Inside Scope

Welcome to our four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury (HRS-AKI). In episode one, our host Muhamad Nadeem Yousaf, MD, speaks with Danielle Adebayo, MD, and Florence Wong, MD, MBBS, FRCPC, to analyze the pathophysiology of HRS-AKI. They cover peripheral vasodilatation hypothesis shortcomings in HRS-AKI, vasoconstrictor systems, bacterial translocation, inflammation, renal dysfunction, and contributory factors like cholemic nephropathy and adrenal insufficiency, while also suggesting the potential of metabolomic studies for future insights. Each episode of this series corresponds to a journal article from a September 2023 supplement of Clinical Gastroenterology and Hepatology (CGH), the official clinical practice journal of the American Gastroenterological Association, focusing on addressing knowledge gaps in HRS-AKI. To read the related journal articles and claim CME for listening, visit agau.gastro.org. This series is supported by an independent educational grant from Mallinckrodt

Welcome to our four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury (HRS-AKI). In our final episode, our host Muhamad Nadeem Yousaf, MD, speaks with Vivian Ortiz, MD, and Neil Shah, MD, to delve into critical aspects of HRS-AKI. They cover the prognosis after initial management, the significance of reversing renal impairment for liver transplant candidates, the predictive role of MELD score in HRS-AKI, treatment's impact on liver transplant waiting lists, decision-making between liver transplant alone or simultaneous liver-kidney transplant, timing considerations for kidney transplant post-liver transplant, and factors affecting post-transplant prognosis. Each episode of this series corresponds to a journal article from a September 2023 supplement of Clinical Gastroenterology and Hepatology (CGH), the official clinical practice journal of the American Gastroenterological Association, focusing on addressing knowledge gaps in HRS-AKI. To read the related journal articles and claim CME for listening, visit agau.gastro.org. This series is supported by an independent educational grant from Mallinckrodt

Welcome to our four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury (HRS-AKI). In episode three, our host Muhamad Nadeem Yousaf, MD, speaks with Nikhilesh Mazumder, MD, MPH, Shilpa Junna, MD, and Pratima Sharma, MD, MBBS, MS, to discuss initial management of patients with HRS-AKI. They’ll explore topics such as the efficacy of non-selective beta-blockers, the recommended plasma expander for those with decompensated cirrhosis, the roles of renal replacement therapy (RRT), TIPS, and extracorporeal liver support system (ELSS), and the significance of liver transplant in the context of HRS-AKI. Each episode of this series corresponds to a journal article from a September 2023 supplement of Clinical Gastroenterology and Hepatology (CGH), the official clinical practice journal of the American Gastroenterological Association, focusing on addressing knowledge gaps in HRS-AKI. To read the related journal articles and claim CME for listening, visit agau.gastro.org. This series is supported by an independent educational grant from Mallinckrodt

Welcome to our four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury (HRS-AKI). In episode two, our host Muhamad Nadeem Yousaf, MD, speaks with Nikki Duong, MD, to discuss the nomenclature, pharmacological options, and care recommendations for HRS-AKI patients. Each episode of this series corresponds to a journal article from a September 2023 supplement of Clinical Gastroenterology and Hepatology (CGH), the official clinical practice journal of the American Gastroenterological Association, focusing on addressing knowledge gaps in HRS-AKI. To read the related journal articles and claim CME for listening, visit agau.gastro.org. This series is supported by an independent educational grant from Mallinckrodt

This special episode of Inside Scope shares key insights from the AGA Clinical Practice Update on Alpha-Gal Syndrome for the GI Clinician. This episode is hosted by Dr. Jana Al Hashash, chair-elect of the AGA Clinical Practice Update Committee and one of the CPU authors. She is joined by: Sarah McGill, MD, MSc, gastroenterologist and associate professor of medicine at the University of North Carolina and lead author of the CPU Thomas Platts-Mills, MD, professor of medicine and microbiology and chief at the University of Virginia, a pioneer in discovery of Alpha Gal Syndrome and senior author of the CPU Hannah Dodson, DNP, nurse Practitioner affiliated with the University of North Carolina and a patient sharing her perspective in navigating life with Alpha Gal Syndrome To access the CPU commentary, visit https://www.cghjournal.org/article/S1542-3565(23)00040-X/fulltext

Dr. G.S. Raju, editor of the Gastro Grand Rounds section in Gastroenterology, is joined by Drs. Marwan Ghabril and Naga Chalasani to discuss their Gastro Grand Rounds article, "A 68-Year-Old Woman With Unexplained Liver Enzyme Elevation and Active Chronic Hepatitis: Beware of Drug-Induced Autoimmune-Like Hepatitis." https://www.gastrojournal.org/article/S0016-5085(23)05078-3/fulltext Dr. Ghabril is a professor of medicine at Indiana University School of Medicine. Dr. Chalasani is the David W. Crabb professor of gastroenterology and hepatology and an adjunct professor of anatomy, cell biology, and physiology at Indiana University School of Medicine. [0:27] Introduction of the authors and outline of the case. [3:30] Initial thoughts from the authors upon patient presentation. [7:29] After considering additional patient history, what do the authors think about the patient? [10:34] Does the family history of the patient cause the authors to refine the diagnosis? [11:52] Further thoughts from the authors after physical examination of the patient. [14:47] What tests are recommended? [18:55] Additional thoughts from the authors after further testing. [21:06] Should we be testing for hepatitis E? [22:56] Should noninvasive testing be used? [25:11] What is the authors' plan to determine next steps? [27:06] How long should the wait be before a biopsy? [29:08] The patient underwent liver biopsy. How were the results interpreted? [34:31] How long does it take to determine that an appropriate course of action was made? [35:37] How is the patient counselled? [38:43] The LiverTox database. [41:41] Final thoughts from the authors. Thank you for listening. Find this and other articles on our website at https://www.gastrojournal.org. We welcome your feedback. Please email us at gastro@gastro.org. This discussion was recorded on Dec. 20, 2023, and reflects medical knowledge at that time. The views and opinions expressed in this podcast are those of the individual speakers only and do not necessarily represent those of the American Gastroenterological Association. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials. In this episode, hosts Drs. Erin Forster and Ayanna Lewis are joined by Drs. Freddy Caldera and Jana Al Hashash, who were part of the inaugural class of participants in AGA’s GI Clinical Trialists Bootcamp program. Today’s discussion focuses on how diversifying participation in clinical trials starts with diversifying our workforce. This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials. In this episode, hosts Drs. Erin Forster and Ayanna Lewis are joined by Melodie Narain-Blackwell, the founder and president of Color of Crohn’s & Chronic Illness (COCCI). COCCI is a nonprofit dedicated to health equity in BIPOC communities that are challenged with digestive diseases and chronic illnesses. Melodie was diagnosed with Crohn’s disease at the age of 36, thirty years after her symptoms began, and has become a passionate health advocate for people of color who battle chronic illness. Today’s discussion focuses on how we talk about clinical research with patients. This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials. In this episode, co-host Dr. Erin Forster is joined by guest Dr. Gabriela Radulescu, vice president of medical research and development at Alimentiv, a contract research organization (CRO) specializing in gastroenterology trials. Dr. Radulescu has more than 20 years of experience working in the pharmaceutical industry across multiple functions, including medical affairs, drug safety and pharmacovigilance, clinical research, real world evidence, and patient support programs. At Alimentiv, Dr. Radulescu provides medical leadership for sponsored clinical trials, operational oversight for R&D projects, and medical input to the business development teams. Today’s discussion will explore how CROs are working with investigators and sponsors to increase the diversity of patients enrolling in clinical trials. This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials. In this episode, co-host Dr. Erin Forster is joined by guest Kenneth Getz, professor of public health and community medicine and director of the Center for the Study of Drug Development at Tufts University School of Medicine. Ken is also the founder and chairman of the board of directors at CISCRP, a nonprofit dedicated to providing education and information about clinical research. Today's discussion will explore how we can bring awareness of and education on clinical research to the community. This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials. In this episode, co-host Dr. Ayanna Lewis is joined by guest Dr. Erica Cohen, an adult gastroenterologist, IBD specialist and director of the IBD Research Program at Capital Digestive Care in Washington, D.C. Today’s discussion focuses on the community GI’s perspective on clinical trials. This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials. In this supersized episode, co-host Dr. Ayanna Lewis is joined by guest Dr. Ryan Stidham, an associate professor at the University of Michigan holding appointments in the departments of medicine and computational medicine. Dr. Stidham is a medical data scientist and has a research program that focuses on the development and testing of new technologies for disease assessment and decision making in gastroenterology and general medicine. Today’s discussion will explore how artificial intelligence may help address challenges with participant recruitment for clinical trials, while also discussing the role of AI in the field of gastroenterology more broadly. This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Dr. G.S. Raju, editor of the Gastro Grand Rounds section in Gastroenterology, is joined by Dr. David Ballard and Dr. Parakkal Deepak to discuss their Gastro Grand Rounds article, "Long-Standing Symptomatic Fistulizing Perianal Crohn’s Disease: Progression Beyond Inflammation." https://www.gastrojournal.org/article/S0016-5085(23)04997-1/fulltext Dr. Ballard is an assistant professor of radiology and director of the 3D Printing Lab at the Mallinckrodt Institute of Radiology at Washington University School of Medicine in St. Louis. Dr. Deepak is an Associate Professor of Medicine in the Division of Gastroenterology at Washington University School of Medicine in St. Louis. [0:27] Introduction of the authors and outline of the case. [2:29] What initial steps does a gastroenterologist take to manage a patient who presents with possible perianal Crohn’s disease? [6:47] How does an imaging specialist plan for imaging of the perianal disease, and what techniques are used in support of the endoscopist or gastroenterologist? [11:33] The role of point-of-care ultrasound in perianal disease. [15:38] When is a colorectal surgeon brought on board, and what does a colorectal surgeon do when examining the patient? [19:57] How does the clinician manage abscess and fistula? [25:13] Are there any radiological signs that indicate that a particular fistula may be particularly difficult to manage? [29:38] What is a standard treatment for perianal fistula that evolves to cancer? [31:27] Did the patient notice a change in the nature of the discharge? [32:35] Final thoughts from the authors. Thank you for listening. Find this and other articles on our website at https://www.gastrojournal.org. We welcome your feedback. Please email us at gastro@gastro.org. This discussion was recorded on Nov. 1, 2023, and reflects medical knowledge at that time. The views and opinions expressed in this podcast are those of the individual speakers only and do not necessarily represent those of the American Gastroenterological Association. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice.

Welcome to the first in a series of new podcast episodes from the pages of Gastroenterology, the flagship journal of the American Gastroenterological Association and the most prominent journal in the field of gastrointestinal disease. This podcast series covers articles in the journal’s “Gastro Grand Rounds” section, which features discussions among multidisciplinary teams of experts on the management of complex clinical cases. Gastro Grand Rounds: Managing Diverticulitis Dr. G.S. Raju, editor of the Gastro Grand Rounds section in Gastroenterology, is joined by Dr. Lisa Strate to discuss her article, “Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder.” https://www.gastrojournal.org/article/S0016-5085(23)00042-2/fulltext Dr. Strate is a professor of medicine at the University of Washington School of Medicine and is the section head of gastroenterology at Harborview Medical Center. Dr. Strate’s research has examined risk factors for the development of diverticular disease. Her work has informed the development of guidelines, dietary recommendations, and measurements for the prevention of diverticulitis. She has investigated the role of chronic inflammation and the gut microbiome in diverticulitis. She is a fellow of AGA. [0:27] Introduction of the author. [2:20] The utility of CT in evaluating diverticulitis. [5:49] Managing a patient with uncomplicated diverticulitis. [11:00] Take-home instructions for the patient. [14:12] Preparing the patient colonoscopy, strategies used during the procedure, and documenting findings. [19:11] Utility of a barium enema. [20:22] The patient returns and has left lower quadrant pain. What are the next steps? [24:30] Laying out the pros and cons of continued medical management compared with surgery for a patient who has recurrent episodes of uncomplicated diverticulitis. [28:00] Does the author’s institution have a support group for patients? [28:55] What is the longest period of antibiotics the author has given to a patient who does not want surgery? [30:34] Take-home messages for fellows and residents. Thank you for listening. Find this and other articles on our website at https://www.gastrojournal.org. We welcome your feedback. Please email us at gastro@gastro.org. This discussion was recorded on Sept. 5, 2023, and reflects medical knowledge at that time. The views and opinions expressed in this podcast are those of the individual speakers only and do not necessarily represent those of the American Gastroenterological Association. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice.

Welcome to our new six-episode series: C. difficile: Preparing the Field for Change. This program will explore how to take a patient-centered approach to treatment and diagnosis, explore emerging treatment options, and discuss best practices for transitions of care. In this episode, Drs. Paul Feuerstadt and Sahil Khanna are joined by guest Dr. Jessica Allegretti to discuss FMT and new microbiome therapies. You can now claim CME for listening – visit agau.gastro.org. This series is supported by educational grants from Aimmune Therapeutics, Inc., Seres Therapeutics, and Ferring Pharmaceuticals, Inc.

Welcome to our new six-episode series: C. difficile: Preparing the Field for Change. This program will explore how to take a patient-centered approach to treatment and diagnosis, explore emerging treatment options, and discuss best practices for transitions of care. In this episode, Drs. Paul Feuerstadt and Sahil Khanna are joined by guests Dr. Kevin Garey and a patient to discuss the impact of recurrent CDI on patients and their lives. This episode does not offer Continuing Medical Education (CME) credits. This series is supported by educational grants from Aimmune Therapeutics, Inc., Seres Therapeutics, and Ferring Pharmaceuticals, Inc.

Welcome to our new six-episode series: C. difficile: Preparing the Field for Change. This program will explore how to take a patient-centered approach to treatment and diagnosis, explore emerging treatment options, and discuss best practices for transitions of care. In this episode, Drs. Paul Feuerstadt and Sahil Khanna are joined by guests Rebecca Perez and Cheri Lattimer to discuss case management and transitions of care in C. difficile infection. You can now claim CME for listening – visit agau.gastro.org. This series is supported by educational grants from Aimmune Therapeutics, Inc., Seres Therapeutics, and Ferring Pharmaceuticals, Inc.

Welcome to our new six-episode series: C. difficile: Preparing the Field for Change. This program will explore how to take a patient-centered approach to treatment and diagnosis, explore emerging treatment options, and discuss best practices for transitions of care. In this episode, Drs. Paul Feuerstadt and Sahil Khanna are joined by guest Dr. Colleen Kelly to discuss how to reconcile guideline differences for testing and treatment of C. difficile. You can now claim CME for listening – visit agau.gastro.org. This series is supported by educational grants from Aimmune Therapeutics, Inc., Seres Therapeutics, and Ferring Pharmaceuticals, Inc.

Welcome to our new six-episode series: C. difficile: Preparing the Field for Change. This program will explore how to take a patient-centered approach to treatment and diagnosis, explore emerging treatment options, and discuss best practices for transitions of care. In this episode, Drs. Paul Feuerstadt and Sahil Khanna describe the shifts in the microbiota with C. difficile infection. This episode was originally released as a bonus episode in November 2022. You can now claim CME for listening – visit agau.gastro.org. This series is supported by educational grants from Aimmune Therapeutics, Inc., Seres Therapeutics, and Ferring Pharmaceuticals, Inc.

Welcome to our new six-part series: C. difficile: Preparing the Field for Change. This program will explore how to take a patient-centered approach to treatment and diagnosis, explore emerging treatment options, and discuss best practices for transitions of care. In this episode, Drs. Paul Feuerstadt and Sahil Khanna cover risk factors for initial and recurrent C. difficile infection. This episode was originally released as a bonus episode in November 2022. You can now claim CME for listening – visit agau.gastro.org. This series is supported by educational grants from Aimmune Therapeutics, Inc., Seres Therapeutics, and Ferring Pharmaceuticals, Inc.