Podcasts about adult patients

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Liam Burns, CEO of Qaelon Medical, about turning ideas into companies. Chapters 00:00 Intro 02:26 JANS 1, Ross Procedure Consensus Statement 13:59 JANS 2, Novel Anastomotic Device 16:03 JANS 3, Tracheobronchoplasty Disorders Analysis 18:32 JANS 4, Revasc Strategies Non-Acute Myocardial 20:22 JANS 5, EACTS Core Curriculum for Cardiac Surgeon 21:51 Video 1, Giant Right Coronary Artery Aneurysm 24:01 Video 2, Bentall-de Bono Procedure 25:29 Video 3, Democratizing MI Mitral Repair 27:01 Liam Burns Interview 37:15 Upcoming Events 38:38 Closing They explored the challenges faced by innovators and emphasized the importance of having a commercial perspective. Additionally, they discussed product design, the fundraising process, and the challenges that commercial leaders face. Burns also shared valuable advice for aspiring innovators.   Joel also highlights recent JANS articles on the EACTS expert consensus statement on the Ross procedure in adult patients, a human cadaver study on a novel anastomotic device for the sandwich technique in type A aortic dissections, a comparative analysis of distinct airway disorders, revascularization strategies for non-acute myocardial ischemic syndromes, and core curriculum for the cardiac/cardiovascular surgeon.  In addition, Joel explores the surgical repair of a giant right coronary artery aneurysm with saphenous vein interpositional grafting, the Bentall-de Bono procedure, and democratizing minimally invasive mitral repair. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients   2.) Novel Anastomotic Device for the Sandwich Technique in Type A Aortic Dissections—A Human Cadaver Study  3.) Tracheobronchoplasty for Excessive Dynamic Airway Collapse and Tracheobronchomalacia: A Comparative Analysis of Distinct Airway Disorders  4.) Revascularisation Strategies for Non-Acute Myocardial Ischaemic Syndromes  5.) The European Association for Cardio-Thoracic Surgery—Core Curriculum for the Cardiac/Cardiovascular Surgeon  CTSNet Content Mentioned  1.) Surgical Repair of a Giant Right Coronary Artery Aneurysm With Saphenous Vein Interpositional Grafting   2.) The Bentall-de Bono Procedure: A Novel, Time-Efficient Mattress-Type Technique for Aortic Root Anastomosis   3.) Democratizing Minimally Invasive Mitral Repair  Other Items Mentioned  1.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  2.) Case of the Month: The Case of a Foreign Body  3.) Resident Video Competition  4.) Career Center   5.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Stephan von Düring, MD, and Eddy Fan, MD, PhD, join CHEST® Journal Podcast Moderator Matt Siuba, DO, MS, to discuss their research into the association between mechanical power within the first 24 hours and ICU mortality in adult patients with acute hypoxemic respiratory failure who are mechanically ventilated.  DOI: 10.1016/j.chest.2025.03.012 Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine. 

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: David Levinthal, MD, PhD Cyclic vomiting syndrome (CVS) is often underdiagnosed in adults due to its episodic nature and symptom overlap with other conditions. Dr. David Levinthal joins Dr. Peter Buch to explore key diagnostic criteria, key differences between CVS and cannabinoid hyperemesis syndrome (CHS), and evidence-based treatment strategies. Dr. Levinthal is the Director of the UPMC Neurogastroenterology and Motility Center and an Associate Professor of Medicine at the University of Pittsburgh School of Medicine.

“She's triple negative and has a very, very aggressive tumor. Instead of going on spring break that year, she sat in our chemo room and got chemo. Her friends from college are good to try to keep her involved and try to surround her and encourage her, but they're right now in very, very different spots in their lives. She's fighting for her life; her friends are fighting for the grade they get in a class—and that's different,” ONS member Kristi Orbaugh, MSN, NP, AOCN®, AOCNP®, nurse practitioner at Community Hospital North Cancer Center in Indianapolis, IN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about metastatic breast cancer in adolescent and young adult patients. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  This podcast is sponsored by Lilly and is not eligible for NCPD contact hours. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer Episode 354: Breast Cancer Survivorship Considerations for Nurses Episode 350: Breast Cancer Treatment Considerations for Nurses Episode 345: Breast Cancer Screening, Detection, and Disparities Episode 307: AYAs With Cancer: Financial Toxicity Episode 300: AYAs With Cancer: End-of-Life Care Planning ONS Voice articles: ‘Cancer Ghosting' May Add Another Layer of Emotional Burden for Patients Discoveries in Race-Related Breast Cancer Biomarkers May Improve Precision Treatments What Is HER-2-Low Breast Cancer? What Oncology Nurses Need to Know About Supporting AYAs With Cancer ONS books: Guide to Breast Cancer for Oncology Nurses Oncology Nursing Forum articles: An Integrative Review of the Role of Nurses in Fertility Preservation for Adolescents and Young Adults With Cancer Impact of Race and Area Deprivation on Triple-Negative Metastatic Breast Cancer Outcomes Relations of Mindfulness and Illness Acceptance With Psychosocial Functioning in Patients With Metastatic Breast Cancer and Caregivers ONS huddle cards: Altered Body Image Fertility Preservation Sexuality Other ONS resources: Breast Cancer Learning Library Fertility Preservation in Individuals With Cancer ONS Biomarker Database American Cancer Society's breast cancer resources American Society of Clinical Oncology continuing education resources Elephants and Tea Life, Interrupted Livestrong National Cancer Institute's breast cancer resources Stupid Cancer Young Survival Coalition To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “When we use ‘adolescent and young adult,' we're really talking about age 19–35. Some groups will say 15–39, but right around that age. When we think about that age, think about what all could be going on during those ages. Late teenagers, they may be going off to college, they may be graduating high school, trying to set up their own life, trying to become independent from mom and dad. If you're talking about early to mid 30s, you could be talking about young parents, young career folks. So, just setting that into place makes you realize this can be a very tumultuous time for folks.” TS 2:06 “Unfortunately, this group tends to have more aggressive subtypes. We see more triple-negative in this group. We see more hormone-negative, HER2-positive in this group. Normal breast cancer cells should be stimulated by hormone. They are stimulated by hormones. So when you have a breast cancer cell that is not driven by hormones, it's much more difficult to treat. We tend to see more aggressiveness in these tumors. We also see a higher incidence in non-Caucasian folks in this age group compared to the older age groups.” TS 4:53 “I think we have gotten much better about understanding the importance of fertility preservation and getting reproductive endocrinologists in, sooner rather than later. If we have earlier-stage cancers and we have patients that want to try to preserve eggs, preserve fertility, sperm banking. … If you have that time to talk to them—maybe a 21-year-old—the primary thing on her mind is not how many children she wants to have one day. Maybe she's not even thought about having kids yet. It's still a question you need to [ask]. Do you want to try to preserve fertility? Do you want to try to harvest some eggs? That's a conversation that needs to be had and is very, very important for that age group.” TS 10:35 “One thing that helps is if you can get them [into] reputable support groups with people their own age that are going through what they're going through. Someone else that doesn't have hair, someone else that isn't going to make it to the big board meeting or isn't going to get the promotion this year because they've had to take a medical leave. Someone else that understands it differently.” TS 16:47 “In breast cancer, many of those biomarkers just get reflexed. And what I mean by reflexed is a breast cancer pathology comes through, or a breast cancer specimen comes through, and it just automatically gets tested for X, Y, Z. HER2 and of course ER/PR. Now we understand that we don't just need to know whether they're HER2 positive or HER2 negative. We need to know: What is the IHC score? And even if the IHC score is zero, is there any membrane staining? And then we need to know what's their ESR1, their PTEN, their AKT, their PIK3CA. Those are so important to know.” TS 18:11 “I think it's important to try to remember what our priorities were when we were in our 20s—what our priorities were when we were starting out as young mothers or starting out our career. Because that's where these folks are. … I can't imagine in the midst of college, when I'm trying to be independent, to suddenly have to be at home and rely on my mom to take me to my chemo appointment. … So I think one really important bias is to remember where they are in the developmental stages of life. They're not 40-something. They haven't lived X amount of life, and we need to take a step back and try to remember when we were their age, what was important to us? Where were our priorities at that point? And then hear them when they're telling us what's important to them.” TS 29:22 “From a female standpoint … we frequently throw these patients into menopause or have early menopausal symptoms, and I think we forget how devastating that can be. … They now are at higher risk for osteopenia or osteoporosis. … And then we tell people, ‘Be as normal as possible, get back and do those normal things.' Well, they're in a relationship, and they want to be intimate [but] suddenly having sexual intercourse is incredibly painful. Or if it's not painful, sometimes they've just lost pure interest in that. They don't feel confident about their body. All of those things need to be addressed because patients are trying to live each day as normally as possible.” TS 31:55 

Listen in as host Dr. Gerard Slobogean talks with Dr. Marcus Sciadini about use of hindfoot nails to treat low demand patients's pilon fractures.  For additional educational resources visit OTA.org

Do adults with chronic spontaneous urticaria (CSU) have a higher risk of death over time compared to people without hives? We review the findings from “Mortality in adult patients with chronic spontaneous urticaria: A real-world cohort study,” published in April 2025, in The Journal of Allergy and Clinical Immunology. While CSU is often considered a non-life-threatening condition, this large study found something surprising: people with CSU had a significantly higher risk of death, especially from suicide. Dr. G and Dr. Blaiss walk through key takeaways from a dataset of over 272,000 CSU patients and nearly 13 million matched controls. They explore what the results mean for mortality risk, clinical care, mental health screening, and the importance of proper, guideline-based treatment. What we cover in our episode about CSU and mortality risk: What is CSU? Chronic hives are an unpredictable, itchy, and sometimes painful condition. It lasts for 6 weeks or longer and can continue for years. Mental health connection: CSU affects more than skin. Anxiety, depression, and suicidal thoughts are common and serious concerns. Study findings: CSU was associated with higher mortality at 3 months, 1 year, and 5 years. Suicide risk was over 3 times higher than in people without CSU. Demographics: Younger and White patients with CSU had the highest increase in risk. Treatment impact: Patients using guideline-recommended treatments like second-generation antihistamines or omalizumab had lower death rates. INFOGRAPHIC The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.   Made in partnership with The Allergy & Asthma Network. Thanks to Novartis for sponsoring today's episode.  This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient's needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but don't let it take your breath away! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Swart P, Nijbroek SGLH, Paulus F, Neto AS, Schultz MJ. Sex Differences in Use of Low Tidal Volume Ventilation in COVID-19-Insights From the PRoVENT-COVID Study. Front Med (Lausanne). 2022 Jan 3;8:780005. doi: 10.3389/fmed.2021.780005. PMID: 35300177; PMCID: PMC8923734. McNicholas BA, Madotto F, Pham T, Rezoagli E, Masterson CH, Horie S, Bellani G, Brochard L, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Demographics, management and outcome of females and males with acute respiratory distress syndrome in the LUNG SAFE prospective cohort study. Eur Respir J. 2019 Oct 17;54(4):1900609. doi: 10.1183/13993003.00609-2019. PMID: 31346004. Swart P, Deliberato RO, Johnson AEW, Pollard TJ, Bulgarelli L, Pelosi P, de Abreu MG, Schultz MJ, Neto AS. Impact of sex on use of low tidal volume ventilation in invasively ventilated ICU patients-A mediation analysis using two observational cohorts. PLoS One. 2021 Jul 14;16(7):e0253933. doi: 10.1371/journal.pone.0253933. PMID: 34260619; PMCID: PMC8279424. Evans, Laura1; Rhodes, Andrew2; Alhazzani, Waleed3; Antonelli, Massimo4; Coopersmith, Craig M.5; French, Craig6; Machado, Flávia R.7; Mcintyre, Lauralyn8; Ostermann, Marlies9; Prescott, Hallie C.10; Schorr, Christa11; Simpson, Steven12; Wiersinga, W. Joost13; Alshamsi, Fayez14; Angus, Derek C.15; Arabi, Yaseen16; Azevedo, Luciano17; Beale, Richard18; Beilman, Gregory19; Belley-Cote, Emilie20; Burry, Lisa21; Cecconi, Maurizio22; Centofanti, John23; Coz Yataco, Angel24; De Waele, Jan25; Dellinger, R. Phillip26; Doi, Kent27; Du, Bin28; Estenssoro, Elisa29; Ferrer, Ricard30; Gomersall, Charles31; Hodgson, Carol32; Hylander Møller, Morten33; Iwashyna, Theodore34; Jacob, Shevin35; Kleinpell, Ruth36; Klompas, Michael37; Koh, Younsuck38; Kumar, Anand39; Kwizera, Arthur40; Lobo, Suzana41; Masur, Henry42; McGloughlin, Steven43; Mehta, Sangeeta44; Mehta, Yatin45; Mer, Mervyn46; Nunnally, Mark47; Oczkowski, Simon48; Osborn, Tiffany49; Papathanassoglou, Elizabeth50; Perner, Anders51; Puskarich, Michael52; Roberts, Jason53; Schweickert, William54; Seckel, Maureen55; Sevransky, Jonathan56; Sprung, Charles L.57; Welte, Tobias58; Zimmerman, Janice59; Levy, Mitchell60. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Critical Care Medicine 49(11):p e1063-e1143, November 2021. | DOI: 10.1097/CCM.0000000000005337  Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, Adhikari NKJ, Amato MBP, Branson R, Brower RG, Ferguson ND, Gajic O, Gattinoni L, Hess D, Mancebo J, Meade MO, McAuley DF, Pesenti A, Ranieri VM, Rubenfeld GD, Rubin E, Seckel M, Slutsky AS, Talmor D, Thompson BT, Wunsch H, Uleryk E, Brozek J, Brochard LJ; American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2017 May 1;195(9):1253-1263. doi: 10.1164/rccm.201703-0548ST. Erratum in: Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum. PMID: 28459336. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, Oczkowski S, Levy MM, Derde L, Dzierba A, Du B, Aboodi M, Wunsch H, Cecconi M, Koh Y, Chertow DS, Maitland K, Alshamsi F, Belley-Cote E, Greco M, Laundy M, Morgan JS, Kesecioglu J, McGeer A, Mermel L, Mammen MJ, Alexander PE, Arrington A, Centofanti JE, Citerio G, Baw B, Memish ZA, Hammond N, Hayden FG, Evans L, Rhodes A. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020 Jun;48(6):e440-e469. doi: 10.1097/CCM.0000000000004363. PMID: 32224769; PMCID: PMC7176264. Wang W, Scharfstein D, Wang C, Daniels C, Needham D, Brower R, NHLBI ARDS Clinical Network. Estimating the Causal Effect of Low Tidal Volume Ventilation on Survival in Patients with Acute Lung Injury. J R Stat Soc Ser C Appl Stat. 2011. PMC: PMC3197806 Brower RG, Thompson BT, NIH/NHLBI/ARDSNetwork. Tidal volumes in acute respiratory distress syndrome--one size does not fit all. Crit Care Med. 2006. Hager DN, Krishman JA, Hayden D, Brower RG, ARDSNet NIH / NHLBI. Tidal Volume Reduction in Patients with acute Lung Injury When Plateau Pressures Are Not High. Am J Resp Crit Care Med. 2005. Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD. Barriers to providing lung protective ventilation to patients with acute lung injury. Crit Care Med. 2004. Chatburn RL, El-Khatib M, Mireles-Cabodevila E. A taxonomy for mechanical ventilation: 10 fundamental maxims. Respir Care. 2014 Nov;59(11):1747-63. doi: 10.4187/respcare.03057. Epub 2014 Aug 12. PMID: 25118309. Guo L, Wang W, Zhao N, Guo L, Chi C, Hou W, Wu A, Tong H, Wang Y, Wang C, Li E. Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis. Crit Care. 2016 Jul 22;20(1):226. doi: 10.1186/s13054-016-1396-0. PMID: 27448995; PMCID: PMC4957383. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, NIH NHLBI ARDS Network. Comparison of the Sp02/FI02 Ratio and the PaO 2/FI02 in Patients with Acute Lung Injury or ARDS. Chest. 2007. Zhang G, Burla MJ, Caesar BB, Falank CR, Kyros P, Zucco VC, Strumilowska A, Cullinane DC, Sheppard FR. Emergency Department SpO2/FiO2 Ratios Correlate with Mechanical Ventilation and Intensive Care Unit Requirements in COVID-19 Patients. West J Emerg Med. 2024 May;25(3):325-331. doi: 10.5811/westjem.17975. PMID: 38801037; PMCID: PMC11112664.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

The ICU Liberation Campaign from the Society of Critical Care Medicine (SCCM) has transformed critical care, but the COVID-19 pandemic and subsequent staffing challenges have posed major obstacles to maintaining progress. In this episode of the SCCM Podcast, host Ludwig H. Lin, MD, speaks with Juliana Barr, MD, FCCM, a key architect of the ICU Liberation Campaign. Dr. Barr was a lead author of the 2013 “Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit,” known as the PAD guidelines, an original cornerstone of the ICU Liberation Campaign (Barr J, et al. Crit Care Med. 2013;41:263-306). The guidelines' recent 2025 update also addressed immobility and sleep disruption (Lewis K, et al. Crit Care Med. 2025;53:e711-e727). Dr. Barr shares her personal journey from traditional ICU practices of heavy sedation and immobility to leading efforts that prioritize patient recovery, well-being, and post-ICU quality of life. She emphasizes how ICU Liberation reintroduced low-tech, high-impact interventions such as minimizing sedation, promoting early mobility, and engaging families—leading to better outcomes at lower costs. She cites the 2017 international survey by Morandi et al that demonstrated uneven but steady improvements in global ICU Liberation practices before the pandemic (Morandi A, et al. Crit Care Med. 2017;45:e1111-e1122). Dr. Barr details the need for reeducation, multidisciplinary team engagement, and reworking electronic health record (EHR) systems to better support ICU Liberation goals. Looking forward, Dr. Barr offers a "burning platform" approach, stressing that delaying ICU Liberation practices risks poorer patient outcomes. She advocates for cultural change, leadership engagement, real-time metrics visibility, and hospital-wide investment—including IT support to surface buried ICU Liberation Bundle data within EHRs. By reframing ICU Liberation as a "team sport" and making best practices part of daily ICU culture, Dr. Barr believes institutions can reestablish the bundle's momentum and reconnect healthcare teams to their core mission—helping patients return to meaningful lives after critical illness. This conversation offers energizing, practical strategies for ICU teams at every stage of ICU Liberation implementation or reinvigoration.

In this episode, Dr. Zanotti discussed the Society of Critical Care Medicine “Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU." This is also known as the PADIS Guidelines. He is joined by Joanna L. Stollings, PharmD, a Board-Certified Pharmacotherapy Specialist and a Board-Certified Critical Care Pharmacotherapy Specialist. Joanna is the Medical Intensive Care Unit (MICU) Clinical Pharmacy Specialist at the Vanderbilt University Medical Center. She also served as vice chair for the PADIS Guideline Focused Update and co-authored the guidelines. Additional resources: Society of Critical Care Medicine Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2025 Update: https://pubmed.ncbi.nlm.nih.gov/39982143/ Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2018 Guidelines: https://pubmed.ncbi.nlm.nih.gov/30113379/ Link to a previous episode of Critical Matters discussing the PADIS 2018 Guidelines: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=635606964 Landing page for the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center: https://www.icudelirium.org/ Books mentioned in this episode: The Prophet. By Kahlil Gibran: https://bit.ly/4lA2Jhx

Maxine Kresse, MD delves into MR safety for patients with implanted devices, exploring challenges, protocols, and strategies to ensure safe imaging. MRI in Adult Patients with Active and Inactive Implanted MR-conditional, MR-nonconditional,and Other Devices. RadioGraphics 2024; 44(3):e230102. 

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/MOC information, and to apply for credit, please visit us at PeerView.com/QQD865. CME/EBAC/MOC credit will be available until December 13, 2025.Improving Care for Pediatric and Adult Patients With Eosinophilic Esophagitis: Expert Insights on the Latest Evidence for Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/MOC information, and to apply for credit, please visit us at PeerView.com/QQD865. CME/EBAC/MOC credit will be available until December 13, 2025.Improving Care for Pediatric and Adult Patients With Eosinophilic Esophagitis: Expert Insights on the Latest Evidence for Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/MOC information, and to apply for credit, please visit us at PeerView.com/QQD865. CME/EBAC/MOC credit will be available until December 13, 2025.Improving Care for Pediatric and Adult Patients With Eosinophilic Esophagitis: Expert Insights on the Latest Evidence for Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/MOC information, and to apply for credit, please visit us at PeerView.com/QQD865. CME/EBAC/MOC credit will be available until December 13, 2025.Improving Care for Pediatric and Adult Patients With Eosinophilic Esophagitis: Expert Insights on the Latest Evidence for Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

In this World Shared Practice Forum podcast, Dr. Mark Peters discusses the Oxy-PICU trial, published in The Lancet in January 2024, which compared conservative to liberal oxygenation targets in critically ill children. The study highlighted the importance of pragmatic trial design and the need for larger trials to confirm these findings. LEARNING OBJECTIVES -Discuss the background driving the investigation of oxygenation in critically ill children -Summarize the study design of the Oxy-PICU Trial -Present the outcomes and challenges of the Oxy-PICU Trial -Identify the key characteristics of pragmatic trial design and the implication of pragmatic trial results AUTHORS Mark Peters, MBChB, MRCP, FFICM, FRCPCH, PhD Professor of Paediatric Intensive Care NIHR Senior Investigator UCL Great Ormond St Institute of Child Health Hon. Consultant Paediatric Intensivist Paediatric Intensive Care Unit and Children's Acute Transport Service Great Ormond St Hospital Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: November 26, 2024. ARTICLES REFERENCED AND ADDITIONAL RESOURCES Peters MJ, Gould DW, Ray S, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial [published correction appears in Lancet. 2024 Jan 27;403(10424):354. doi: 10.1016/S0140-6736(24)00100-4]. Lancet. 2024;403(10424):355-364. https://pubmed.ncbi.nlm.nih.gov/38048787/ Fan E, Del Sorbo L, Goligher EC, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome [published correction appears in Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum]. Am J Respir Crit Care Med. 2017;195(9):1253-1263. https://pubmed.ncbi.nlm.nih.gov/28459336/ Peters MJ, Ramnarayan P. Randomized Trials to Reduce Clinical Uncertainty: Gold Standard or Fool's Gold? Pediatr Crit Care Med. 2024;25(8):775-777. https://pubmed.ncbi.nlm.nih.gov/39101806/ Darnell R, Brown A, Laing E, et al. Protocol for a Randomized Controlled Trial to Evaluate a Permissive Blood Pressure Target Versus Usual Care in Critically Ill Children with Hypotension (PRESSURE). Pediatr Crit Care Med. 2024;25(7):629-637. https://pubmed.ncbi.nlm.nih.gov/38629915/ Taccone FS, Rynkowski Bittencourt C, Møller K, et al. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial. JAMA.Published online October 09, 2024. https://pubmed.ncbi.nlm.nih.gov/39382241/ Jones GAL, Eaton S, Orford M, et al. Randomization to a Liberal Versus Conservative Oxygenation Target: Redox Responses in Critically Ill Children. Pediatr Crit Care Med. 2023;24(3):e137-e146. https://pubmed.ncbi.nlm.nih.gov/36728001/ UK-ROX: https://www.icnarc.org/research-studies/uk-rox/ MegaROX: https://www.anzics.org/current-active-endorsed-research/mega-rox/ ICU-ROX: https://www.thebottomline.org.uk/summaries/icm/icu-rox/ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/rq7kgwqkh4hk4nk67584pfj/202411_-_WSP_-_Less_is_more_Oxygenation_Targets_in_Critically_Ill_Children_-_Transcript?position=2 CITATION Peters MJ, Burns JP. Less is More: Oxygenation Targets in Critically Ill Children. 11/2024. OPENPediatrics. https://soundcloud.com/openpediatrics/less-is-more-oxygenation-targets-in-critically-ill-children-by-m-peters-openpediatrics.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on using blood biomarkers to predict 10-year clinical outcomes in adult patients with Congenital Heart Disease.

Linda Thoresen joins me today for a special Member Spotlight. She is an SLP and a member of ABA Speech Connection, and I first met her in her onboarding meeting. During this conversation, Linda shares about her journey from medical therapy to teletherapy. As a seasoned therapist, Linda has been in the field for 20+ years. We discuss the changes in course work from her training to the present day, as well as the change in working with adults to now school-age and autistic learners. She has a great perspective to share on her membership with ABA Speech about her ASHA course library access and the comprehensive education available.  #autism #speectherapyWhat's Inside:Membership Spotlight, SLP JourneyMedical therapy vs teletherapyChanges in the field ABA Speech Connection MembershipMentioned In This Episode:Join us in the ABA SPEECH Connection MembershipRegister for our Naturalistic Interventions CourseRose Griffin (@abaspeechbyrose) on Instagram

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA information, and to apply for credit, please visit us at PeerView.com/DET865. CME/AAPA credit will be available until August 21, 2025.Mapping a New Treatment Journey in NF1: New Developments With MEKi for Pediatric and Adult Patients With NF1-Plexiform Neurofibromas In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from SpringWorks Therapeutics, Inc.Disclosure information is available at the beginning of the video presentation.

Anna K. Barker, MD, PhD, joins CHEST Journal Podcast Moderator Gretchen Winter, MD, to discuss a study exploring early deep sedation practices for patients on mechanical ventilation during the COVID-19 pandemic.

Host: Mary Katherine Cheeley, PharmD, BCPS, CLS, FNLA Guest: Christin Iroegbu PhD, RN If left untreated, chronic kidney disease (CKD) can progress to end-stage renal disease, requiring dialysis or kidney transplant as the only treatment options. So communicating this to patients, along with chronic conditions that could contribute to this are key. To learn more about raising awareness of the causes of CKD and to help slow the progression, join Dr. Mary Katherine Cheeley who's speaking with Dr. Iroegbu, Co-Author of the article published in the Journal of Advanced Nursing, titled “An Integrative Review: Chronic Kidney Disease Awareness and the Social Determinants of Health Equity,” and T32 Postdoctoral Research Fellow at the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

https://www.cursotdc.com.br/antibiotico/lead/

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/AGP865. CME/MOC/AAPA credit will be available until March 7, 2025.Overcoming Challenges in the Treatment of Pediatric and Adult Patients With Uncontrolled Moderate to Severe Asthma: Comparing Approaches to the Use of Targeted Biologic Therapy With Experts Around the World In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerLeonard B. Bacharier, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Aravax; AstraZeneca; Avillion LLP; DBV Technologies; GlaxoSmithKline; Kinaset Therapeutics; Regeneron Pharmaceuticals Inc.; Sanofi; and Vertex Pharmaceuticals Incorporated.Speaker for Regeneron Pharmaceuticals Inc. and Sanofi.Other Financial or Material Support for Patents and Royalties from Elsevier.Faculty/PlannerKlaus F. Rabe, MD, PhD, FERS, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; CSL Behring; Regeneron Pharmaceuticals Inc.; and Sanofi.Speakers Bureau participant with AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; The Menarini Group; Regeneron Pharmaceuticals Inc.; and Sanofi.PresenterArzu Yorgancioglu, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abdi İbrahim; AstraZeneca; CHIESI USA, Inc.; and GlaxoSmithKline.Grant/Research Support from Sanofi.Speaker for Abdi İbrahim; AstraZeneca; Bilim Pharmaceuticals; CHIESI USA, Inc.; GlaxoSmithKline; and Novartis Pharmaceuticals Corporation.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/AGP865. CME/MOC/AAPA credit will be available until March 7, 2025.Overcoming Challenges in the Treatment of Pediatric and Adult Patients With Uncontrolled Moderate to Severe Asthma: Comparing Approaches to the Use of Targeted Biologic Therapy With Experts Around the World In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerLeonard B. Bacharier, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Aravax; AstraZeneca; Avillion LLP; DBV Technologies; GlaxoSmithKline; Kinaset Therapeutics; Regeneron Pharmaceuticals Inc.; Sanofi; and Vertex Pharmaceuticals Incorporated.Speaker for Regeneron Pharmaceuticals Inc. and Sanofi.Other Financial or Material Support for Patents and Royalties from Elsevier.Faculty/PlannerKlaus F. Rabe, MD, PhD, FERS, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; CSL Behring; Regeneron Pharmaceuticals Inc.; and Sanofi.Speakers Bureau participant with AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; The Menarini Group; Regeneron Pharmaceuticals Inc.; and Sanofi.PresenterArzu Yorgancioglu, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abdi İbrahim; AstraZeneca; CHIESI USA, Inc.; and GlaxoSmithKline.Grant/Research Support from Sanofi.Speaker for Abdi İbrahim; AstraZeneca; Bilim Pharmaceuticals; CHIESI USA, Inc.; GlaxoSmithKline; and Novartis Pharmaceuticals Corporation.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/AGP865. CME/MOC/AAPA credit will be available until March 7, 2025.Overcoming Challenges in the Treatment of Pediatric and Adult Patients With Uncontrolled Moderate to Severe Asthma: Comparing Approaches to the Use of Targeted Biologic Therapy With Experts Around the World In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerLeonard B. Bacharier, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Aravax; AstraZeneca; Avillion LLP; DBV Technologies; GlaxoSmithKline; Kinaset Therapeutics; Regeneron Pharmaceuticals Inc.; Sanofi; and Vertex Pharmaceuticals Incorporated.Speaker for Regeneron Pharmaceuticals Inc. and Sanofi.Other Financial or Material Support for Patents and Royalties from Elsevier.Faculty/PlannerKlaus F. Rabe, MD, PhD, FERS, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; CSL Behring; Regeneron Pharmaceuticals Inc.; and Sanofi.Speakers Bureau participant with AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; The Menarini Group; Regeneron Pharmaceuticals Inc.; and Sanofi.PresenterArzu Yorgancioglu, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abdi İbrahim; AstraZeneca; CHIESI USA, Inc.; and GlaxoSmithKline.Grant/Research Support from Sanofi.Speaker for Abdi İbrahim; AstraZeneca; Bilim Pharmaceuticals; CHIESI USA, Inc.; GlaxoSmithKline; and Novartis Pharmaceuticals Corporation.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/AGP865. CME/MOC/AAPA credit will be available until March 7, 2025.Overcoming Challenges in the Treatment of Pediatric and Adult Patients With Uncontrolled Moderate to Severe Asthma: Comparing Approaches to the Use of Targeted Biologic Therapy With Experts Around the World In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerLeonard B. Bacharier, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Aravax; AstraZeneca; Avillion LLP; DBV Technologies; GlaxoSmithKline; Kinaset Therapeutics; Regeneron Pharmaceuticals Inc.; Sanofi; and Vertex Pharmaceuticals Incorporated.Speaker for Regeneron Pharmaceuticals Inc. and Sanofi.Other Financial or Material Support for Patents and Royalties from Elsevier.Faculty/PlannerKlaus F. Rabe, MD, PhD, FERS, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; CSL Behring; Regeneron Pharmaceuticals Inc.; and Sanofi.Speakers Bureau participant with AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; The Menarini Group; Regeneron Pharmaceuticals Inc.; and Sanofi.PresenterArzu Yorgancioglu, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abdi İbrahim; AstraZeneca; CHIESI USA, Inc.; and GlaxoSmithKline.Grant/Research Support from Sanofi.Speaker for Abdi İbrahim; AstraZeneca; Bilim Pharmaceuticals; CHIESI USA, Inc.; GlaxoSmithKline; and Novartis Pharmaceuticals Corporation.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/AGP865. CME/MOC/AAPA credit will be available until March 7, 2025.Overcoming Challenges in the Treatment of Pediatric and Adult Patients With Uncontrolled Moderate to Severe Asthma: Comparing Approaches to the Use of Targeted Biologic Therapy With Experts Around the World In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Sanofi and Regeneron Pharmaceuticals.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerLeonard B. Bacharier, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Aravax; AstraZeneca; Avillion LLP; DBV Technologies; GlaxoSmithKline; Kinaset Therapeutics; Regeneron Pharmaceuticals Inc.; Sanofi; and Vertex Pharmaceuticals Incorporated.Speaker for Regeneron Pharmaceuticals Inc. and Sanofi.Other Financial or Material Support for Patents and Royalties from Elsevier.Faculty/PlannerKlaus F. Rabe, MD, PhD, FERS, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; CSL Behring; Regeneron Pharmaceuticals Inc.; and Sanofi.Speakers Bureau participant with AstraZeneca; BERLIN-CHEMIE AG; Boehringer Ingelheim International GmbH; CHIESI USA, Inc.; The Menarini Group; Regeneron Pharmaceuticals Inc.; and Sanofi.PresenterArzu Yorgancioglu, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abdi İbrahim; AstraZeneca; CHIESI USA, Inc.; and GlaxoSmithKline.Grant/Research Support from Sanofi.Speaker for Abdi İbrahim; AstraZeneca; Bilim Pharmaceuticals; CHIESI USA, Inc.; GlaxoSmithKline; and Novartis Pharmaceuticals Corporation.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

Certified Child Life Specialist, Jessica Lewin, talks with friend and CCLS, Shira Miller, about her almost 2 decades of experience working within the same hospital, moving up the clinical ladder and creating the COAST (Children of Adults Support Team) Program.COAST program and the ways in which child life services have evolved to support not just end-of-life situations but the entire spectrum of a parent's health challenges is a remarkable example of how child life can expand within the hospital setting.Shira takes us through the development of a dedicated team to address the emotional demands of this work, safeguarding against burnout and ensuring that both families and specialists are well-cared for. This proactive and holistic approach to family support, stresses the importance of clear communication and the dedication of the COAST team to foster resilience in the midst of adversity.Shira has so much to share in her passion for educating staff on the important principles and best practices that is child life. Rather than get defensive, seeing a child be put in a comfort position before she enters the room, it tells her that the staff is learning developmentally appropriate care and for that she is grateful. Child life is essential, but is not typically available 24/7. In order for patients and families to continue to get the best care possible, it's imperative that we not hold our services to a higher than thou mentality. We must share what we know in order to provide outstanding patient care.  Tune in to this episode for a deep and inspiring look at the transformative power of empathy and expertise in the midst of healthcare challenges.You can follow Shira on Instagram at @shiramiller81.Track: Odessa — LiQWYD & Scandinavianz [Audio Library Release]Music provided by Audio Library PlusWatch: https://youtu.be/jNy-Dp3lgcgFree Download / Stream: https://alplus.io/odessa

In this episode, Dr. Zanotti is joined by Dr. Eddy Fan for a discussion about Respiratory Support in ARDS. Dr. Fan is an associate professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management, and Evaluation at the University of Toronto. He is also a staff intensivist at the University Health Network/Mount Sinai Hospital. Dr. Fan is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital and the Director of Critical Care Research at the University Health Network/Mount Sinai Hospital. Dr. Fan's research has focused on advanced life support for acute respiratory failure and patient outcomes from critical illness. He is a co-author of the ESICM ARDS Clinical Guidelines. Additional Resources: ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping, and respiratory support strategies. Intensive Care Med 2023: https://pubmed.ncbi.nlm.nih.gov/37326646/ An Update on Management of Adult Patients with ARDS. Official ATS Clinical Practice Guideline. Am J Respir Crit Care Med 2024; https://www.atsjournals.org/doi/full/10.1164/rccm.202311-2011ST Prone Positioning in Severe Acute Respiratory Distress Syndrome. PROSEVA Clinical Trial. N Engl J of Med 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214103 Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. The EOLIA Trial. N Eng J of Med 2018: https://www.nejm.org/doi/full/10.1056/NEJMoa1800385 Books mentioned in this episode: A Portrait of the Artist as a Young Man. By James Joyce: https://bit.ly/49kzmtn

Tune in for an installment of my gut health Q&A, where I answer your questions about all things gut health. This installment is a probiotic edition, where I'll touch on probiotic foods, dosing, side effects, and talk about whether the hype around Akkermansia is warranted. Be sure to tune in!  And if you have any questions you would like answered in a future installment, let me know in the comments!   Watch/Read Next… How Often to Take Probiotics and Other Probiotic Basics: https://drruscio.com/how-often-to-take-probiotics/  The Best Probiotic Protocol? The “Triple Therapy” Approach: https://drruscio.com/triple-therapy-probiotic-protocol/  A Review of Probiotic Research (2023): https://drruscio.com/probiotics-research-updates-2023/  SIBO, Probiotics, and Your Gut Health: A Long-Term Strategy: https://drruscio.com/sibo-probiotics/    Timestamps 00:00 Intro 01:27 Is Akkermansia hype warranted?  11:24 What are the best probiotics for IBS?  18:20 How long should I take probiotics?  22:00 Can probiotic foods be enough?  26:06 What if probiotics make symptoms worse?  29:04 Probiotics with histamine intolerance? 33:21 Are lacto-bifido probiotics actually bad for SIBO?   Featured Studies  Akkermansia muciniphila secretes a glucagon-like peptide-1-inducing protein that improves glucose homeostasis and ameliorates metabolic disease in mice: https://pubmed.ncbi.nlm.nih.gov/33820962/  The role of Akkermansia muciniphila in IBD: https://pubmed.ncbi.nlm.nih.gov/36685588/  Strategies to promote abundance of Akkermansia muciniphila, an emerging probiotics in the gut, evidence from dietary intervention studies: https://pubmed.ncbi.nlm.nih.gov/30416539/  Regulation of gut microbiome by ketogenic diet in neurodegenerative diseases: https://pubmed.ncbi.nlm.nih.gov/36313018/  Triggering Akkermansia with dietary polyphenols: A new weapon to combat the metabolic syndrome? : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856456/  Akkermansia muciniphila abundance is lower in severe obesity, but its increased level after bariatric surgery is not associated with metabolic health improvement: https://pubmed.ncbi.nlm.nih.gov/31265324/  Decreased Abundance of Akkermansia muciniphila Leads to the Impairment of Insulin Secretion and Glucose Homeostasis in Lean Type 2 Diabetes: https://pubmed.ncbi.nlm.nih.gov/34085773/  Outcome-Specific Efficacy of Different Probiotic Strains and Mixtures in IBS: https://pubmed.ncbi.nlm.nih.gov/37686889/  The Efficacy and Safety of Single-Strain Probiotic Formulations Containing Bifidobacterium lactis or Bacillus coagulans in Adult Patients with IBS: https://pubmed.ncbi.nlm.nih.gov/37510953/  A combination of rifaximin and neomycin is most effective in treating IBS patients with methane on lactulose breath test: https://pubmed.ncbi.nlm.nih.gov/19996983/  Probiotics for Preventing and Treating SIBO: https://pubmed.ncbi.nlm.nih.gov/28267052/  The effect of multistrain probiotics on functional constipation in the elderly: https://pubmed.ncbi.nlm.nih.gov/35927504/  Probiotic supplementation improved cognitive function in cognitively impaired and healthy older adults: https://pubmed.ncbi.nlm.nih.gov/36529793/  Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation - a pilot study: https://pubmed.ncbi.nlm.nih.gov/30256365/  Fermented Foods: Definitions and Characteristics, Impact on the Gut Microbiota and Effects on Gastrointestinal Health and Disease: https://pubmed.ncbi.nlm.nih.gov/31387262/  Effects of kefir or milk supplementation on zonulin in overweight subjects: https://pubmed.ncbi.nlm.nih.gov/32171508/  Fermented dairy foods consumption and depressive symptoms: https://pubmed.ncbi.nlm.nih.gov/36745637/  Role of Probiotics in Patients with Allergic Rhinitis: https://pubmed.ncbi.nlm.nih.gov/36405454/ , Effect and safety of probiotics for treating urticaria: https://pubmed.ncbi.nlm.nih.gov/37221968/  The Effectiveness of Probiotics in Treating Food and Cow's Milk Allergies among Pediatric Age Groups: https://pubmed.ncbi.nlm.nih.gov/37496406/  Effect of a Preparation of Four Probiotics on Symptoms of Patients with IBS: Association with Intestinal Bacterial Overgrowth: https://pubmed.ncbi.nlm.nih.gov/29508268/     Get the Latest Updates Facebook - https://www.facebook.com/DrRusciodc Instagram - https://www.instagram.com/drrusciodc/ Pinterest - https://www.pinterest.com/drmichaelrusciodc    DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Music featured in this video: "Modern Technology" by Andrew G, https://audiojungle.net/user/andrew_g  *Full transcript available on YouTube by clicking the “Show transcript” button on the bottom right of the video.

A check-in on COVID, flu and RSV cases, and an overview of new COVID and Long Covid studies. AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, reports that the tripledemic wave is declining, but vaccination levels for COVID, flu and RSV among adults are still low. Plus, continued supply issues for the RSV vaccine for children, administration errors for the RSV vaccine, and two new studies that could inform future treatments for COVID and Long COVID. American Medical Association CXO Todd Unger hosts.

New research doesn't just tell us that probiotics improve leaky gut, candida, and IBS, it tells us how.  Join me to unpack the exciting findings behind probiotics for leaky gut, candida, and IBS, and a protocol you can use at home to help find relief.  And if you have any additional questions you would like answered in the future, let me know in the comments!   Watch/Read Next… Create a Leaky Gut Diet Plan: https://drruscio.com/?p=56263  How to Spot Leaky Gut: https://www.youtube.com/watch?v=7QER7XXJ5CM&t=3s What's the Strongest Candida Killer?: https://drruscio.com/strongest-candida-killer/  What is IBS? https://drruscio.com/what-is-ibs  How to Relieve the Symptoms of IBS Attacks: https://drruscio.com/stop-the-struggle-how-to-relieve-the-symptoms-of-ibs-attacks/    Timestamps 00:00 Intro  01:58 Impressive vaginal candida effectiveness  04:51 Gastrointestinal candida findings  05:56 Remarkable leaky gut results  10:04 Positive impacts to IBS symptoms  18:04 Where probiotics made no difference  19:58 Do different probiotics have different benefits?  22:46 The most effective probiotics for IBS 23:40 Research-based probiotic protocol    Featured Studies  Comparing the Effect of Probiotic and Fluconazole on Treatment and Recurrence of Vulvovaginal Candidiasis: a Triple-Blinded Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/36198994/ Probiotics Prevent Candida Colonization and Invasive Fungal Sepsis in Preterm Neonates: A Systematic Review and Meta-Analysis of Randomized Controlled Trials: https://pubmed.ncbi.nlm.nih.gov/27793494/ Candida albicans- The Virulence Factors and Clinical Manifestations of Infection: https://pubmed.ncbi.nlm.nih.gov/33499276/ Effect of a Multistrain Probiotic on Leaky Gut in Patients with Diarrhea-Predominant Irritable Bowel Syndrome: A Pilot Study: https://pubmed.ncbi.nlm.nih.gov/36007493/ Probiotics fortify intestinal barrier function: a systematic review and meta-analysis of randomized trials: https://pubmed.ncbi.nlm.nih.gov/37168869/ An 8-Week Course of Bifidobacterium longum 35624® Is Associated with a Reduction in the Symptoms of Irritable Bowel Syndrome: https://pubmed.ncbi.nlm.nih.gov/37702965/ Efficacy and dose response of Lactiplantibacillus plantarum in diarrhea-predominant irritable bowel syndrome: https://pubmed.ncbi.nlm.nih.gov/37576702/ Efficacy and safety of Bifidobacterium quadruple viable tablets combined with mosapride citrate in the treatment of constipation in China: a systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/37464298/ Evaluation of the effects of the FODMAP diet and probiotics on irritable bowel syndrome (IBS) symptoms, quality of life and depression in women with IBS: https://pubmed.ncbi.nlm.nih.gov/37430435/ The Efficacy and Safety of Single-Strain Probiotic Formulations Containing Bifidobacterium lactis or Bacillus coagulans in Adult Patients with Irritable Bowel Syndrome-A Randomized Double-Blind Placebo-Controlled Three-Arm Interventional Trial: https://pubmed.ncbi.nlm.nih.gov/37510953/ Outcome-Specific Efficacy of Different Probiotic Strains and Mixtures in Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis: https://pubmed.ncbi.nlm.nih.gov/37686889/    Get the Latest Updates Facebook - https://www.facebook.com/DrRusciodc Instagram - https://www.instagram.com/drrusciodc/ Pinterest - https://www.pinterest.com/drmichaelrusciodc    DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Music featured in this video: "Modern Technology" by Andrew G, https://audiojungle.net/user/andrew_g  *Full transcript available on YouTube by clicking the “Show transcript” button on the bottom right of the video. Click here to apply for our YouTube Channel & Podcast Manager position. https://drruscio.bamboohr.com/careers/71?source=aWQ9MjE%3D 

Listen to a soundcast of the November 27, 2023 FDA approval of OGSIVEO (nirogacestat) for adult patients with progressing desmoid tumors who require systemic treatment.

FDA D.I.S.C.O. Burst Edition: FDA approval of Fruzaqla (fruquintinib) for adult patients with metastatic colorectal cancer

In this episode, we discuss the evaluation of fever in the adult ICU patient. We discuss updates from the recently published Society of Critical Care Medicine and Infectious Diseases Society of America clinical guidelines. My guest is Dr. Andre Kalil, a critical care and infectious disease physician. Dr. Kalil is a Professor in the Division of Infectious Disease and Director of Transplant Infectious Disease at the University of Nebraska Medical Center (UNMC). A renowned clinician, educator, and researcher, Dr. Kalil has received many distinctions, including the 2021 Scientist Laureate Award at UNMC. Dr. Kalil is an author of the 2023 Society of Critical Care Medicine and The Infectious Disease Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU.

Many patients in intensive care develop delirium and there are several Cochrane reviews of ways to treat it. In November 2023, we added a review on the reliability of the confusion assessment method for diagnosing it and asked lead author, Fabian Miranda from the Universidad de Chile in Santiago, to tell us about the topic and the review's findings in this podcast.

Many patients in intensive care develop delirium and there are several Cochrane reviews of ways to treat it. In November 2023, we added a review on the reliability of the confusion assessment method for diagnosing it and asked lead author, Fabian Miranda from the Universidad de Chile in Santiago, to tell us about the topic and the review's findings in this podcast.

Dr. Evan Katz is a practicing chiropractor in Boulder, Colorado. He practices the Chiropractic Biophysics Approach (CBP), and has participated in an published multiple research articles in the chiropractic field. Today we discuss one of his most recent publications, "Non-Surgical Management of Upper Cervical Instability via Improved Cervical Lordosis: A Case Series of Adult Patients" In this episode, we discuss: how UCI is measured radiographically static vs. dynamic imaging of the upper cervical spine the relationship between the cervical lordosis and upper cervical instability outcomes of the study an evidence informed model of subluxation care and more. Check out Professionally Integrated to access Dr. Katz's full library of research articles, references, and professional development resources. https://professionallyintegrated.com/ References mentioned in the show: (click for full text downloads) Non-Surgical Management of Upper Cervical Instability via Improved Cervical Lordosis: A Case Series of Adult Patients Diagnostic Accuracy of Videofluoroscopy for Symptomatic Cervical Spine Injury Following Whiplash Trauma Translational and Rotational Postural Aberrations Are Related to Pulmonary Functions and Skill-Related Physical Fitness Components in Collegiate Athletes Click here for the rapid research review episode discussing this last article: Postural distortions, cardiopulmonary function, and athletic performance - Rapid Research Review

Join endocrine experts Ricardo Correa, MD, FACP, FACMQ, FAPCR, FACE; Rajesh Garg, MD, PhD; and Geetha Gopalakrishnan, MD, FACE, as they share valuable tips and success stories on how to talk to patients with diabetes about the importance of vaccinations in diabetes management. Key topics include strategies for addressing barriers in workflows, differences in cultural norms and vaccine hesitancy. AACE endocrine experts share available patient resources along with a wealth of information aimed at enhancing your interactions with patients. 

CHEST October 2023, Volume 164, Issue 4 Praleene Sivapalan, MD, joins CHEST Podcast Moderator, Dominique Pepper, MD, to discuss IV fluid management in sepsis. DOI: https://doi.org/10.1016/j.chest.2023.04.036   Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine.

PT, PTA, OT, OTA – this podcast may help you meet your continuing education requirements. Access Relias Academy to review course certificate information.    Older adult patients in all rehabilitation settings are chronically under-dosed when it comes to the intensity of rehabilitation therapy. In this episode, we talk with Aimee Perron, a physical therapist, patient advocate, and national presenter, about best practices in prescribing exercise to improve strength, balance, endurance, and aerobic capacity in our older adult clients. How are we doing? Click here to give us feedback  (01:38) Takeaways From Today's Discussion  (02:56) Key to Dosing Appropriately: The FITT-VP Principle  (06:44) Underdosing and Possible Reasons  (12:39) Is My Patient Ready to Start Exercising? How Do I Know?  (13:16) Tests and Measures  (18:51) One Repetition Maximum: Example  (25:16) Matching Interventions to Meaningful Activities  (29:39) Identifying Readiness to Change  (31:28) Health Confidence and Chronic Conditions  (37:35) Everyday Tools and Equipment Considerations  (41:23) Am I Too Eager and Overdosing My Patients? How Do I Know?  (43:49) Supporting Patients in the Maintenance Phase  (46:57) Nutrition and Medication Considerations  (49:22) Conclusion   The content for this course was created by Aimee E. Perron, PT, DPT.  This course was created by Wendy Phillips, PT, BSPT. Here is how Relias can help you earn continuing education credits:  Access your Relias Library offered by your employer to see course certificate information and exam;   or   Access the continuing education library for clinicians at Relias Academy. Review the course certificate information, and if eligible, you can purchase the course to access the course exam and receive your certificate.  Learn more about Relias at www.relias.com.    Legal Disclaimer: The content of Stretch: Relias Rehab Therapy Education is provided only for educational and training purposes for healthcare professionals. The educational material provided in this podcast should not be used as medical advice to treat any medical condition in either yourself or others.  Resources  American College of Sports Medicine's Recommendations for Exercise Participation Health Screening: https://www.acsm.org/docs/default-source/files-for-resource-library/updating_acsm_s_recommendations_for_exercise-28-(1).pdf?sfvrsn=3aa47c01_4  American Physical Therapy Association: Choosing Wisely: https://www.choosingwisely.org/ General Physical Activities Defined by Level of Intensity: https://www.cdc.gov/nccdphp/dnpa/physical/pdf/pa_intensity_table_2_1.pdf Prescription for Health Series (A series of common chronic conditions and their exercise prescriptions): https://www.exerciseismedicine.org/eim-in-action/health-care/resources/rx-for-health-series/  Self-Efficacy for Managing Chronic Disease 6-item Scale: https://selfmanagementresource.com/wp-content/uploads/English_-_self-efficacy_for_managing_chronic_disease_6-item.pdf  Quick Health Check Up: http://www.healthconfidence.org/ 

Dr. Julia Rowland shares the newest evidence-based recommendations from SIO and ASCO on integrative therapies for managing anxiety and depression symptoms in adults with cancer. Listen in to hear recommended options, such as acupuncture, aromatherapy, hypnosis, mindfulness, music therapy, relaxation, reflexology, Tai Chi and/or Qigong, and yoga. Dr. Rowland also discusses therapies the panel investigated but found insufficient evidence to support a recommendation for use in treating anxiety and depression. We also review how this guideline complements the recent ASCO guideline on conventional therapies for managing anxiety and depression, and the impact for patients and clinicians. Read the full guideline, "Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults with Cancer: SIO-ASCO Guideline" at www.asco.org/survivorship-guidelines TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/survivorship-guidelines. Read the full text of the update and review authors' disclosures of potential conflicts of interest disclosures in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.23.00857    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. Julia Rowland from the Smith Center for Healing in the Arts, Co-chair on “Integrative Oncology Care of Anxiety and Depressive Symptoms in Adult Patients with Cancer: Society for Integrative Oncology – American Society of Clinical Oncology Guideline.”  Thank you for being here, Dr. Rowland.   Dr. Julia Rowland: Lovely to be here, Brittany. Thanks for this opportunity.  Brittany Harvey: We're glad to have you on.  Then before we discuss this guideline, I'd just 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 the guest on this episode, are available in line with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes.  So then I'd like to jump into the content of this guideline. So Dr. Rowland, what is the purpose of this joint SIO and ASCO guideline?  Dr. Julia Rowland: The purpose of the joint guideline, Brittany, published in the Journal of Clinical Oncology is to provide evidence-based recommendations to healthcare providers on integrative approaches to managing anxiety and depression symptoms in their adult cancer patients. By integrative approaches, we mean such interventions as yoga, relaxation, hypnosis, mindfulness, acupuncture, music therapy in treating anxiety and depression. Many of these therapies are already being used by people with cancer both during and after their treatment, with rates increasing over time. While use of integrative interventions can serve to improve quality of life, reduce stress, and provide individuals with a sense of control over their health, and they're often reported by patients as doing just that, it's important to note that for the purpose of this guideline, we examine specifically the ability of these interventions to significantly reduce symptoms of anxiety and depression. Brittany Harvey: Great. And then, as you just mentioned, this guideline covers both anxiety and depression. So then I'd like to review the recommendations made by the expert panel and we'll go in order of those. So starting with those recommendations for anxiety, what integrative therapies are recommended for managing symptoms of anxiety experienced after diagnosis or during active treatment?  Dr. Julia Rowland: The strongest recommendations in the guideline are for the use of mindfulness-based interventions, which include mindfulness-based stress reduction, meditation, and mindful movement. These interventions were recommended across the board to treat both anxiety and depression symptoms in patients in active treatment, and those post-treatment due to the strong evidence to show their benefits to patients. Yoga was also recommended for patients with breast cancer to treat both anxiety and depression symptoms, although the strength of the evidence was moderate. Data was less compelling for its use during or after treatment in other cancers, likely due to the lack of small numbers of non-breast cancer survivors included in study samples. There was also evidence for the use of relaxation, music therapy, and reflexology for treating anxiety symptoms during active treatment, and that the use of hypnosis and aromatherapy using inhalation were of modest to some benefit during diagnostic or treatment procedures. Brittany Harvey: Understood. Thank you for reviewing those recommendations. And you already mentioned a few items that are helpful and recommended for adults with cancer experiencing anxiety post-treatment, but which additional integrative therapies are recommended for this patient population?  Dr. Julia Rowland: In addition to mindfulness-based interventions and yoga, acupuncture, Tai Chi, and/or Qigong, and reflexology are recommended for treating anxiety symptoms post-treatment.  Brittany Harvey: Excellent. Thank you for that summary of recommendations. So then, moving into the recommendations on depression, what does the expert panel recommend for adults with cancer experiencing symptoms of depression?  Dr. Julia Rowland: For depression symptoms during treatment, the panel recommended mindfulness-based interventions, yoga, music therapy, relaxation, and reflexology, while post-treatment mindfulness-based interventions, yoga, and Tai Chi or Qigong were recommended.  Brittany Harvey: Excellent. Thank you for reviewing all the recommendations that the panel put forward. So this guideline reviewed a large breadth of integrative therapies. Are there any therapies that the panel reviewed but couldn't make a recommendation for, for this particular guideline?  Dr. Julia Rowland: Thank you for asking that question because as people listen to this podcast, they may realize that there are some therapies that may be widely used by their population or in their center or clinic, including such things as natural products and supplements, melatonin, healing touch, massage, light therapy, to name a few. Where the panel found in its review of the literature of over 110 studies or systematic reviews, there was insufficient evidence for the vast majority of these to make any conclusive recommendation. It just means we have a lot more work to do in assessing the efficacy of these, especially in treating anxiety and depression.  One intervention stands out in particular that's widely used and that's expressive writing. While this may be very helpful for improving quality of life or making sense of the cancer experience and providing an outlet for self-expression, the data does not support its use for treating anxiety and depression. It may be because it's too brief an intervention for conditions that have more depth and permanence. It doesn't mean you can't use it for other purposes, but the panel did not recommend its use for treating anxiety and depression. Brittany Harvey: Understood. That makes sense that there are some integrative therapies that work across different parts of the treatment spectrum and that there are some areas in which we just don't have the evidence yet. So, thank you for reviewing all of those recommendations.  So then, how does this guideline complement the recently published ASCO Guideline on the Management of Anxiety and Depression in Adult Survivors of Cancer?  Dr. Julia Rowland: That's a terrific question. The recently published ASCO Guideline on Management of Anxiety and Depression in Adult Cancer Survivors represents an update of our original 2014 guideline. The ASCO guideline provided recommendations regarding the use of conventional therapies, psychological, behavioral, and psychopharmacologic interventions for managing anxiety and depression. The current SIO and ASCO guidelines sought to expand upon and essentially complement these recommendations by identifying those integrative therapies that might also be effective in the management of anxiety and depression in adults treated for cancer. Further, the SIO and ASCO guidelines attempted to determine when, in the course of care, during diagnosis and active treatment and/or post-treatment, these interventions worked best. Both sets of recommendations strongly endorse the benefits of mind-body interventions in addressing both anxiety and depression, specifically mindfulness-based interventions in this SIO and ASCO guideline and cognitive, behavioral, behavioral activation, and mindfulness-based stress management programs in the ASCO guideline. Brittany Harvey: It's great to have these complementary guidelines available at the same time for a complete approach to managing anxiety and depression during treatment and post-treatment. So then, in your view, Dr. Rowland, what is the importance of this guideline and how will it impact clinicians and patients with symptoms of anxiety and/or depression? Dr. Julia Rowland: Brittany, cancer takes a significant psychological toll on affected individuals. Research has shown that cancer survivors have a significantly elevated risk of developing mental health disorders compared with the general population. Despite this, their psychological symptoms are often under-recognized and undertreated. As the number of cancer survivors continues to grow, so does the challenge to healthcare providers of meeting their mental health needs. Anxiety and depression symptoms have long been associated with lower quality of life and higher mortality in people with cancer. Treating symptoms of anxiety and depression using evidence-based, integrative therapies has the potential to not only improve patients' quality of life and help them better manage their care but may also improve length of life.  With the publication of this guideline, we now know which therapies could have the biggest impact. An added benefit of incorporating, or at least considering, integrative therapies to manage anxiety and depression are that they have few, if any, side effects, can be readily modified to accommodate individuals with multiple comorbidities, are well received by the majority of patients, and can be received in a variety of settings, including at home and online. Brittany Harvey: Those are key points that you just made. These recommendations are key for improving quality of life for patients, and it's great to have options for patients, including, as you mentioned, at home.   So then finally, what are the outstanding questions for the use of integrative approaches in managing anxiety and depression in patients with cancer? Dr. Julia Rowland: As I look at these new guidelines, both the SIO and ASCO, as well as the renewed ASCO guidelines, perhaps the biggest question raised is how to increase the use of recommended care. And I think there are three parts to this challenge. One critical first part is raising awareness about these guidelines, which it's hoped this podcast will help us achieve. A second, equally critical step, however, is identifying available treatment resources. While most treatment clinics and centers have access to mental health resources in a number of settings, this may be quite limited. Further, it's not clear how many such programs include integrative programs and services.  In addition to the questions about availability, lack of familiarity with some of these therapeutic modalities may leave clinicians reluctant to refer their patients for such care and raise questions for them about how to assess the training and qualifications of integrative care providers and the rigor of the therapy they provide. An important recommendation made by both ASCO and the SIO and ASCO Anxiety and Depression Management Guideline panels is that oncology clinicians should conduct a landscape analysis of who is and what types of programs are available to provide the recommended therapies to their patients. Arguably, not knowing where to refer a patient suffering from anxiety and depression is the most significant area to that patient's receipt of optimal care. The landscape review should include in-house or affiliated mental health providers, integrative program leads if present, local professionals, and organizations offering this care, as well as access to community-wide and national groups providing integrative care remotely via online and telephone. Asking patients themselves who they have seen and found helpful in improving their emotional well-being can also broaden resource lists generated.   A third challenge is how best to identify and refer those patients most in need. Recommendations regarding screening and assessment of anxiety and depression were not within the scope of the SIO and ASCO guidelines. However, in the two published ASCO Guidelines on use of conventional interventions for managing anxiety and depression, both the 2014 original and the updated 2023 revised, the expert panels emphasize the critical need to routinely screen for both anxiety and depression using standardized measures such as the GAD-7 and the PHQ-9.  ASCO's QOPI or Quality Oncology Practice Initiative already includes screening for emotional distress early in the course of care as a key practice standard. Other appropriate times for screening include changes in disease or treatment status, transition to palliative and end-of-life care, and when clinically indicated. Screening is the critical and necessary first step to identification and referral for appropriate and timely care of cancer patients and survivors suffering from anxiety and depression. Figuring out how to do this well and systematically should be a priority for reducing the burden of cancer nationally. Brittany Harvey: Absolutely. As you mentioned, screening is critical for identifying patients experiencing anxiety and depression, and I appreciate you reviewing those implementation barriers and how clinicians and practices can work to reduce these barriers and increase the uptake of these recommendations. We'll have some of those resources linked in the guideline also on the ASCO website and in the show notes of this episode.  So I want to thank you so much for your insights on this guideline and for your time today, Dr. Rowland. Dr. Julia Rowland: My pleasure, Brittany. I hope the word gets out and we'll see more uptake of these affected therapies and in broader use. Thank you.  Brittany Harvey: Definitely. That's the goal of all of these guidelines.  I also want to thank all of our listeners for tuning into the ASCO Guidelines Podcast. To read the full guideline, go to www.asco.org/survivorship-guidelines.  You can also find many of our guidelines and interactive resources in the newly redesigned ASCO Guidelines app available for free in the Apple App Store or the Google Play Store. If you have 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 medical 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, we will discuss prone position ventilation in adult respiratory distress syndrome (ARDS). Despite clinical trials demonstrating a benefit on mortality, the adoption of prone position ventilation has been challenging. We will discuss the impact the COVID-19 pandemic had on the use of prone position ventilation and lessons learned that can help increase the proper use of this treatment modality moving forward. Our guest is Dr. Chad Hochberg, a member of the Division of Pulmonary and Critical Care Medicine, Department of Medicine, at John Hopkins University Medical School in Baltimore, Maryland. Additional Resources Factors Influencing the Implementation of Prone Positioning during the COVID-19 Pandemic. Hochberg C, et al. Ann Am Thorac Soc, 2023; https://pubmed.ncbi.nlm.nih.gov/35947776/ Declining Use of Prone Positioning After High Initial Uptake in COVID-19 Adult Respiratory Distress Syndrome. Hochberg C, et al. Crit Care Med 2023: https://pubmed.ncbi.nlm.nih.gov/37294144/ ESICM Guidelines on ARDS 2023. Intensive Care Medicine 2023: https://link.springer.com/article/10.1007/s00134-023-07050-7 ATS/ESICM/SCCM Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome: https://www.atsjournals.org/doi/10.1164/rccm.201703-0548S Prone Position for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Munshi L, et al. Ann Am Thorac Soc 2017: https://pubmed.ncbi.nlm.nih.gov/29068269/ Prone Positioning in Severe Acute Respiratory Distress Syndrome. Guerin C. Et al. PROSEVA Trial. New Eng J Med 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214103 Books Mentioned in this Episodes The Omnivore's Dilemma: A Natural History of Four Meals, By Michael Pollan: https://bit.ly/42FpndS

Cannabis use among seniors is on the rise, but so are visits to the emergency department as a result. Joining to discuss the risks of cannabis for seniors and how doctors can talk to their older patients about them is Alison Moore, MD, MPH, professor and chief of geriatrics, gerontology and palliative care at the University of California San Diego. American Medical Association CXO Todd Unger hosts.