion, bypassing examinations and PCR testing, guaranteeing inflated case numbers. 02:18:37 — COVID Protocols Created the Deaths Zoe explains that most fatalities were caused by hospital protocols — organ shutdown, sedation, remdesivir toxicity — not the virus itself. 02:21:01 — Vaccine Injuries Exploded Immediately She recounts severe neurological, cardiovascular, and clotting disorders occurring right after vaccination, all dismissed or unreported by medical staff. 02:34:38 — PCR Was a DNA Data-Mining Operation Zoe details how PCR samples were routed to global gene banks, turning COVID testing into a worldwide DNA-harvesting and sequencing program. 02:49:44 — Palantir & Tiberius Used to Track Vaccine Compliance Operation Warp Speed used Palantir's real-time data systems to monitor ICU beds, ventilators, demographics, and vaccination rates, creating a national surveillance infrastructure. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.
300+ ostriches were destroyed in Canada over a year-old PCR result. Del discusses what it means for farming, food security, independent science, and health freedom; Jefferey Jaxen breaks down a bombshell new study exposing major flaws in the PCR test that shaped global COVID policy and New details about the intelligence-linked “fact-checking” industry, including why President Trump is now threatening to deport one of its key players who once targeted ICAN; Aaron Siri, Esq., is put to the test to see if he can beat Elon Musk's AI, Grok, in a vaccine quiz showdown.Guests: Katie Pasitney, Aaron Siri, Esq.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-highwire-with-del-bigtree--3620606/support.
[00:01:03] – Trump's Veterans Day with an Al-Qaeda LeaderKnight opens with outrage over Trump meeting a Syrian warlord linked to Al-Qaeda, framing it as proof of U.S. hypocrisy and the intelligence community's long alliance with terrorist networks. [00:06:56] – The 50-Year Mortgage and Debt SlaveryHe mocks Trump's plan for 50-year mortgages as the next stage of financial serfdom, arguing that Americans will “own nothing” while banks and the state profit from endless debt cycles. [00:42:06] – The CIA and the Birth of the Feral GovernmentKnight traces the origins of the national security state, accusing Truman's creation of the CIA and NSA of birthing an unaccountable “feral government” that now rules America through secrecy and surveillance. [01:09:19] – Feeding Candy to Cattle and mRNA MeatHe exposes candy companies selling waste candy as cattle feed and the USDA's quiet approval of mRNA livestock vaccines, calling it a convergence of food corruption and biotech experimentation. [01:11:22] – The FACE Act and Criminalized SpeechKnight examines how the FACE Act is being used to prosecute both pro-life and anti-war activists, warning it's a bipartisan tool for suppressing free expression under moral pretense. [01:34:13] – The Universities as Marxist SeminariesKnight argues modern academia has become an ideological indoctrination system rooted in the Frankfurt School — designed to dismantle faith, family, and free enterprise from within. [01:45:33] – The Clinton Foundation's Untouchable CrimesHe revisits Trump's refusal to pursue investigations into the Clinton Foundation, describing it as evidence of systemic bipartisan corruption shielding globalist elites. [02:03:06] – The Medical Coder Whistleblower: Zoe Smith's TestimonySmith exposes how hospitals received federal bonuses for COVID diagnoses and ventilator use, revealing how financial incentives turned healthcare into a profit-driven death machine. [02:23:37] – PCR Tests and Genetic Data HarvestingSmith explains that PCR testing was repurposed from diagnostic use into mass data collection, linking it to global DNA databases used for AI-driven biotech development. [02:59:40] – Cash Bans and the Digital Totalitarian FutureKnight closes warning that Europe's cash bans and central bank digital currencies represent the final step toward total economic surveillance and the end of financial freedom. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.
[00:01:03] – Trump's Veterans Day with an Al-Qaeda LeaderKnight opens with outrage over Trump meeting a Syrian warlord linked to Al-Qaeda, framing it as proof of U.S. hypocrisy and the intelligence community's long alliance with terrorist networks. [00:06:56] – The 50-Year Mortgage and Debt SlaveryHe mocks Trump's plan for 50-year mortgages as the next stage of financial serfdom, arguing that Americans will “own nothing” while banks and the state profit from endless debt cycles. [00:42:06] – The CIA and the Birth of the Feral GovernmentKnight traces the origins of the national security state, accusing Truman's creation of the CIA and NSA of birthing an unaccountable “feral government” that now rules America through secrecy and surveillance. [01:09:19] – Feeding Candy to Cattle and mRNA MeatHe exposes candy companies selling waste candy as cattle feed and the USDA's quiet approval of mRNA livestock vaccines, calling it a convergence of food corruption and biotech experimentation. [01:11:22] – The FACE Act and Criminalized SpeechKnight examines how the FACE Act is being used to prosecute both pro-life and anti-war activists, warning it's a bipartisan tool for suppressing free expression under moral pretense. [01:34:13] – The Universities as Marxist SeminariesKnight argues modern academia has become an ideological indoctrination system rooted in the Frankfurt School — designed to dismantle faith, family, and free enterprise from within. [01:45:33] – The Clinton Foundation's Untouchable CrimesHe revisits Trump's refusal to pursue investigations into the Clinton Foundation, describing it as evidence of systemic bipartisan corruption shielding globalist elites. [02:03:06] – The Medical Coder Whistleblower: Zoe Smith's TestimonySmith exposes how hospitals received federal bonuses for COVID diagnoses and ventilator use, revealing how financial incentives turned healthcare into a profit-driven death machine. [02:23:37] – PCR Tests and Genetic Data HarvestingSmith explains that PCR testing was repurposed from diagnostic use into mass data collection, linking it to global DNA databases used for AI-driven biotech development. [02:59:40] – Cash Bans and the Digital Totalitarian FutureKnight closes warning that Europe's cash bans and central bank digital currencies represent the final step toward total economic surveillance and the end of financial freedom. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.
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