Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing liver health concern that's closely linked to obesity and other cardiometabolic risk factors, yet it remains underrecognized in clinical practice. That's why Dr. Peter Buch joins us to discuss how emerging perspectives are changing the way we think about metabolic-related liver disease. Dr. Buch is a board-certified clinical gastroenterologist and Associate Professor at the Frank H. Netter, MD School of Medicine at Quinnipiac University in Connecticut.

Obesity introduces distinct changes to respiratory physiology that ripple across care settings—from subtle outpatient symptoms to complex ventilatory challenges in the ICU and heightened perioperative risks. Dr. Sujith Cherian explains real-world scenarios and physiologic insights to show how excess weight influences not just lung mechanics, but length of stay, postoperative recovery, and cardiopulmonary complications. Dr. Cherian is an Associate Professor in the Divisions of Critical Care, Pulmonary, and Sleep Medicine at University of Texas Health-McGovern Medical School. He also serves as the Director of Interventional Pulmonology and Pleural Diseases at Lyndon B. Johnson Hospital in Houston.

Timely surgical intervention is critical for reducing mortality and complications in high-risk hip fracture patients. However, anticoagulation therapy often presents barriers to prompt care, requiring careful coordination and clinical judgment. Joining Dr. Steve Jackson to discuss anticoagulant reversal strategies and multidisciplinary approaches for managing high-risk fracture patients are Drs. Anna Miller and Michael Weaver. Dr. Miller is a Professor of Orthopedics and the Chair of the Department of Orthopedics at Dartmouth-Hitchcock Medical Center and the Geisel School of Medicine at Dartmouth in Lebanon, New Hampshire. Dr. Weaver is an Associate Professor of Orthopedic Surgery at Harvard Medical School, as well as the Chief of Orthopedic Trauma and Distinguished Chair in Orthopedic Surgery at Brigham and Women's Hospital in Boston.

What if a rare, progressive neuromuscular disease like thymidine kinase 2 deficiency (TK2d) could not only be stabilized, but partially reversed? Based on findings from a pooled analysis of pediatric patients, pyrimidine nucleoside or nucleotide therapy reduced mortality risk up to 95%, with nearly 75% of patients regaining at least one motor milestone. Joining Dr. Charles Turck to explore these survival and functional outcomes is Dr. Caterina Garone, Associate Professor of Medical Genetics in the Department of Medical and Surgical Sciences at the Alma Mater Studiorum University of Bologna in Italy.

From minimizing wrong-drug and dosing errors to easing cognitive burden in the OR, ready-to-administer (RTA) medications are enhancing both safety and efficiency in anesthesiology and perioperative care. Join Dr. Charles Turck and Dr. John Hertig as they explore key medication safety challenges, compare FDA-approved versus 503B compounded products, and share strategies for effectively integrating RTA medications into clinical workflows. Dr. Hertig is a member of both the Board of Directors for the Alliance for Safe Online Pharmacies and the U.S. Food and Drug Administration Drug Safety and Risk Management Advisory Committee.

Caring for individuals with thymidine kinase 2 (TK2) deficiency can place extraordinary demands on families, yet caregiver experiences are often overlooked in clinical care. To shed light on this burden, a mixed-methods study explored the physical, emotional, and financial impacts on caregivers. Here with Dr. Charles Turck to share the findings and how we can better support these families is Dr. Philip Yeske, the United Mitochondrial Disease Foundation Science and Alliance Officer.

How fast does thymidine kinase 2 deficiency (TK2d) progress without intervention? That’s the question explored by the largest dataset to date on untreated pediatric-onset TK2d, and the results reveal a median survival of just 2.6 years from symptom onset. Additionally, more than 80% lost at least one motor milestone, and many experienced escalating care needs, including ventilatory and feeding tube support. Here with Dr. Charles Turck to discuss the findings that highlight the urgent need for earlier diagnosis and intervention is Dr. Cristina Dominguez-Gonzalez, a physician in the Department of Neurology at the University Hospital 12 de Octubre in Madrid.

Emerging research suggests that the effects of obesity extend beyond metabolism, reaching the brain in ways that may influence the development of Alzheimer’s disease. Tune in as Dr. Stephen Wong discusses how fat-derived vesicles act as molecular messengers, potentially linking systemic inflammation and lipid imbalance to neurodegenerative changes. Dr. Wong is the John S. Dunn Presidential Distinguished Chair in Biomedical Engineering at Houston Methodist Hospital and Associate Director at Houston Methodist Cancer Center. He’s also a Professor of Radiology, Neurosciences, Pathology, and Laboratory Medicine at Weill Cornell Medicine.

How often are ICU patients conscious during intubation despite paralysis? Hear from Dr. Yana Zemkova as she discusses new findings on the incidence of awareness with paralysis and the urgent need for improved monitoring in critical care. Dr. Zemkova is Clinical Assistant Professor of Internal Medicine specializing in Pulmonary, Critical Care and Occupational Medicine at the University of Iowa, and she spoke about this topic at the 2025 CHEST Annual Meeting.

Obesity impacts how the lungs function in a variety of ways, and understanding these impacts is essential for interpreting pulmonary function tests, identifying restrictive or obstructive patterns, and managing ventilation. Learn more with Dr. Sujith Cherian, who's an Associate Professor in the Divisions of Critical Care, Pulmonary, and Sleep Medicine at University of Texas Health-McGovern Medical School and the Director of Interventional Pulmonology and Pleural Diseases at Lyndon B. Johnson Hospital in Houston. He also spoke about this topic at the 2025 CHEST Annual Meeting.

About 40 percent of patients with metastatic HR+/HER2- breast cancer have an activating mutation in the PIK3CA gene,^1,2 which plays a key role not only in tumor growth, but also in driving resistance to endocrine therapy.^3-5 And while there are several FDA-approved PI3K pathway-targeted agents for patients with PIK3CA tumor mutations,^6-8 they come with challenges, like modest efficacy and on-pathway effects.^9-12 Given this unmet need, the ReDiscover trial evaluated the investigational agent RLY-2608 in combination with fulvestrant in in patients with PIK3CA-mutated HR+/HER2- aBC previously treated with a CDK4/6 inhibitor.¹³ Joining Dr. Charles Turck to share updated safety and efficacy data from the trial is Dr. Sarah Sammons, a Senior Physician at the Dana-Farber Cancer Institute and an Assistant Professor of Medicine at Harvard Medical School in Boston.

References:

1. Vasan N, Cantley LC, Vasan N, Cantley LC. At a crossroads: how to translate the roles of PI3K in oncogenic and metabolic signalling into improvements in cancer therapy. Nat Rev Clin Oncol. 2022;19(7):471-485. doi:10.1038/s41571-022-00633-1
2. Network TCGA. Comprehensive molecular portraits of human breast tumours. Nature. 2012;490(7418):61-70. doi:10.1038/nature11412
3. Saal LH, Johansson P, Holm K, et al. Poor prognosis in carcinoma is associated with a gene expression signature of aberrant PTEN tumor suppressor …

In a 2025 study investigating salivary metabolites as potential biomarkers in cystic fibrosis, researchers identified distinct metabolic patterns linked with key complications as well as correlations with lung function. In this AudioAbstract, Ryan Quigley discusses how a simple saliva sample could provide clinicians with an accessible, non-invasive tool to stratify patients, monitor therapies, and advance personalized care in cystic fibrosis. This topic was also discussed at the 2025 CHEST Annual Meeting.