Episodes

  • Journal Review in Surgical Oncology: The MAGIC and FLOT-4 Landmark Trials

    Journal Review in Surgical Oncology: The MAGIC and FLOT-4 Landmark Trials
    Oct 7 2024
    In this episode, we review key components of the landmark MAGIC and FLOT-4 trials that investigated perioperative chemotherapy in the treatment of locally advanced gastric cancer. We discuss limitations of both trials and the evolving clinical landscape of gastric cancer treatment.

    Hosts:
    - Timothy Vreeland, MD, FACS (@vreelant) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist/HPB surgeon at Brooke Army Medical Center.
    - Daniel Nelson, DO, FACS (@usarmydoc24) is a Surgical Oncologist/HPB surgeon at Kaiser Permanente Los Angeles Medical Center.
    - Connor Chick, MD (@connor_chick) is a Surgical Oncology Senior Fellow at Ohio State.
    - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncology Junior Fellow at MD Anderson Cancer Center.
    - Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center.

    Learning Objectives:
    1. Understand background, methodology, results, and interpretation of the MAGIC trial.
    2. Understand background, methodology, results, and interpretation of the FLOT trial.
    3. Be able to discuss the evolution of chemotherapeutic regimens in the treatment of locally advanced gastric cancer and rationale for their use.
    4. Be able to describe key limitations for the above regimens.
    5. Discuss the the evolving clinical landscape for chemotherapy in gastroesophageal junction tumors.

    Links to Papers Referenced in this Episode:

    Journal Articles:
    Cunningham, D., Allum, W. H., Stenning, S. P., Thompson, J. N., Van de Velde, C. J., Nicolson, M., ... & Chua, Y. J. (2006). Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. New England Journal of Medicine, 355(1), 11-20.
    https://pubmed.ncbi.nlm.nih.gov/16822992/

    Al-Batran, S. E., Homann, N., Pauligk, C., Goetze, T. O., Meiler, J., Kasper, S., ... & Hofheinz, R. D. (2019). Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. The Lancet, 393(10184), 1948-1957.
    https://pubmed.ncbi.nlm.nih.gov/30982686/

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    28 mins
  • Is the Medical Publishing Industry a Scam?

    Is the Medical Publishing Industry a Scam?
    Oct 3 2024
    Is the medical publishing industry a scam? As the open access model has grown, pay-to-publish has helped large publishers maintain profit margins similar to that of large tech companies. The problem? They do so by exploiting the blood, sweat, and tears of academics and the institutions that support them. Join Dr. Patrick Georgoff (@georgoff, Duke Surgery), Dr. Ayman Ali (BTK education fellow, Duke Surgery), and special guest Dr. Allan Detsky for an engaging discussion.

    Paper discussed: The Changing Medical Publishing Industry: Economics, Expansion, and Equity (https://link.springer.com/article/10.1007/s11606-023-08307-z)

    DR. ALLAN S. DETSKY, MD, PhD, FRCPC, CM is Professor, Institute of Health Policy, Management and Evaluation, and Department of Medicine at the University of Toronto; former Physician-in-Chief, Mount Sinai Hospital(1997-2009); and former Head of the Division of General Internal Medicine at The Toronto Hospital and University of Toronto (1987-1997). Dr. Detsky received his B.S. from Massachusetts Institute of Technology, his M.D. from Harvard Medical School, and his Ph.D. (in Economics) from Massachusetts Institute of Technology in 1978. He has served on the editorial board of the New England Journal of Medicine, and as a member of the Drug Quality and Therapeutics Committee for the Province of Ontario where he spearheaded the effort to formally include cost-effectiveness considerations into the Canadian drug reimbursement process. Dr. Detsky has received 2 Tony nominations as a producer (Jesus Christ Superstar 2012, Come From Away 2017 and an Olivier Award for Best Musical in 2018. In June 2018, he was appointed by the Governor General to the Order of Canada.

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    39 mins
  • USA vs. UK: ASGBI Ep. 1 - Surgical Training

    USA vs. UK: ASGBI Ep. 1 - Surgical Training
    Sep 30 2024
    Welcome to the first episode of our new collaborative series with the Association of Surgeons in Great Britain and Ireland! During this series, BTK fellow Jon Williams and ASGBI hosts Kellie Bateman and Jared Wohlgemut compare and contrast the surgeon profession between the United States and the United Kingdom, debating who does what better. In this episode, we take a deep dive into surgical training in the US and the UK, from fostering student interest to trainee operating to specialization and certification. Dr. Jeremy Lipman represents the US while Dr. Jon Lund represents the UK in this thought-provoking conversation.

    Dr. Lipman is a colorectal surgeon at the Cleveland Clinic and the director of graduate medical education for all training programs at the Cleveland Clinic. Additionally, he is an Associate Dean for Graduate Medical Education and Professor of Surgery at Case Western Reserve University. After going to Boston College for his bachelor degree, he obtained his medical degree from Drexel University College of Medicine in Philadelphia. Subsequently he completed his general surgery residency training at Case Western and his colorectal surgery fellowship at Cleveland Clinic. After practicing at MetroHealth Medical Center where he served many training and education leadership roles, he returned to Cleveland Clinic as faculty where he remains today.

    Dr. Lund is Professor and Head of the Department of Surgery at University of Nottingham at Derby, and Consultant Colorectal Surgeon at Royal Derby Hospital. He is Chair of the Joint Committee on Surgical Training, and before that was Surgical Director of the Intercollegiate Surgical Curriculum Programme, the online training management system used by all trainees and trainers in Surgery in the UK. He has recently been appointed as Dean of education at the Royal College of Surgeons of Edinburgh.

    So, who trains surgeons better? UK or US? Give the episode a listen and decide for yourself!

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

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    1 hr and 8 mins
  • Journal Review in Surgical Education: Navigating the Surgical Residency Match Process

    Journal Review in Surgical Education: Navigating the Surgical Residency Match Process
    Sep 26 2024
    In this episode, podcast hosts Dr. Josh Roshal, Dr. Darian Hoagland, and Dr. Maya Hunt dive into two important papers that provide guidance on navigating the hidden curriculum of the surgical residency match process. Joined by fellow CoSEF members Dr. Ariana Naaseh and Dr. John Woodward, the discussion revolves around practical tips for finding your perfect surgical residency and filtering out the noise during the application process.

    Journal Club Hosts:
    –Dr. Josh Roshal, University of Texas Medical Branch, @Joshua_Roshal, jaroshal@utmb.edu
    –Dr. Darian Hoagland, Beth Israel Deaconess Medical Center, @DHoaglandMD, dlhoagla@bidmc.harvard.edu
    –Dr. Maya Hunt, Indiana University, @dr_mayathehunt, mayahunt@iu.edu
    –CoSEF: @surgedfellows, cosef.org

    Journal Club Authors:
    -Dr. Ariana Naaseh, Washington University in St. Louis, @ariananaaseh, a.naaseh@wustl.edu
    -Dr. John Woodwad, University at Buffalo, @JohnWoodward76, jmwoodwa@buffalo.edu

    Medical Students:
    -Rachel Kalbfell (MS4), Washington University in St. Louis, @rachelkalbfell, rkalbfell@wustl.edu
    -Keith Makhecha (MS4), Indiana University, kmakhech@iu.edu

    References:
    1. Woodward JM, Lund S, Brian R, Anand A, Moreci R, Navarro SM, Zarate Rodriguez J, Naaseh A, Tate K, Roshal J, Silvestri C, Gan CY, Sathe T, Thornton SW, Cloonan M, Weaver L, Oh MH, Godley F, L’Huillier JC. Find Your Perfect Match for Surgical Residency: Six Steps to Building Your BRANDD from the Collaboration of Surgical Education Fellows. Annals of Surgery. 2024;5(3). doi:10.1097/AS9.0000000000000466.

    2. Naaseh A, Roshal J, Silvestri C, Woodward JM, Thornton SW, L’Huillier JC, Hunt M, Sathe TS, Hoagland DL, Godley F IV, Jindani R, Tieken KR, Rodriguez JGZ, Anand A, Chen JH, Navarro SM, Lund S. Filter Out the Noise: How to Narrow Your Search for the Perfect Match by the Collaboration of Surgical Education Fellows (CoSEF). Journal of Surgical Education. 2024;81(10):1394-1399. doi:10.1016/j.jsurg.2024.07.010
    https://pubmed.ncbi.nlm.nih.gov/39178489/

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
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    31 mins
  • Medicine Consult Series: Ep. 3 - Acute Kidney Injury

    Medicine Consult Series: Ep. 3 - Acute Kidney Injury
    Sep 23 2024
    Low urine output – when is it a cause for alarm? Emma Burke is joined by Dr. Brian Tucker to discuss quick hits on acute kidney injury as part of the Med/Surg Consult series.

    Host:
    - Emma Burke, MD – General Surgery Resident at Baylor College of Medicine, @emmaburke017

    Guest:
    - Brian Tucker, DO – Nephrologist at Baylor College of Medicine, @bmtucker3

    Learning Objectives:
    - Define acute kidney injury (AKI) using KDIGO guidelines.
    - Develop a framework for initial workup of perioperative AKI.
    - Discuss the importance of in urine output in AKI management.
    - Identify AKI risk factors and preventative measures for high-risk surgical patients.

    References:
    - KDIGO AKI Guidelines: https://kdigo.org/guidelines/acute-kidney-injury/

    Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    DOMINATE THE DAY
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    17 mins
  • Medicine Consult Series: Ep. 2 - Diabetes Management

    Medicine Consult Series: Ep. 2 - Diabetes Management
    Sep 19 2024
    SHOWNOTES


    Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    DOMINATE THE DAY
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    16 mins
  • Medicine Consult Series: Ep. 1 - Postoperative Atrial Fibrillation

    Medicine Consult Series: Ep. 1 - Postoperative Atrial Fibrillation
    Sep 16 2024
    You're the new intern on your first night of night float. First page, right off the bat – AFib with rates into the 150s. What's your next move?! Dr. Nathan Anderson takes the anxiety out of approaching Atrial Fibrillation in the post-operative patient. Join him and Dr. Elizabeth Maginot as they discuss this very common post-operative you're guaranteed to see on the wards.

    Hosts:
    - Dr. Nathan Anderson, Internal Medicine Associate Professor and Hospitalist, University of Nebraska
    - Dr. Elizabeth Maginot, General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95

    Learning Objectives:
    - Discuss the underlying pathophysiological mechanisms that contribute to the development of atrial fibrillation in the postoperative setting.
    - Critically approach the different management options for atrial fibrillation in the post-cardiac and non-cardiac surgery settings, including rate versus rhythm control, indications for cardioversion, and the role of anticoagulation.
    - Identify common risk factors for atrial fibrillation in the post-operative setting.
    - Discuss long-term management and follow-up strategies for patients who develop atrial fibrillation after surgery.

    References:
    1. Bhave PD, Goldman LE, Vittinghoff E, Maselli J, Auerbach A. Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. AmericanHeart Journal. 2012;164(6):918-924. doi:10.1016/j.ahj.2012.09.004
    https://pubmed.ncbi.nlm.nih.gov/23194493/
    2. Gialdini G, Nearing K, Bhave PD, et al.. Perioperative Atrial Fibrillation and the Long-term Risk ofIschemic Stroke. JAMA. 2014;312(6):616. doi:10.1001/jama.2014.9143
    https://pubmed.ncbi.nlm.nih.gov/25117130/
    3. Snow V, Weiss KB, LeFevre M, McNamara R, Bass E, Green LA, Michl K, Owens DK, Susman J, Allen DI, Mottur-Pilson C; AAFP Panel on Atrial Fibrillation; ACP Panel on Atrial Fibrillation.Management of newly detected atrial fibrillation: a clinical practice guideline from the AmericanAcademy of Family Physicians and the American College of Physicians. Ann Intern Med. 2003 Dec16;139(12):1009-17. doi: 10.7326/0003-4819-139-12-200312160-00011. PMID: 14678921.
    https://pubmed.ncbi.nlm.nih.gov/14678921/
    4. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NewEngland Journal of Medicine. 2002;347(23):1825-1833. doi:10.1056/nejmoa021328
    https://pubmed.ncbi.nlm.nih.gov/12466506/

    Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    DOMINATE THE DAY
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    29 mins
  • Clinical Challenges in Hernia Surgery: Parastomal Hernias

    Clinical Challenges in Hernia Surgery: Parastomal Hernias
    Sep 12 2024
    Parastomal hernias are some of the toughest cases in abdominal wall reconstruction. Join Drs. Ajita Prabhu, Lucas Beffa, Sara Maskal and Ryan Ellis as they talk through their approach to these difficult cases.

    Hosts:
    - Ajita Prabhu, MD, Cleveland Clinic, @aprabhumd1
    - Lucas Beffa, MD, Cleveland Clinic, @BeffaLukeMD
    - Ryan Ellis, MD, Cleveland Clinic, @EllisMD2020
    - Sara Maskal, MD, Cleveland Clinic

    Learning Objectives:
    - Review anatomy of parastomal abdominal wall hernias
    - Review perioperative pitfalls and tips for staying out of trouble
    - Review common surgical approaches to repair

    References:
    - Maskal SM, Ellis RC, Miller BT. Parastomal hernia repair, trying to optimize the impossible reconstruction. Hernia. 2024 Apr 28:1-6. https://pubmed.ncbi.nlm.nih.gov/38678529/
    - Maskal SM, Thomas JD, Miller BT, Fafaj A, Zolin SJ, Montelione K, Ellis RC, Prabhu AS, Krpata DM, Beffa LR, Costanzo A. Open retromuscular keyhole compared with Sugarbaker mesh for parastomal hernia repair: Early results of a randomized clinical trial. Surgery. 2024 Mar 1;175(3):813-21.
    https://pubmed.ncbi.nlm.nih.gov/37770344/

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

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    37 mins