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In this week's episode, both of our storytellers discover shocking truths through genetic analysis. Part 1: When Mackenzie Brown's adoptive father passes away suddenly from a heart condition, she is determined to find out what genes she did inherit. Part 2: Martha Buford Reiskind thought the case of her mom's murder was closed when no DNA match came up for the single piece of hair left at the scene. Mackenzie Brown grew up in Charlotte, North Carolina and graduated with a Masters of Public Health from the Brody School of Medicine at East Carolina University. Her graduate research focused on understanding how depressive symptoms impact disease management strategies in people with hypertension in the rural South. After a year of collecting data across the country as a Research Fellow with Stanford University, she moved to New York and worked as a Research Coordinator conducting behavioral interventions for individuals with rheumatic diseases. Now at DAC, she is interested in pursuing a PhD to explore how early birth trauma and premature birth can impact mental health across the lifespan. Martha Buford Reiskind started her undergraduate career as a theater arts and music major at a small liberal arts school in Bronxville NY, Sarah Lawrence College. At the time there were only 1,200 students and it had only recently become a coed school. After several years in what she likes to call her Liberal Arts Tour, she finished up her undergraduate work at University of California Berkeley, in Integrative Sciences. She started her Faculty Position at NC State in 2012 and conducts research in conservation genetics and teaches courses in population genetics, conservation science, science communication and science ethics. She is also a sister, daughter, wife, auntie, and mother and love those roles as much as the research and teaching she does. She directs a first-year graduate training program at NC State, the Genetics & Genomics Scholars program, and graduate training and education is one of her passions. She seeks out opportunities to combine the arts and sciences and help her students develop effective science communication, both visual and oral. You can find her near or in the water or with her hands in soil or dough. Learn more about your ad choices. Visit megaphone.fm/adchoices
On today's episode, meet Dr. Ronny Bell, the Fred Eshelman Professor and Chair of the Division of Pharmaceutical Outcomes and Policy at the Eshelman School of Pharmacy at UNC Chapel Hill. Dr. Bell received his undergraduate degree in Public Health Nutrition from the University of North Carolina at Chapel Hill School of Public Health and his Master's and Doctorate in Foods and Nutrition from the University of North Carolina at Greensboro. Dr. Bell completed a post-doctoral fellowship in Gerontology and completed a Master's in Epidemiology from the Wake Forest School of Medicine. From 1996 – 2016, Dr. Bell was a member of the faculty in the Department of Epidemiology at Wake Forest, and from 2006 – 2016, he served as Director of the Maya Angelou Center for Health Equity. From 2016 – 2020, Dr. Bell served as Chair of the Department of Public Health in the Brody School of Medicine at East Carolina University. Dr. Bell is an enrolled member of the Lumbee tribe of eastern North Carolina, and currently serves a Chair of the North Carolina American Indian Health Board. He also serves as co-lead the Southeastern American Indian Cancer Health Equity Partnership (SAICEP). Among his awards and honors, Dr. Bell was most recently appointed to U.S. Department of Health and Human Services Advisory Committee on Minority Health (2024).
Tenured professor, Kendall M. Campbell, MD, conveys his passion for academic family medicine via discovery, innovation, defining a problem, and finding a solution. Dr Campbell shows listeners how a career in academic family medicine begins when you find an idea in your own backyard and then continue moving forward with a mentor. He then discusses promotion through the ranks of academic family medicine for both academicians and community faculty. Hosted by Saria Saccocio, MD, MHA, FAAFPCopyright © Society of Teachers of Family Medicine, 2023Resources:STFM's Leadership through Scholarship FellowshipSTFM's URM Mentorship ProgramSubmit It Again! Learning From Rejected ManuscriptsReleasing the Net to Promote Minority Faculty Success in Academic MedicineURM JAM Podcast: Know Your Worth During Contract Negotiations with Kendall Campbell, MDNegotiation in Academic Medicine: A Necessary Career SkillNegotiation in Academic Medicine: Narratives of Faculty Researchers and Their MentorsGuest Bio:Kendall M. Campbell, MD, is Professor and Chair of the Department of Family Medicine at the University of Texas Medical Branch (UTMB), in Galveston, Texas. He is the Sealy Hutchings and Lucille Wright Hutchings Chair in Family Medicine.Dr. Campbell came to UTMB from the Brody School of Medicine at East Carolina University where he served as a tenured Associate Professor of Family Medicine, Senior Associate Dean for Academic Affairs, and Director of the Research Group for Underrepresented Minorities in Academic Medicine. Previous academic appointments have been at the University of Florida (UF) and Florida State University (FSU). His clinical interests have been for underserved patients for which he has developed medication access initiatives, integrated pharmacy and social services with primary care and led community health education initiatives. While at FSU, he Co-founded and Co-Directed the Center for Underrepresented Minorities in Academic Medicine with Dr. José E. Rodríguez to study issues that impact recruitment and retention of faculty underrepresented in medicine.Dr. Campbell is nationally recognized for his work in primary care and in support of underrepresented learners and faculty. He has received honors and awards for his service to the field of medicine including the Martin Luther King, Jr. Distinguished Service Award, the Exemplary Teacher Award, and the 2021 STFM President's Award. He was a 2014-2016 Fellow of the National Academy of Medicine and is a member of the NAM Roundtable on Health Equity. He also completed the AAMC Leadership Education and Development (LEAD) certificate program.www.stfm.org/stfmpodcast112023
Dr. Karlene Cunningham is a health psychologist and clinical associate professor in the Department of Psychiatry and Behavioral Medicine at Brody School of Medicine. In the department, she wears several hats, including being the interim co-director of the Behavioral Medicine Division, the vice chair of diversity inclusion for the department, and the chair for all of the departments at the School of Medicine. But her passion lies in her work of directing the SHARE2 Lab, which stands for Sexual Health And Reproductive Equity Engagement Lab. Her lab is where she uses a reproductive justice lens to conceptualize the gaps in perinatal mental health research, trains healthcare learners to center patient needs, and works toward improving systems/structures that care for birthing people, especially those who are birthing in rural contexts.She is also an alumnus of our Get That Grant® coaching program!Listen in to learn more about Karlene's journey into coaching and the profound shift she experienced through our Get That Grant® coaching program:Recognizing the power of language and framing in academic researchApproaching the struggle of overworking as a trauma responseHow she personally internalized rest as a form of resistance and empowermentThe tangible impact of isolation on her career and the importance of finding the right communityThe value of taking one's time and savoring the content while embarking on the journey of transformation through coachingLoved this convo? You can find more information about Dr. Karlene Cunningham and her important work on her lab's website, https://www.share2lab.com. Also, please go find Dr. Cunningham on Twitter @DrKarleneCunni1 and show her some love!And if you'd like to learn more foundational career navigation concepts for women of color in academic medicine and public health, sign up for our KD Coaching Foundations Series: www.kemidoll.com/foundations.
Dr. Laura Matarese, PhD, RDN, LDN, FADA, FASPEN, FAND is a Professor of Medicine in the Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine and Adjunct Professor of Surgery at the Brody School of Medicine at East Carolina University in Greenville, NC. She has over 40 years of experience in nutrition support and gastrointestinal nutrition, and is the author of numerous manuscripts, abstracts, chapters and books, including the new second edition of The Health Professionals Guide to Gastrointestinal Nutrition. Dr. Matarese currently serves on the editorial boards of several journals, has lectured extensively, both nationally and internationally, and has held numerous positions within the Academy of Nutrition and Dietetics, the Commission on Dietetic Registration, and the American Society for Parenteral and Enteral Nutrition. She is the past president of the National Board of Nutrition Support Certification and currently serves as a Councillor for the Obesity, Metabolism and Nutrition section of the American Gastroenterological Association and on the Board of Advisors of the Oley Foundation. She is the recipient of numerous honors and awards and, prior to joining East Carolina University, held positions at the University of Cincinnati Medical Center, the Cleveland Clinic, and the Starzl Transplant Institute at the University of Pittsburgh. This episode was recorded on 7/18/23 and is hosted by Christina M. Rollins, MBA, MS, RDN, LDN, FAND, CNSC.
Jim Eubanks, MD, is a board-certified physiatrist and newly minted attending at the Medical University of South Carolina Dr. Eubanks graduated from Furman University in Greenville, SC, and received his medical degree from Brody School of Medicine at East Carolina University, graduating with Distinction in Research. He completed his residency in PM&R at the University of Pittsburgh Medical Center (UPMC) where he served as academic chief resident. He subsequently completed a fellowship in spine and musculoskeletal medicine and health policy at UPMC before joining the faculty at MUSC as an Assistant Professor. Dr. Eubanks also has a Master of Science (MS) in sports science and rehabilitation. Dr. Eubanks has presented nationally and internationally on a number of topics related to spine care, and serves on the Editorial Board of PM&R, the official scientific journal of the American Academy of Physical Medicine and Rehabilitation (AAPM&R). He serves on AAPM&R's Innovative Payment and Practice Models committee, and is currently involved in leadership roles at the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) and the North American Spine Society (NASS). He was selected as a 2023 recipient of NASS's "20 under 40" award. Mentioned in the show: Jim on Buddhism Biopsychosocial model UPMC Value-Based Fellowship in Spine and MSK Built to Move by Kelly and Juliette Starrett Gabapentin Spinal Manipulation Social media: Jim Eubanks Twitter Jim Eubanks Instagram
Dr. John Bream, a product of ECU's Brody School of Medicine, joins Dave Richmond to discuss the decision to close Martin General Hospital in Williamston, NC, the strain it will place on the infrastructure of EMS and local health systems and solutions to re-open the hospital. We will take your questions and comments! We would really appreciate if you SUBSCRIBE to our YOUTUBE Channel and click the notification bell / all...... --- Support this podcast: https://podcasters.spotify.com/pod/show/thesportsobj/support
Dr. John Bream, a product of ECU's Brody School of Medicine, joins Dave Richmond to discuss the decision to close Martin General Hospital in Williamston, NC, the strain it will place on the infrastructure of EMS and local health systems and solutions to re-open the hospital. We will take your questions and comments! We would really appreciate if you SUBSCRIBE to our YOUTUBE Channel and click the notification bell / all......
Twenty years ago, health outcomes in Eastern North Carolina lagged behind state averages but those deficits have largely been erased, and Dr. Mike Waldrum, Dean of the Brody School of Medicine at East Carolina University, thinks he knows why. “We've done it primarily with a community-based focus and taking students only from North Carolina that we know have a propensity to want to practice medicine in the environments that we're here to serve. That's kind of our sauce,” he tells host Shiv Gaglani. Building on that approach, the university started a rural residency program in recent years, and out of four graduates in its first cohort, two have agreed to stay in the communities in which they trained. And while that kind of incremental progress on the ground level is important, Dr. Waldrum knows change is needed at the system level as well. Some things ECU Health can do on its own, such as implementing a unified electronic medical record across all of its care sites that allows it to model where health needs are and intervene early. But what he sees as the necessary restructuring of how the healthcare system is organized and financed will take a group effort. “We need Medicare, Medicaid, the insurance industry and others as partners in how we transform the system.” Tune in for a thoughtful look at the challenges of improving healthcare in rural communities, and the special role academic “safety-net” health systems play in that effort. Mentioned in this episode: https://medicine.ecu.edu/
Keeping your liver clean is yet another way to boost your cognitive longevity and enhance the likelihood that your brain stays sharp as long as possible. Though many people pay little attention to the liver and have scant knowledge of what it does, this vital organ performs many critical roles in enabling the body to continue functioning. Most significantly, it rids the bloodstream of harmful toxins. “Your liver is vitally important,” explains Dr. Lisa Broyles. “It removes toxins and chemicals that are dangerous for us from our blood and gets rid of them.” Dr. Broyles, a certified functional medicine doctor who is specially trained in preventing and reversing cognitive decline, says that people should pay attention to the liver and take steps to detoxify the organ if it is struggling to perform its many functions. Among those functions, besides detoxifying the blood stream, are producing and regulating the level of cholesterol, regulating sex hormones, storing sugar when the body needs it, tending to the body's immune health, and guarding against blood clotting. When the liver is having difficulty in its effort to remove bodily toxins, it can lead to such problems as migraine headaches, autoimmune disease, cancer, lupus, and arthritis. The liver must be clean, Dr. Broyles says, if it is to effectively do its job. “I do think that every six months, ideally, everyone should do a liver and gallbladder flush, and followed by some colon hydrotherapy, both before and after,” she recommends. Dr. Broyles says that a number of companies offer liver cleansing approaches and kits. She talks about three phases of liver detoxification - oxidation, conjugation (making toxins more water soluble so they excrete into the intestines and leave the body), and transportation where toxins are broken down (to assure a healthy gallbladder). The food you eat and the medicines and vitamins you take can all enhance — or in some cases hinder — the the way the three phases clean the liver of its toxins. For instance, Tylenol can shut down the process of liver conjugation, according to Dr. Broyles. She points out that genetic make-up also plays a role in liver detoxification; each person is different and testing can help determine the right steps to take in cleaning the liver. ***** Dr. Lisa Broyles, MD, is trained in the Bredesen Protocol, a personalized program to prevent and reverse cognitive decline. It is estimated that nearly 50 million currently living Americans will die of Alzheimer's disease if effective prevention and reversal are not implemented–almost 100 times more than have died of COVID-19. Mainstream medicine would have you believe that it can't be prevented, is untreatable, and progressive, with most patients not surviving beyond three to eleven years post-diagnosis. But we are learning that the disease is a pathology of multiple causes that is preventable and even reversible in the early stages through the kind of holistic and individualized approach prescribed by the Bredesen Protocol. A certified functional medicine doctor with an interest in holistic/integrative medicine, Dr. Broyles is transforming medical care in rural North Carolina. Addressing the underlying causes of disease rather than simply treating symptoms, Dr. Broyles uses a systems-oriented, holistic approach that engages both patient and practitioner in a therapeutic partnership. The result has been a palpable rise in health IQ and wellness in the community she serves. “People are hungry for this kind of patient/physician collaborative care. They want to take charge of their well-being. They want to feel empowered. Too often, though, the insurance system in America limits choices for physicians and patients alike. Functional medicine represents a fundamental paradigm shift from symptom suppression to an integrative body/mind approach to optimal health,” said Dr. Broyles. Hoping to help more people than her limited practice can accommodate, Dr. Broyles is reaching out to her community through the Cutting-Edge Health podcast and other platforms. Having graduated from the Brody School of Medicine at East Carolina University and completed her three-year residency at the University of Tennessee in Knoxville, Dr. Broyles is currently a family practitioner in Saluda, North Carolina. For the past several years, she served patients at urgent care and occupational medicine centers in South Carolina and Tennessee. Prior to this, she was medical director for the East Tennessee Spine and Nerve Center in Chattanooga and the Johnson City Tennessee Downtown Clinic. Dr. Broyles graduated from Brody school of medicine at East Carolina University in Greenville North Carolina and obtained her functional medicine certification from Functional Medicine university in Greer South Carolina. ***** Cutting Edge Health podcast website: https://cuttingedgehealth.com/ Cutting Edge Health Social and YouTube: YouTube channel: youtube.com/@cuttingedgehealthpodcast Instagram - https://instagram.com/cuttingedgehealthpodcast Facebook - https://www.facebook.com/Cutting-Edge-Health-Podcast-with-Jane-Rogers-101036902255756 Please note that the information provided in this show is not medical advice, nor should it be taken or applied as a replacement for medical advice. The Cutting Edge Health podcast, its employees, guests and affiliates assume no liability for the application of the information discussed. Special thanks to Alan, Maria, Louis, and Nicole on the Cutting Edge Health team!
Crystal T. Dixon, MPH, MA is Founder and CEO of Mango Consulting and is an Associate Professor of the Practice, Health and Exercise Science at Wake Forest University. She is someone whose academic research and scholarship explores the intersection of environmental racism, sustainability, and public health. She conferred a Bachelor of Science in Health Education and Promotion, Community Health at East Carolina University then got her Master of Public Health in Health Analysis and Management at The Brody School of Medicine at East Carolina University before working in several roles. She then went on to get a Master of Arts in Sustainability at at Wake Forest University.Crystal on LinkedIn: https://www.linkedin.com/in/crystal-t-dixon-mph-ma-27175532/Full shownotes: https://thephmillennial.com/episode159Support The Public Health Millennial: https://ko-fi.com/thephmillennialChapters:@0:00 Episode Teaser@1:37 Intro@2:16 Crystal Dixon, MPH, MA Intro@3:50 Environmental Racism, Sustainability, & Public Health@7:04 What is Public Health?@7:33 Bachelors Health Education & Promotion at East Carolina University@10:37 Experience during bachelors@15:30 Undergrad takeaways@16:54 Chronic Disease Case Manager at Greene County Health Care Inc@18:22 Master of Public Health at The Brody School of Medicine at East Carolina University@22:08 Experiences during MPH@26:40 MPH Takeaways@30:02 Public Health Education Specialist at Durham County Government@32:48 Adjunct Instructor at NC Central University@34:40 Roles at UNC at Greensboro@38:05 Founder & CEO at Mango Consulting@44:47 Master of Arts in Sustainability at Wake Forest University@50:20 Takeaways from Masters@51:29 Nationally Board Certified Health & Wellness Coach and Training Facilitator@53:30 Community Engagement and Research Support at The Anna Julia Cooper Center@55:42 Associate@58:43 Advice in Teaching@1:02:24 How to get into a sub consulting@1:04:10 Consulting with Robert Wood Johnson Foundation@1:07:37 Future Predictions@1:09:00 The Furious FiveSupport the showThanks for tuning in. Let's all work together towards a culture of health, wellbeing, and equity for all. ⭐⭐ SUBSCRIBE & Leave a 5-STAR REVIEW! ⭐⭐ Follow & Support:- Contribute to the show (one-time or monthly)- The Public Health Millennial on IG - The Public Health Millennial on LinkedIn - The Public Health Millennial Website- Omari Richins, MPH on LinkedIn- Support on The Public Health Store
Most women should consider bioidentical hormone replacement therapy at menopause to increase estrogen production and enhance their health and cognitive functions, according to Dr. Lisa Broyles, a functional medicine doctor. “We can prove that it does improve cognition and lessens the risk of you developing Alzheimer's in the future,” she says. Even prior to menopause, those women who experience symptoms like anxiety, forgetfulness and sleep difficulty should contemplate the hormone therapy, Dr. Broyles suggests. “Studies show the sooner that you start it, the better you're going to do as far as your cognition,” she says. “Women that start it right away when they go through menopause and stay on hormone therapy for those first 10 years, between ages 50 to 60, consistently have less risk of developing Alzheimer's dementia than those that aren't on it at all, or that start it after that 10-year period. She strongly cautions, however, that women focus on bioidentical hormone replacement therapy, or that which is similar to human-grade progesterone. Research two decades ago by the Women's Health Initiative found that some estrogen replacements — particularly those that contained the synthetic progesterone, medroxyprogesterone — diminished cognition and potentially could lead to heart attacks or breast cancer. Dr. Broyles also recommends avoiding oral replacement therapy and advises that all women first consult doctors since individual risk factors must be taken into account prior to initiating the bioidentical hormone replacement therapy. Sections of the brain first impacted by Alzheimer's — including the hypothalamus, the pituitary gland and the forebrain — all have estrogen receptors, Dr. Broyles points out. Estrogen makes blood vessels more pliable and increases the strength of synaptic signals in the brain that allow for neurons to communicate with one another and reproduce more freely. Progesterone to Estrogen Ratio Calculator 10:100 Personally, I've read the ideal is a ratio in this online calculator of 10. https://www.omnicalculator.com/health/pg-e2-ratio ***** Dr. Lisa Broyles, MD, is trained in the Bredesen Protocol, a personalized program to prevent and reverse cognitive decline. It is estimated that nearly 50 million currently living Americans will die of Alzheimer's disease if effective prevention and reversal are not implemented–almost 100 times more than have died of COVID-19. Mainstream medicine would have you believe that it can't be prevented, is untreatable, and progressive, with most patients not surviving beyond three to eleven years post-diagnosis. But we are learning that the disease is a pathology of multiple causes that is preventable and even reversible in the early stages through the kind of holistic and individualized approach prescribed by the Bredesen Protocol. A certified functional medicine doctor with an interest in holistic/integrative medicine, Dr. Broyles is transforming medical care in rural North Carolina. Addressing the underlying causes of disease rather than simply treating symptoms, Dr. Broyles uses a systems-oriented, holistic approach that engages both patient and practitioner in a therapeutic partnership. The result has been a palpable rise in health IQ and wellness in the community she serves. “People are hungry for this kind of patient/physician collaborative care. They want to take charge of their well-being. They want to feel empowered. Too often, though, the insurance system in America limits choices for physicians and patients alike. Functional medicine represents a fundamental paradigm shift from symptom suppression to an integrative body/mind approach to optimal health,” said Dr. Broyles. Hoping to help more people than her limited practice can accommodate, Dr. Broyles is reaching out to her community through the Cutting-Edge Health podcast and other platforms. At the end of each podcast, Dr. Broyles will answer your questions. Having graduated from the Brody School of Medicine at East Carolina University and completed her three-year residency at the University of Tennessee in Knoxville, Dr. Broyles is currently a family practitioner in Saluda, North Carolina. For the past several years, she served patients at urgent care and occupational medicine centers in South Carolina and Tennessee. Prior to this, she was medical director for the East Tennessee Spine and Nerve Center in Chattanooga and the Johnson City Tennessee Downtown Clinic. Dr. Broyles graduated from Brody school of medicine at East Carolina University in Greenville North Carolina and obtained her functional medicine certification from Functional Medicine university in Greer South Carolina. ***** Thank you to our Cutting Edge Health supporters: CZTL Methylene Blue Get a $10 discount by using this link: https://cztl.bz?ref=3OqY9 on an order of $70 or more OR use this discount code at checkout: jane10 Renue by Science: 10% off NMN https://renuebyscience.com/product/pure-nmn-sublingual-powder-30-grams/ Enter jane10 at checkout for 10% off. Cutting Edge Health podcast website: https://cuttingedgehealth.com/ Cutting Edge Health Social and YouTube: YouTube channel: youtube.com/@cuttingedgehealthpodcast Instagram - https://instagram.com/cuttingedgehealthpodcast Facebook - https://www.facebook.com/Cutting-Edge-Health-Podcast-with-Jane-Rogers-101036902255756 Please note that the information provided in this show is not medical advice, nor should it be taken or applied as a replacement for medical advice. The Cutting Edge Health podcast, its employees, guests and affiliates assume no liability for the application of the information discussed. Special thanks to Alan, Maria, Louis, and Nicole on the Cutting Edge Health team!
Dr. V, also known as E. Benita Varnado, MD, is a prominent OB/GYN physician, podcast host, and community leader. Born and raised in High Point, North Carolina, Dr. V was inspired by her parents, both of whom were first-generation college graduates and accomplished medical professionals, to pursue a career in healthcare. She obtained her BS in Biological Sciences with Honors from Hampton University, and then her medical degree at The Brody School of Medicine at East Carolina University, followed by a 4-year Obstetrics and Gynecology residency at Tulane University. Dr. V is passionate about empowering others to achieve and maintain good health. She actively participates in her community as the lead physician with the Greensboro group Walk with a Doc and serves as a board member of a local charter school. She is also a sought-after speaker for local organizations and a member of her church's Health and Wholeness ministry. Through her medical practice and her podcast, Office Visits with Dr. V, she shares the benefits of lifestyle changes on medical diseases and overall wellness and health. Dr. V's ultimate goal is to help her listeners reach their health goals and become their best selves. Her dedication and expertise make her a well-respected leader in her field and a valued member of her community. Do you ever feel like you're burning out from work? You're not alone. In today's fast-paced world, burnout has become a common phenomenon that affects individuals from all walks of life. To shed light on this issue, James invites Dr. V, a burnout specialist, onto the show. Dr. V emphasizes that burnout is not a weakness, but rather a prolonged mental and physical exhaustion resulting from recurrent stressors. She stresses the importance of acknowledging burnout and seeking help to prevent its detrimental effects on personal and professional life. In this insightful conversation, James and Dr. V discuss various symptoms of burnout and the significance of healthy relationships in mitigating its impact. They also offer practical solutions such as limiting workloads and establishing healthy boundaries at work. Tune in to this episode for valuable insights into recognizing burnout symptoms and prioritizing self-care habits like exercise and sleep hygiene practices – essential ingredients for thriving in your career! Let's dive in! [00:01 – 08:44] Opening Segment Welcome to the show Dr. V defines burnout as prolonged mental and physical exhaustion from stressors Burnout affects personal and professional life The culture of normalizing burnout [08:45 – 17:45] Recognizing and Addressing Burnout Recognizing burnout symptoms such as exhaustion, irritability, and resentment The importance of acknowledging burnout and seeking help The significance of healthy relationships Asking for help is not a sign of weakness [17:46 – 26:09] Closing Segment The importance of systemic change in self-care Setting boundaries at work and in personal life Parting Notes You can connect with E. Benita Varnado, MD: officevisitswithdrv.com, Podcast, Facebook, Youtube, Instagram E-mail: prwellness.org@gmail.com Let's connect! Find me on my LinkedIn, Facebook, and Instagram. I'd love to hear from you. You have the strength of a hero within you. Check out my website www.engineeryoursuccessnow.com and learn how to unlock your potential and achieve success both in business and in life. Register for the Engineer Your Success On-Ramp: http://bit.ly/3SUeilY Mastering Crucial Conversations: Advanced Training Session https://bit.ly/EYSATCC Additional Effective Communication Resources https://www.engineeryoursuccessnow.com/blog/communicating-effectively-3-practical-tips-for-getting-your-message-across/ Tweetable Quotes: “One of the signs of burnout is that the quality of your work has declined.” - Dr. E. Benita Varnado, MD “But when you get the deep sleep….You are restoring your physical body and you're restoring your mind.” - Dr. E. Benita Varnado, MD
Dr. V, also known as E. Benita Varnado, MD, is a prominent OB/GYN physician, podcast host, and community leader. Born and raised in High Point, North Carolina, Dr. V was inspired by her parents, both of whom were first-generation college graduates and accomplished medical professionals, to pursue a career in healthcare. She obtained her BS in Biological Sciences with Honors from Hampton University, and then her medical degree at The Brody School of Medicine at East Carolina University, followed by a 4-year Obstetrics and Gynecology residency at Tulane University. Dr. V is passionate about empowering others to achieve and maintain good health. She actively participates in her community as the lead physician with the Greensboro group Walk with a Doc and serves as a board member of a local charter school. She is also a sought-after speaker for local organizations and a member of her church's Health and Wholeness ministry. Through her medical practice and her podcast, Office Visits with Dr. V, she shares the benefits of lifestyle changes on medical diseases and overall wellness and health. Dr. V's ultimate goal is to help her listeners reach their health goals and become their best selves. Her dedication and expertise make her a well-respected leader in her field and a valued member of her community. Do you ever feel like you're burning out from work? You're not alone. In today's fast-paced world, burnout has become a common phenomenon that affects individuals from all walks of life. To shed light on this issue, James invites Dr. V, a burnout specialist, onto the show. Dr. V emphasizes that burnout is not a weakness, but rather a prolonged mental and physical exhaustion resulting from recurrent stressors. She stresses the importance of acknowledging burnout and seeking help to prevent its detrimental effects on personal and professional life. In this insightful conversation, James and Dr. V discuss various symptoms of burnout and the significance of healthy relationships in mitigating its impact. They also offer practical solutions such as limiting workloads and establishing healthy boundaries at work. Tune in to this episode for valuable insights into recognizing burnout symptoms and prioritizing self-care habits like exercise and sleep hygiene practices – essential ingredients for thriving in your career! Let's dive in! [00:01 – 08:44] Opening Segment Welcome to the show Dr. V defines burnout as prolonged mental and physical exhaustion from stressors Burnout affects personal and professional life The culture of normalizing burnout [08:45 – 17:45] Recognizing and Addressing Burnout Recognizing burnout symptoms such as exhaustion, irritability, and resentment The importance of acknowledging burnout and seeking help The significance of healthy relationships Asking for help is not a sign of weakness [17:46 – 26:09] Closing Segment The importance of systemic change in self-care Setting boundaries at work and in personal life Parting Notes You can connect with E. Benita Varnado, MD: officevisitswithdrv.com, Podcast, Facebook, Youtube, Instagram E-mail: prwellness.org@gmail.com Let's connect! Find me on my LinkedIn, Facebook, and Instagram. I'd love to hear from you. You have the strength of a hero within you. Check out my website www.engineeryoursuccessnow.com and learn how to unlock your potential and achieve success both in business and in life. Register for the Engineer Your Success On-Ramp: http://bit.ly/3SUeilY Mastering Crucial Conversations: Advanced Training Session https://bit.ly/EYSATCC Additional Effective Communication Resources https://www.engineeryoursuccessnow.com/blog/communicating-effectively-3-practical-tips-for-getting-your-message-across/ Tweetable Quotes: “One of the signs of burnout is that the quality of your work has declined.” - Dr. E. Benita Varnado, MD “But when you get the deep sleep….You are restoring your physical body and you're restoring your mind.” - Dr. E. Benita Varnado, MD
Episode 128: Food insecurity and obesity. Nausheen defines food insecurity, presents some statistics about obesity, and how food insecurity is linked to obesity. She ends her presentation with possible solutions to this problem.Written by Nausheen Hussain, OMS3, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Editing by Hector Arreaza, MD.Welcome: You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Arreaza: Hello, my name is Hector Arreaza. I am a family physician, currently practicing and teaching in the Central Valley of California. Today we will talk about an important and growing problem: Food insecurity and its relationship to obesity. I would like to introduce my guest today, Nasheen Hussain.Arreaza: Can you tell me what defines food insecurity? Nausheen: As defined by the U. S. Department of Agriculture (USDA), food insecurity is the limited availability of nutritionally adequate food or the limited access to this food. So, I want you to imagine you are living in a community where the closest grocery store is not within walking distance, you have no reliable access to transportation, and you are surrounded by liquor stores, McDonald's, and Burger King. Now you can see the two parts of that definition: the grocery store with healthy food exists, but it is too far, and you can't get to it. Whereas within walking distance is nonnutritious food. I want to challenge our audience to pay attention to these two concepts in the communities around them.Arreaza: I have noticed a concentration of fast-food places lining certain streets. Now that we understand the concept, do we know if there is a way to quantify or measure food insecurity? Nausheen: Yes, Dr. Arreaza. So, the term “food swamp” actually describes what you just stated. To answer your question, yes. Food insecurity is actually measured by the USDA by a 6-18 item questionnaire - asking questions such as: Were you worried if food would run out before you got money to buy more? It is conducted as an annual supplement to the Current Population Survey. Arreaza: The Current Population Survey (CPS) is the primary source of labor force statistics for the population of the United States. It is sponsored jointly by the U.S. Census Bureau (bee-uro) and the U.S. Bureau of Labor Statistics (BLS). The CPS is conducted monthly. Nausheen: The 2021 questionnaire identified 12.5% of households in the U. S. as being food insecure. However, this may underestimate the true number of individuals who may be suffering from food insecurity. Arreaza: Screening for food insecurity is not been routinely done in many clinics. Food Insecurity: Preventive Services. An Update for This Topic is In Progress. LAST UPDATED: Jul 24, 2022. So now, let's talk about the connection of this to obesity. What factors in general increase the likelihood of obesity?Nausheen: Sure! Obesity is classified based on a person's body mass index or BMI, which is your weight in kilograms (or pounds) divided by the square of height in meters (or feet). A BMI of 30 or greater is considered to be in the obesity category. Obesity is affected by several factors, such as a person's genetics, level of activity, and a high-calorie diet consisting of low-nutrition food.Arreaza: How does food insecurity play into this? Nausheen: Think back to the example we discussed earlier. If a person is experiencing food insecurity due to a lack of access, they will use what is around them (fast food, 24-hour mart without fresh foods) so they can put food on the table. If it is due to financial inaccessibility, they will choose to, say, go to Jack in the Box for their $5.00 deals. Both of these lead to a diet filled with non-nutritious food. This shouldn't come as a surprise: most people that experience food insecurity are likely to be living in low-income communities. The generalization here is that these communities tend to have fewer parks, and if they are present, there tends to be a lot of litter and a cloud of unsafe space hovering over it. Arreaza: I see what you mean.Nausheen: These people will probably be less likely to go out for walks and take their kids out…leading to a sedentary lifestyle. The last association I see is that of mental health. People who are struggling to find food are likely to have stress due to their circumstances and there is a relationship that has been found between depression and the increased likelihood of developing obesity. As a recap, there are three effects of food insecurity that contribute to obesity: lack of adequate nutrition, lack of physical activity, and poor mental health. Arreaza: So, there are several factors of food insecurity that seem to be making individuals more likely to develop obesity. Why does it matter? Nausheen: Well obesity is the gateway to several other diseases such as diabetes and hypertension, which are known to the medical profession as "silent killer diseases." In short, what we typically refer to as "that person is larger built" can have major adverse effects on health and can substantially reduce a person's longevity and quality of life. If we can understand and reduce risks of developing obesity, we can prevent the onset of the disease and/or prevent the progression to more severe outcomes. To bring this more into perspective, the CDC found that from 2017-2020, 1 in 5 children had obesity and about 2 in 5 adults had obesity, with an overall prevalence of 41.9% in the U.S. Arreaza: Let's talk about possible solutions.Nausheen: I think the best solution to this issue has to be two parts. 1. Increased access to healthy foods. 2. Nutrition education on how foods you put into your body impact your health both now and long term. I work with urban farmers in Pomona, CA as part of a grassroots effort to increase access to nutritious foods. Arreaza: Tell me more about it.Nausheen: The system consists of several small-scale community farms that produce chemical-free, pesticide-free, fresh vegetables and fruits that are sold to the community members at a low price or a “pay what you can, take what you need” basis. I believe replicating this system in other communities is effective because 1. It is important for the people to know and trust where their food is coming from, and 2. People can volunteer to help the community farms thrive which not only allows for the sustainability of efforts but gives them a reason to be outside and be active which helps combat obesity! Arreaza: I believe nutrition education is a key element to combat obesity, but the battle is unfair. I see there needs to be a better effort from our government to control such things as the false advertisement of so-called “healthy foods” and “miracle supplements” that promise the cure of obesity. I feel like there needs to be more control of these vendors and pay for false science. Nausheen: Nutrition education itself is also important so that people understand what nutrients their bodies need, what foods can give it to them, how to cook those foods, and lastly how it all affects their health. This should start from elementary school with short lessons embedded into the school curriculum. Arreaza: Thank you for sharing that. This brings our episode to a close. If you are or if you know someone who is struggling with food insecurity, find some resources in your community such as food banks, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and other resources. Nausheen: Find community gardens where you live._______________Conclusion: Now we conclude episode number 128 “Food insecurity and obesity.” Nausheen explained that a lack of access to fresh and healthy foods is linked to increased risk of obesity. Dr. Arreaza called for improved controls for scammers and pseudoscientists that frequently commit fraud to patients who are struggling with obesity.This week we thank Hector Arreaza and Nausheen Hussain. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!_____________________Sources:Hartline-Grafton, H. (2018, April 18). Understanding the connections: Food insecurity and obesity (October 2015). Food Research & Action Center. Retrieved February 5, 2023, from https://frac.org/research/resource-library/understanding-connections-food-insecurity-obesity.U.S. Department of Health and Human Services. (2022, March 24). What are overweight and obesity? National Heart Lung and Blood Institute. Retrieved February 5, 2023, from https://www.nhlbi.nih.gov/health/overweight-and-obesity.Food Security in the U. S. - Measurement. USDA ERS - Measurement. (2022, October 17). Retrieved February 5, 2023, from https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/measurement.Craven, K., Patil, S. (unknown). Understanding Food Security & Obesity Paradox: A Case Study. Department of Family Medicine, Brody School of Medicine.Blasco BV, García-Jiménez J, Bodoano I, Gutiérrez-Rojas L. Obesity and Depression: Its Prevalence and Influence as a Prognostic Factor: A Systematic Review. Psychiatry Investig. 2020 Aug;17(8):715-724. doi: 10.30773/pi.2020.0099. Epub 2020 Aug 12. PMID: 32777922; PMCID: PMC7449839.Centers for Disease Control and Prevention. (2022, May 17). Childhood obesity facts. Centers for Disease Control and Prevention. Retrieved February 6, 2023, from https://www.cdc.gov/obesity/data/childhood.html.Centers for Disease Control and Prevention. (2022, May 17). Adult obesity facts. Centers for Disease Control and Prevention. Retrieved February 6, 2023, from https://www.cdc.gov/obesity/data/adult.htmlRoyalty-free music used for this episode: “Gushito - Latin Pandora." Downloaded on October 13, 2022, from https://www.videvo.net/
Sarc Fighter: Living with Sarcoidosis and other rare diseases
In Episode 74 of the Sarc Fighter Podcast we take a deep dive into the reality that Sarcoidosis in more prevalent in people of color, but they are less likely to participate in clinical trials. That's a problem for medical professionals who are trying to help solve the sarcoidosis riddle, to find more effective treatments and help more people. Why is that? Three guests join me today to talk about it. They share their thoughts and ideas about the reluctance of patients to participate often because of trust issues, and bias on behalf of medical professionals to recruit African Americans for trials. Dr. Ogugua Obi of the Brody School of Medicine at East Carolina University in North Carolina. Kathryn Washington, a sarcoidosis patient and member of the FSR ACTe Now Patient Advisory Committee Calvin Harris, sarcoidosis patient and a member of the ACTe Now Patient Advisory Committee Show Notes The FSR ACTe now webpage: https://www.stopsarcoidosis.org/actnow/ Take the FSR Survey: https://rx4good.qualtrics.com/jfe/form/SV_4MYoU9YGjvAbuJg More on aTyr Pharma: https://atyrpharma.com/ Participate in the aTyr Clinical Trial: https://bit.ly/3EUOxNq aTyr News Release: https://investors.atyrpharma.com/news-releases/news-release-details/atyr-pharma-announces-dosing-first-patient-pivotal-phase-3-efzo FSR Webpage on Financial planning for life with Sarc: https://www.stopsarcoidosis.org/financial-assistance-support-for-those-living-with-sarcoidosis/ #Makeitvisible https://www.stopsarcoidosis.org/fsr-updates-and-publications/ The New FSR Initiative https://www.stopsarcoidosis.org/foundation-for-sarcoidosis-research-launches-groundbreaking-global-rare-disease-initiative/ Nourish by Lindsey: https://www.nourishbylindsey.com/ MORE FROM JOHN Cycling with Sarcoidosis http://carlinthecyclist.com/category/cycling-with-sarcoidosis/ Do you like the official song for the Sarc Fighter podcast? It's also an FSR fundraiser! If you would like to donate in honor of Mark Steier and the song, Zombie, Here is a link to his KISS account. (Kick In to Stop Sarcoidosis) 100-percent of the money goes to the Foundation. https://stopsarcoidosis.rallybound.org/MarkSteier The Foundation for Sarcoidosis Research https://www.stopsarcoidosis.org/ Donate to my KISS (Kick In to Stop Sarcoidosis) fund for FSR https://stopsarcoidosis.rallybound.org/JohnCarlinVsSarcoidosis?fbclid=IwAR1g2ap1i1NCp6bQOYEFwOELdNEeclFmmLLcQQOQX_Awub1oe9bcEjK9P1E My story on Television https://www.stopsarcoidosis.org/news-anchor-sarcoidosis/ email me carlinagency@gmail.com
Long before medical school, conversations with my mentors and colleagues about the intersection of theology and medicine left me desiring something more... something different.For me and many (silent/less vocal) others, I knew that my beliefs would definitely shape me as a physician, provider, and practitioner.Physicians are taught implicitly and pretty powerfully that there's a stark division between the private and the public and any and all personal beliefs should be left at the door once you don the white coat. However, like many of the other boxes that others have tried to place me in, separating my faith from my focus, my personal from my professional, wasn't even a remote possibility. My basic sense of morality guided me to a career in medicine undergirded by my commitment to serving others and caring for them in spaces of vulnerability, sickness, dis-ease, and generally being unwell. This conventional thinking, reductive at the very least, didn't sit well with me as I didn't feel that one's faith, identity, or tradition should have to be left at the door.My faith has allowed for a more fulfilling and flourishing professional life and I firmly believe that in very tangible ways, it allows me to care for clients better.About Dr. Varnado:Dr. Varnado was born and raised in North Carolina and has been living out a childhood dream of taking care of women of all ages as an OB/GYN.Dr. Varnado left her career of almost 20 years in conventional medicine (Obstetrics and Gynecology) in 2021 to address the broken healthcare system, which currently puts the most resources in treating symptoms, when it really needs to address the root cause of diseases.Through her years of practice, she has realized that many know what it takes to be healthy but outside of a support system their efforts rarely yield the desired outcome because their environments often reinforce poor habits. Her focus now is to help others achieve optimal mental and physical health by focusing on lifestyle-based treatment, which she believes, could prevent and manage most ailments.She is a proud graduate of Hampton University and The Brody School of Medicine at East Carolina University. She completed her OB/GYN residency at Tulane University in New Orleans, LA, where she learned how to be an excellent surgeon and physician. Being a mother of two, having a marriage of 17 years, a supportive family, and a strong relationship with God are keys to her success.Resources Mentioned:Office Visits with Dr. V Podcast - Spotify, Apple Podcasts, and Google PodcastsAmerican College of Lifestyle MedicineHealth CoachingConnect with Dr. VarnadoInstagram: @office_visits_with_dr_vFacebook: Office Visits with Dr. VWebsite: http://officevisitswithdrv.com/The podcast's hashtag is #nourishyourflourish. You can also find our practice on the following social media outlets:Facebook: The Eudaimonia CenterInstagram: theeudaimoniacenterTwitter: eu_daimonismFor more reproductive medicine and women's health information and other valuable resources, make sure to visit our website.
Lifestyle medicine is a medical specialty that's been getting a lot of buzz recently and is a medical approach that uses evidence-based behavioral interventions to prevent, treat and manage chronic disease.Lifestyle medicine is a coordinated team-based approach to healthcare that integrates six vital “pillars” of good health to treat, reverse, and prevent chronic lifestyle-related diseases. Physicians, dietitians, physical therapists, mental health professionals, and other lifestyle medicine practitioners partner with motivated individuals to make meaningful and long-lasting changes that will benefit all aspects of a client's health for years to come.And no... lifestyle medicine is not new. It is actually the foundation of traditional medicine. What is new is the recognition of lifestyle medicine as a well-defined practice in today's healthcare environment.About Dr. Varnado:Dr. Varnado was born and raised in North Carolina and has been living out a childhood dream of taking care of women of all ages as an OB/GYN.Dr. Varnado left her career of almost 20 years in conventional medicine (Obstetrics and Gynecology) in 2021 to address the broken healthcare system, which currently puts the most resources in treating symptoms, when it really needs to address the root cause of diseases.Through her years of practice, she has realized that many know what it takes to be healthy but outside of a support system their efforts rarely yield the desired outcome because their environments often reinforce poor habits. Her focus now is to help others achieve optimal mental and physical health by focusing on lifestyle-based treatment, which she believes, could prevent and manage most ailments.She is a proud graduate of Hampton University and The Brody School of Medicine at East Carolina University. She completed her OB/GYN residency at Tulane University in New Orleans, LA, where she learned how to be an excellent surgeon and physician. Being a mother of two, having a marriage of 17 years, a supportive family, and a strong relationship with God are keys to her success.Resources Mentioned:Office Visits with Dr. V Podcast - Spotify, Apple Podcasts, and Google PodcastsAmerican College of Lifestyle MedicineHealth CoachingConnect with Dr. VarnadoInstagram: @office_visits_with_dr_vFacebook: Office Visits with Dr. VWebsite: http://officevisitswithdrv.com/The podcast's hashtag is #nourishyourflourish. You can also find our practice on the following social media outlets:Facebook: The Eudaimonia CenterInstagram: theeudaimoniacenterTwitter: eu_daimonismFor more reproductive medicine and women's health information and other valuable resources, make sure to visit our website.
Today, we're talking about all things Dr. Kellye W. Hall! Kellye Hall is a Board-Certified Emergency Physician. She practiced medicine for seventeen years, thirteen of those being in the Emergency Department. She is a two-time best-selling author as a contributing author in The HBCU Experience Anthology: North Carolina Agricultural & Technical State University Edition. She also wrote a memoir, I Am The Beat; God Sets The Pace. Born in Rochester, New York, but raised in Soul City, North Carolina, she fulfilled her dream of becoming a physician by attending college at North Carolina. She attended medical school at The Brody School of Medicine at East Carolina University and stayed there for her emergency medicine residency. Her experiences in the field of emergency medicine have led to her desire to write about her experiences with people, both in and out of medicine. Four years ago, she returned to her true passion, dance. While it was always God's plan for her to be a physician, in 2019, she joined forces with former NBA dancer and hip-hop dance studio owner, Ana Obgueze to become Co-Owner and COO of NC Dance District, Incorporated, Charlotte. She is a dancer with Project: FULL OUT, a NC Dance District affiliate. She is married to her husband Eric Hall, and a new mother to a baby girl, Alessandra. She also has three fur-babies, her dogs, Mumslye, Kooler, and Germonye. Here's Dr. Kellye Hall's Social Media Accounts, make sure to check her out! Facebook: https://www.facebook.com/kellye.w.hall LinkedIn: https://drkellyewhall.com/contact/ Twitter: https://twitter.com/AggieDivaDoc Instagram: https://www.instagram.com/divadoc5/ Purchase her latest book now! https://www.amazon.com/Am-Beat-God-Sets-Pace/dp/1952840082 ----- Thank you so much for listening to Season 3, what I'm calling the Physician Focus Code #PFC here on The One Percent Code Podcast! Let me be your experienced physician entrepreneur strategist! After helping my inner circle of physician friends get unstuck…, invest in real estate, create profits year 1 of a new business venture, evaluate franchise opportunities, acquire existing businesses, invest in startup and joint ventures, transformative work on imposter syndrome to growth mindset, create more time freedom, residual income streams with leveraged strategies as full time physicians especially my working physician parent friends… It was time for me to FOCUS on helping more physician entrepreneurs learn my methods of navigating entrepreneurship. If you are a physician entrepreneur feeling overwhelmed, having self-doubt, fear of failure or fear of success and want to launch or supercharge your business, I invite you to schedule a quick 15-minute strategy call with me, Dr. Melva and let me share my proven signature method, we'll see if we're a good team, I'll give you one actionable piece of advice to get you closer to the profitable physician entrepreneur identity you desire faster than you could ever imagine on your own, let's go! https://www.talkwithdrmelva.com ---- Never miss any updates! Follow us on your favorite podcast platform: Spotify : https://open.spotify.com/show/2iXvqgO... Apple Podcasts : https://podcasts.apple.com/us/podcast... Google Podcasts : https://podcasts.google.com/feed/aHR0… Follow my social media accounts: LinkedIn: https://www.linkedin.com/in/doctormelva Instagram: https://www.instagram.com/docmelva Facebook: https://www.facebook.com/doctormelva
Do you need help interpreting the SBI report you received from the State on your DWI case? On today's episode, Jake visits with Dr. Korin Leffler, an assistant professor of pharmacology and toxicology at the Brody School of Medicine, East Carolina University. Dr. Leffler holds a PhD in pharmacology and toxicology and helps bridge the gap between science and the law by providing the right steps to meaningfully interpreting the substances identified as present in an SBI lab report. Highlights: Hear Dr. Leffler discuss the difference between pharmacology and toxicology. Learn why science demands two forms of testing: presumptive and confirmatory. Uncover the testimonial limitations that an SBI lab analyst might face and some big picture challenges to present to an inexperienced analyst being tendered as an expert in pharmacology or toxicology. Discover why it may be difficult to determine whether your client was actually impaired by most drugs that are confirmed in your client's system in a SBI lab report. For a copy of Dr. Leffler's CV visit Forensic Resources of IDS. Contact Dr. Leffler by email at leffler.korin@gmail.com
Dear Life Warriors, Dr. Varnado left her traditional career of almost 20 years in Obstetrics and Gynecology in 2021 to address the broken healthcare system, which currently puts the most resources in treating symptoms, when it really needs to address the root cause of diseases. Through her years of practice, she has realized that many know what it takes to be healthy but outside of a support system their efforts rarely yield the desired outcome because their environments often reinforce poor habits. Her focus now is to help others achieve optimal mental and physical health by focusing on lifestyle based treatment, which she believes, could prevent and manage most ailments. This shift was born from starting her podcast in November 2020, Office Visits with Dr. V, where she not only educates women about their gynecologic health and how their bodies function but also about their overall health and wellness. Dr. Varnado was born and raised North Carolina and has been living out a childhood dream of taking care of women of all ages as an Ob/Gyn. She is a proud graduate of Hampton University and The Brody School of Medicine at East Carolina University. She completed her Ob/Gyn residency at Tulane University in New Orleans, LA, where she learned how to be an excellent surgeon and physician. Being a mother of two, having a marriage of 17 years, a supportive family and a strong relationship with God are keys to her success.Topics:How to leave your dream career for purposeLiving a life of purposeWomen's HealthHow to implement lifestyle changesHow to improve your health through lifestyle changesMommy GuiltCovid mindset shiftMommy guiltChallenges for health professionalsFaith and MedicineSpirituality in the practice of medicine Dr. Varnado is an Obstetrics and Gynecology in 2021 to address the broken healthcare system, which currently puts the most resources in treating symptoms, when it really needs to address the root cause of diseases. Through her years of practice, she has realized that many know what it takes to be healthy but outside of a support system their efforts rarely yield the desired outcome because their environments often reinforce poor habits. Her focus now is to help others achieve optimal mental and physical health by focusing on lifestyle based treatment, which she believes, could prevent and manage most ailments. This shift was born from starting her podcast in November 2020, Office Visits with Dr. V, where she not only educates women about their gynecologic health and how their bodies function but also about their overall health and wellness. Dr. Varnado was born and raised North Carolina and has been living out a childhood dream of taking care of women of all ages as an Ob/Gyn. She is a proud graduate of Hampton University and The Brody School of Medicine at East Carolina University. She completed her Ob/Gyn residency at Tulane University in New Orleans, LA, where she learned how to be an excellent surgeon and physician. Being a mother of two, having a marriage of 17 years, a supportive family and a strong relationship with God are keys to her success.Purchase Char's Journal: https://www.amazon.com/30-DAYS-NEW-YO.. ABOUT DEAR LIFE WARRIORS (DLW): Dear Life Warrior's mission is to empower people of color with unyielding tenacity to hang on until destiny is fulfilled. Our vision is that everyone that watches Dear Life Warriors will have a great understanding that the Journey of Life is a process, and if a process is to be fruitful it will take determination to reach completion.#dearlifewarriors #softskillstraining #lifecoach #professionaldevelopment #softskillstrainer #corporatetrainer #lifecoachingtips
Welcome to Episode 106 of the Autism Parenting Secrets. Our guest this week is Dr. Cammy Benton She's a Family Physician and the owner of Benton Integrative Medicine, a Direct Primary Clinic that also offers Functional Medicine and a more Integrative approach.In addition to her medical expertise, she's a mom of three girls who have experienced health challenges.She's not afraid to challenge conventional thinking.The secret this week is … Go BEYOND The Standard of CareYou'll Discover:The Most Important Thing To Keep In Mind (2:22)Why Doctors Judge And How To Respond (10:49)A Functional Medicine Success Story (17:07)A Homeopathy Success Story (35:50)Why Cognitive Dissonance Gets In The Way (43:02)The Opportunity of Personalized Medicine (46:08)How To Take Control Now (49:20)An Overview of Approaches To Wellness (51:29)A Cutting Edge Model For Affordable Medical Care (57:28) About Our GuestDr. Cammy Benton, MD, ABIHM, IFMCP is a patient-focused, family physician that practices Integrative and Functional Medicine. She is the owner of Benton Integrative Medicine that is a Direct Primary Clinic that also offers Functional Medicine and a more integrative approach. She graduated from Brody School of Medicine at East Carolina in Greenville, NC and completed her Family Medicine residency at UNC Chapel Hill in 2004.After working in a group practice, she realized there must be more to medicine than doling out pills ills. She is certified by the American Board of Holistic and Integrative Medicine and the Institute of Functional Medicine. https://www.bentonintegrative.com/meetdrbentonReferences in This Episode:Compass Integratve HealthThe Biology of Belief by Bruce LiptonAdditional Resources:Free Resource: 33 Mistakes Most Autism Parents Make and How To Avoid ThemGot a Picky Eater? - this can helpTo learn more about Cass & Len, visit us at www.autismparentingsecrets.comBe sure to follow Cass & Len on InstagramIf you enjoyed this episode, share it with your friends.Don't forget to subscribe to the show on Apple Podcasts to get automatic episode updates for our "Autism Parenting Secrets!"And, finally, please take a minute to leave us an honest review and rating on Apple Podcasts. They really help us out when it comes to the ranking of the show and we read every single one of the reviews we get. Thanks for listening!
State‐level drug paraphernalia laws increase the risk of infection or overdose for drug users by preventing legal access to clean needles, syringes, and products to test drugs for deadly contaminants. Every state except Alaska criminalizes the possession and/or sale of illicit drug paraphernalia. Thus, Alaskans can legally operate needle exchange programs and other harm‐reduction measures. Recognizing that harm‐reduction strategies reduce overdoses and disease, many states are considering reforms to their drug paraphernalia laws. To discuss the impact of drug paraphernalia laws on health and how states can implement better rules, we are pleased to have Corey S. Davis, the director of the Harm Reduction Legal Project of the Network for Public Health Law and adjunct faculty at the Brody School of Medicine at East Carolina University; Robin Lutz, executive director of the Alaskan AIDS Assistance Association, which has provided harm‐reduction services in Alaska since 1985; and Haley B. Coles, executive director of Sonoran Prevention Works, which has been engaged in harm‐reduction and syringe services in Arizona since 2010. The discussion will be moderated by Cato Institute senior fellow Jeffrey A. Singer. See acast.com/privacy for privacy and opt-out information.
"A Soft Spot," by Rebecca Snyder: A surgical oncologist discusses the hidden emotional toll experienced by patients with cancer. TRANSCRIPT Narrator: ‘A Soft Spot', by Rebecca A. Snyder, MD, MPH. I remember a day as a child when my father, a vascular surgeon, came home and immediately retreated to his bedroom. He did not emerge for some time, and when he did, he spoke very little to anyone. When I asked my mother why, she told me softly, ‘One of your father's favorite patients died today, and he is sad.' This surprised me at the time that my father felt so deeply for his patients that it affected him for hours after coming home from work. I understand it better now. I first met Gary after his medical oncologist asked me to consider operating on him for colorectal liver metastases. During our initial visit, I observed that he was a quiet man: nervous, kind, and polite, saying little unless prompted. Over time, I came to learn that he was a solitary person who found fulfillment and purpose in his work, enjoying hunting and fishing in his spare time. He lived almost an hour and a half away in a rural part of North Carolina. Outside of his visits, we communicated mostly via his brother, because his cell phone rarely had reception. In the months before our first visit, he had been treated heavily with chemotherapy and appeared to have had a good response to treatment. Although he had disease in both sides of his liver, it looked as though his disease was resectable with a two-stage operation. The first stage to remove the left part of his liver and the second stage to remove two metastases in his right liver. He was young, in his early 50s, and otherwise healthy - a good candidate for surgery. The first-stage operation went smoothly, but when I saw him back in the office to plan for the second, his imaging revealed significant growth in the two remaining metastases in his right liver. To make matters worse, his normal liver had failed to hypertrophy enough to allow for another resection. He silently stared at the floor, visibly disappointed when I shared this with him. I told him I was disappointed too. Together with his clinical team, we then embarked on a series of treatments, beginning with microwave ablation therapy to the growing tumors. Unfortunately, in the interim, he developed a new liver metastasis with resulting biliary obstruction. We attempted unsuccessfully to drain his liver with an endoscopic stent with the goal to restart systemic chemotherapy. At our most recent visit, I expressed my concerns that the endoscopic stent had not been effective and recommended a percutaneous drain to decompress his bile duct. His gaze drifted to the floor. Sensing he was upset, I placed a hand on his shoulder, hoping to convey a steadiness and confidence that might offer some reassurance. As tears formed in his eyes, I felt his discomfort at displaying emotion in front of me, so I offered him a few minutes of privacy with his brother. Although he had been willing to undergo repeated endoscopic procedures, it seemed as though the idea of having a drain outside his body, a visible and tangible reminder of his progressive cancer, was clearly distressing to him. When I re-entered the room, we reviewed our plan for him to have an external drain placed and then begin a modified regimen of chemotherapy next week, which he and I both knew would not be curative. We did not speak this aloud, but the eye contact he made with me communicated that we shared a common understanding. I silently hoped that it would buy him some time at least. Two weeks later, I unknowingly clicked open an automated message in the electronic health record stating very matter-of-factly that Gary had been brought in by emergency medical services, dead on arrival, from a gunshot wound. I called his medical oncologist, who reluctantly confirmed the news. He told me he had hoped that I would not find out because he knew I would not take it well. Suffice it to say, he was right. Although most of the cancers I treat, pancreatic, metastatic, colorectal, and cholangiocarcinoma, are aggressive malignancies with poor long-term survival, Gary was the first patient of mine to commit suicide. When I first learned of Gary's suicide, my mind immediately returned to my last visit with him. ‘Had I been too honest and direct, not buffering the concerns we discussed with enough hopefulness? Had he expressed signs of clinical depression that I had missed, misinterpreting his responses as a normal disappointment when in fact they reflected much deeper despair? Should I have confronted him more directly?' I called his older brother while the news still freshly stung, feeling a sense of urgency to make sure his family knew how much Gary mattered to me and to his treatment team. After we exchanged platitudes, I found myself telling him that I had always had a soft spot in my heart for Gary, which was true. I tried very hard then not to cry but failed. As a private person myself, I have always felt a particular sense of community with introverts like Gary, a shared experience of a need for privacy, an appreciation for quiet and aloneness, and a discomfort with being overly expressive among anyone other than close friends or family. Nature or nurture, I inherited this trait from my mother, who preferred pursuing her solitary artistic hobbies over small talk. Like Gary, my mother also became deeply depressed when she was diagnosed with metastatic lung cancer, a depression that worsened when she experienced debilitating side effects of treatment, only to learn that these treatments had not even been effective. As her daughter and one of her caregivers, it was not her physical suffering but her emotional suffering that was most agonizing to witness. During my mother's experience with end-stage cancer, I gained an intimate awareness of cancer's emotional toll in a way never afforded by my formal training or in my clinical practice. Stepping beyond awareness toward confident intervention with my own patients, though, has remained uncomfortable for me. I listen, offering empathy and understanding, explaining treatment options when there are any, and comfort when not. For some patients and families, I morph into a punching bag, offering them an outlet for their anger when I cannot offer them anything else. With Gary, I tried to communicate to him that beneath his displays of hesitancy and reservation, I recognized the struggle he was experiencing, his hopes, and perhaps more importantly, his disappointments. Now, I do not feel like this was enough. Losing patients to cancer is something I have experienced from both a professional and personal standpoint and unfortunately, with which I have grown all too familiar. Knowing that a timid and kindhearted patient of mine felt a sense of hopelessness and despair this deep, however, is acutely and newly painful. I imagine I will always carry a soft spot for Gary with me, a tender soreness that lasts. It may go unnoticed at times, forgotten temporarily with the distraction of another patient's triumph: a curative resection, a follow-up scan with no evidence of disease, or a grandchild's high school graduation witnessed. Yet, I expect it will sting again, just as a bruise does when pressed intentionally and gently, to confirm that it is still there. I will be reminded of him, feeling a familiar ache when I witness someone's growing despair. Next time, I will pause to ask, ‘Are you losing hope?' Perhaps you will ask too. Dr. Lidia Schapira: Welcome to JCO's Cancer Stories: The Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one at podcast.asco.org. I'm your host Lidia Schapira, Associate Editor for Art of Oncology and Professor of Medicine at Stanford. With me today is Dr. Rebecca Snyder, Assistant Professor of Surgery and Public Health at Brody School of Medicine at East Carolina University. We'll be discussing her Art of Oncology article, ‘A Soft Spot'. Our guest has no disclosures. Rebecca, welcome to our podcast. Dr. Rebecca Snyder: Thank you, Lidia. Dr. Lidia Schapira: It's a pleasure to have you with us today. I'd love to start by asking you as a gifted storyteller - I've read some of your stories published also in other publications - tell me a little bit about your writing process. Why do you write? When do you write? What brings a story to the page for you? Dr. Rebecca Snyder: I would say that I don't have a very structured process. Typically, it begins with some ideas that percolate in my mind, oftentimes prompted by one specific event. And then I think once I have time to sort of bring in some other thoughts and start to formulate them, then it really happens when I have a moment to sit down where there's quiet, and my children are not interrupting me and my pager is not interrupting me, and have a few hours to really sit down and get something on the page. And then I do quite a bit of editing over time. I reread a lot and rethink about the way I say things until I get it just right. So, it takes me days. Dr. Lidia Schapira: That's very interesting. Let's go back to something you said. Let's chase after that a little bit. You said something that sort of stays with you or percolates; is it a moment of particular emotional resonance? Is it a difficult situation? Is it something that triggers a deep memory for you? Can you tell us a little bit more about what got you to write, say this piece about Gary, you've also written about your mother, you've written about being a petite surgeon in a sexist world, what are those ideas that stay with you, that then lead you to write about them? Dr. Rebecca Snyder: They're each a little bit different. So, I don't know that I have one answer to that. I think my experience with my mother took me a long time to be ready to write about it. It was something way too emotional for me to even confront for myself for a long time. And then eventually, I felt like I was in a place where I could put something on a page and that was very therapeutic for me. With Gary, that was really an acute event. And when it happened, and I processed it emotionally, I knew that it would help me to write about that. And so, I actually did that, I believe, either the same day or the next day that I learned of that event. At that point, I wasn't necessarily writing with the intention of publishing, but just to help me get through those feelings in that experience. Dr. Lidia Schapira: So, I'd like to talk a little bit about this idea of writing and sharing with others. One thing is to write to process a difficult experience, which you've so nicely stated. The other is to take the further step of writing for publication, which means putting something that's really private out in front of your colleagues, your peers, and so on. Tell us a little bit about that. What triggers you to say, 'Alright, I've written this to process but now I want to share it'? Dr. Rebecca Snyder: I write about how I consider myself an introvert. Some people who know me well aren't surprised to hear that. Some people say, ‘Oh, I wouldn't have expected that you consider yourself an introvert.' I think that for me, there are thoughts that I don't feel comfortable communicating, necessarily in a public forum, or with people that maybe I don't know as well. But when I can do it in written form, for some reason, that's more comfortable. So, it's a way for me to share things that I feel compelled to share that I think are important and relevant to other people and may resonate with them in some way, but that I might not be comfortable broadcasting to a large audience. And so, writing allows me to share those feelings within the comfort of my introversion. Dr. Lidia Schapira: What role does narrative and narrative medicine play in your professional portfolio? Do you read other narratives? Dr. Rebecca Snyder: Honestly, it's one of the things I enjoy the most, aside from operating. I don't have formal training in it. Although I imagined I would really enjoy taking some courses. I think my writing has been informed by my own amateur reading and writing over time, I've always been a big reader. I've written about my mother's love for books. And that was something she shared with me beginning when I was a young child. I think it's become part of how I see myself professionally. Although it still feels a bit like a hobby. I think that it should play a significant role in medicine. But I don't think that we have done a great job as a medical community of incorporating that into the dialogue. Dr. Lidia Schapira: I share that sentiment. It would be lovely to see narrative medicine in the mainstream of medical education, rather than perhaps at the margins or as an optional thing for some, I think stories that are enormously powerful. And so, with that, let me ask you another question, and that is, what have you read recently that you recommend to others? Dr. Rebecca Snyder: You asked if I read another narrative medicine? I read, A Piece of My Mind at JAMA every week, and I read the Art of Oncology. One of my other favorite weekly columns is Modern Love in the New York Times, I look for that every Sunday. And then I read a variety of books. I would like to say I read more than I do because I think my clinical reading takes up quite a bit of my time as well. The last novel I read was, The House in the Cerulean Sea by TJ Klein, which was a great, very magical, lovely story. I found with the pandemic that I can't read things that are really intense or distressing. So, I chose things that are uplifting in some way or positive, and that was a lovely fantasy-type book to read. And then I read some nonfiction. I'm reading a book about the Old Testament now because I wanted to learn more about that. So, I try to have a diversity of literature that I'm reading at a given time. Dr. Lidia Schapira: Do you read books or screens? Dr. Rebecca Snyder: Books, 100%. I don't like screens to read. I print off every peer review, I do. I have to print it. I can't read. Other than editing, I don't like to read on a screen. Dr. Lidia Schapira: Let's go back to your story about this patient, Gary, whom you met and operated on. And the need you had to talk about the emotional response you had to learning that he suicided, that is something that is so very difficult for all of us. So, first of all, my deep condolences to you for your loss. Tell us a little bit about the relationship you had with Gary. Dr. Rebecca Snyder: I don't know if we're supposed to admit, as physicians, that we have favorite patients sometimes, but he was one of my favorite patients. What I appreciated about Gary early on is he was very soft-spoken, he was very bashful, and he would blush easily. I could tell he never wanted to be a burden, even in my clinic. So, he didn't want to take up too much of anybody's time. He usually brought his brother with him and allowed his brother to speak for him. And he would speak up when I would ask him directly, but often would nod or use body language and was very quiet. The first time I saw him he had been treated for a long time with chemotherapy. I believe he was sort of under the impression that he did not have any surgical options. He'd never seen a surgeon before, but his medical oncologist approached me and said, ‘I know that you're willing to be aggressive, and he's healthy and young, would you consider it?' And I had reviewed his scans ahead of time and thought it was worth an attempt. And so, I met with him and in some ways, I feel like I probably gave him some hope at that point. Maybe he had already processed that, but I reignited that. I got to know him pretty well because I cared for him for a while. Obviously, I saw him several times prior to surgery, then I operated on him, and cared for him postoperatively. And then once he recovered, and we planned for the second stage. And so, I grew attached to him because he was in no way demanding or difficult, but very unassuming, very kind, and just a gentle soul. Dr. Lidia Schapira: And you talk about having moments of sort of shared silence or shared understanding, right? So, it sounds like you, you bonded with him. Most of the communication was done through his brother because he didn't have a cell phone or his cell phone was out of reach, right? And so, you hoped with him that you would be able to really help prolong his life. And then came the bad news that his cancer was growing. Bring us a little bit into the consultation room where you share that news with him. Dr. Rebecca Snyder: When we first talked about it. He was quiet. He looks at the floor a lot. And he didn't verbalize his disappointment, but I could see it. I validated that for him and told him I was disappointed too. But I think when I really saw a shift was when I told him that I thought he needed to have an external biliary drain placed. I think he was continuing to work through all this. And that was really important to his identity, and the idea that he might have to have a drain, I think for him was incredibly distressing. I think to him it kind of marked him as different, as this is permanent, and would mean that he might not be able to work, and that was a big blow for him and I could tell that. I could tell he was starting to tear up but he was very uncomfortable doing that in my presence. So, I told him I would give him a few minutes of privacy and left the room so that he could express his emotions more comfortably. Dr. Lidia Schapira: And that was the last time you saw him, right? Dr. Rebecca Snyder: That's right. Dr. Lidia Schapira: So, then he leaves and you received the news that he suicided, but you're not told directly. You read it in the chart. And you immediately called the medical oncologist and they said that they wanted to protect you from this news. How did that feel? Dr. Rebecca Snyder: It was shocking. You know the Electronic Medical Record has some wonderful things about it. It's easy to keep up to date with your patients, you get alerts anytime a patient of yours is admitted to the hospital or discharged from the hospital. But yet, it's obviously incredibly impersonal and abrupt. And so, I had a notification that he was deceased. My initial thought was, ‘Wow! He must have had cholangitis. And he didn't complain about his symptoms and he didn't tell me by the end, so he must have gotten really sick and septic. And then that must have been what had happened. But then when I looked at the chart, and I called his medical oncologist, and I read the details, I realized that's not what had happened, and that was very hard. Dr. Lidia Schapira: I imagine it must have been absolutely awful. Again, my deep condolences to you. How did you deal with that news? How did you get on with your day after that? Dr. Rebecca Snyder: I called his brother first. I wondered, maybe I shouldn't now because it shouldn't be about my grief - I'm the physician - it should be about his family's grief. But I still wanted to connect in some way pretty immediately with someone else, in addition to his medical oncologist. He was very gracious and appreciative. We didn't speak for long, but I just wanted to make sure that he understood that we all cared that that had happened because otherwise, I would never have spoken with him. If I don't reach out. There's no follow-up visit, there's no opportunity in the system to complete that conversation. That helped me a little bit, and then I had to try to turn it off. I had to go lead our GI tumor board and have afternoon clinic and go on with the rest of the day. Dr. Lidia Schapira: Well, I'm deeply grateful to you for having written about it and decided to share it with us. I think that losing a patient is terribly hard. We do connect with our patients and feel for them. But this, learning in this way that one of your patients suicided or found living unbearable, is probably the hardest thing. Fortunately, we don't deal with it often. And many of us have or have not had those experiences. So, thank you so much, Rebecca, for reflecting and sharing that reflection with us. Are there any other thoughts that you want to share with readers of the piece that may help them understand the story or the message here? Dr. Rebecca Snyder: I can say since it's been published, I've already heard from several colleagues that they have experienced something similar. One was particularly devastating because the patient had actually completed therapy but had lost his business and committed suicide because of the financial burden of his care. If you think about it, those are the patients with the greatest extent of distress. But that's not even touching the emotional burden that so many patients are experiencing that we never see. I don't think it's possible or it's on us to alleviate that because some of that is a normal reaction to a cancer diagnosis. But I do think that being aware of the depth of despair that patients can experience is important. And having witnessed my mother being on this side of the patient, even just that recognition and empathy from one's physician can mean a lot to a patient and their family. So, I hope that we can all at least bring that awareness into our clinical encounters and try to offer that empathy when we sense those feelings. Dr. Lidia Schapira: Well, I'd like to thank you for sending us your story, and thank you very much for participating in this conversation. I deeply enjoyed it. Dr. Rebecca Snyder: Thank you, Lidia! I really appreciate being here. Dr. Lidia Schapira: Until next time, thank you for listening to this JCO's Cancer Stories: The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple podcasts or wherever you listen. While you're there, be sure to subscribe so you never miss an episode of JCO's Cancer Stories: The Art of Oncology Podcast. This is just one of many of ASCO's podcasts, you can find all of the shows at podcast.asco.org. 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 you in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
Joining us on the Faculty Factory this week for a very special reunion episode is Leigh A. Patterson, MD, MAEd. Dr. Patterson is Associate Dean for Faculty Development at the Brody School of Medicine at East Carolina University, and Chair of Emergency Medicine at ECU. Today's episode of the Faculty Factory Podcast is another reunion episode where we visit with past podcast guests and learn about what's new since we last chatted. She discusses the shifts and developments in her career since we first spoke with her on the podcast nearly three years ago. As an Emergency Medicine Physician on the front lines, Dr. Patterson also chats with us about the challenges brought on by the pandemic. You can learn more about our first interview with Dr. Patterson here: https://facultyfactory.org/a-faculty-factory-interview-with-leigh-a-patterson-md-maed/ Learn more about our podcast here: https://facultyfactory.org/podcast
Listen to a blog summary of a research paper selected as the cover for Volume 14, Issue 8, entitled, "Wild type and gain of function mutant TP53 can regulate the sensitivity of pancreatic cancer cells to chemotherapeutic drugs, EGFR/Ras/Raf/MEK, and PI3K/mTORC1/GSK-3 pathway inhibitors, nutraceuticals and alter metabolic properties." __________________________ Patients over the age of 50 years old who have been diagnosed with pancreatic cancer have a poorer rate of survival compared to younger patients. This means that pancreatic cancer is a disease associated with aging. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma (PDAC) and it is frequently diagnosed in its later stages. PDAC is often refractive to chemotherapies and develops resistance to inhibitors and other drugs. Therefore, there is a critical need for researchers to discover novel strategies to overcome drug resistance in PDAC cells. One potential strategy is to focus on a key gene known for its involvement in many cell processes, including drug resistance and metabolism: TP53. The TP53 gene is often mutated or deleted in cancer cells, which can lead to drug resistance and cancer metastasis. In PDACS, this tumor suppressor gene has been shown to be mutated in 50–75% of patients. “Many genes have been implicated in PDAC including KRAS, TP53, CDKN2A, SMAD4 and PDGFβR [3, 8, 9, 18–22].” In a new study, researchers—from Brody School of Medicine at East Carolina University, Università di Bologna, University of Parma, and University of Wroclaw—further elucidated TP53's role in drug resistance in PDAC cells. On April 27, 2022, their research paper was published in Aging (Aging-US) on the cover of Volume 14, Issue 8, and entitled, “Wild type and gain of function mutant TP53 can regulate the sensitivity of pancreatic cancer cells to chemotherapeutic drugs, EGFR/Ras/Raf/MEK, and PI3K/mTORC1/GSK-3 pathway inhibitors, nutraceuticals and alter metabolic properties.” Full blog - https://aging-us.org/2022/05/tp53-restoration-sensitizes-pancreatic-cancer-to-multiple-drugs/ DOI - https://doi.org/10.18632/aging.204038 Corresponding author - James A. McCubrey - mccubreyj@ecu.edu Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.204038 Keywords - aging, TP53, targeted therapy, PDAC, metabolic properties, chemotherapeutic drugs About Aging-US Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at http://www.Aging-US.com or connect with us: SoundCloud - https://soundcloud.com/Aging-Us Facebook - https://www.facebook.com/AgingUS/ Twitter - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/agingus LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Aging-US is published by Impact Journals, LLC: http://www.ImpactJournals.com Media Contact 18009220957 MEDIA@IMPACTJOURNALS.COM
Dr. Varnado left her traditional career of almost 20 years in Obstetrics and Gynecology in 2021 to address the broken healthcare system, which currently puts the most resources in treating symptoms, when it really needs to address the root cause of diseases. Through her years of practice, she has realized that many know what it takes to be healthy but outside of a support system their eorts rarely yield the desired outcome because their environments often reinforce poor habits. Her focus now is to help others achieve optimal mental and physical health by focusing on lifestyle based treatment, which she believes, could prevent and manage most ailments. This shift was born from starting her podcast in November 2020, Oce Visits with Dr. V, where she not only educates women about their gynecologic health and how their bodies function but also about their overall health and wellness. Dr. Varnado was born and raised North Carolina and has been living out a childhood dream of taking care of women of all ages as an Ob/Gyn. She is a proud graduate of Hampton University and The Brody School of Medicine at East Carolina University. She completed her Ob/Gyn residency at Tulane University in New Orleans, LA, where she learned how to be an excellent surgeon and physician. Being a mother of two, having a marriage of 17 years, a supportive family and a strong relationship with God are keys to her success.
Dr. Paul Cook, Professor of Medicine at ECU's Brody School of Medicine, and an expert in the area of infectious diseases, including SARS-COVID and HIV, talks what a COVID endemic will be like-timeline/will our vaccines stand-up/need boosters every year/Omicron—Non-Profit Spotlight: Red Cross
Dr. Thomas White talks to Dr Jim Jones, a North Carolina Family Physician, former President of the NCAFP and the AAFP, and former Chair of the Department of Family Medicine at the Brody School of Medicine at East Carolina University. Often referred to as the “Godfather of Family Medicine in North Carolina”, Dr Jones shares in this podcast the impact of his faith, the challenges he overcame and barriers he broke as a Native American, stories from his years in practice in Jacksonville NC (including a case you will not forget!), and his efforts to further Family Medicine in his state and nationally. You will hear lessons you will not forget, and you will be wiser for listening to this Legend of Family Medicine.
Sowmya Nagaraj, MD is currently the Assistant Professor of Medicine and the Associate Program Director of the Internal Medicine residency program at the East Carolina University. Dr Nagaraj grew up in India and completed her medical school from JSS Medical College in India before moving to the United States. She then pursued a residency in Internal Medicine from Hurley Medical Center of Michigan State University. After completing residency, she joined as a faculty member at Brody School of Medicine at East Carolina University. For Dr. Sowmya Nagaraj, it's all about picking your battles: What do you want in life? How much are you willing to fight for it? Are you going to do whatever it takes? And what if what you want now isn't the same as what you want in 10 years? Keep a timeline for goals and revisit them every few years: Is this still what you want? Do you need to make a change? Dr. Nagaraj shares her wisdom about recognizing that people and goals and aspirations change, and that's okay. Change is necessary for growth. Pearls of Wisdom: 1. Arm yourself with an ecosystem to prepare for the battles: start with being kind to yourself, then find people you trust. 2. Understand that change is inevitable and come from within. What you want now might not be what you want in five years. That's okay. Embrace that. 3. Strive to become fearless of failure. Self-doubt is dangerous and gets in the way of success. Instead, cultivate a feeling of self-worth.
We are now a year-and-a-half into the COVID-19 pandemic. With the talk of vaccine boosters and possible new treatments, there is a lot of new information out there. In Season 3, Episode 2 of Talk Like a Pirate, we welcome for the second time, Dr. Paul Bolin. He is the Chair of Internal Medicine at ECU's Brody School of Medicine.
In this preview of Season 3, Episode 2 of Talk Like a Pirate, Dr. Paul Bolin urges people to get vaccinated for COVID-19. He is the Chair of Internal Medicine at ECU's Brody School of Medicine.
Joseph Zanga, M.D., a past president of the American Academy of Pediatrics (AAP) and the American College of Pediatricians (acpeds.org), is a specialist in pediatrics and the retired Chief of Pediatrics for Columbus Regional Health/Columbus Children's Hospital in Columbus, Georgia. Dr. Zanga was the Distinguished Chair and Assistant Dean in Primary Care at Brody School of Medicine at East Carolina University. He also served as Chair of Pediatrics at Loyola in Chicago, and Vice Chair at Louisiana State University (LSU) Medical Center, and as Professor of Pediatrics and Emergency Medicine at both LSU and Tulane University. This is an audio podcast of The Dr J Show. Full video episode is available here with additional resources.
Women Physicians Flourish. A Podcast About Life and Wellbeing
Full Transcript HereDr. Andrea Staneata is a board certified Physical Medicine and Rehabilitation physician and is fellowship trained in interventional spine and pain management, and is now practicing at Cape Fear Orthopedics & Sports Medicine, in North Carolina. She has a compelling story: after medical school and two years of orthopedics residency in Romania, she immigrated with her then husband to the united states by winning a lottery sponsored by the romanian government. Upon relocating to the United States, she went on to complete her Internship and Residency in Physical Medicine & Rehabilitation at East Carolina University's Brody School of Medicine, followed by a fellowship in Interventional Spine & Pain management at OrthoCarolina in Winston Salem, North Carolina.She is the coauthor of the anthology Warrior Women: A Sisterhood of Immigrants, and in her chapter she details her story of burnout, depression/anxiety, and an abusive marriage she courageously left while her children were young. She has a passion for sharing her story so that others can learn from her experience. FB - Andrea StaneataLinkedIn - Andrea Staneata, MDIG - @andreastaneataWarrior Women Project bookThe Road Back To You - book
On this episode of “Beyond the White Coat,” Rosha McCoy, MD, AAMC senior director for advancing clinical leadership and quality, talks with health care providers and experts to debunk common myths and share accurate information about the COVID-19 vaccines as part of the nation’s efforts to increase vaccinations and end the pandemic.Episode GuestsEaric Bonner, MD, is an internal medicine physician at Vidant Internal Medicine in Edenton, North Carolina. He also works at Vidant Chowan Hospital as a hospitalist and at the Brody School of Medicine at East Carolina University as an assistant professor of internal medicine. Currently, he serves as the medical director for ambulatory quality and patient safety; the regional medical director for the Vidant practices in Bertie, Chowan, and Perquimans counties; and director of continuing medical education for Vidant Chowan Hospital. He was formerly the hospitalist medical director and chief of medicine for Vidant Chowan Hospital. In his practice, he continues to teach students and residents from North Carolina’s medical, nursing, and physician assistant schools.Mamie Williams, MPH, is the director of nurse safety and well-being at Vanderbilt University Medical Center. She is currently completing a PhD in nursing from the University of Kansas. At present, she serves as the co-chair of the VUMC African American Employee Resource Group and the VUMC Racial Equity Task Force. Ms. Williams is also an advisory board member for the American Nurses Association’s Healthy Nurse, Healthy Nation national initiative. In her spare time, Ms. Williams is an avid gardener. Ross McKinney Jr., MD, is the AAMC’s chief scientific officer, an infectious disease specialist, and a member of the Duke University faculty for over 30 years. During his time at Duke, he was director of the Division of Pediatric Infectious Diseases, vice dean for research at Duke University School of Medicine, and director of the Trent Center for Bioethics, Humanities, and History of Medicine. Dr. McKinney leads the AAMC’s programs that support medical research and the training of physician-scientists in academic medicine.Zanthia Wiley, MD, is the director of antimicrobial stewardship at Emory University Hospital Midtown. She completed medical school at the University of Alabama School of Medicine and both her Internal Medicine residency and Infectious Diseases fellowship at Emory. She has the unique experience of having worked as an academic hospitalist at Emory for 10 years prior to pursuing a career in infectious diseases. Dr. Wiley is dedicated to education and received the Jonas A. Shulman Teacher of the Year Award for 2018-2019, which is awarded yearly by the Emory Infectious Diseases fellows to a faculty member for excellence in teaching. She is a member of the Society for Healthcare Epidemiology of America Education Committee and the Infectious Diseases Society of America Medical Education Community of Practice. Dr. Wiley is the joint principal investigator on an institutional Woodruff Health Sciences Center COVID-19 Center for Urgent Research Engagement Award assessing “Clinical Characteristics, Outcomes, and Predictors of Readmission in Hospitalized COVID-19 Patients at Eight Atlanta Hospitals.” She is an investigator in several clinical trials, including the large national Adaptive COVID-19 Treatment Trial studies, and she is a co-investigator in the Emory Vaccine and Treatment Evaluation Unit. Dr. Wiley is a member of the Diversity, Equity, and Inclusion Council in Emory University School of Medicine's Department of Medicine and the Emory Collaborative Community Outreach and Health Disparities Research Initiative, and she serves as the physician lead of the Emory Healthcare COVID-19 Treatment Guidance Committee. She has given numerous talks on COVID-19 disparities on a local, regional, and national level and is dedicated to educating patients, their families, health care providers, and the community on the importance of COVID-19 vaccination.Credits:Hosted by Rosha McCoy, MD, AAMC senior director for advancing clinical leadership and quality.Produced by Stephanie Weiner, AAMC director of digital strategy and engagement.Recorded and edited by Laura Zelaya, AAMC production manager.With special contributions from Michelle Zajac, AAMC digital copy editor; Sholape Oriola, AAMC video specialist; John Buarotti, AAMC senior media relations specialist; and Mikhaila Richards, AAMC senior digital content strategist.You Might Also Be Interested In:“Convincing Rural Residents to Get a COVID-19 Vaccine” AAMCNews, April 15, 2021 More episodes in the “VaccineVoices” podcast seriesAAMC resources for media covering COVID-19 vaccination efforts Myths and facts about COVID-19 vaccines (CDC)
In this episode, AFSO21 Radio, The Weekend Wrap-up host, Kevin Ferrara speaks one-on-one with Doctor Jamie DeWitt from the Brody School of Medicine at East Carolina University (ECU), North Carolina.Dr. DeWitt shares her work on per- and polyfluoroalkyl substances (PFAS) and the impact it has on the human body, especially firefighters who use products containing PFAS in their everyday tasks.Dr. Dewitt explains that even if the production of PFAS were to stop today, we would still be exposed due to the amount of PFAS that exists emphasizing that prevention is critical in reducing exposure. She further explains that some PFAS that was produced by manufacturers, data is not readily accessible. Dr. DeWitt when asked about PFAS blood testing, she explains what she would do if her blood test results indicated high levels of PFAS. Rather than focusing on the "numbers", Dr. DeWitt explains she would focus on "risks" such as family history of thyroid, kidney cancer, or other diseases. LinksJamie C. DeWitt, Ph.D.Toxicology ChickThe Big Reveal: Hundreds of Health Studies on Next Gen PFASDr. DeWitt Congressional Testimony (July 24, 2019)Dr. DeWitt Congressional Testimony (March 21, 2021)Feedspot's Top 15 Fire Protection & Safety PodcastsAFSO21 Your leadership, management, and fire protection and emergency services consulting solutionFire Dept. Coffee Veteran owned and run by firefighters, Fire Dept. Coffee offers a wide variety of delicious coffeePod Decks Pod Decks helps podcasters grow their audience while having unique and deeper conversations.AFSO21 Delivering strategic & operational planning fundamentals to emergency services around the worldSupport the show (https://afso21.com/podcast)
When it comes to the COVID-19 vaccines, there is a lot of misinformation out there. So, to help you wade through it all, we brought in the chair of Internal Medicine at ECU's Brody School of Medicine. In Season 2, Episode 14 of Talk Like a Pirate, Dr. Paul Bolin breaks it down for you from the front lines in the fight against COVID-19.
As more people get COVID-19 vaccines, many wonder when mask-wearing will come to an end. In this preview of Season 2, Episode 14 of Talk Like a Pirate, chair of Internal Medicine at ECU's Brody School of Medicine Dr. Paul Bolin explains why mask wearing is here to stay – for now anyway.
La'Meshia Whittington is a Professor in the Division of Sociology at Meredith College. She is also the Deputy Director for Advance Carolina and the Campaigns Director for the North Carolina Black Alliance. She is the co-convener of the NC Black & Brown Policy Network, former National Democracy Campaigner for Friends of the Earth, Chairwoman of the FRENC Fund Administration, Founding member of Democracy Green, member of the Burke Women's Fund in Western NC and the former NC spokesperson on fair courts for The Leadership Conference on Civil and Human Rights. Professor Whittington leads the work on intersectional democracy and environmental justice, she was a co-author of NC Senate Bill 673, prioritizing environmentally contaminated communities-of-color in voting rights, and a co-author in several Pro-Democracy North Star legislation bills. Professor Whittington is a member of the NC PFAS Team anchoring AFFF legislation, and a convener of the Black Firefighters Fighting PFAS Collective. Professor Whittington has created and co-convened national, regional, and statewide tours and workshops on environmental justice, namely chemical contaminants, and dirty corporations. Professor Whittington continually works with the Brody School of Medicine at East Carolina University, DHHS and government agencies to ground community needs and strategies in alleviating health disparities in Black and Brown communities. Professor Whittington led the development of a statewide map to highlight the intersection of environmental justice contamination zones and the frequency in which they are located within gerrymandered Black majority voting districts. Professor Whittington is a petitioner in two active petitions to the U.S. Environmental Protection Agency, for more information: PFAS and 1,4 Dioxane. Professor Whittington is an Afro-Indigenous woman from North Carolina, hailing from a former environmental justice settlement: The Kingdom of the Happy Land. She received her education at Western Piedmont Community College and Meredith College. She is also a classically trained instrumentalist performing over 7 instruments! Instagram: @Nebiyah_ Twitter: @LaMeshiaLe www.AdvanceCarolina.org www.NCblackalliance.org www.democracygreen.org ---------------------------------------------------------------------------------------------------- Follow Therese "Tee" Forton-Barnes and The Green Living Gurus: Website and blog: thegreenlivinggurus.com Facebook Healthy Living Group Facebook Green Living Gurus Page Instagram YouTube Services For further info contact: Therese Forton-Barnes Email: Greenlivinggurus@gmail.com Cell: 716-868-8868
While people of color are disproportionately affected in severe coronavirus disease, many remain hesitant regarding whether or not to be vaccinated. As a Black physician, the Brody School of Medicine's Dr. Cedric Bright — who has received the vaccine — fact-checks common myths and advocates for people of color to get the vaccine in Season 2, Episode 13 of Talk Like a Pirate.
While people of color are disproportionately affected in severe coronavirus disease, many remain hesitant regarding whether or not to be vaccinated. As a Black physician, the Brody School of Medicine's Dr. Cedric Bright — who has received the vaccine — fact-checks common myths and advocates for people of color to get the vaccine in Season 2, Episode 13 of Talk Like a Pirate.
In this episode of NCFM Today, Ryan Paulus, DO, a second-year family medicine resident at UNC, discusses continuity of care in family medicine and the scope of family medicine and why that drew him to this career. In addition, Hannah Smith, a fourth-year medical student at the Brody School of Medicine at East Carolina University, talks about why she chose family medicine as her specialty and discusses what sparked her love affair with family medicine. Finally, we provide a few brief updates on what's going on in NC impacting family medicine this month.
In this episode: Dr. Eric Bolin, Chair of the Brody School of Medicine, responds to a social media post that offers advice for people diagnosed with COVID-19.
In this episode: Dr. Eric Bolin, Chair of the Brody School of Medicine, responds to a social media post that offers advice for people diagnosed with COVID-19.
Today we're joined by Dr. Cedric Bright, the Associate Dean of Diversity and Inclusion at the Brody School of Medicine. Dr. Bright talks about his 30 years in medicine, and how it started with majoring in film as an undergrad. He talks about going from selling solar panels in the 80s to retaking the MCAT and getting into medical school after a lot of work. He also talks about his work in health equity and the importance of diversity in medicine. I met Dr. Bright at a premed talk, and I, alongside my fellow premedical students, see him as a role model, and a mentor to talk to with any of our concerns in becoming a physician. --- Send in a voice message: https://anchor.fm/medspectives/message
Um episódio apenas não foi suficiente. Por isto já estou de volta! Vou seguir apresentando os artigos com os mais importantes achados de pesquisa para a prática clínica em 2018-2019, segundo o professor Sy Saeed da Brody School of Medicine.
Coronavirus- True/False COVID-19 info from Dr. Paul Cook, chief of the Division of Infectious Diseases at ECU’s Brody School of Medicine. Should we panic? NOTE: At the time of this broadcast, COVID was in early stages and not as much was know as now. At that time, face masks were not considered necessary. However, now we know they are important in fighting the disease and mandatory in many areas. Therefore, please act accordingly.
Before 1889, Montana exerted little oversight of those who claimed to be healers. Starting that year, however, the state required all medical practitioners to register with the newly formed State Board of Medical Examiners. Dr. Todd L. Savitt, historian of medicine at East Carolina University’s Brody School of Medicine, reveals a group demographic picture of the doctors who did (and did not) register and tells stories of some particularly interesting physicians in that group.
On today's episode of the Faculty Factory podcast we have a chat with Leigh A. Patterson, MD, MAEd. Dr. Patterson is Associate Dean for Faculty Development at the Brody School of Medicine at East Carolina University.
The guests on this podcast are 2018-19 Clerkship Directors in Emergency Medicine (CDEM) President Luan Lawson, MD, The Brody School of Medicine at East Carolina University and President-Elect: Kathy M. Hiller, MD, MPH, University of Arizona College of Medicine - Tucson.
The newest RAMS(Resident and Medical Student)Ask-a-Chair podcast features Angela M. Mills, MD, Chair of Emergency Medicine and the J.E. Beaumont Professor of Emergency Medicine at Columbia University Vagelos College of Physicians and Surgeons, who answers questions about differences between being vice chair and chair, challenges facing EM chairs, and how residents interested in administration should position themselves. The podcast is moderated by John Hurley, medical student, Brody School of Medicine at East Carolina University.
Todd L. Savitt, historian of medicine at East Carolina University’s Brody School of Medicine, discusses attempts at regulating medicine in early Montana. During its territorial and early statehood years, Montana did little to regulate healers of many varieties. In an effort to protect Montana’s citizens from what they saw as unscientific and unscrupulous practitioners, regularly trained physicians faced a variety of trials and tribulations as they passed a Medical Practice Act and established a respected Board of Medical Examiners.
The 30th volume of The Sports Objective features a chat with long-time Carolina Panthers play-by-play man Mick Mixon, who enters his 14th season with the organization. We will also chat with Dr. John Bream, graduate of ECU's Brody School of Medicine, re: some football coverage and other things he has going on with his "Right The Ship" Facebook group. Last, but not least, we will talk with Mike Bell, who is General Manager of the Wilson Tobs in the Coastal Plain League (Collegiate Summer Baseball). Follow us on Twitter and Instagram @TheSportsOBJ so you will be aware of when we release our latest podcasts. Like The Sports Objective Facebook page. Subscribe to our YouTube Channel via the link below so you can see the various pictures and video we take from around the state, region and nation as we travel to various high schools, colleges/universities, pro stadiums, and other interesting sports-related sites. https://www.youtube.com/channel/UC4c8mCy0MB2iTlex0-eaLEw
Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, Associate Editor, from the National Heart Center and Duke-National University of Singapore. Now, the SGLT2 inhibitor, empagliflozin, has been shown to improve outcomes in the EMPA-REG OUTCOMES trial. But do these benefits also apply in the real world, and to other SGLT2 inhibitors as a class? Well, we may just have some answers this week in the CVD-REAL study. More soon right after these summaries. The first original paper this week uncovers the mechanism of beneficial action of T-cells for proper healing after myocardial infarction. Now, the pro-inflammatory danger signal, adenosine triphosphate or ATP, is released from damaged cells, and degraded by the ectonucleotidase CD73 to the anti-inflammatory mediator, adenosine. Using newly-generated CD4-CD73 null mice, first author, Dr. Borg, corresponding author, Dr. Schrader, and colleagues from Heinrich Heine University of Düsseldorf in Germany, showed that a lack of CD73 on T-cells enhanced tissue fibrosis and worsened myocardial function in the remodeling phase after myocardial infarction. T-cells migrated into the injured heart and upregulated their enzymatic machinery to enhance the extracellular degradation of ATP to adenosine. T-cells lacking CD73 showed accelerated production of pro-inflammatory and profibrotic cytokines. Finally, the adenosine 2B receptor was upregulated on cardiac immune cells in the remodeling phase. In summary, therefore, local adenosine formation by CD73 on T-cells appears to be the body's own defense mechanism to control inflammation induced by myocardial infarction. This is a mechanism that might be exploited to promote healing or remodeling by specifically targeting the adenosine 2B receptor in the infarcted heart. The next paper provides insights on genetic determinants of susceptibility to peripheral artery disease, and specifically puts the spotlight on Bcl-2-associated athanogene-3, or Bag3, which is a cell chaperone protein previously identified in a genetic screen for determinants of tissue loss with hindlimb ischemia. In the current study, Dr. McClung from East Carolina University, Brody School of Medicine in Greenville, North Carolina, and colleagues, used adeno-associated viruses to show that an isoleucine to methionine variant at position 81 in Bag3 was sufficient to confer susceptibility to ischemic tissue necrosis in BALB/c mice. In a series of elegant experiments, they demonstrated that Bag3 was a modulator of ischemic muscle necrosis and blood flow. In summary, this study provides evidence that genetic variation in Bag3 plays an important role in the prevention of ischemic tissue necrosis, and highlights a pathway that preserves tissue survival and muscle function in the setting of ischemia. The next study provides insights into inflammatory atherogenesis by studying psoriasis, a chronic inflammatory disease associated with an accelerated risk of myocardial infarction. First author, Dr. Lerman, corresponding author, Dr. Mehta from the NHLBI, National Institutes of Health in Bethesda, United States, and colleagues, hypothesized that the increased cardiovascular risk observed in psoriasis would be partially attributable to an elevated subclinical coronary artery disease burden composed of non-calcified plaques with high-risk features. To test this hypothesis, they compared total coronary plaque burden, non-calcified coronary plaque burden, and high-risk plaque prevalence between 105 psoriasis patients, 100 older hypolipidemic patients eligible for statin therapy, and 25 non-psoriasis healthy volunteers. All patients underwent CT coronary angiography, and a sample of the first 50 psoriasis patients were scanned again at one year following therapy. The authors found that patients with psoriasis had greater non-coronary burden and increased high-risk plaque prevalence compared to healthy volunteers. Furthermore, compared to older hypolipidemic patients, patients with psoriasis had elevated non-calcified burden, and equivalent high-risk plaque prevalence. Finally, improvement in skin disease severity was associated with an improvement in non-calcified coronary burden at one year. The clinical implications are that patients with psoriasis have similar coronary artery disease risk as hyperlipidemic patients one decade older, and these patients with psoriasis should be screened earlier for cardiovascular disease and educated about their elevated risks. Further investigations focus on the longitudinal impact of psoriasis treatment on high-risk plaque morphology, as well as on the extent of cardiovascular risk mitigation in randomized trials. Well, those were your summaries. Now for our feature discussion. Now, we've heard of the EMPA-REG OUTCOME trial, that prospective randomized, controlled trial, showing a substantial reduction in cardiovascular death and hospitalization for heart failure with the sodium-glucose cotransporter 2, or SGLT2 inhibitor, empagliflozin, and that's, remember, that was in patients with type 2 diabetes and established atherosclerotic cardiovascular disease. Well, our paper today really extends our knowledge and tells us a bit more about the role of SGLT2 inhibitors in real-world clinical care. And I'm so please to have with us the first and corresponding author, Dr. Mikhail Kosiborod from Saint Luke's, Mid America Heart Institute, as well as Dr. Gabriel Steg, associate editor from Paris, France, joining us today. Hello, gentlemen. Dr. Gabriel Steg: Hello. Dr. Mikhail Kosiborod: Hi. Good morning, Carolyn. Dr. Carolyn Lam: Mikhail, I am going to say what I said to you at the ACC and at the ESC Heart Failure: Congratulations on CVD-REAL. Please tell us about CVD-REAL. Dr. Mikhail Kosiborod: Right, well, we know, as you just mentioned, that the EMPA-REG OUTCOME trial showed substantial reduction in cardiovascular death, and hospitalizations for heart failure in patients with type 2 diabetes and established cardiovascular disease. We were all very excited once that data got presented in September of 2015 in Stockholm, but there were several very important questions that weren't really addressed, and truly, could not be addressed, in EMPA-REG's trial. The first, actually, and probably the most important is, we all know that clinical trials, while we regard them as the gold standard of evidence, as we should, they do have their own set of limitations, the most important of which is that they examine a relatively small sliver of patients; and many patients we see in the clinic, in the hospital, don't look like patients in clinical trials. I think the most important questions we tried to address was, "Will this translate to real-world clinical practice?" The second was, as you recall, again, all patients on EMPA-REG had established cardiovascular disease, so we wanted to know whether the benefits associated with the use of SGLT2 inhibitors could potentially extend to lower-risk patients with type 2 diabetes without established cardiovascular disease, a much broader spectrum of patients. And finally, and also very importantly, I think, the third question was, "Is it an empagliflozin-specific effect or is it a class effect?" These are all the critical questions we tried to address in the CVD-REAL study. Dr. Carolyn Lam: Great. Could you give us the topline results, please? Dr. Mikhail Kosiborod: Right. So, just as a reminder, we collected data from well-established registries in six countries, so the United States and some five countries in Europe, Sweden, Norway, and Denmark, and also, the United Kingdom and Germany. And really, the inclusion/exclusion criteria for the study were quite broad, you just had to have type 2 diabetes and be newly started on either an SGLT2 inhibitor or any other glucose-lowering medications, which was the comparative group. And after we did the one-to-one propensity match to make sure, comparable samples, we ended up with about 154,000 patients, and each treatment group, over 300,000 patients overall. What we actually observed was a marked and highly significant reduction in the risk of hospitalization for heart failure that was associated with use of SGLT2 inhibitors versus other glucose-lowering drugs. In fact, the magnitude of reduction in risk that was associated with SGLT2 inhibitors, so that outcome was quite similar, about 39% relative risk reduction, quite similar to what we see in the EMPA-REG OUTCOME trial. But this, of course, was for the entire class of SGLT2 inhibitors, so patients in the study were treated primarily with canagliflozin and dapagliflozin, with a small proportion being treated with empagliflozin. We also saw dramatic and highly significant associated reduction in the risk of all-cause death with SGLT2 inhibitors versus other glucose-lowering drugs, about a 51% relative risk reduction, and the composite of those two outcomes, obviously, there was significant associated reduction in risk as well. So, again, the hazard ratio estimate that we saw for these outcomes were quite similar, and in some cases, almost identical to what we've seen in EMPA-REG, but for a patient population that was much broader, in fact, about 90% of patients, close to 90% of patients in our study did not have established, documented cardiovascular disease. And, of course, as I mentioned before, important implications to these findings, in my opinion. Dr. Carolyn Lam: Yeah, that is just remarkable. Gabriel, could you share some of the discussions that happened among the editors about this paper? Dr. Gabriel Steg: We were really excited by this paper. I think this is truly a landmark paper for a number of reasons. It's a very large, multinational study, but even more than the size, I think what's interesting here are a couple of key aspects. First of all is data on all-cause mortality, which is a highly reliable outcome when you look at many of the observational studies. Non-fatal outcomes can easily be skewed or biased in ascertainment or assessment, but this is relatively reliable. And here, we have a very large multinational cohort that finds benefits on death, heart failure, and their composite, which are remarkably consistent internally, consistent across countries, and consistent with the randomized trial data evidence from the EMPA-REG OUTCOME trial. So that is striking, and this is consistent across six countries using a very large sample size. But again, the size of the sample is not the most important thing, because in observational studies, you often have very large sample sizes, but if you have bias in your observational study, the bias is just replicated times the size of the study. The consistency here between the treatment effects across the various countries, the consistency with the efficacy assessed in randomized clinical trials is really a crux in the quality of the data and how believable the results are. Another key aspect that got us really excited is the fact that only a minute fraction of the data is related to use of empagliflozin. Most of the data was acquired using other SGLT2, and we still only have results now with empagliflozin, we don't have outcome trial data with the other agents. They are pending, but pending the availability of these trials, the fact that this large study sees a consistent benefit, in terms of heart failure and mortality, of the other agents in the class suggests that this is a class effect. And likewise, the fact that we're seeing these benefits in a population that is much, much broader than the population of EMPA-REG OUTCOMES is also very, very intriguing, and exciting, and makes us really want to see more data not only from the randomized trials that are upcoming, but also from this study. Because now, what we would like to see is, see the detailed cardiovascular outcomes in these cohorts, and I know that Mikhail and his colleagues are working very, very actively on preparing these analyses. I think this is going to be exciting. This is the first of a series of landmark papers from a model observational study. There are many issues with observational studies. This is almost as good as it can ever get, and I want to compliment Mikhail and the consortium that's with him, because this is a tremendous effort, across several countries, on achieving this. I think it's very exciting for our readership and for clinicians around the world. Dr. Carolyn Lam: I couldn't agree more, and I share your compliments for Mikhail. Perhaps, Mikhail, could you give us a sneak peek at the future and the ongoing work? Dr. Mikhail Kosiborod: We frequently think of, and I think perhaps mistakenly at times, think of clinical trials and observational real-world data as competing with one another. In many cases, they're really complementary, and I think if you really, kind of, think of interventions that we consider as those gold standards enshrined in clinical guidelines, or something we absolutely should be doing for our patients. Just to pick one example, statins for secondary prevention after a cardiovascular event, for example, there is data from both sources suggesting that these drugs are highly beneficial, right? So it is very important to have data from both sides, and I think, as Gabriel mentioned, I look at CVD-REAL as a model, in many ways, of how compelling the data from non-randomized, large, real-world observational studies can be when done well. In terms of a sneak peek for the future, there are many, many things going on. We are carefully examining the outcomes that we are reporting in circulation, including heart failure and all-cause mortality in various subgroups. We are, of course, as Gabriel mentioned, intently looking at other outcomes, including myocardial infarction, stroke, cardiovascular death, and a composite of major adverse cardiac events. We're also examining some of the diabetes, one could argue, maybe, diabetes-specific outcomes, such as hypoglycemia rates. We, of course, as cardiologists tend to concentrate on cardiovascular outcomes, but it's also important to remember that there are other important outcomes that could be associated benefits. So these medications may be associated with marked reduction of cardiovascular events, such as death and heart failure, but they may also reduce hypoglycemia rates and, of course, that's important from a quality-of-life standpoint for patients with diabetes, so some of that work is ongoing. And I would say, importantly, one of the other things that we're hoping to be able to do in the future is to go beyond cardiovascular outcomes, and perhaps blood glucose-specific outcomes, such as hypoglycemia, and start looking at events such as renal disease events, which I think are very important, of course. Interact quite a bit with, I suspect, in many ways, with some of the cardiovascular benefits that we're observing with those agents, both in the clinical trials and, now, in large observational studies. And that's just the beginning. I mean, I think it's fair to say that, as Gabriel mentioned, a huge amount of work went into putting this together, right? And we're actually not only expanding things from a standpoint of outcomes. We're also expanding things from a standpoint of countries that will be participating in CVD-REAL consortium. So we're actually planning to add at least two or three more countries from Europe, Middle East, and Asia in the coming months, and more so in the future. And of course, once you have a resource like this, there are additional questions that can be addressed, actually, both with SGLT2 inhibitors as a class, but also with other classes of type 2 diabetes medication. So that's, I think, as much of a sneak peek as I can give you right now. Just definitely promise you that there is a lot more coming. In addition to ADA, we're going to have abstracts being presented at ESC in August, and also the European Association for the Study of Diabetes meeting in Lisbon, in September, and there's going to be a lot more afterwards as well. So just stay tuned, I would say. This is definitely just the beginning. There's going to be a lot more coming. Dr. Carolyn Lam: You took the words right out of my mouth. Listeners, stay tuned, and don't forget to tune in next week as well.
Tourette Syndrome is typically noticed in the early stages of childhood and has an average onset between ages three and nine.Tourette syndrome is a neurological disorder branded by unusual repetitive, involuntary and unwanted movements or vocalizations known as tics. For instance, you may repeatedly blink your eyes, shrug your shoulders or jerk your head. In some cases, you might unintentionally blurt out offensive words.Tourette Syndrome is typically noticed in the early stages of childhood and has an average onset between ages three and nine.How do you know when to play attention to tics?Tics become worse when your child becomes excited, anxious, tired or bored and appear to be better during calm activities. If you begin to notice these unwanted patterns of behavior, a sniffle, a hand movement or throat clearing and it doesn't seem to go away, you should contact your pediatrician.There are several medication and dietary options in helping reduce symptoms of Tourette's, but they are not 100 percent curative.However, your child might not have Tourette's but instead may be suffering from a mild form of Tourette's known as Tic disorder, a temporary condition when your child makes one involuntary repetitive movement or noise.If your child is diagnosed with Tourette's, is this something they will live with for the rest of their life?Assistant professor at East Carolina University, Brody School of Medicine, Christine Tangredi, MD joins Melanie Cole, MS, to explain what Tourette syndrome is, the difference between tic disorder and Tourette's and what treatment options are available.
Tourette Syndrome is typically noticed in the early stages of childhood and has an average onset between ages three and nine.Tourette syndrome is a neurological disorder branded by unusual repetitive, involuntary and unwanted movements or vocalizations known as tics. For instance, you may repeatedly blink your eyes, shrug your shoulders or jerk your head. In some cases, you might unintentionally blurt out offensive words.Tourette Syndrome is typically noticed in the early stages of childhood and has an average onset between ages three and nine.How do you know when to play attention to tics?Tics become worse when your child becomes excited, anxious, tired or bored and appear to be better during calm activities. If you begin to notice these unwanted patterns of behavior, a sniffle, a hand movement or throat clearing and it doesn't seem to go away, you should contact your pediatrician.There are several medication and dietary options in helping reduce symptoms of Tourette's, but they are not 100 percent curative.However, your child might not have Tourette's but instead may be suffering from a mild form of Tourette's known as Tic disorder, a temporary condition when your child makes one involuntary repetitive movement or noise.If your child is diagnosed with Tourette's, is this something they will live with for the rest of their life?Assistant professor at East Carolina University, Brody School of Medicine, Christine Tangredi, MD joins Melanie Cole, MS, to explain what Tourette syndrome is, the difference between tic disorder and Tourette's and what treatment options are available.
Janet Malek, PhD is an Associate Professor in the Department of Bioethics and Interdisciplinary Studies at East Carolina University. In this talk she argues that transparency with patients is both ethically and practically preferable and that enlisting patients in the learning process can improve both educational outcomes and the learning environment as a whole. Dr. Malek received her BA in Genetics, Bioethics and Health Policy at Duke University and her PhD in Philosophy with a specialization in Bioethics at Rice University. She is the Course Director for Ethical Issues in Medicine at the Brody School of Medicine and has published articles on various topics in medical ethics. This Stambaugh Lecture was presented on Thursday, February 27th from noon-1pm in the Kornhauser Library Auditorium.
Guest: W. Randolph Chitwood, Jr., MD Host: Mark Nolan Hill, MD The most pressing question facing cardiac valve surgery is whether to undergo a replacement or repair procedure. Though outcomes of valve reconstruction are, in many cases, proving notably better than valve replacement, it is estimated that only a small majority of potential candidates are undergoing the valve repair. How can we reconcile this discrepancy—one that would appear to be placing our patients at greater risk? Host Dr. Mark Nolan Hill welcomes Dr. Randolph Chitwood, professor and chair of cardiovascular surgery at the Brody School of Medicine at East Carolina University, founding director of the East Carolina Heart Institute in Greenville, North Carolina, and one of the earliest pioneers of these procedures, to share his perspective on the current state of robot-assisted valvular surgery. Dr. Chitwood also takes a moment to peer into the future of cardiac surgery, anticipating what we'll see from the field of robotics in the years to come.
Guest: W. Randolph Chitwood, Jr., MD Host: Mark Nolan Hill, MD The most pressing question facing cardiac valve surgery is whether to undergo a replacement or repair procedure. Though outcomes of valve reconstruction are, in many cases, proving notably better than valve replacement, it is estimated that only a small majority of potential candidates are undergoing the valve repair. How can we reconcile this discrepancy—one that would appear to be placing our patients at greater risk? Host Dr. Mark Nolan Hill welcomes Dr. Randolph Chitwood, professor and chair of cardiovascular surgery at the Brody School of Medicine at East Carolina University, founding director of the East Carolina Heart Institute in Greenville, North Carolina, and one of the earliest pioneers of these procedures, to share his perspective on the current state of robot-assisted valvular surgery. Dr. Chitwood also takes a moment to peer into the future of cardiac surgery, anticipating what we'll see from the field of robotics in the years to come.