Podcasts about Circulation

Welcome to the latest Midlife Minute. This episode unpacks ongoing research on Lp(a), explores how women's lipids change during the perimenopause-to-menopause transition, and clarifies what we can do about it. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: How total cholesterol, LDL, and ApoB tend to rise most steeply around the final menstrual period, rather than increasing gradually with chronological aging Why women should have their Lp(a) checked both before and after menopause How oral and transdermal estradiol can affect LDL, HDL, triglycerides, and Lp(a) differently Why I recommend including ApoB when checking your lipids during the perimenopause window How your lifestyle can reduce your cardiovascular risk, even when your Lp(a) is elevated Why omega-3 fatty acids and commonly used lipid medications do not lower Lp(a) Why supplements are not replacements for statins in genuinely high-risk patients  I review the various PCSK9 inhibitors currently available, how they are administered, and their effects  How a CAC, a CT angiogram, and an AI-assisted CT angiogram can help women and their providers determine how aggressive their approach should be when Lp(a) is elevated Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line References: 1. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association.Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline 2. Menopause: A Cardiometabolic Transition. The Lancet. Diabetes & Endocrinology. 2022. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T.Review 3. Dyslipidemia Across the Menopause Transition: Mechanisms, Trajectories, and Opportunities for Cardiovascular Prevention. Maturitas. 2026. Castaneda R, Tatit CP, Hurtado Andrade MD, Faubion SS, Shufelt CL.RecentReview 4. Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. Michos ED, Saucier S, Mehran R, Koschinsky ML. 5. Lipid Metabolism in Women: A Review. Atherosclerosis. 2025. van Oortmerssen JAE, Mulder JWCM, Kavousi M, Roeters van Lennep JE.Review 6. Are Changes in Cardiovascular Disease Risk Factors in Midlife Women Due to Chronological Aging or to the Menopausal Transition?. Journal of the American College of Cardiology. 2009. Matthews KA, Crawford SL, Chae CU, et al.Observational 7. Trajectories of Lipids Around the Menopause Transition in Chinese Women: Results of the Kailuan Cohort Study. Fertility and Sterility. 2023. Dai Q, Wu S, Cao Z, et al. 8. Lipid Management in Patients With Endocrine Disorders: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2020. Newman CB, Blaha MJ, Boord JB, et al.Guideline 9. The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis. Frontiers in Pharmacology. 2022. Nie G, Yang X, Wang Y, et al.SR 10. Perspectives on Dyslipidemia and Coronary Heart Disease in Women. Journal of the American College of Cardiology. 2005. Bittner V.Review 11. Dyslipidemia in Midlife Women: Approach and Considerations During the Menopausal Transition. Maturitas. 2022. Torosyan N, Visrodia P, Torbati T, Minissian MB, Shufelt CL.Review 12. Effects of gender, age and menopausal status on serum apolipoprotein concentrations.13.Lipoprotein(a).The Journal of the American Medical Association. 2025. Mora S, Kronenberg     14. Why, how and in whom should we measure levels of lipoprotein(a): A review of the latest evidence and clinical implications. Diabetes, Obesity & Metabolism. 2025. Razavi AC, Bhatia HS, Blumenthal RS, Shapiro MD, Mehta A.RecentReview 15. Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar. Journal of the American College of Cardiology. 2021. Cicero AFG, Fogacci F, Zambon A.Review 16. Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Drugs. 2023. Blais JE, Huang X, Zhao JV.SR 17. Non-Genetic Influences on Lipoprotein(a) Concentrations. Atherosclerosis. 2022. Enkhmaa B, Berglund L.Review 18. NHLBI Working Group Recommendations to Reduce Lipoprotein(a)-Mediated Risk of Cardiovascular Disease and Aortic Stenosis. Journal of the American College of Cardiology. 2018. Tsimikas S, Fazio S, Ferdinand KC, et al.Review 19. Consumption of a defined, plant‐based diet reduces lipoprotein(a), inflammation, and other atherogenic lipoproteins and particles within 4 weeks. Clinical Cardiology. 2018. Najjar RS, Moore CE, Montgomery BD. 20. Lipoprotein(a): Current Evidence for a Physiologic Role and the Effects of Nutraceutical Strategies. Clinical Therapeutics. 2019. Santos HO, Kones R, Rumana U, et al.Review 21. Effect of Lipid-Lowering Therapies on Lipoprotein(a) Levels: A Comprehensive Meta-Analysis of Randomized Controlled Trials. Atherosclerosis. 2025. Xie S, Galimberti F, Olmastroni E, et al.Recent 22. Effect of Omega-3 Fatty Acid Supplementation on the Postprandial Metabolism of Apolipoprotein(a) in Familial Hypercholesterolemia. Journal of Atherosclerosis and Thrombosis. 2023. Ying Q, Croyal M, Chan DC, et al.RCT 23.Lipoprotein(a) and Cardiovascular Disease. Lancet. 2024. Nordestgaard BG, Langsted A.Review 24. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arteriosclerosis, Thrombosis, and Vascular Biology. 2022. Reyes-Soffer G, Ginsberg HN, Berglund L, et al.Guideline 25.Clinical Trial Design for Lipoprotein(a)-Lowering Therapies: JACC Focus Seminar 2/3.Journal of the American College of Cardiology. 2023. Malick WA, Goonewardena SN, Koenig W, Rosenson RS.Review 26.2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026. Writing Committee Members, Blumenthal RS, Morris PB, et al.Guideline 27. Noninvasive Coronary Atherosclerotic Plaque Imaging. JACC. Cardiovascular Imaging. 2023. Kwiecinski J, Tzolos E, Williams MC, et al.Review 28. Computed Tomography Angiography Versus Agatston Score for Diagnosis of Coronary Artery Disease in Patients With Stable Chest Pain: Individual Patient Data Meta-Analysis of the International COME-CCT Consortium. European Radiology. 2022. Wieske V, Walther M, Dubourg B, et al.SR 29. Association of Coronary Artery Calcium Score With Qualitatively and Quantitatively Assessed Adverse Plaque on Coronary CT Angiography in the SCOT-HEART Trial. European Heart Journal. Cardiovascular Imaging. 2022. Osborne-Grinter M, Kwiecinski J, Doris M, et al.Clinical Trial 30. AI-Guided Quantitative Plaque Staging Predicts Long-Term Cardiovascular Outcomes in Patients at Risk for Atherosclerotic CVD. JACC. Cardiovascular Imaging. 2024. Nurmohamed NS, Bom MJ, Jukema RA, et al.Observational 31. The Lancet Commission on Rethinking Coronary Artery Disease: Moving From Ischemia to Atheroma. Lancet. 2025. Zaman S, Wasfy JH, Kapil V, et al.Review 32. Efficacy and safety of novel lipoprotein(a)‐targeted therapies: A systematic review and meta‐analysis of randomized controlled trials. Diabetes, Obesity & Metabolism. 2026. Santana AUL, Yusufzai MO, Freitas APS, et al. Recent Opinion

Contributor: Travis Barlock, MD Educational Pearls: What is pulmonary edema?  Pulmonary edema is the accumulation of fluid initially in the interstitium of the lungs, that when severe enough can also accumulate in the alveolar air sacs. It develops when the rate of fluid filtration through the pulmonary vasculature out-paces the lymphatics ability to drain the fluid.  There are 2 theories for what causes pulmonary edema in the setting of naloxone administration: catecholamine surge vs negative pressure/barotrauma Catecholamine Surge : Naloxone administration precipitates an acute opioid withdrawal in which epinephrine and norepinephrine surge causing marked vasoconstriction on both the heart and the lungs   Negative Pressure/Barotrauma: This mechanism is not directly naloxone related but may be confounded by opioid effects. High dose synthetic opioids can induce sustained laryngospasm that is not mu-opioid mediated (thus not easily reversed by naloxone). With rapid awakening, respiratory muscles induce a negative pressure in the thoracic cavity against a closed glottis. This results in an alveolar barotrauma and a transudative pulmonary edema. What is the treatment for pulmonary edema secondary to opioid overdose reversal? Positive pressure ventilation is the mainstay treatment (CPAP/BiPAP) with oxygen supplementation. Importantly, diuretics are not recommended. The patient is not fluid overloaded like in the case of other pulmonary edemas, and diuresing the patient can worsen kidney injury which is already at an increased risk in opioid overdoses (rhabdomyolysis in particular).     References: Saari TI, Strang J, Dale O. Clinical Pharmacokinetics and Pharmacodynamics of Naloxone. Clin Pharmacokinet. 2024;63(4):397-422. doi:10.1007/s40262-024-01355-6 DailyMed - NALOXONE HYDROCHLORIDE injection, solution. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=201fdedf-1736-4e52-9d7d-de14292547fd Boyer EW. Management of Opioid Analgesic Overdose. New England Journal of Medicine. 2012;367(2):146-155. doi:10.1056/NEJMra1202561 Dezfulian C, Orkin AM, Maron BA, et al. Opioid-Associated Out-of-Hospital Cardiac Arrest: Distinctive Clinical Features and Implications for Health Care and Public Responses: A Scientific Statement From the American Heart Association. Circulation. 2021;143(16):e836-e870. doi:10.1161/CIR.0000000000000958 Kienbaum P, Thurauf N, Michel M, Scherbaum N, Gastpar M, Peters J. Profound Increase in Epinephrine Concentration in Plasma and Cardiovascular Stimulation after [micro sign]-Opioid Receptor Blockade in Opioid-addicted Patients during Barbiturate-induced Anesthesia for Acute Detoxification Anesthesiology. 1998;88(5):1154-1161. doi:10.1097/00000542-199805000-00004 Summarized by Dan Orbidan, OMS3 | Edited by Dan Orbidan & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/   Join our mailing list: http://eepurl.com/c9ouHf

In this short bonus episode, Craig explores the powerful connection between your beliefs and your income, revealing how your bank account can become a mirror for the stories you hold about money. He breaks down why receiving is a practice, how turning down compliments, help, opportunities, and money can quietly block the very abundance you're asking for, and why circulation is essential to expansion. Drawing from his study of tithing and unconditional giving, Craig shares the principle that what you circulate expands, and explains why money needs to flow with purpose rather than being held from a place of fear or attachment. Through a powerful real estate story, he challenges us to trust, release the need to cling, and become a greater vessel for what we're calling in.0:15 Money Mirrors Your Beliefs00:50 Receiving as a Spiritual Practice02:01 What You Circulate Expands02:49 When Money Stops Flowing03:55 Trust Over ClingingEarly Bird Tickets now available for our October live event, CLS: Formation HERE:Check out The Command Room HERE: To join our community click here.➤ To connect with Craig Siegel follow Craig on Instagram➤ Order a copy of my new book The Reinvention Formula today! ➤ Join our CLS texting community for free daily inspiration and business strategies to elevate your day, text (917) 634-3796➤ INSTAGRAM➤ FACEBOOK➤ TIKTOK➤ YOUTUBE➤ WEBSITE➤ LINKEDIN➤ X

Welcome to the latest Midlife Minute. Today, I'm answering listeners' questions about cardiovascular risk, focusing on Lp(a), LDL, statins, and the changes women experience after menopause. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: Why women should have their Lp(a) checked both before and after menopause How Lp(a) works as a risk enhancer, and how cardiovascular risk becomes more significant when elevated Lp(a) occurs alongside high LDL Why family history is particularly helpful for women with a 10-year calculated cardiovascular risk that looks reassuringly low I review the current guidelines for primary prevention Why, even though research has shown reductions in major cardiac events with GLP-1s, GLP-1s do not replace statins for lowering LDL  What a CAC score can reveal about coronary artery calcification, and what it cannot detect How AI-assisted CT angiography (such as Clearly) can map, quantify, and characterize plaque throughout the coronary branches Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line References: 1.  ​Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. Michos ED, Saucier S, Mehran R, Koschinsky ML.Recent 2.  ​Sex Differences of Lipoprotein(a) Levels and Associated Risk of Morbidity and Mortality by Age: The Copenhagen General Population Study. Atherosclerosis. 2022. Simony SB, Mortensen MB, Langsted A, et al. 3. Managing Atherosclerotic Cardiovascular Risk in Young Adults: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2022. Stone NJ, Smith SC, Orringer CE, et al.Review 4. Thirty-Year Risk of Cardiovascular Disease Among Healthy Women According to Clinical Thresholds of Lipoprotein(a). JAMA Cardiology. 2026. Nordestgaard AT, Chasman DI, Moorthy V, et al.RecentObservational 5.  ​Lipoprotein(a).The Journal of the American Medical Association. 2025. Mora S, Kronenberg  6. Clinical Practice Guideline on Lipid Management for Cardiovascular Disease Risk Reduction. Department of Veterans Affairs (2026). 2026. Paul Heidenreich, Lance Spacek, Neil Gregor, et al. Guideline 7. Lipoprotein(a) and Family History Predict Cardiovascular Disease Risk. Journal of the American College of Cardiology. 2020. Mehta A, Virani SS, Ayers CR, et al.Observational 8. 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2010. Greenland P, Alpert JS, Beller GA, et al.Guideline 9. Prevalence and Prognostic Implications of Coronary Artery Calcification in Low-Risk Women. The Journal of the American Medical Association. 2016. Kavousi M, Desai CS, Ayers C, et al.SR 10. ​Coronary Artery Calcium Scores and Risk for Cardiovascular Events in Women Classified as “Low Risk” Based on Framingham Risk Score: The Multi-Ethnic Study of Atherosclerosis (MESA). Archives of Internal Medicine. 2007. Lakoski SG, Greenland P, Wong ND, et al.Observational 11. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2019. Arnett DK, Blumenthal RS, Albert MA, et al.Guideline 12. HOPE for Rational Statin Allocation for Primary Prevention: A Coronary Artery Calcium Picture Is Worth 1000 Words. Mayo Clinic Proceedings. 2020. Orringer CE, Maki KC.Review 13. Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2020. Cho L, Davis M, Elgendy I, et al.Review 14. Health Maintenance in Postmenopausal Women. American Family Physician. 2025. Plesa M, Wong A, Katsaggelos E.Guideline 15.  ​Semaglutide and Cardiovascular Outcomes by Baseline HbA1c and Change in HbA1c in People With Overweight or Obesity but Without Diabetes in SELECT. Diabetes Care. 2024. Lingvay I, Deanfield J, Kahn SE, et al.RCT 16.  ​Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. The New England Journal of Medicine. 2023. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al.RCT 17. Long-Term Weight Loss Effects of Semaglutide in Obesity Without Diabetes in the SELECT Trial. Nature Medicine. 2024. Ryan DH, Lingvay I, Deanfield J, et al.RCT 18. Interventions for the Prevention and Management of Cardiometabolic Multiple Long-Term Conditions. Lancet. 2026. Valabhji J, Hope D, Sayed NE, et al.RecentReview 19. Glucagon‐Like Peptide‐1 Receptor Agonists and Major Adverse Cardiovascular Events in Patients With and Without Diabetes: A Meta‐Analysis of Randomized‐Controlled Trials. Clinical Cardiology. 2024. Hosseinpour A, Sood A, Kamalpour J, et al.SR 20. ​FDA Orange Book. FDA Orange Book. 2026. 21. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2026. Diabetes Care. 2026. American Diabetes Association Professional Practice Committee for Diabetes*.RecentGuideline 22. Premature Coronary Artery Disease in Women: Sex-Specific Risk Factors, Pathogenetic Mechanisms and Clinical Implications. Annals of Medicine. 2026. Li F, Hong D, Yang M, et al.RecentReview 23. Cardiovascular Disease Risk Factors in Women: The Impact of Race and Ethnicity: A Scientific Statement From the American Heart Association. Circulation. 2023. Mehta LS, Velarde GP, Lewey J, et al.Guideline 24. Preventing CVD in Women: Common Questions and Answers. American Family Physician. 2023. Westfall E, Viere AB, Genewick JE.Review 25. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline

New study attempts to resolve question over which has contributed more to our current obesity epidemic—diet or sedentary lifestyle? Pros/cons of CT scans vs. MRIs for investigating abdominal complaints; Fish oil rivals effectiveness of antibiotics for periodontal disease; The MIND diet vs. KetoFLEX Diet for fending off cognitive decline; Vitamin B3 helps relieve Raynaud's symptoms; After American Heart Association green lights coffee, new study shows high consumption can accelerate bone loss; High-dose vitamin D protects memory in light sleepers.

If you've got heavy legs, nighttime cramps, varicose veins or swelling in the legs, you may have blood flow issues. When you consider that our bodies contain an incredible 60,000 miles worth of blood vessels, it's really not uncommon. Something like a varicose vein is usually relatively harmless. Other conditions include hemorrhoids, and phlebitis, which is a blood clot in a deep vein. Worse still are varicose ulcers, which are a complication of varicose veins or phlebitis. It's important to know the cause behind any blood circulation issues and get treatment to avoid complications. How does the circulatory system work? Are there specific factors that would make me more likely to have poor blood circulation? Why do I feel like the symptoms are always worse in the summer?  ⁠⁠⁠In under 3 minutes, we answer your questions !⁠⁠⁠ To listen to the latest episodes, click here: ⁠⁠⁠Will the British museum finally give back the Parthenon marbles?⁠⁠⁠ ⁠⁠⁠What did the Jane Collective do for US women's rights?⁠⁠⁠ ⁠⁠⁠What is tagskryt, the Scandinavian sustainable travel trend?⁠⁠⁠ A podcast written and realised by Joseph Chance. First Broadcast: 21/9/2022 Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of *PICU Doc on Call*, Drs. Pradip Kamat and Rahul Damania dive into the topic of beta-blocker toxicity. They walk through a case of a 15-year-old who comes in with bradycardia, hypotension, hypoglycemia, and altered mental status after an intentional ingestion. Using a board-style question, they break down how to tell the difference between beta-blocker and calcium channel blocker poisoning and review key points about cardiac physiology and receptor signaling.Drs. Kamat and Damania discuss management strategies, including glucagon, high-dose insulin therapy, vasopressors, calcium, and ECMO as a last resort. They also spend some time focusing on specific agents like propranolol and sotalol, highlighting what makes their toxicologic profiles unique. This is a high-yield episode packed with pearls for pediatric intensivists!Show Highlights:Clinical case of a 15-year-old patient with bradycardia and hypotension due to intentional drug ingestionBeta-blocker toxicity and its clinical featuresDifferentiation between beta-blocker and calcium channel blocker toxicityKey physiological concepts related to cardiac action potentials and beta receptor functionClinical presentation and diagnostic workup for beta-blocker toxicityManagement strategies for beta blocker overdose, including airway control and fluid resuscitationSpecific toxicologic profiles of common beta-blockers (e.g., propranolol, sotalol, metoprolol)Importance of recognizing hypoglycemia and CNS effects in beta-blocker toxicitySummary of critical management steps and take-home points for pediatric intensivistsEncouragement for further learning and engagement on related topicsReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 126. Toxidromes and their treatment. Joshi P. Pages 1504-1505Reference 1: Rogers textbook of Pediatric Intensive Care: Chapter 36: Poisoning. Nares M, Jeyapalan A, Weisman R: pages 525-543Reference 2: Lavonas EJ, Akpunonu PD, Arens AM, Babu KM, Cao D, Hoffman RS, Hoyte CO, Mazer-Amirshahi ME, Stolbach A, St-Onge M, Thompson TM, Wang GS, Hoover AV, Drennan IR; American Heart Association. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Oct 17;148(16):e149-e184. doi: 10.1161/CIR.0000000000001161. Epub 2023 Sep 18. PMID: 37721023.Suarez F, Koyfman A, Long B. Pearls and Pitfalls for the Emergency Clinician: Beta Blocker and Calcium Channel Blocker Toxicity. J Emerg Med. 2026 May;84:1-11. doi: 10.1016/j.jemermed.2026.01.021. Epub 2026 Jan 27. PMID: 41833262.

Les partis politiques sont en mode séduction des personnes âgées pendant les élections | Un boeuf plus abordable importés… de l’Australie! | Encore un drame en voiture… respectez les vitesses svp! | Le 3e lien, faut vraiment se faire une raison | Les progrès de l’IA commencent presque à faire peur | Le récit hallucinant de cette habitant d’Hochelaga sur l’itinérance Dans cet épisode intégral du 4 septembre, en entrevue : Martin Nadeau, propriétaire du St-Hubert sur Ste-Catherine dans le Village. Josée Bélanger, créatrice de FILAMENT. Maxime Tardif, entrepreneur, ancien policier au SPVM Anna* (nom fictif), résidente d’Hochelaga. Une production QUB Septembre 2026Pour de l'information concernant l'utilisation de vos données personnelles - https://omnystudio.com/policies/listener/fr

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Eh les influenceurs, Benoit a 2-3 mots à vous dire | Les cols bleus passent leur temps en grève… | Le Village tombe-t-il en ruines pour des raisons pécuniaires?? | Frapper son bébé et ressortir libre? Oui… et on dira merci à Justin Trudeau s’il récidive! | PSPP et Duhaime sont tannés des vieilles histoires Dans cet épisode intégral du 3 septembre, en entrevue : Stephanie Kusie, députée conservatrice dans Calgary Midnapore. Éric Paradis, producteur du Fetish Weekend de Montréal. Mathieu Côté, Capitaine à la retraite au Royal 22e Régiment. Une production QUB Septembre 2026Pour de l'information concernant l'utilisation de vos données personnelles - https://omnystudio.com/policies/listener/fr

Drainville sur Trump | Un Canadien sauvé au Népal | Définition de l’immigration | Provinciales 2026 | L’arnaqueur Serge Rivard | Rôle des infirmières | Nooran Rezayi | Témoignage d’une mère monoparentale | Emy Lalune | Est-ce que votre médecin s’en cogne? | Dans cet épisode intégral du 3 septembre, en entrevue : Luc Mathieu, président de l’Ordre des infirmières et infirmiers du Québec (OIIQ) Julie Lamonde, mère monoparentale de Lévis en attente d'une place en garderie Caroline Cloutier, victime de Serge Rivard Benoît Heppell, médecin de famille en Estrie Emy Lalune, créatrice de contenu numérique Une production QUB Septembre 2026 Pour de l'information concernant l'utilisation de vos données personnelles - https://omnystudio.com/policies/listener/fr

Marwah Rizqy s’en prend à cet ex députée libérale | Comment vaincre le problème des intimidateurs à l’école?? | Ce candidat conservateur était ouvertement anti-vaccins | Le Mexique plus malin que le Canada? | PRB, pas tendre avec Christine Fréchette Dans cet épisode intégral du 2 septembre, en entrevue : Marie-Claude Archambault, résidente de Blainville, candidate pour Climat Québec, équipe Martine Ouellet dans Blainville. Christine Gingras, médiatrice professionnelle, maman d’une victime d’intimidation. Dr Gilbert Boucher, président de l'Association des spécialistes en médecine d'urgence du Québec (ASMUQ). Une production QUB Septembre 2026Pour de l'information concernant l'utilisation de vos données personnelles - https://omnystudio.com/policies/listener/fr

Avec : Daniel Riolo, journaliste RMC. Benjamin Müller, journaliste. Et Yael Mellul, ancienne avocate. - Accompagnée de Charles Magnien et sa bande, Estelle Denis s'invite à la table des français pour traiter des sujets qui font leur quotidien. Société, conso, actualité, débats, coup de gueule, coups de cœurs… En simultané sur RMC Story.

Au Québec, ça marche E-N F-R-A-N-Ç-A-I-S | Ensemble Montréal? Oubliez ça! | Le trafic à MTL, on n’est plus capable… | La CAQ se montre généreuse | Les rats sont PARTOUT | Vous voulez séduire une femme? Ne vous lavez pas, ça ne vaut plus le coup Dans cet épisode intégral du 1er septembre, en entrevue : Luis Felipe Cisneros Martinez, professeur titulaire au Département d'entrepreneuriat et d’innovation au HEC. L’Automobiliste de Montréal, de son vrai nom Jean-François Thibault. Marie-Claire Guidon, présidente de RATS Canada. Une production QUB Septembre 2026Pour de l'information concernant l'utilisation de vos données personnelles - https://omnystudio.com/policies/listener/fr

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Each week, join Editor-in-Chief Brad Maron, along with cohosts Mercedes Carnethon and Jane Wilcox for the new iteration of Circulation on the Run.  This week, please join Brad, Jane, and Mercedes as they welcome 3 authors of recently published articles for the 2026 ESC Congress. First, our three hosts welcome James Januzzi Jr. as they discuss his article "Oral Relaxin Receptor Agonist AZD5462 in Participants with Chronic Heart Failure: Primary Results from the LUMINARA Trial." Then, Dr. Axel Diederichsen joins our podcast to discuss his article "Vitamin K2 and D3 Supplementation in Patients with Severe Coronary Artery Calcification: The DANCODE Trial." In in our final segment of the podcast, Jane and Mercedes interview Dr. Martin Maron as they discuss his article "Global Efficacy of Aficamten in Nonobstructive Hypertrophic Cardiomyopathy: Results from ACACIA-HCM."

Lac Ontario ou America? | Provinciales 2026 | Mélanie Joly | PCQ: abolir la TVQ? | La calvitie: la prochaine mine d’or de Wall Street? | Colombie: nouveau président anti-narco | Cadre financier | Le Tricheur avec José Gaudet | Blue Jays Dans cet épisode intégral du 31 août, en entrevue : Sol Zanetti, co-porte-parole et candidat de Québec solidaire dans la circonscription de Jean-Lesage. Luc Godbout, professeur titulaire de la chaire de recherche en fiscalité et en finances publiques de l'Université de Sherbrooke Mélanie Joly, ministre de l’Industrie, Ministre responsable de Développement économique Canada (DEC) pour les régions du Québec et députée de Ahuntsic-Cartierville pour le Parti libéral du Canada Dr. Maud Bélanger, chirurgienne plasticienne à la clinique Sensa MD Bruno Guglielminetti, analyste, conférencier et animateur du balado d’actualité numérique «Mon Carnet» José Gaudet, animateur du jeu télévisé Le Tricheur Une production QUB Août 202Pour de l'information concernant l'utilisation de vos données personnelles - https://omnystudio.com/policies/listener/fr

Welcome to SEASON SEVEN, Superwomen!  I'm so excited to be back in your listening ears, and I'm truly pumped for what this season is going to look like. This podcast started in 2019, pulled us all through the last seven years, and we are now entering the 147th episode, in the seventh season. Holy cow!  Today on the podcast, I'm asking a very important question... "What if your periods could give us clues about the health you'll need to protect ten, twenty or thirty years from now — even if there was never anything "wrong" with them?" We'll explore why hormone and reproductive health belong in the preventative-health conversation. We look at what menstrual cycles, pregnancy history, PCOS, perimenopause and menopause can tell us about cardiovascular health, metabolic health, body composition, bone and healthspan. But this isn't an episode about looking for hormone problems. A normal menstrual history is information. An uncomplicated pregnancy is information. The timing and pattern of perimenopause are information too. We'll look at how reproductive history can help us understand health trajectory earlier — and why something doesn't have to be wrong before it becomes useful information. Hormones are data, not destiny. The goal is to use that data to build better preventative-health plans long before we're treating the outcomes we're trying to prevent. RESEARCH USED IN THIS EPISODE Global Healthspan-Lifespan Gaps Among 183 WHO Member States — Garmany & Terzic, JAMA Network Open, 2024. This is the study behind the discussion that women have a wider healthspan-lifespan gap than men. JAMA Network Open full article | PubMed Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Cardiovascular Disease — Wang et al., JAMA Network Open, 2022; 80,630 women followed for 24 years. JAMA Network Open full article | PubMed Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Premature Mortality — Wang et al., BMJ, 2020; 79,505 women followed prospectively. PubMed Association Between Reproductive Life Span and Incident Nonfatal Cardiovascular Disease — Mishra et al., JAMA Cardiology, 2020; pooled data from 307,855 women. JAMA Cardiology full article | PubMed Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women — American Heart Association Scientific Statement, Circulation, 2021. PubMed Gestational Diabetes and the Risk of Cardiovascular Disease in Women: A Systematic Review and Meta-analysis — Kramer et al., Diabetologia, 2019; more than 5.3 million women. PubMed Hypertensive Disorders of Pregnancy and Risk of Cardiovascular Disease-Related Morbidity and Mortality — systematic review/meta-analysis involving more than 13 million women. PubMed Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention — American Heart Association Scientific Statement, Circulation, 2020. This is one of the most important papers supporting the episode's preventative-health framing of perimenopause. PubMed Are Changes in Cardiovascular Disease Risk Factors in Midlife Women Due to Chronological Aging or to the Menopausal Transition? — SWAN; Matthews et al., JACC. The study separating age-related changes from menopause-associated changes in LDL, total cholesterol and ApoB. PubMed Changes in Body Composition and Weight During the Menopause Transition — SWAN; Greendale et al., 2019. Fat gain accelerated and lean mass declined around the menopause transition without a corresponding acceleration in overall weight gain. PubMed Abdominal Visceral Adipose Tissue Over the Menopause Transition and Carotid Atherosclerosis — SWAN Heart Study, 2021. PubMed Bone Mineral Density Loss in Relation to the Final Menstrual Period — SWAN; Greendale et al., 2012. The research behind our discussion of the accelerated bone-loss window around menopause. PubMed

Send us Fan MailDr. Lana Castellucci and Dr. Kerstin de Wit join CLOT Conversations to discuss the 2026 guideline for the evaluation and management of acute pulmonary embolism in adults and what its recommendations mean for clinical practice.The conversation explores the new A–E clinical categories for acute PE, including how to recognize patients whose condition may be deteriorating despite not meeting traditional criteria for high-risk PE. The discussion also covers the role of PE response teams (PERT), outpatient versus inpatient management, the recommendation for low-molecular-weight heparin over IV unfractionated heparin when parenteral therapy is required, and patient selection for systemic thrombolysis and catheter-directed therapies.The guests also address a common patient question about flying after PE, important evidence gaps, and a fundamental clinical message: avoid unnecessary delays in anticoagulation while determining next steps.Creager MA, Barnes GD, Giri J, et al. 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026 Mar 24;153(12):e977-e1051. doi: 10.1161/CIR.0000000000001415. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001415Hosts: David Airdrie, Dr. Jameel Abdulrehman and Dr. Maha Othman.Visit thrombosiscanada.ca for clinical guides, tools, education and patient resources.Support the showhttps://thrombosiscanada.caRegister today for our upcoming conference on November 7, 2026 in Montreal at https://thrombosiscanada.ca/2026ConferenceTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-499 Overview: Stay in the know with this breakdown of the latest American College of Cardiology (ACC)/American Heart Association (AHA) recommendations for lipid testing and management. New approaches to evaluating hyperlipidemia, as well as limitations of the updated guidelines, are discussed to provide you with practical strategies for tailoring treatment decisions to individual patient risk. Episode resource links: Writing Committee Members, Blumenthal RS, Morris PB, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154-e1276.  Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-499 Overview: Stay in the know with this breakdown of the latest American College of Cardiology (ACC)/American Heart Association (AHA) recommendations for lipid testing and management. New approaches to evaluating hyperlipidemia, as well as limitations of the updated guidelines, are discussed to provide you with practical strategies for tailoring treatment decisions to individual patient risk. Episode resource links: Writing Committee Members, Blumenthal RS, Morris PB, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154-e1276.  Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Each week, join Editor-in-Chief Brad Maron, along with cohosts Mercedes Carnethon and Jane Wilcox for the new iteration of Circulation on the Run. This week, please join Brad and Jane as they first welcome Deputy Editor Philippe Gabriel Steg to discuss trends and the increase in Clinical Trials. Then, Brad and Jane talk with Specialty Associate Editor Erin Bohula to discuss critical care in medicine article types, and what authors of critical care cardiology manuscripts should consider when submitting to Circulation. For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260824.20983

Does lower cholesterol equal less plaque? The answer may surprise you. On this episode of Vitality Radio, Jared explores emerging research on nattokinase, a systemic enzyme derived from fermented soybeans, and its potential role in supporting cardiovascular health. He reviews a 2017 clinical trial comparing nattokinase with a commonly prescribed statin, discusses why imaging studies of arterial plaque may offer a different perspective than cholesterol markers alone, and explains how fibrin may influence plaque structure. Jared also breaks down the importance of dosage, why many studies suggest higher amounts may produce different results than standard servings, and how systemic enzymes fit into a broader heart health strategy. As always, he encourages listeners to understand the research, ask better questions, and work with qualified healthcare professionals when making decisions about their cardiovascular health.Products:NattokinaseFibrenza Systemic EnzymesSun Nutrition Vascular Defense Systemic Enzyme & N.O. BlendVisit the podcast website here: VitalityRadio.comYou can follow @vitalitynutritionbountiful and @vitalityradio on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.This podcast is produced by DrTalks.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drtalks.com/podcast-service/

CardioNerds (Drs. Dr. Natalie Marrero, Dr. Ritika Tuli, and Dr. Rafael Toro Manotas) discuss multimodality imaging for risk stratification, evaluation, and management of chronic coronary artery disease with Dr. Panithaya Chareonthaitawee. Audio editing by CardioNerds intern Iman Razeghian. This episode was produced as part of the CardioNerds Academy curriculum by House Taussig under the guidance of House Chief, Dr. Natalie Marrero and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course. In this episode, we discuss the pathophysiology and risk stratification of chronic coronary artery disease (CAD), as well as the current landscape of non-invasive evaluation of this condition. CAD remains a leading cause of morbidity and mortality despite advances in pharmacological and non-pharmacological strategies for the prevention and treatment of atherosclerotic disease. The concept of chronic CAD has shifted from the traditional model of stable, obstructive, flow-limiting disease, toward the current understanding of a dynamic process that extends beyond obstructive epicardial lesions to include non-obstructive plaque, diffuse atherosclerosis, and microvascular disease. Similarly, the imaging modalities used to evaluate CAD have evolved, and clinicians now have an extensive menu of options, each with distinct advantages and limitations, that must be selected carefully to maximize diagnostic accuracy and optimize treatment guidance, while also considering resource availability, local expertise, and high-value care. By the end of the episode, listeners will understand the pathophysiology of chronic CAD, risk-stratify patients with suspected CAD, recognize the advantages and pitfalls of each non-invasive diagnostic modality, and select the most appropriate diagnostic tool for a given clinical scenario. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls: Chronic CAD is a complex process that extends beyond obstructive epicardial stenosis to include non-obstructive disease, dynamic plaque burden and ischemia, diffuse atherosclerosis, microvascular dysfunction, vasospasm, among others. When evaluating patients with suspected CAD, the diagnostic process should be guided by a specific and appropriate clinical question before ordering any tests. The current diagnostic tool arsenal is broadly divided into anatomic and functional imaging modalities. These are complementary, each with distinct properties and limitations, addressing different clinical questions and assessing different aspects of disease. Local availability and expertise, along with patient-specific considerations and contraindications, determine the choice of diagnostic modality. No single test is best for every patient. INOCA and coronary microvascular dysfunction represent a common and increasingly recognized entity that is diagnosable and treatable; initial evaluation includes non-invasive testing such as stress PET and stress CMR. References Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029 https://pubmed.ncbi.nlm.nih.gov/34709879/ Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024;45(36):3415-3537. doi:10.1093/eurheartj/ehae177 https://pubmed.ncbi.nlm.nih.gov/39210710/ Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148(9):e9-e119. doi:10.1161/CIR.0000000000001168 https://pubmed.ncbi.nlm.nih.gov/37471501/ Edvardsen T, Asch FM, Davidson B, et al. Non-Invasive Imaging in Coronary Syndromes: Recommendations of The European Association of Cardiovascular Imaging and the American Society of Echocardiography, in Collaboration with The American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2022;35(4):329-354. doi:10.1016/j.echo.2021.12.012 https://pubmed.ncbi.nlm.nih.gov/35379446/ Douglas PS, Hoffmann U, Patel MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372(14):1291-1300. doi:10.1056/NEJMoa1415516 https://pubmed.ncbi.nlm.nih.gov/39210710/ Sharma A, Coles A, Sekaran NK, et al. Stress Testing Versus CT Angiography in Patients With Diabetes and Suspected Coronary Artery Disease. J Am Coll Cardiol. 2019;73(8):893-902. doi:10.1016/j.jacc.2018.11.056 https://pubmed.ncbi.nlm.nih.gov/30819356/ SCOT-HEART Investigators, Newby DE, Adamson PD, et al. Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. N Engl J Med. 2018;379(10):924-933. doi:10.1056/NEJMoa1805971 https://pubmed.ncbi.nlm.nih.gov/30145934/ Li Z, Xu T, Wang Z, et al. Prognostic Significance of Computed Tomography-Derived Fractional Flow Reserve for Long-Term Outcomes in Individuals With Coronary Artery Disease. J Am Heart Assoc. 2025;14(2):e037988. doi:10.1161/JAHA.124.037988 https://pubmed.ncbi.nlm.nih.gov/39791423/ Bateman TM, Al-Mallah MH, et al. Clinical indications for positron emission tomography myocardial perfusion imaging and myocardial blood flow quantification: An American Society of Nuclear Cardiology position statement. J Nucl Cardiol. 2026;57:102619. doi:10.1016/j.nuclcard.2025.102619 https://pubmed.ncbi.nlm.nih.gov/41482140/ Taqueti VR, Di Carli MF. Coronary Microvascular Disease Pathogenic Mechanisms and Therapeutic Options: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018;72(21):2625-2641. doi:10.1016/j.jacc.2018.09.042 https://pubmed.ncbi.nlm.nih.gov/30466521/ Taqueti VR, Hachamovitch R, Murthy VL, et al. Global coronary flow reserve is associated with adverse cardiovascular events independently of luminal angiographic severity and modifies the effect of early revascularization. Circulation. 2015;131(1):19-27. doi:10.1161/CIRCULATIONAHA.114.011939 https://pubmed.ncbi.nlm.nih.gov/25400060/ Mehta PK, Huang J, Levit RD, Malas W, Waheed N, Bairey Merz CN. Ischemia and no obstructive coronary arteries (INOCA): A narrative review. Atherosclerosis. 2022;363:8-21. doi:10.1016/j.atherosclerosis.2022.11.009 https://pubmed.ncbi.nlm.nih.gov/36423427/ Kunadian V, Chieffo A, Camici PG, et al. An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group. EuroIntervention. 2021;16(13):1049-1069. doi:10.4244/EIJY20M07_01 https://pubmed.ncbi.nlm.nih.gov/32624456/

Contributor: Taylor Lynch, MD Educational Pearls:  CPR is an important life-saving measure designed for anyone to perform. Chest compressions works by two mechanisms:  Cardiac pump: Direct squeezing of the heart Thoracic pump: Increasing intrathoracic pressure, causing increased blood flow Proper hand placement per current AHA guidelines:  Hands are placed in the center of the chest, on the lower half of the sternum A recent study challenged this approach, using TEE during chest compressions to visualize the cardiac structures being compressed. They found that when hands were placed ~1cm to the left of the sternum, this compressed the left ventricular outflow tract, potentially restricting forward blood flow. Hand placement ~4cm to the left of the sternum resulted in more effective compression of the left ventricle. While this is not yet reflected in AHA guidelines, the study presents an interesting finding that may influence how CPR is performed in the future.  Key takeaway: Always prioritize administering high quality compressions. References:  American Heart Association. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025;152(23_suppl_1). doi:10.1161/CIR.0000000000001378. Chu S, Cheng C, Chang C, et al. Transesophageal echocardiography during CPR in patients with out-of-hospital cardiac arrest: the EXECT-CPR randomized clinical trial. JAMA Intern Med. 2026;186(5):557-566. doi:10.1001/jamainternmed.2026.0102.   Summarized by Ashley Lyons, OMS4 | Edited by Ashley Lyons & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/   Join our mailing list: http://eepurl.com/c9ouHf

Low-fat dairy shown to confer no weight, cholesterol benefits over full-fat dairy; FDA and USDA to define ultra-processed foods for first time—but what are they really? Newly discovered tick-borne Bourbon virus can be fatal—but is it more pervasive than we think? Thorne supplement maker—sold 3 years ago for $700 million—acquired by Procter & Gamble for $3.8 billion. Those dark skin blotches—are they melasma, or just age spots? Is low-mercury salmon a hype? That fishy smell—does it mean your seafood is spoiled?

Each week, join Editor-in-Chief Bradley Maron, along with cohosts Mercedes Carnethon and Jane Wilcox for the new iteration of Circulation on the Run. This week, please join Brad and Mercedes as they first welcome Specialty Associate Editor Mukta Srivastava to discuss the new Circulation article type, Images of Cardiovascular Medicine. Then, Brad and Mercedes talk with Chair and First Author Mary Norine "Minnow" Walsh to discuss the "AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026)." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260817.380420

CardioNerds (Dr. Apoorva Gangavelli, Dr. Cory Sejo, and Dr. Joseph Kassab), discuss tricuspid regurgitation evaluation and management with Dr. Sunil Mankad. This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course.  Audio editing by CardioNerds intern Emma Winakur. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Key Points: Tricuspid regurgitation is common and associated with increased mortality at every stage, regardless of etiology. Outcomes are worse with worsening severity, so accurate grading is critical. Etiology is critical to guide treatment decisions. Etiology includes primary vs secondary (atrial or ventricular) vs CIED-related TR. 3D echocardiography can be very helpful in determining TR etiology, especially in CIED-related TR. Diuresis with the goal of euvolemia is step one. Additionally, underlying contributory conditions (eg. pulmonary HTN, HFrEF, atrial fibrillation) should be addressed, if appropriate, and then TR severity reassessed. The choice between T-TEER and TTVR hinges on anatomy, RV function, pulmonary hypertension, and the ability to tolerate anticoagulation. T-TEER is generally first line in atrial functional TR with appropriate anatomy, in patients with poor RV function who cannot tolerate a sudden increase in RV afterload, or in patients who cannot tolerate the necessary anticoagulation with TTVR. TTVR is preferred with wide coaptation gaps and CIED-related TR. This is a team sport. Multidisciplinary discussions utilizing imaging (TTE/TEE, CT), risk scores (TRI-SCORE or TRIO), patient preference, and prior institutional experience are essential for the effective treatment of severe TR. Notes: What is the clinical importance of tricuspid regurgitation? TR is very common with approximately 4% of people over 75 having moderate or greater severity. TR (even mild) is associated with increased mortality. Those outcomes worsen as the TR severity worsens, and this phenomenon is independent of the mechanism of regurgitation. What is unique about the tricuspid valve compared to the other cardiac valves? It is at an anterior location which allows it to be imaged well with transthoracic echocardiography It is the largest valve and composed generally of 3 leaflets (but very often can have 4+ leaflets). Importantly, the RV is compliant and changes size and shape readily based on loading conditions. The TV annulus similarly changes size and shape based on hemodynamic conditions such as preload. What is a good framework for approaching the causes of tricuspid regurgitation? Determine the presence and define the severity of TR. Using TTE, we want to measure the right atrial size, the RV size, and any other concomitant valvular lesions.  Use TTE (2D and 3D) to characterize leaflet anatomy and characteristics. Subtypes of TR mechanisms (many times etiology is mixed). Primary: primary leaflet abnormality, occurs in ~10% of cases. Look for prolapse, flail, endocarditis, etc. Secondary/functional: leaflets normal but surrounding structures are abnormal. Atrial: RA and tricuspid annular dilation but normal RV size/shape, and can be related to arrhythmias like atrial fibrillation. Ventricular: RV dilated and/or dysfunctional with leaflet tethering. Can be related to pulmonary hypertension or primary RV disease. Cardiac implantable electronic device (CIED): Related to device (usually pacemakers or ICD) interaction with TV leaflets. Includes perforation, entanglement in subvalvular apparatus, impingement, etc. 3D TTE particularly helpful to evaluate How do we grade TR severity? It is very important to grade the severity of TR, and this is generally done with echocardiography. There are both quantitative and qualitative methods which use Doppler and various equations to estimate TR severity. Current recommendations have expanded TR severity beyond mild/moderate/severe to include “massive” and “torrential” categories. The most important parameters measured/calculated are vena contracta width, regurgitant volume, regurgitant fraction, and effective regurgitant orifice area. Helpful qualitative metrics include hepatic venous flow reversal. When should additional studies beyond transthoracic echocardiography, such as transesophageal echocardiography (TEE), cardiac computed tomography (CT), and cardiac magnetic resonance imaging (MRI) be pursued? TEE is particularly helpful if TTE views are poor. Since TEE is used during transcatheter intervention, a pre-procedure TEE to define anatomy, determine procedure candidacy, and plan for the procedure is critical.  CT is also helpful for procedure planning and has particular strengths in defining annulus size and geometry. A CT is required prior to transcatheter tricuspid valve replacement (TTVR). MRI is helpful for measuring RV volumes and function, but is not generally used to assess TR severity.  What is the approach to the treatment for severe tricuspid regurgitation? The first step is to try to determine the etiology. For secondary TR, treating the underlying condition is indicated. For example, pulmonary vasodilators for pulmonary HTN or guideline therapy for heart failure with reduced ejection fraction. Diuretics are the mainstay for treatment, with the goal to obtain euvolemia. This may require inpatient admission to optimize volume status and medication regimen. Once reversible etiologies are addressed, if the patient is still symptomatic from TR, additional therapies can be considered. What is the role of right heart catheterizations (RHC) in patients with severe TR? RHC is very helpful for many reasons. We use it in TR to help determine volume status, cardiac output, and RV function. Additionally, identifying and characterizing pulmonary hypertension (with pulmonary artery pressures and calculating pulmonary vascular resistance) is an important factor when choosing future therapies.  With severe tricuspid regurgitation, when should we refer for intervention (either with surgery or transcatheter repair or replacement)? Once reversible etiologies are addressed and euvolemia has been achieved, if the patient is still symptomatic from TR despite aggressive medical optimization, additional therapies can be considered. Once euvolemic, a repeat TTE should be ordered to reassess the severity of the TR. Use calculators (for example, either the TRI-SCORE or TRIO score) to predict operative mortality for isolated TR surgery. What are our transcatheter treatment options in severe tricuspid regurgitation, and how do we choose between them? The primary approved transcatheter treatment options for severe TR include transcatheter tricuspid edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR), of which the Edwards EVOQUE valve is the only one currently approved by the FDA. There are other TTVR device under investigation. These decisions should be made with a multi-disciplinary team including representation from cardiac imaging, interventional cardiology, and cardiothoracic surgery. Factors that go into the decision between T-TEER and TTVR include anatomy (annulus width, coaptation gap, leaflet length), RV reserve, pulmonary hypertension presence, ability to tolerate anticoagulation, patient preference, and institutional experience.  T-TEER is generally the first line with atrial functional and suitable anatomy. It is successful at reducing TR but does not generally eliminate it.  TTVR with EVOQUE is preferred in certain anatomic considerations like a large coaptation gap or when there is CIED-related TR (as this was excluded in T-TEER trials). Patients must be suitable for anticoagulation to receive TTVR as there is risk of leaflet thrombosis without it. If moderate/severe pulmonary hypertension is present, or there is poor RV function, TTVR may be avoided as the sudden elimination of TR causes a sudden increase in RV afterload which may not be tolerated. What is the role in advanced metrics for evaluating RV function? Advanced metrics like RV/PA coupling are under investigation but have not made it into the guidelines. The clinical utility is not yet known.  Assessing the RV function is important as stated above. Dr. Mankad prefers using 3D TTE to calculate an RVEF, or tracking RV longitudinal free wall strain. If you do encounter CIED-related TR, how do you treat it? Evaluate with TTE or TEE. 3D is very helpful to identify relative anatomy and leaflet-device interactions. There is no clear consensus about treatment if CIED-related TR is the primary mechanism of severe TR. If recently implanted, repositioning may be a valid option, but requires discussions with multiple teams including electrophysiology, advanced cardiac imaging, CT surgery, and interventional cardiology. References O’Gara PT, Lindenfeld J, Hahn RT, et al. 10 Issues for the Clinician in Tricuspid Regurgitation Evaluation and Management: 2025 ACC Expert Consensus Decision Pathway. J Am Coll Cardiol. 2025;S0735-1097(25)07047-0. O’Gara PT, Little SH, Badhwar V, et al. Operator and Institutional Recommendations and Requirements for Tricuspid Interventions: 2026 ACC/AHA/ASE/HRS/STS Expert Consensus Systems of Care Document. J Am Coll Cardiol. 2026;S0735-1097(26)05481-1. Hahn RT. Tricuspid Regurgitation. N Engl J Med. 2023;388(20):1876-1891. Davidson LJ, Tang GHL, Ho EC, et al. The Tricuspid Valve: A Review of Pathology, Imaging, and Current Treatment Options: A Scientific Statement From the American Heart Association. Circulation. 2024;149(22):e1223-e1238.

Seu paciente treina pesado, tem exames "impecáveis" e quase nunca fala sobre uso de atalhos químicos.Até o dia em que chega ao pronto-socorro. Quanto você realmente sabe sobre o paciente que usa anabolizantes?Neste episódio, William Batah e Fernanda Justo recebem a Dra. Luciana Oliveira, endocrinologista pela UFPR, mestre pela UNIFESP e preceptora do ambulatório de endocrinologia do exercício, para destrinchar um tema que a cardiologia não pode mais ignorar. Luciana também lidera uma plataforma de notificação de complicações do uso indevido de hormônios e implantes no Brasil, o que dá ao episódio uma visão rara de quem lida com as consequências reais desse uso na prática.

durée : 00:05:13 - Les Matins de France Culture - par : Marie Dorcet - Le 8 août 2026, un adolescent de 14 ans a perpétré une fusillade dans un lycée près de Bangkok. Le Premier ministre annonce des mesures pour mieux contrôler les armes à feu dans un pays qui en compte 10 millions en circulation. Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France

656.Can increased muscle mass improve circulation of blood lymph? Find Get-Fit Guy on Facebook and Twitter, or subscribe to the newsletter for more fitness tips.Get-Fit Guy is a part of Quick and Dirty Tips.Links:https://www.quickanddirtytips.comhttps://www.facebook.com/GetFitGuyhttps://twitter.com/GetFitGuy Hosted on Acast. See acast.com/privacy for more information.

CardioNerds (Dr. Apoorva Gangavelli, Dr. Rebecca Garber, and Dr. Tina Reddy), discuss pre-pregnancy risk stratification and counseling with Dr. Katy Young across a range of risks.  This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course. Audio editing by CardioNerds intern, Dr. Patrick Pekyi-Boateng. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Notes:  Why is pregnancy considered a “physiologic stress test,” and why does risk extend beyond delivery? Blood volume, heart rate, and cardiac output rise while systemic vascular resistance falls, peaking in the late second/early third trimester; underlying (even undiagnosed) heart disease can be unmasked or worsened. Postpartum (“fourth trimester”) is a high-risk period, not a safe zone – fluid shifts, rising SVR, and bleeding risk can precipitate decompensation in patients with heart failure, pulmonary hypertension, valvular disease, or aortopathy. Adverse pregnancy outcomes (hypertensive disorders, gestational diabetes, preterm birth, fetal growth restriction, peripartum cardiomyopathy) are markers of future cardiovascular risk and warrant long-term preventive follow-up. What is the practical framework for approaching pre-pregnancy cardiovascular risk? Four broad categories: (1) patients who may need cardiac screening before pregnancy, (2) patients needing risk-factor/medication optimization, (3) known cardiovascular disease where pregnancy is reasonable with structured risk stratification, and (4) high-risk disease where pregnancy may need to be delayed, modified by intervention, or discouraged. Testing should be targeted, not blanket – reserved for symptoms, abnormal exam, concerning family history, or reduced functional capacity. How is risk stratified in patients with known cardiovascular disease? Use a combination of tools per 2025 ESC guidelines: mWHO 2.0 (broad maternal risk category), CARPREG II (additional predictors of maternal cardiac events), and ZAHARA (useful in congenital heart disease). Key lesion-specific factors: aortic size/growth, valve severity, ventricular function, symptoms, blood pressure, and family history of dissection. Translate risk into practical terms for patients rather than leading with a numerical score. Which cardiovascular medications require review before conception? ACE inhibitors, ARBs, and ARNIs should be transitioned off before pregnancy; statins, MRAs, and SGLT2 inhibitors also need review. DOACs are contraindicated in pregnancy and lactation; mechanical valve anticoagulation requires individualized shared decision-making, as no strategy is risk-free for mother and fetus. Medication changes are best made proactively, before conception, rather than reactively. This is not an exhaustive list! The medication list needs to be reviewed carefully. Which conditions carry high or prohibitive risk in pregnancy? Pulmonary arterial hypertension, Eisenmenger syndrome, severe ventricular dysfunction, prior peripartum cardiomyopathy with residual LV dysfunction, severe left-sided obstructive valve disease (e.g., severe mitral stenosis), mechanical valves, significant aortopathy, cyanotic congenital heart disease, and Fontan physiology. Common theme: limited cardiovascular reserve and high risk of decompensation, thrombosis, arrhythmia, heart failure, aortic dissection, or death. These patients need expert multidisciplinary evaluation before pregnancy. Severe mitral stenosis is poorly tolerated because tachycardia shortens diastolic filling time and raises left atrial pressure, risking pulmonary edema and decompensation. When should genetic testing or counseling be offered? Consider when a diagnosis may be inherited or affect the patient, pregnancy, or family members: inherited cardiomyopathies, aortopathies, channelopathies, select congenital heart disease, and some pulmonary hypertension syndromes. Recurrence risk of congenital heart disease in offspring is roughly 6-10% when the mother has CHD; fetal echocardiography should be offered. How should contraception be approached in high-risk cardiac patients? Frame contraception as part of the cardiac care and reproductive safety plan to prevent unplanned high-risk pregnancy. Long-acting reversible contraception is often preferred; progestin-only methods are generally safer than estrogen-containing options with thrombosis risk, pulmonary hypertension, or mechanical valves. What are key delivery-planning considerations for cardiac patients? Vaginal delivery is preferred unless there is an obstetric indication for cesarean or a specific cardiac reason (e.g., unstable maternal status, therapeutic INR) to avoid labor. Planning should address delivery location, anesthesia involvement, telemetry needs, fluid management, and postpartum monitoring, clearly communicated across the multidisciplinary team in advance. How should clinicians counsel patients when pregnancy is discouraged but strongly desired? Acknowledge the patient’s goals and the emotional weight of the conversation; separate the goal (family building) from the timeline (safety now vs. after optimization). If pregnancy remains prohibitively risky, discuss alternatives for family building and ensure adequate patient support. What are the key gaps and future directions in cardio-obstetric risk stratification? Current risk tools (mWHO, CARPREG II, ZAHARA) provide common language but do not fully capture functional status, prior pregnancy history, or how risk evolves over time. Future direction: individualized, dynamic risk prediction incorporating imaging, biomarkers, exercise capacity, and social drivers of health, with better long-term links between pregnancy complications and cardiovascular prevention. References 1. European Society of Cardiology. 2025 ESC Guidelines for the management of cardiovascular disease and pregnancy. 2. Mehta LS, et al. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association. Circulation. 2020;141:e884-e903. PMID: 32362133. doi:https://doi.org/10.1161/CIR.0000000000000772 3. ACOG Practice Bulletin No. 212. Pregnancy and Heart Disease. Obstet Gynecol. 2019;133(5):e320-e356. PMID: 31022123. doi:https://doi.org/10.1097/AOG.0000000000003243

Sign up for my free newsletter/1 page action plansIn this episode of Live Long and Well, Dr. Bobby looks at the evidence behind breakfast—not as a slogan, but as a real-life question: what problem is breakfast solving?For some people, breakfast may help with blood sugar, protein intake, morning exercise, or avoiding late-day overeating. For others, skipping breakfast may work perfectly well. And for many adults, “breakfast” may really mean coffee—which can improve alertness and exercise performance, but is not the same as food, protein, fiber, or fuel.Dr. Bobby also explores where the breakfast slogan came from, including its ties to cereal companies, health reformers, and early public relations campaigns. The episode then compares breakfast, lunch, and dinner through three practical questions:Does this meal help my body and health?Weight, blood sugar, disease risk, protein, and muscle.Does this meal help me perform today?Exercise, energy, focus, cognition, and school performance.Does this meal help me live well?Family rhythm, connection, and the social meaning of meals.The conclusion: there is probably no single “most important meal” for everyone. The best meal is the one that helps you live the day you are actually trying to live.In this episodeWhy “breakfast is the most important meal” may be more marketing than medical factWhat observational studies suggest about breakfast skipping and heart disease riskWhy healthy-user bias makes breakfast research trickyWhat randomized trials show about breakfast, skipping breakfast, weight loss, and metabolismHow chrononutrition raises a better question: are we eating too much too late?Why coffee may help you skip breakfast—but does not replace breakfast nutritionallyWhen eating before morning exercise mattersWhat we know about breakfast, cognition, and school performance in childrenWhy “hangry” may be realHow breakfast, lunch, and dinner each serve different rolesHow to decide whether breakfast matters for youKey takeawaysBreakfast does not magically turn on your metabolism.Randomized trials do not show that simply adding breakfast leads to meaningful weight loss.Skipping breakfast is not automatically harmful.It may work well for some people, especially if it reduces total calories without causing overeating later.The observational data are complicated.Breakfast skippers often look less healthy in long-term studies, but they may also smoke more, sleep less, exercise less, work irregular schedules, or eat more late at night.Chrononutrition gives breakfast its strongest argument.The body may handle calories better earlier in the day than late at night. The issue may be less “everyone must eat breakfast” and more “be careful about pushing most calories to the evening.”Coffee is not breakfast.Coffee may improve alertness and exercise performance, and it may reduce appetite for a while. But it is not protein, fiber, or fuel.Kids are different.For a hungry child, breakfast may matter for learning readiness, behavior, and attention.Exercise changes the answer.For a short, easy workout, coffee and water may be enough. For a long run, long ride, intervals, or race-like effort, food or carbohydrate may help.Dinner may win the connection argument.Shared meals are strongly linked with well-being. Dinner may not be best for blood sugar, but it may be powerful for family, friendship, and decompression.Lunch deserves more respect.Lunch may be the underrated meal that prevents the 3 p.m. slump and the 9 p.m. snack attack.A practical experimentRather than adopting a slogan, try a personal experiment.For two weeks, eat a real breakfast with protein, fiber, and minimal added sugar. Track your hunger, mood, exercise quality, afternoon energy, evening snacking, and sleep.Then, if it is safe for you, try two weeks of delaying or skipping breakfast while keeping your coffee/caffeine routine consistent.Ask yourself:Do I feel better or worse?Do I eat less overall—or make it up later?Are my workouts better or worse?Am I sharper or more irritable?Does skipping breakfast lead to a chaotic dinner?Am I still getting enough protein?The question is not whether breakfast works in theory. The question is whether breakfast works for you.Who should be more cautious about skipping breakfast?Be more careful with breakfast skipping if you are a child or adolescent, pregnant, diabetic, prone to low blood sugar, have a history of eating disorders, do long or intense morning workouts, or struggle to get enough protein—especially as an older adult.Dr. Bobby's bottom lineFor me, breakfast is not the most important meal most days.If I have a long workout ahead, I eat breakfast. Coffee alone is not enough.If I am just writing, reading, or working in the morning, coffee may be enough until I am actually hungry.And if I am eating with family or friends, breakfast matters for a different reason. Sometimes the table matters more than the eggs.Maybe breakfast is not the most important meal of the day.Maybe it is the most marketed.The most important meal is the one that helps you live the day you are actually trying to live.

On today's episode Mike Farley is joined by guest Hunter Gary of H2 Outdoor Living from Middle Tennessee, to discuss how Hunter entered pool design and launched his design firm three years ago and a newer build/GC arm. They focus on why detailed construction and hydraulic plans matter to prevent costly, hard-to-fix underground plumbing problems and to ensure apples-to-apples bidding. The epsiode outline homeowner red flags and checkpoints, including clean, well-laid-out equipment pads, photo documentation, flow meters, and builders who can explain pump curves and turnover rates. They emphasize larger plumbing, variable-speed pumps, cartridge filters, proper circulation, quieter systems, safety/entrapment avoidance, Venturi skimmers, in-floor returns/cleaning, and correct design of perimeter overflows and vanishing-edge basins, including surge capacity and filtration/sanitation.   Discover more and connect: https://h2outdoorliving.com/ https://www.farleypooldesigns.com/ https://www.youtube.com/@MikeFarleyDesigns https://www.instagram.com/farleydesigns/ https://www.instagram.com/luxuryoutdoorlivingpodcast/   Watch episodes on YouTube: https://www.youtube.com/@MikeFarleyDesigns/podcasts   00:00 Podcast intro 01:17 Meet Hunter Gary 02:07 How He Started 03:44 From Service to Design 07:41 Million Dollar Challenge 08:43 Launching His Company 10:20 Design Process Explained 12:41 Why Working Drawings Matter 15:41 Hydraulics Intro 17:54 Equipment Pad Clues 20:14 Photos and Hydraulic Plans 24:40 Circulation and Filtration 29:23 Pipe Sizing and Efficiency 34:15 Noise and Suction Lines 36:58 Pumps for Water Features 39:58 Turnover and Flow Meters 41:11 Flow Meters and Turnover 42:35 Venturi Skimmers Explained 43:49 Main Drains vs Skimmers 44:51 Service Knowledge Pitfalls 48:12 Hydraulics Are Just Math 50:22 Perimeter Overflow Returns 52:51 In Floor Circulation Systems 54:31 Vanishing Edge Basin Design 58:17 Equipment Pad and Expansion 59:40 Elevation and Split Equipment 01:01:29 Entrapment Safety and Drains 01:04:20 Budgeting and Spare Lines 01:08:27 Personal Q and A Wrap Up 01:12:06 Final Thanks and Mission    

Is your pool service business making money this summer, or is the summer running your business? In Episode #313 of the Pool Nation Podcast, Edgar and John "JJ Flawless" break down the 5 mid-season checks every pool professional should be making right now to protect their customers, employees, equipment, routes, and most importantly, their profits. August is one of the toughest months in the swimming pool industry. Water temperatures are climbing, chlorine demand is increasing, equipment is working harder, technicians are battling extreme heat, customers are using their pools more, and chemical, fuel, labor, and operating costs can quietly destroy your margins. This episode is a mid-season business checkup for pool service companies. Edgar and John break down five critical areas: • Water & Chemistry → Why the chemistry strategy that worked in May may not work in August, how higher water temperatures accelerate demand, and why pool pros have to stay ahead of problems instead of reacting to them. • Pool Equipment & Filtration → Pumps, filters, salt systems, automation, plumbing, seals, circulation, and other equipment are under maximum stress during the summer. Learn what you should be watching before a small issue becomes an emergency call. • Route Efficiency → Driving all over town costs more than time. Poor route density, unnecessary drive time, fuel costs, and inefficient scheduling can quietly destroy the profitability of your pool route. • Your Team → Your technicians are dealing with the same summer heat and pressure you are. Edgar and John discuss workload, heat, burnout, employee retention, leadership, and why taking care of your team becomes even more important during peak season. • The Profit Check → The check almost nobody wants to do. Are your pools actually profitable? Increased chemical usage, overtime, fuel, callbacks, filter neglect, equipment issues, and extra service time can turn what looks like a profitable account into a pool that is quietly costing you money every week. They also dive deep into one of the most overlooked parts of summer pool maintenance: filtration. Putting off filter cleanings doesn't just create water problems. It can lead to increased chemical consumption, algae, callbacks, unhappy customers, longer service stops, lost filter-cleaning revenue, employee frustration, and ultimately lost customers. John shares a real-world example of how his company has prioritized filter cleanings during peak season and how properly maintaining filtration can create additional revenue while making the route easier to manage. The bigger lesson? Summer exposes the weaknesses in your pool service business. Your systems. Your pricing. Your routes. Your equipment. Your leadership. Your customer service. And your profitability. If you own or operate a pool service company, pool cleaning business, pool repair company, pool maintenance route, or swimming pool business, this episode will help you identify the problems that could be costing you money before the season is over. Edgar and John also share a personal Pool Nation update as Zac "The Pool Boy" Nicholas steps away from Pool Nation to focus on the continued growth of The Pool Boys, his family, employees, and business. The guys reflect on Zac's contribution to Pool Nation and why sometimes business growth requires making difficult decisions and focusing on the opportunity directly in front of you. Plus, Pool Nation gives an update on upcoming industry training and a major announcement coming August 14 at 4:00 PM Central Time. TIMESTAMPS 00:00 → Welcome to the Pool Nation Podcast 01:00 → The 5 Mid-Season Checks Every Pool Pro Should Make 02:00 → Surviving Extreme Summer Heat 05:00 → Pool Nation's August 14 Major Announcement 06:00 → Pool Nation Women's Summit & Upcoming Events 07:00 → Upcoming Hands-On Pool Industry Training 11:00 → A Personal Update About Zac "The Pool Boy" Nicholas 16:00 → The Pool Nation Mission Moving Forward 17:00 → Is Your Business Running You This Summer? 20:00 → Protecting Pool Technicians During Extreme Heat 22:00 → Growth, Experience & Surviving Peak Pool Season 23:00 → Why Summer Is the Best Time to Grow Your Pool Route 27:00 → The 5-Part Mid-Season Pool Business Checkup 30:00 → The Profit Check Every Pool Company Needs to Make 33:00 → What August Heat Does to Pool Water Chemistry 36:00 → Why Summer Pool Chemistry Is Harder 38:00 → Sponsor Break 43:00 → Summer Pool Equipment Problems 46:00 → Circulation, Pumps & Equipment Stress 47:00 → Why Filter Cleaning Matters More in Summer 49:00 → The Expensive Mistake Pool Pros Make With Filters 52:00 → How Filter Neglect Costs Your Pool Business Money 54:00 → The Hidden Revenue Opportunity in Filter Cleaning 57:00 → Sponsor Break 1:02:00 → Mid-Season Checkup Recap & What's Coming Next 1:03:00 → The August 14 Pool Nation Announcement 1:04:00 → Final Thoughts 1:06:00 → Closing THANK YOU TO OUR VISIONARY PARTNERS The Pool Nation Podcast would not be possible without the companies that continue to support Pool Nation, professional education, and the swimming pool industry. Thank you to: SPPA BluRay XL AquaStar Pool Products Natural Chemistry Raypak Heritage Pool Supply Hayward Pool Products OnCore Filtration Poolside Tech Pool Brain Nidec / U.S. Motors Encore Brands Your continued support helps Pool Nation provide education, training, resources, events, and conversations designed to help pool professionals Master the Business and Perfect the Craft. ABOUT THE POOL NATION PODCAST The Pool Nation Podcast is built for swimming pool professionals who want to build better businesses, become stronger leaders, improve their technical knowledge, and become more profitable. From pool service and repair, water chemistry, filtration, pumps, heaters, automation, and equipment to pricing, leadership, employees, route efficiency, customer retention, business growth, and profitability, Pool Nation is committed to helping pool pros build businesses and lives they are proud of. It's all pool talk, and we ain't talking about netting and jetting or splashing and dashing. We're talking about becoming a Nation of Pool Pros. Master the Business. Perfect the Craft.

This week, please join Brad and Mercedes as they welcome Deputy Editor Ryan J. Tedford and they discuss the advance of SGLT-2, non-steroidal MRA, and GLP-1 therapies that provide clinicians options to treat patients and HFpEF comorbidities. Then, Associate Editor Mark Chandy joins the podcast to discuss highlights from the recent BCVS Scientific Sessions in Boston, as well as how he prioritizes different types of basic and scientific manuscripts at Circulation. For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260810.584625

[REDIFF] Tu veux que je te raconte l'histoire du rond-point sans route? Alors attrape ta brosse à dents, ton dentifrice, et c'est parti!

Ryan Pineda and Brian Davila sit down with longevity expert John Jubilee to explore his 88-day cellular hydration protocol, the science and claims behind brain and body optimization, and the daily habits he believes can dramatically improve long-term health and performance.⁣⁣Connect with John - ⁣https://www.energizedhealth.com/⁣https://www.instagram.com/johnjubilee/⁣https://www.instagram.com/energized.health/⁣__________⁣If you'd like my team to run your marketing & sales department to scale your business apply here https://www.pinedapartners.com⁣⁣Join our private mastermind for elite business leaders who golf. https://www.mastermind19.com⁣⁣Want to be featured on the Wealthy Way Podcast? Apply here https://www.wealthyway.com⁣⁣If you want to start your real estate investing business, we'll give you 1:1 coaching, seller leads, software, & everything you need. https://www.wealthyinvestor.com⁣⁣Tired of paying so much in taxes every year? We'll give you strategy, tax prep, and accounting all in one place. https://www.taylor-tax.com⁣⁣Join free Bible studies and workshops for Christian business leaders. https://www.tentmakers.us⁣__________⁣Chapters:⁣00:00 - Perfect Health & Hydration⁣01:44 - Bench Press Record & Biblical Principles⁣08:50 - Testimonials & Health Turnarounds⁣15:01 - Brain Fog & Failed Diets⁣16:59 - Cellular Hydration Discovery⁣19:06 - 12-Step Hydration Protocol⁣30:04 - Follow the Money⁣30:32 - TRT, GLP-1s & Hydration⁣36:24 - Inflammation & Forgiveness⁣45:08 - Forgiveness & Healing⁣47:36 - Spiritual Strongholds & Freedom⁣50:40 - Knowledge & Cellular Healing⁣1:00:09 - Diet & Moderation⁣1:00:48 - Supplements & MSM⁣1:04:45 - Movement & Circulation⁣1:15:12 - Marriage, Family & COVID⁣1:16:29 - Online Coaching & Growth⁣1:18:41 - Longevity & Elite Performance

Pastor Brandon returns to start a brand new series called "Kardia", which is the greek word for heart. As this series is all about the very core of our beings. Our heart represents the innermost character, thoughts, and emotions of who we are. And our foundational concept to root our mindset during this series is that our heart is essential to life because it is the soil in which every decision in life grows. Which is an echo of Proverbs 4:23, "Above all else, guard your heart, for everything you do flows from it." One of the things we can pay attention to in the transformation of our hearts is that our mouths are an indicator and an activator for growth. And to cultivate a healthy heart, we need to speak our heart. You also need to remind yourself of God's faithfulness. And ultimately, you have to remember that your heart hears what your heart says. - Key Verses // Proverbs 4:23, Luke 6:45 - For Sermon Notes, the Connect Card, and our other online resources: https://linktr.ee/Celebrationchurchlive

Each week, join Editor-in-Chief Brad Maron, along with cohosts Mercedes Carnethon and Jane Wilcox for the new iteration of Circulation on the Run. This week, please join Brad and Jane as they welcome author Zahra Raisi-Estabragh as the three discuss her review article regarding 10 Years of Scientific Discovery with the UK Biobank CMR Imaging Study. Then, Brad and Jane chat with Specialty Associate Editor Betty Raman as she discusses her Clinician Lighthouse, a new article type at Circulation, and what prospective authors should consider when submitting their own Clinician Lighthouse manuscript to Circulation. For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260803.13306

In this episode of Resiliency Radio with Dr. Jill, Dr. Jill Carnahan welcomes Eric Fernandez, Senior Director of Hyperice's Rehab Division, for an exciting conversation about the science behind recovery, circulation, and nervous system regulation. From elite athletes to individuals living with chronic illness, they explore how technologies like Normatec compression therapy are transforming recovery, improving circulation, reducing inflammation, and supporting long-term health. Together they discuss the growing role of compression therapy in performance, lymphatic health, dysautonomia, longevity, and everyday wellness. Whether you're looking to recover faster, optimize performance, improve circulation, or simply age more gracefully, this episode offers practical, science-backed strategies to help your body recover and thrive.

Charles Berde, MD, PhD, is the Sara Page Mayo Chair in Pediatric Pain Medicine and a Professor of Anaesthesia at Harvard Medical School. As a co-founder of the Pain Treatment Center at Boston Children's Hospital, he has spent decades at the forefront of pediatric analgesic pharmacology and the development of novel local anesthetics. His extensive translational research focuses on local anesthetic mechanisms and prolonged-duration formulations, making him a preeminent authority on the physiological impacts and safety profiles of these agents in neonates and children. A recipient of the Myron Yaster Lifetime Achievement Award from the Society for Pediatric Anesthesia, Dr. Berde brings unparalleled expertise to the discussion of managing and preventing local anesthetic systemic toxicity (LAST) within the high-stakes environments of the PICU and pediatric operating rooms.Guest Conflicts of Interest (COI)Algavita Bio: Collaborator/Developer of novel, prolonged-duration local anesthetics.Quiver Bioscience: Unpaid Scientific Advisor and co-PI on an NINDS-HEAL grant focused on rare disease pain treatments.Latigo Biotherapeutics: Scientific Advisor and recipient of past research support for novel analgesics development.Algos: Scientific Advisor for non-opioid analgesics development.Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to the management of local anesthetic systemic toxicity (LAST) in children.References:Patient and Doctor Reconcile for Greater GoodBerde CB. Toxicity of local anesthetics in infants and children. J Pediatr. 1993 May;122(5 Pt 2):S14-20. doi: 10.1016/s0022-3476(11)80004-1.McMahon K, Paster J, Baker KA. Local anesthetic systemic toxicity in the pediatric patient. Am J Emerg Med. 2022 Apr;54:325.e3-325.e6. doi: 10.1016/j.ajem.2021.10.021. Epub 2021 Oct 25. Lavonas et al. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Oct 17;148(16):e149-e184. doi: 10.1161/CIR.0000000000001161. Epub 2023 Sep 18. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com.  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!