Podcasts about Cleveland Clinic

RAMS Ask a Chair Podcast - Moderated by: Hamza Ijaz, MD, University of Cincinnati

Chief Improvement Officer at the Cleveland Clinic Episode page My guest for Episode #449 of the Lean Blog Interviews Podcast is Lisa Yerian, MD. She joined Cleveland Clinic in anatomic pathology in 2004, and has held several pathology and enterprise leadership positions. After 10 years serving as Medical Director of Continuous Improvement, Dr. Yerian was named Cleveland Clinic's first Chief Improvement Officer of Continuous Improvement in December 2019. She's going to be one of the keynote speakers at the 2022 AME Conference, being held in Dallas — Oct 17 to 20. I'll be there and I hope you will be too. Lisa was previously a guest here in Episode 282 back in 2017. Also joining that for that episode was our friend and her colleague, Nate Hurle. Today, we discuss topics and questions including: Remembering Nate Hurle (my blog post) My last podcast with him (episode 404), Nate talked about how the CCIM and your continuous improvement work was helping with Covid testing, treatment, and vaccination… new processes. As you shared recently at the Catalysis Lean Healthcare Transformation Summit, how did your Lean management system get you through Covid?  Daily management system Tiered daily huddles Problem solving systems “Covid put that system to the test” Adaptations were required — learned how to make changes to the standard work in hours, not weeks Urgency – had to work past the old expectation that it takes 3 months to solve problems The Cleveland Clinic journey 2006: project-based work and some basic tools 2012: deliberately focused on building culture Started a “culture of improvement” A3 Defined current state, future state — and the gap Challenge: perception that we're already doing well enough Little Red Book of Selling (a book Nate loved) Culture of excellence – “Not getting better fast enough” A3 problem solving “Having a piece of paper is a way to de-escalate…” Building on a culture of patients first Lisa's appearance with me on the Habitual Excellence podcast Good enough, world class, vs. aiming for zero harm?  

This week's special podcast features the CardioNerds. Join Maryjane Farr, Vanessa Blumer, and M. Trejeeve (Tre) Martyn as they interview Amit Goyal and Daniel Ambinder, who started the Cardio Nerds podcast, website, and learning resources. Dr. Maryjane Farr: Welcome, everybody, to Circulation on the Run. My name is Maryjane Farr from UT Southwestern, and here we have an opportunity to take a week from Circulation on the Run and let our social media editors take over and do an interview of their choice. To welcome both two of our social media editors, first, Vanessa Blumer, who is going to be doing her postgraduate year seven in Cleveland Clinic, in advanced heart failure, and Trey Martin, who is a newly-minted faculty member in heart failure and amyloidosis and population health at the Cleveland Clinic. And they've chosen to interview Dan Ambinder and Amit Goyal of CardioNerds. Dr. M. Trejeeve (Tre) Martyn: So, thanks to Vanessa and to Dr. Farr for setting this up, and thanks for Amit and Dan for being here. Really excited to talk to you guys. The first thing I want to start off with is to get a little bit of an origin story about CardioNerds. And if you could tell us how you got started and how this all came to be, I think the listeners would be interested to hear that. Dr. Daniel Ambinder: Thank you so much, Trey, and it is really great to be here and nice to meet you. This is Dan. So, the origins of CardioNerds actually began early 2019. One of our mentors put us together, Dr. Reza Manesh, who's one of the co-founders of Clinical Problem Solvers, and thought that we should be thinking about potentially starting a podcast. And that definitely lit the spark and is it going to be something that's worthwhile pursuing? Dr. Daniel Ambinder: And so, we said to ourselves, at rounds we could teach five people at Noon conference, maybe we could reach out to 20 and to 40 people, but maybe with a podcast, we could reach 500 people at a time and that would be something that would be really worthwhile. So let's just sit down, create a script and start from there. And we created the first episode, aortic stenosis, and we did the recording and we just loved that process. And after that, we said, "This is worth it." So we made a couple more episodes- Dr. Amit Goyal: Hey, I'm just going to chime in here real quick. This is Amit. And I'll start off by saying, thank you so much for this invitation and what a joy it is to be doing this with two people who we respect so much, Vanessa and Trey. The process of creating this podcast and education, we learned so much. And it was so much fun that we decided why don't we just give it a shot and trial it by creating maybe three, maybe four episodes and seeing how it goes from there. So that was a backstory. Dr. M. Trejeeve (Tre) Martyn: I was curious how you guys thought about initially getting traction. Because that, I think, is the really challenging part and how you thought about getting listenership for your podcast and expanding. And was it focusing on the product, obviously? But I was curious how you, because now you have, you guys have this gravitational pull of prominent faculty and trainees that want to work with you, but how did you get there, and what was the strategy in doing that? Dr. Amit Goyal: I'll say that, initially, like Dan said, that we went out with the idea of just giving it a shot, seeing if it fit with our schedules, seeing if we enjoy the process and if there was enough of a need and a desire for this. And so, we said, why don't we create a short number of episodes? And if we could get 500 listeners, that would be the biggest audience that we have individually reached. And before you knew it, the 500 per episode turned into 5,000 per episode. Dr. Amit Goyal: And we realized that, even without actively and very deliberately trying to promote this, there was already a need and a desire for this. There was a niche that we were filling that we hadn't realized. The value of asynchronous medical education for people within or people who are interested in the care of patients with cardiovascular illness. So I think that's one. I think that's one takeaway, that there is value for open access, asynchronous education that is high quality. Dr. Amit Goyal: I think from there, our next big major pivot was well into COVID-19 when ACGME and the bodies decided that we should have virtual recruitment. This is when, enter Dr. Nosheen Reza, who was the chair of ACC FIT section at the time. And she messaged us on Twitter early afternoon, one day, saying, hey, is there maybe a way we could potentially use social media and the growth that cardio nurses has already had up until that point to maybe help connect residents with programs, ACGME accredited cardiology program, to have their fellows present a case, use one of their experts to provide an editorial expert commentary and then had the program director have a message for the applicants. Dr. Amit Goyal: And in discussing the case, the fellows would also talk about the program. And what that did was, I think, internally for us, it helps us realize that this just made it so much, the quality of the content and the breadth of the content, the depth of content just skyrocketed, right? I mean, we had fellows bring us cases of preeclampsia and bicuspid aortic valve, aortic stenosis with pregnancy. I mean, it was just, it was incredible that CardioNerds wasn't just about what we wanted, it was very rapidly turning into a communal entity that other people could take pride of. And so, that became really important to us. Dr. Daniel Ambinder: Yes. And I'll just add, again, as Amit's explained is, it happened sequentially. But it was actually a pivotal moment, right before the CardioNerds case report series was launched, where things were feeling stale. We definitely love to teach, there's no doubt about it, and that is a huge part of this. But there was a certain point where we were teaching and we just felt like there needs to be something more. Dr. Vanessa Blumer: Thank you so much, Dan and Amit. I mean, I think everything that you do, this is Vanessa. I think everything that you guys do, it's so inspiring for, I think, all generations, right? I think it's inspiring for future generations, but I think you guys inspire people at all levels. When you think about CardioNerds, what is your purpose? What drives you? What is your motivation? What do you think is your ultimate, why? Dr. Daniel Ambinder: While we had this passion to educate, that is not necessarily the why. And all of a sudden, as soon as we took off, there was multiple opportunities and multiple things dragging us in different directions. And we immediately sought out our mentor, Dr. Sanjay Desai, who is our program director at the Osler Medical Residency, and he said, "You got to find out your why right away." So, now our why includes to create and disseminate education, promote diversity, equity, inclusion, foster wellness, and humanity in the field of cardiology and in life, and provide mentorship and sponsorship and invigorating a love of cardiovascular medicine and science. Choices were easy. We can just say, "Does this fit the rubric of our mission? Is this an opportunity that we want to pursue? Is this something that's going to enhance this mission?" Dr. Amit Goyal: Putting words to a mission was extremely helpful for us. And actually, part of that conversation we're having at that time was around diversity and inclusion, because that's when Sanjay was saying you have to define what your organization stands for and what is a mission, and who are the people that are going to represent these cardiology fellowship training programs, in the eyes of residents who are thinking about a field in cardiology, and how deliberate we want to be about asking program directors to be cognizant about representing diversity in the fellows that they have representing the programs. And so, around these discussions, that's when Sanjay said, okay, there are a lot of things that you can do with CardioNerds, but before you do that, figure out what is your goal and how every action fits into that goal. Dr. M. Trejeeve (Tre) Martyn: Thanks, Amit. So, keeping that mission that you described in mind, what do you think is the ultimate goal of CardioNerds? Or, I guess I should say, where do you see CardioNerds being in five to 10 years? I know that's far out and some of the days you're just trying to get through the day you have in front of you. But if you could envision a future and, in the structure or the mission, keeping that in mind, where do you see CardioNerds in five years, let's say? Dr. Amit Goyal: Yeah, thanks, Trey. That is such an important question and a very difficult question to answer. I will say that things have evolved so quickly. And so, I think our one challenge that we talk about that we don't know how to resolve just yet is how to build CardioNerds in a way that's scalable, that outlives us. How do we make CardioNerds go beyond us? And that's Dan and I, but also everyone else within CardioNerds, a generation later. How do you maintain CardioNerds? Dr. Amit Goyal: And I think the logistic part of that is probably not that hard to figure out, right? You need admin support, you need resources, you need to delegate, you need leadership structure, but how do you grow it and have it outlive you in a way that still continues within the ethos of how you started it, within that mission, within the goals that you set it out to? And I think that's really something that we have to figure out, but that's going to be probably a deliberate way of how we grow it and how people grow into a leadership structure within it, how we design the programs. So I think that that part of the growth depends on the actions and the decisions we make today. Dr. Daniel Ambinder: Yeah. I definitely agree with all of that. And just to be brief, I just reiterate, CardioNerds is really for the people and what people want changes. And so, we're always listening and we're getting tons of feedback. And as the network grows, people are coming to us with projects and ideas, and we always try to find people that are just really passionate about what they want to do and give them a space to do it and try to give them as many resources and mentorship and sponsorship as we can, and then get out of the way. And so, that has already been a great recipe for a lot of different outpouchings and outgrowths of CardioNerds that really, again, goes back to the entire mission. And so, it's almost really hard to predict what will happen in five to 10 years, but we are ready and listening and looking to see what we can help the community with and vice versa. Dr. Vanessa Blumer: Thank you so much, Dan. And I mean, these answers have been fascinating, honestly. This interview, in general, has just been so enlightening. Dan, I think you touched on the point of democratizing cardiovascular education, which I think is, or should be, one of the highlights of this interview. Can you maybe touch a little bit more on this? And we talked about the why, can you talk about the how and see how you see this moving forward? Dr. Daniel Ambinder: Yeah. Thanks so much, Vanessa. We agree, democratization of cardiovascular education, what does that even mean? But what we mean by that is that why should somebody, somewhere off in a distant country, not have the ability to take care of their patients in the most topnotch way, because they may not have had the exposure to a particular part of cardiovascular education? Breaking down some of the formal barriers between levels of trainees, so, for example, CardioNerds' journal club really encompasses that. Dr. Daniel Ambinder: Once a month, our CardioNerds Academy, which you haven't talked about, puts on an amazing show. It's really a way where journal club hits Twitter in a traditional format, same process of discussing the article, but in the Twitter format. So it allows for this amazing group of, usually hundreds of people, honestly, to come together and discuss. And what's so amazing is that the scientific community has really gotten on board. So we often have authors of the papers that we're discussing join the actual Twitter club. Dr. Daniel Ambinder: And then we have medical students that are asking questions of the authors and this amazing engagement between multi-levels of education coming together. There are certainly ways that some, I wouldn't say the barriers, there are certain ways that these things can be helpful, like traditional learning and formats like that, but sometimes not. And so, we aim to be constructively destructive in terms of that way. And that's what we've done with democratization of cardiovascular education. Dr. Amit Goyal: If I might just add, then when we think about democratizing cardiovascular education, it's both for the learner, in terms of making high-quality education available and accessible, but also for the educators, right? I had a conversation with a mentee when he was a resident, and he called me and said, "Amit, I want to be an interventional cardiologist, but I also want to be a medical educator. How does that work?". And the fact that he was asking that is, for me, a problem, right? Dr. Amit Goyal: I've had this conversation with Dr. Katie Berlacher, who was also a medical educator, but is a cardiologist. Why does there seem to be strain between becoming a medical educator and becoming a cardiologist, right? That's not there for hospitalist medicine and other fields. So that's part of the reason we really enjoy having all sorts of trainees and faculty come on and teach on the show and be deliberate about how they want to teach on the show. Dr. M. Trejeeve (Tre) Martyn: Thanks a lot, Amit and Dan. In some ways, it sounds like you guys have been able to democratize another area other than education, which is clinical trials. And I wanted to get your perspective and hear a little bit more about the CardioNerds Clinical Trials Network. It really seems like an amazing program you guys have set up. Dr. Amit Goyal: It all goes back to the mission, but the origins of that is, Dr. Starling, he was a pretty early adopter for CardioNerds. He was a part of our very early heart failure series back in early 2020. And he was such a great supporter and source of encouragement and mentorship for so long. And Trey, I know you understand this, and Vanessa, you too, but he, for one reason or another, he brought up CardioNerds at a meeting about PARAGLIDE-HF. And I think present were Dr. Eugene Braunwald, who's part of the steering committee and Dr. Robert Mentz, who is the lead principal investigator, began recruiting around the time of COVID-19, affecting recruitment for a lot of trials. Lot of challenge there that I think we can all understand at this point. Dr. Amit Goyal: And we said, "Okay, well, not sure. We haven't thought about clinical trials, but why don't we think about it and get back to you?" So then, we said, okay, well, what's the core strength of CardioNerds? It's the people, right? After we did the CNCI recruitment series, hosting fellowship training programs, we realized that that worked out really well, because brilliant fellows from all these different programs came and elevated the education. So we established the Healy Honor Roll, after Dr. Bernadine Healy, of training programs who are part of the honor roll by nominating a FIT ambassador, a fellow and training ambassador, who's interested in education. Dr. Amit Goyal: We said, okay, well, why don't we just extrapolate that to a clinical trial? Instead of fellowship training programs, it would be trial sites that have training programs affiliated with them. Instead of a program director nominating a FIT ambassador for education, it would be the site PI nominating a FIT trialist for recruitment. But how would that fit as part of the mission? Well, with the Healy Honor Roll, with the academy, with everything else, hosting people on the podcast, it's always been, how do we pair content creation with personal and professional development? Dr. Amit Goyal: So, with a clinical trials network, the question was, how do we pair equitable trial enrollment with FIT personal and professional development? How do we meaningfully engage the fellows in the conduct of clinical trials, but also meaningfully help develop their interest in clinical trials and academic careers? How do we equip them with important skills and knowledge in the space? So we created a curriculum that's related to career development and equitable enrollment. And then, also, how do we make sure that they have, and deliberately, they have networking and mentorship as part of this? Dr. Amit Goyal: Since then, after we got all the fellows involved, the impact has been absolutely amazing. Because there are two goals here, right? There's equitable recruitment and there's fellow development. And just by having these meetings, by having the curriculum, the fellows are already engaged. So at the very minimum, half the mission is working out really well. But what about the other half, and that's equitable recruitment. So I will say from the time of the first FIT-recruited patient up until June 2nd, okay? So, that's February 8 to June 2nd, we account for 16% of all trial sites, but 49% of patients enrolled. Dr. Amit Goyal: Of the patients that we have enrolled, 54% are women compared to 47% for the non-CardioNerds sites. And 80% are BIPOC, or Black, Indigenous and people of color populations, compared to 19% for patients not enrolled by CardioNerds fellows. So, the impact there is, I think it's flooring, honestly. It is earth shattering and we are all amazed by it. And part of the question has been, can this be consistent, right? Is this a fluke? But since, when we had 30 patients enrolled, then we had 35 patients enrolled, we had 40 patients enrolled, these numbers had stayed relatively consistent. Dr. Amit Goyal: The question now is why? How is it that we've been so effective in disproportionately recruiting patients who had been historically underrepresented? And that's a very important question that we are really excited to dive deep into the data and try to understand. So our plans with Rob Mentz and the rest of the people who really made this possible is to really look at the numbers in terms of recruitment. Dr. M. Trejeeve (Tre) Martyn: That's really amazing, guys. And I have to applaud you on the vision to do that, and then to think about how to meet your mission, and then also to meet an unmet need that is... Because clinical trial enrollment, when you go through it, it's always slower than you hope. And this is such a great way to light that, to one, ignite a new generation into how to do clinical trials on the ground floor, but then also to increase the diversity of enrollment is amazing and you guys should be applauded for that. Dr. Vanessa Blumer: I also want to congratulate the both of you. Thank you. You guys are trailblazers and definitely are changing the world for all of us and making it a better place. So, we're so proud of you. We have to wrap up, so maybe just one last question before we go. So, maybe a two-part question, or you can choose to answer one or the other. But what do you guys feel most proud of? And what do you guys think has been the most important lesson that you have learned in the CardioNerds journey so far? Dr. Daniel Ambinder: Thanks, Vanessa. It definitely always helps to emphasize this. We really started this right before COVID. We had no idea COVID-19 would hit. And, really, the whole world was lurched into this virtual space. And there was always the hashtag, in real life? Is this even real life? And there was a sense that maybe it wasn't. And when we went to ACC and we met our people in person, and relationships were, not like they were just starting, but they had been ongoing for years. We really, really felt that this is something so real, and that is the lesson of CardioNerds. The lesson of CardioNerds is that the cardiovascular community is a real cohesive, beautiful community, and there's a lot of CardioNerds out there that embrace their nerdom when it comes to cardiology. Dr. Amit Goyal: I think in terms of what I'm taking away from this journey and what I'm going to keep relying on, the lessons I'm going to keep relying on, are one, is just find something you love and lean in. Right? I mean, when we first started telling people, "Oh, we're going to make a podcast and, hey, by the way, we're going to call the CardioNerds," the reactions we were getting from people, people we deeply respect and look to for advice and for role models, there were a lot of people who said, "Oh, that's great. It's so nice to have a hobby, but what are you going to do during your research block?" Right. That's great. Dr. Amit Goyal: But I think the reason why we've been able to stick with it is because we found something that we genuinely love to do. And so, I think that's really, whatever it is for you, that's really important. I think the second thing that's been extremely important for us is to surround yourself by people who inspire you, who push you, who will advise you, who make you want to be better. And that's people who are senior to you, people who are your peers, people who are junior to you, right? Because you can get as much inspiration from somebody who's 10 years your junior as you can from somebody who's 10 years your senior. Dr. Amit Goyal: I know I've taken a lot of inspiration from Vanessa and Trey and have relied on both of you for advice. I remember Vanessa, I think I had a very, a specific conversation about the clinical trials program when it was just a burgeoning idea way back when. And if number two is to take inspiration, take advice, take mentorship, number three is give. To flip that around and try to just give yourself and make yourself available to as many people around you, because that's how you build a community and that's how you give back and thank the people who give to you. Dr. Maryjane Farr: Okay, great. So, thank you. Thanks all of you. Four contemporaries who are leading the way into the future of cardiovascular medicine, science, and education. So, on behalf of Circulation on the Run, we have been so delighted and honored for you to spend some time with us, have a podcast about the podcasters. But you're not just podcasters, this is a real and amazing and innovative platform, and we are so excited to see where you go next. Any final, last words from Trey and Vanessa or Amit and Dan? Dr. Vanessa Blumer: Thank you so much to Circulation on the Run and Dr. Farr for this opportunity. Amit, Dan, like always, it's such a pleasure. I learn so much from you every single time that I get the opportunity to interact with the both of you and you are an inspiration to all of us. So thank you so much for this platform. Dr. M. Trejeeve (Tre) Martyn: Thanks to Dr. Farr for Circulation on the Run, for this platform, Amit and Dan for taking the time out of their evening to be here, Vanessa, for joining me in Cleveland. And I would say that you guys, the CardioNerds founders, you're an inspiration that you don't necessarily have to wait to make an impact. Dr. Amit Goyal: Yes. Thank you so much. I don't even know what to say. I'm speechless. I'll say that, for Dan and I, we're still just a couple of nerds. I do my recordings in my attic, Dan's in his home office. I think if you, we're still besides ourselves with disbelief that we are a topic of conversation for a platform like Circulation on the Run. It is absolutely a privilege and an honor for us. And so, I think all I can do is just say thank you so much, and then to Dr. Farr for the invitation to have this conversation for Circulation, and Dr. Hill for giving us this platform. I think this is just such a... Again, we are speechless. Thank you. Thank you so much. Dr. Daniel Ambinder: I'm equally as speechless and this podcast, Circ on the Run, really reminds me of my earlier roots, reaching out of my own institution, because it was a Circ social media team that first gave me a great glimpse at what happens outside of the institution that I had been training at for many, many years. And to see how the sausage is made, in terms of how research is vetted and undergoes a strict peer review, was really amazing. And I had the opportunity of meeting Dr. Hill and also being part of the team as COVID was revving up and Circulation had to... We're getting bombarded with all these COVID-related articles. And there was just a very important understanding that what gets published is going to be really, really important. Dr. Daniel Ambinder: So, watching that from the sidelines, under the mentorship of Dr. Amit Kara, just seeing how that happened, gave me such an important understanding that what you put out into the world, whether you're Circulation or writing a personal tweet or putting something out on CardioNerds is just really important and treat it as if it's something that's going to be there forever. And I learned so much about collaboration and I also learned so much about podcasting, because of Circ on the Run, it was actually the first podcast I was on and I don't like to listen to that very often. So thank you so much. This is such an honor to bring this full circle and come back and join you all. Dr. Greg Hundley: This program is copyright of the American Heart Association, 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

In Episode 64 of the Sarc Fighter podcast Mary McGowan, CEO of the Foundation for Sarcoidosis Research and Tricha Shivas, Chief Strategy Officer talk about an exciting new development that will make it easier to patients to find the right doctor, and for doctors to find the right methods to treat Sarcoidosis.    Show notes The New FSR Initiative https://www.stopsarcoidosis.org/foundation-for-sarcoidosis-research-launches-groundbreaking-global-rare-disease-initiative/ Learn about the clinical trial from Novartis: https://bit.ly/3o9LXKk The FSR Summit: https://www.stopsarcoidosis.org/events/fsrs-third-annual-virtual-sarcoidosis-education-summit-unveiling-possibilities/ The Mayo Clinic article: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/how-to-be-happy/art-20045714 Calvin Harris Blog: https://sarcoidosisnews.com/2022/05/19/im-grateful-that-despite-sacroidosis-i-can-run-my-own-race/ aTyr Pharma News Release: https://investors.atyrpharma.com/news-releases/news-release-details/atyr-pharma-presents-clinical-data-efzofitimod-atyr1923-american Merlin: https://merlin.allaboutbirds.org/ Universal Barriers Podcast:  https://www.stopsarcoidosis.org/sarc-fighter-podcast/ More on Universal Barriers https://www.stopsarcoidosis.org/events/universal-barriers-in-dealing-with-a-chronic-disease-a-sarcoidosis-perspective/ Ignore No More https://www.stopsarcoidosis.org/ignore-no-more-foundation-for-sarcoidosis-research-launches-african-american-women-sarcoidosis-campaign/ Sarcoidosis Awareness Film: https://www.purpledocumentary.com/ Nourish by Lindsey: https://www.nourishbylindsey.com/ Dr. Jinny Tavee's book, The Last Day of Suffering: https://www.amazon.com/Last-Day-Suffering-Health-Happiness/dp/0615542751 Read about the patient trial with aTyr 1923 https://investors.atyrpharma.com/news-releases/news-release-details/atyr-pharma-announces-positive-data-phase-1b2a-clinical-trial Also -- Note that investors also believe in the promise of aTyr 1923: https://investors.atyrpharma.com/news-releases/news-release-details/atyr-pharma-announces-closing-863-million-public-offering Yale University and sarcoidosis skin treatment | Dr. William Damsky: https://news.yale.edu/2018/12/26/yale-experts-treat-severe-disfiguring-sarcoidosis-novel-therapy Stanford University Clinical trial | Dr. Mathew Baker: https://med.stanford.edu/sarcoidosis/clinical-trial.html MORE FROM JOHN Cycling with Sarcoidosis http://carlinthecyclist.com/category/cycling-with-sarcoidosis/ Watch the Prednisone Town Hall on YouTube https://youtu.be/dNwbcBIyQhE More on aTyr Pharma: https://www.atyrpharma.com/ Do you like the official song for the Sarc Fighter podcast?  It's also an FSR fundraiser! If you would like to donate in honor of Mark Steier and the song, Zombie, Here is a link to his KISS account.  (Kick In to Stop Sarcoidosis)  100-percent of the money goes to the Foundation.  https://stopsarcoidosis.rallybound.org/MarkSteier The Foundation for Sarcoidosis Research https://www.stopsarcoidosis.org/ Donate to my KISS (Kick In to Stop Sarcoidosis) fund for FSR  https://stopsarcoidosis.rallybound.org/JohnCarlinVsSarcoidosis?fbclid=IwAR1g2ap1i1NCp6bQOYEFwOELdNEeclFmmLLcQQOQX_Awub1oe9bcEjK9P1E My story on Television https://www.stopsarcoidosis.org/news-anchor-sarcoidosis/ email me  carlinagency@gmail.com   The following is an Internet generated transcript of the interview.  Please excuse spelling and grammatical errors. John Carlin: welcome back to the Sarc Fighter podcast. I am so pleased today to have the people that make FSR absolutely run and operate here as guests today to talk about this new initiative. Our CEO, uh, Mary McGowan and Chief Strategy Officer Tricia Chivas are both here. Welcome to the podcast. Mary McGowan: Thank you, John. It's always a pleasure to be a guest on your podcast. Tricha Chivas: Thanks so much, John. We're excited to talk to you today. John Carlin: So the email went out this week, and we're talking late June. In 2022, FSR has a new program that deals with how FSR will be recognizing endorsing recommending clinics. Mary, tell me how all that works and tell me the gist of this new announcement. Mary McGowan: John, we're so excited this, week to have announced publicly this really exciting new initiative called the FSR Global Sarcodosis Clinic Alliance. The whole concept of this is to bring hospitals and Sarcodosis clinics together globally in the fight against Sarcodosis. So we were thrilled the very first presentation that we did was in March. We were, uh, hoping to launch this in January, but due to COVID, we couldn't for, um, obvious reasons, because the clinics were so engaged in taking care of COVID patients. And in relatively very short period of time, we are so thrilled that we had 22 esteemed founding members join us as they learned about this. Um, and we're continuing to accept founding, uh, members through September to continue to grow this and work with them as part of a leadership council. And, um, so anyway, this all developed because we, uh, saw this opportunity to be able to connect more closely with Sarcodosis clinics and hospitals. And after we had the vision for this, we actually sent out a survey to clinicians across the globe. Uh, and they, too, verified this opportunity and this need for bringing us all together to share best practices and to network both at the clinician and patient level. And that is why, uh, we decided to move forward with this extraordinary rare disease initiative. John Carlin: Yeah, that is a lot, and there's so many things I want to unbundle here. But let's start with what are the ways that patients will be supported by this alliance? If I've got psychodosis, how does this help me? Mary McGowan: Well, we want to ensure in every community across the globe that Sarcoidosis patients have access to the most up to date, uh, Sarcodosis information, education and support services. So what we're going to do is, through, uh, an application process, we're going to have Sarcoidosis patients apply to be peer led support group leaders. And we're going to host support group meetings monthly, uh, at institutions throughout the globe. In addition to that, some of the, uh, volunteers will receive training on how to be community educators and how to work with the media so that we can amplify, uh, the messaging about Sarcodosis about this rare disease throughout local communities, again, around the globe. So we're really excited to be recruiting for these leadership positions, and we're, uh, going to have ongoing trainings that are going to support these leaders and also provide opportunities for these leaders to network with each other. In other words, the, uh, other leaders across the globe in this effort to, uh, be able to provide these kinds of support services to patients. John Carlin: So these leaders will be patients? Mary McGowan: Yes, these leaders will be patients. We believe very strongly at FSR in the peer led leadership approach because it's, uh, really the patients who have the best understanding of what it's like living with Sarcodosis. And if we can empower them to, uh, be leaders of the support group sessions, then we believe that that has the strongest impact. John Carlin: And do you foresee in a post covered world of these support groups would meet in person? Mary McGowan: Yes, we do hope that they will be meeting shortly in person as the, uh, world hopefully continues to try to get back to normal and as we, uh, continue to fight Cobid and its forces, we do hope to have these in person. And up until the point when they can't be in person, we will be doing these virtually. John Carlin: And you did ring one of my bells when you said media training, how to deal with the media. Mary McGowan: Yes. John Carlin: Maybe I can help you with that. Mary McGowan: We, uh, would love that, John, of course, because, uh, we want to make sure that our volunteer leaders feel comfortable working with the media and, uh, have an opportunity, uh, to rehearse their talking points and again, empowering them so that they can empower others in their local communities. John Carlin: Got you. So there's 22 of these centers. That is center the right word? We're going to call somebody who's one of the 22. Mary McGowan: We're calling them founding members of the FSR, uh, Global Clinic Alliance. John Carlin: Alliance. Alliance members. Alliance members. Got it. And there's 22 alliance members. But that's all around the world right now, as you and I are speaking on June 24, 2022. Mary McGowan: Yeah. So right now, the 24 that have joined are from the United States. We are, uh, doing a webinar in July to invite all clinics globally, from around the world to the webinar about the alliance. And we're hoping, uh, at that point, that we will then have an opportunity to introduce this to International Sarcodosis, uh, Clinic Alliance potential members and have them join also as a founding member, I. John Carlin: Know because I've talked to so many doctors in other parts of the world through the podcast that FSR has got a long reach. So I don't anticipate that. I think, uh, it's going to be very popular in other parts of the world. Mary McGowan: We agree. And we're very excited to be working with our International Clinic, uh, future, uh, members. John Carlin: Right. I got you. So now, we talked a little bit about the patient side, but this has a big upside for the doctors, the researchers, the clinicians, I guess, is the proper term. Uh, what is the clinician facing program that the alliance offers? Mary McGowan: Well, there are several. I'll highlight a few. First of all, we believe, and we also confirmed again through the survey, that there's a real desire for these clinicians to have an opportunity for peer case review for, uh, cases that they have. Sorkidosis cases. So we're providing a platform for these peer case review sessions so, uh, that the clinicians can share the information and can get guidance, uh, and advice and input from other clinicians at other clinics, uh, worldwide. So that's one, the other one that we're really excited to be launching is a journal club, and we believe, uh, a, uh, Sarcoidosis specific journal club that's going to be supporting early career professionals and also encourages clinicians to stay up to date on Sarcodosis, um, medical literature, uh, is really going to be very effective. And again, an, uh, opportunity to bring these experts in these global clinics together to learn and talk about these journal articles. And then finally, we're also providing clinical, uh, engagement and education through, uh, our Clinic Engagement series. We just held our conference on June 15. We had, uh, I think, nine different countries that were represented over, uh, 100 registrants. And we had Dr. Menza from the NHLBI, who was, uh, the keynote speaker at this, um, really exciting conference. So we're going to be doing these quarterly, uh, and again, it's an opportunity to bring clinics together globally, to stay up to date on research and other topics around orchidosis care, education, research and support. John Carlin: I guess the end goal for all this, because when I'm talking to patients on the podcast, what they're saying is, I go to my local doctor and they've never heard of Sarcoidosis. This would be the beginning of a way to fix that, right? Mary McGowan: Correct. That's our belief as well. We do know, uh, that, again, uh, awareness is large, not only in the general population, so that if an individual does have psychedosis, uh, and has signs and symptoms of Sarchidosis, that they can bring that up to their doctor, hopefully for a shorter time period for an accurate diagnosis. But also to your point, John, from the clinician standpoint, again, there are, uh, so many rare diseases, and we want to make sure that Sarcodosis is front and center with clinicians, uh, and again, for the opportunity, uh, for a more timely, uh, accurate diagnosis, which, of course, can be lifesaving. And this is, um, critically important. And FSR beliefs strongly in making sure that we are working as hard as possible to bring this awareness to clinicians, uh, as well as to patients themselves. John Carlin: Basically, what this is infrastructure that's going to have doctors talking to each other more, sharing their research, sharing their best practices, sharing their success and failure stories, so that more doctors and more places are conversing about Sarcoidosis and understanding best practices, best paths forward, making patients have better outcomes. Mary McGowan: Absolutely. Beautifully said, John. Thank you. John Carlin: Okay. All right, well, that's my job. I like distilling stuff. First, I want to ask you, I know that FSR has been doing, uh, some stuff with the National Institutes of Health, and there really is some momentum now to get some federal backing for some of the things that FSR is doing and for Sarcodosis related research from the government, which we never have had before. Tricha Chivas: Yeah, thanks, John. We've been working really hard to grow relationships with the National Institutes of Health. And one of the ways that we've been doing that is to make sure that we are engaged in different institutes at the National Institutes of Health. So there's a lot of different institutes that have a particular focus. So Mary mentioned earlier that we had a session with Dr. George Menza, um, from the NHLBI, which is the National Heart and Lung and Blood Institute. And that is one of the, uh, areas, um, that has been a big focus for where Sarcodosis has been in the past. But we're also focusing in other areas, such as in the, um, environmental health studies area. So there's an institute that focuses on environmental impact, since we know there may be some environmental causes to Sarcodosis, um, and making sure we're part of that. We've been working with the organization that focuses on arthritis, um, and musculoskeletal disease and skin disease. Right. So we know there's different manifestations of psychosis, and we're having conversations now at all of these different spaces. In fact, this year in February, um, you may recall that FSR was able to participate in the NIH Rare Disease Day by having a panel, um, there. So really kind of activating and showing the NIH again, what we are doing and why the work that we're doing is so critically important in this space. And these are conversations that we're continuing. But in addition to the NH, we've also started working with the FDA on a number of different things in order to draw more attention from that federal level as well. John Carlin: And are we making some progress with respect to this work? Tricha Chivas: Yeah, so very excitingly. We just had a FDA patient listening session, uh, on pulmonary Sarcoidosis. This is a really, um, unique opportunity for FSR to get directly in front of the FDA and many, um, members of the FDA. We had 50 attendees at this session. It was a very well attended session, representing a lot of different institutes at the FDA. And for all of your listeners. I know everybody is a little, um, bit more familiar with the FDA now after cobid, but the FDA approves drugs, but they also, um, approve technologies that are being used for diagnosis. And they also, um, can help with the process, um, for repurposing drugs. So they have a number of different angles that we wanted to highlight that tie into the work and the needs of our patient population. And so what we did was we had this listening, um, session, which is a closed session, we weren't able to have that available to the public. That's the rules of the session itself. And then we had patients that came together, shared their stories. We had six patients, one caregiver. Mary shared a bit about things that we had learned from the community on this. And then, um, Dr. Lisa Meyer, who had provided the clinician perspective. And so that was our, uh, main goal was to get that information out. And these were really passionate stories that reflected what we heard from the community. John Carlin: So what would actually happen in a listening session? The doctors are listening to the patient's talk and see how Sarcidosis affects their lives. Tricha Chivas: Sure. Great question. So basically, it's an hour and a half long, um, meeting, and you have all of these different folks at the FDA who are making decisions about how drugs are approved or how technologies move forward. And we wanted to give them a chance. A lot of them are very scientific and don't necessarily have the chance to truly understand the patient experience. So, um, what this is, is a chance for them to understand how Sarcodosis is impacting individuals daily lives. What were the challenges that people faced with diagnosis, um, where did the technology, um, fail? And why do we need different technologies that might be able to do a better job, to do better at diagnosing? Understanding the drug, um, development process from the patient perspective would have been the barriers or challenges. So we raised issues there about diversity and, um, the challenges for diverse populations to be involved. We raise challenges for the drugs that are currently available, not adequately addressing the needs of, um, those living with Sarcodosis. So steroids is actually FDA approved in Sarcoidosis. And so that is oftentimes, um, a go to, as I know you've talked about many times on the podcast, a go to for clinicians as they're moving forward because it's cheaper there, um, are ways that it does work sometimes for some patients, but the cost was also something we reflected in those stories. So the stories were individual people sharing how all of those different things came to play. John Carlin: Um, if nothing else, Sarcodosis is on the FDA's radar now, right? Tricha Chivas: Yes. John Carlin: There's so many orphan diseases and everybody's clamoring to be recognized, but it sounds like, thanks to the work of FSR, that's happening now. Our voice is a little bit louder, 100%. Tricha Chivas: We are on the, um, radar, and we have some really exciting things that are going to be coming out as a result of that. And Mary, I don't know if you wanted to share some of the things that were coming out as a result of what we did with the listening session. Mary McGowan: Absolutely. So after the listening session took place, we started creating, uh, a white paper that have a little bit more details on the session. And we're going to be launching the white paper in mid July. In addition to that, we're going to be hosting a community webinar in August, because we're so grateful to the community. I think. You know, John, our approach at FSR is always about engaging the community in our efforts. So, in preparation for the FDA patient listening session, we sent a survey to our clinicians, to all of our patients, and to our industry partners, because we wanted to get, uh, what they thought was the important messaging to send to the FDA. And that's how we came up with our messages. That's how we came up with the patients who had those stories that, uh, reflected those messages. And so we want to give back to the community and share the results of the survey and share the details of this really milestone event for FSR that took place. In addition to that, we are, um, also now working on the possibility of hosting a patient focused drug development session sometime later next year. And these sessions are much larger. They are open to the public, and they are important for advancing clinical trials and drug development. So we're really excited about that. And at the same time, we're also exploring conducting additional patient listening sessions and other manifestations, such as neurosychotosis or cardiac sarcoidosis to deepen the FDA's understanding, uh, and needs of those living with this complex disease. John Carlin: Yeah, when you, uh, say neurosark, I'm so happy to hear that. I'm an orphan among orphans as the neurosark representative. So I'm, um, glad that that's getting spotlighted, uh, a little bit. Mary McGowan: Uh, absolutely. John Carlin: Yeah. All right, so now we got clinical trials, and it does seem like there's a lot more going on right now with clinical trials and trisha. Can you bring us up to speed on what's going on with that? I've talked to several different people, and I know there's a bunch of pharmaceutical companies out there, so can you kind of let us know where we are with that? Tricha Chivas: Yeah, 100%. So this is a really exciting time as far as clinical trials goes in sarcodosis. In the past, we've had, um, one clinical trial running at a time, or many times even no clinical trials running in our space. But right now, um, there is a lot of interest and engagement in the clinical, um, trial space. And as you know, SSR has done a lot of background work to try to make sure that this is really possible for pharmaceutical companies to come into this space. So what's important and what we have done is we've made it so that they understand there is an eager population that's interested in clinical trials that wants more and new drugs, and helping to do that education on the back end for them. And then, in addition, we have really worked very closely with pharmaceutical partners, getting them access to, um, some of the key opinion leaders in the space, some of those expert clinicians that are out there so that they could have really good conversations and understand a little bit more about how their drug might work, whether it's a good fit for the clinical practices that they're trying to meet. And then in addition to that, we've worked really closely with the patient, so we know that patients are, um, interested, so we want to make sure we're getting that in front of them. And so we put in place a system that allows for people to know about clinical trials that are going on. So we do a lot of marketing and advertising, um, for that, for patients, so they can get involved if they're interested in being part of that process. And I'm really excited to share with you that we have seven sponsored clinical trials underway right now. And so, remember, I said there was about one or two happening, staggering over in the past. And now, um, we have seven potential clinical trials that are starting off. And just to clarify for your audience very quickly, when we're talking clinical trials here, we're talking pharmaceutical sponsored or biotech sponsored clinical trials, which are the ones which will end up resulting ultimately in a new drug. And so we have the academic studies which are building all the background for that, and they continue. And those are very important, but these are the ones that are getting much closer to getting that new therapy available for patients. John Carlin: Seven. Tricha Chivas: Seven. John Carlin: That's amazing. Just in the time that we've been doing the Stark Fighter podcast, I think, like you said, one or two, and that was reason to celebrate. And now, a couple of years later, it's up to seven, potentially. And that could result in seven new drugs that patients could take. And the farther you can get those of us who are patients away from steroids, the happier we all will be. Tricha Chivas: Exactly. Yeah. So it is a really exciting time. If anybody does want to know more, um, about clinical trials, please reach out to us, how they work. We're happy to give more background information, but this is the moment where we hopefully can get more and more engagement and more excitement around this. And this is why partly, we're talking to the FDA as well, because it's very important for us to continue those conversations. John Carlin: So anything else happening that listeners should know about? Tricha Chivas: Sure, yeah, there's a lot going on in research right now. Um, thank you to everyone who has supported all the research efforts that we have. FSR has been taking our research funding worldwide. You may know that we have funded over, um, $6 million worth of Sarco Dosis specific research efforts. And last year, we gave out about $200,000, uh, in research grants to academic researchers. This year, we're poised to give out over $300,000 in research funding to our academic researchers. And so this is really an exciting time. We just, right now, are in the final wrap up stages for our fellow that's going to be coming out this year. So we have received those applications and are finalizing the announcement, so keep an eye out for that. And very excitingly, we have grants that just came, um, out, uh, specifically for, um, pilot grants, which are early background kind of information studies that can help make it possible for researchers to get bigger funding to move the needle forward, and a new grant, which we have not had up until this point specifically available for cardiac sarcidosis, and we had an incredible amount of engagement around that. John Carlin: Yeah, so let me ask you about that. How excited are the researchers, Mary, uh, for this opportunity? Mary McGowan: Really very exciting, and I think it builds off the momentum that Trisha has been talking about, just about the interest in clinical trials and in research in the sarcodosis space. Again, we received the most applications ever for our pilot grants, and we received a very high number of cardiac sarcodosis grants, by the way, which was made, uh, available through a very generous donor to FSR, and wanted us to be providing funding, uh, specifically for cardiac sarcodosis. So we are so grateful to donors who allow this type of, uh, funding for additional support and research for, uh, sarcodosis. But I think all of this combined, John, is really building on this tremendous momentum for sarcodosis. Again, we see it at the FDA, we see it through the Clinic Alliance, we see it through research, we see it through the patient engagement, and it's just such an exciting time to really be moving the needle forward for sarcoidosis. We have our upcoming Patient Summit, uh, and thank you for your leadership, uh, as part of the Patient Advisory Group. And you all coming up with the title of Unveiling Possibilities Moving forward. And really, this is just what is happening at foundation for Sarcoidosis and for sarcodosis globally. And it's most exciting. John Carlin: Yeah. Tricia, do you want to add anything to that? Tricha Chivas: I don't have much to add, uh, except to say that we are also very, very excited. I know that the, um, conference itself is something we're very excited about. There's a lot of opportunities for us to engage around the conference. If you have not attended, um, an FSR conference, this is virtual, it is available. Last year, we had many individuals from all over the world participating in this. There's opportunities for networking, there are opportunities for engaging with global experts. So, um, whether you're brand new or you've, uh, had sarcodosis for a little bit of awhile, we'll have different tracks that can help you learn a little bit more about what's happening in the disease or what you need to know. And then we also have these great tracks that came out of the wonderful theme that you came up with that's really focused specifically on things, um, like understanding your, um, finances, how to talk to your clinician, how to engage and learn, um, from others when you're trying to navigate the symptoms of your disease kind of life hacks, as it were, in order to think about things. So we're really excited about, um, that coming up and what that conference is going to be when we invite all of you to join us. John Carlin: Yes, the summits are wonderful, and I hope we get back to a point where they're in person again. Hopefully, we, uh, can get the pandemic behind us, and that's just my thought, just thinking, um, out loud, the networking opportunities, I think, are as good as they are virtually. I'm hoping that eventually we um, can all kind of meet in person. Because every time I've been for work to an event, you learned, uh, as much having a beer after the day, sitting around with your fellow conference as you do in the conferences themselves. Mary McGowan: Right? Tricha Chivas: And I think that's one of the things that will be another benefit coming from the Clinic Alliance is that um, opportunity for um, more local level engagement, uh, with others. And that is definitely something we want to be focusing in on as we move things forward there. John Carlin: Got you. So let me shift gears a little bit, Mary. Last year, early this year, there was some really exciting programming, uh, focused on increasing diversity. I was involved in some of that and inclusion with respect to uh, sarca dosis. How will FSR be continuing that work? Mary McGowan: Uh, John, this is such an important area for FSR. We believe so strongly in diversity and inclusion in everything that we do at FSR. But we were so thrilled, uh, with the very successful results, uh, of the Ignore No More Campaign. This campaign was focused on African American women and sarcoidosis. It was just an incredible reach with over 500,000 media impressions. We were so thrilled to have Gerald Prescott Galen, who's an actress of AMC's Walking, uh, Dead, and Bets All the Queen's Men. She's been living with sarcodosis for many years, but most recently was diagnosed with cardiac sarcodosis. She's been an amazing PSA for us that got over 1000 views in just one month and really helping to amplify our uh, messaging about this really critically important, uh, work. As you know, African American women have the highest prevalence of sarcodosis and by far the worst outcomes. And so it's important that the African American, uh, community understand this and also that clinicians understand this. And so that's what this was really uh, all about. This campaign. We're um, really excited as part two, we've just gotten uh, funding for uh, a part two campaign that's, uh, going to be called Ignore No More Act. Now act stands for Advanced Clinical Trials, Equity in Sarcodosis. And this is really going to be taking a deeper dive into how we um, can support and encourage clinical trial participation, uh, among all African Americans. Um, and our goal is to really learn from the community and to create strategies that can be captured in white paper, uh, and will be helpful tool for, again, both academic as well as, uh, industry sponsored trials. And we're really excited to be, as part of this campaign, hosting a congressional briefing to drive change at the federal level. So I hope listeners stay tuned for this really exciting expansion of this national campaign, and thank you for asking that question. We also have a Chance Zuckerberg initiative going on. I'll turn it over to tricia. She's been working very closely with the Chan Zuckerberg group, uh, on this exciting diversity campaign as, um, well, yeah, so. Tricha Chivas: The Chanceuckaberg Initiative, I think it's really important to say, for the community. So everyone knows this has been not just a grant and then the work that comes, uh, out of that, but this has really afforded FSR a lot of other opportunities for advancing and growing the skill sets of the staff, for reaching out and understanding from others that are in the network, um, best practices that they're using that we can, uh, then bring back to our community. So this has really afforded us a lot of opportunities in order to expand and grow and move things forward for those living with Sarcoidosis, which is our ultimate goal. The actual grant itself will be looking to work with clinics. So, um, members of the alliance, or, um, others that will be working with those clinics and helping to improve the diagnostic, um, and what we'll call the referral pathway. And what I mean by that is the ways that you get from your local doctor, your, um, local pulmonologist, or your local generalist to those more expert, uh, care. And what is that pathway? Um, and how do we really define that so that we can, again, reduce the amount of time for diagnosis and improve the pathway for treatment, especially if someone's living more rurally and they don't have that kind of connection to a more urban center that might be more, um, advanced in this space? John Carlin: I've never heard of that term before, the referral pathway. And you, um, guys are so good at sort of finding terms because you see this stuff all the time. The individual patient that lives in the middle of north or South Dakota or some rural area, in fact, not too far from where I live here in Virginia. That's what they talk about. They say my doctor had never heard of sarcle dosis before. Um, I'm not in a real large urban area, but we do have a large clinic here. People drive 4 hours to get to where I am in Roanoke, Virginia, for care, because we're the big medical center in this part of the world, right, serving the western half of the state of Virginia. But even here, there are very few Sarca doses patients. I might have been one of six for my Rheumatologist doctor, which is not the same as, um, going to Cleveland Clinic, which is what I ultimately decided to do, where I'm dealing with a center where that's all the doctor sees. So that's not so. That term is a referral pathway, and you're trying to sort of take that from being a rural road to an interstate to get you to that doctor quicker. Tricha Chivas: That's all right. I think for us, what we're trying to do is help to identify those areas where patients are being seen and create a kind of a conversation both ways from, um, the major centers to some of those more local level individuals that are, um, supporting individuals living with Sarcodosis, and then, um, also allowing an opportunity for them to have that conversation back. And because a lot of times, even as you're going to Cleveland Clinic, John, you still have the local doctor that you're going to want to talk to, and giving that kind of conversation, allowing them to get the kind of education they need. And then when a case is more complex or they need more support, they can have that support that way. And that's what we're trying to build. John Carlin: Awesome. So, so many exciting things. Mary, what else can listeners look forward to as we move forward over the next few months? Mary McGowan: Well, we have so many exciting things that we've been talking about going on at FSR. Tricia and I are continuing to speak internationally at different conferences. As a matter of fact, in just two weeks, we're headed to Boston. We're both going to be speaking at the World, uh, Orphan Drug Congress, which is really exciting. It's a very large conference, and it's wonderful to have Sarcoidosis being represented, uh, there at that conference. So we're really looking forward to that. Uh, I think also the viewers, if they want to stay in touch with us in terms of the Clinic Alliance and its growth, if, uh, anybody is being treated at the center or alliance that is not on our web page and would like to share contact information, please, uh, let us know, because we want to ensure that we are reaching out, uh, to everybody to offer this opportunity to bring them into this really extraordinary, uh, unique effort. And also, please sign up for our patient conference, um, July 30 and 31st. It's going to be so exciting this year. Last year, we had over 300 attendees from around the world, so we're really looking forward to a really exciting conference this year as well. So those are just a couple of other events. We have some other events on our web page that are coming up. Uh, we have a couple of, uh, painting sessions, so I would encourage anybody who's listening to please join FSR if you have not, all you, uh, simply do is fill out a quick form with your email and that helps you stay up to date on all of our different events and activities. John Carlin: Okay, so I've got a note here to ask you about life, uh, hacks and living with Sarquoidosis. So how will patients be able to take advantage of those or find out what those are? Tricha Chivas: Sure, I'll jump in if that's okay. Mary. Mary McGowan: Great. Tricha Chivas: The life hacks things that we're trying to do here is learn from folks like you, John. Like, what do you do when the fatigue is overwhelming? Or what do you do when you're just having a really painful day? Or what are those things that you're doing? Life hacks are the tips and tricks that people have used in their own daily lives to navigate the disease and learning from individuals that are living with the disease to, um, do that. So this is going to be one of the exciting kinds of sessions that we're having this year are, um, beyond all of our wonderful chat boards and we have a coffee break that's open and chatting. This session is a chance for people to talk back and forth with one another, um, and share how, um, they are managing their day to day. John Carlin: Got it. Life hacks. I love it. And so can people now sign up? Is there not a discount if you sign, uh, up early? How's that work? Early bird? Is that how that works? And how long is that available? Mary McGowan: Early bird registration right through the end of the month. So it's a great opportunity. And there's also, John's, scholarships that are available. So for people who want to attend the conference, uh, there is a registration fee, but we want to make sure that there are no barriers to anybody joining this conference. So if anybody needs financial assistance, there's information there as part of the registration as well. Uh, and so, please, we, uh, want to be able to ensure that everybody has access to attending this really important educational, global event as part of that. But, yes, please pay attention to, uh, the early bird registration, uh, as well. John Carlin: Got you. And if somebody can't afford it, but they want to be there, we'll find a way to make it happen. Mary McGowan: That's absolutely correct. We want to make sure that everybody has access again, uh, to support education, opportunity to ask questions, all the networking that takes place. We understand that this is critically important to bring people together, living with Sarcoid doses to support one another. And that's what this patient conference is all about. John Carlin: Uh, well, guys, look, we've covered a lot in a short amount of time. I'm just thrilled to have had both of you on. But more than that, thrilled to hear about all the momentum, uh, on all the different fronts. So congratulations on just really getting Sarcudos out there and advancing the cause you really deserve. Kudos. Mary McGowan: Well, thank you, John, and thank you for all that you're doing. These podcasts just really help, uh, to, again, amplify the messaging, the incredible interviews that you've done, the highlights of the campaigns that you continue to do. We are so grateful to you for doing this incredibly important work and sharing, uh, this information worldwide. And so you're, uh, part of the great success, uh, that we are all having, as well as all of the patients, the entire Sarcodosis community. It's everybody working, uh, together to spread the word, to spread the awareness, to engage in initiatives. And this is really the result of everybody's success in working together, um, building this momentum. And we're looking forward to the near future to continue to see great successes on the continuation of this momentum building so rapidly now. John Carlin: All right, well, thank you all very much. Tricha Chivas: Thank you so much. Mary McGowan: James on. Tricha Chivas: We appreciate it.    

About 200,000 Americans are classified as “porn addicts” but is porn addiction fact or fiction? 40 million American people regularly visit porn sites. 35% of all internet downloads are related to pornography. One-third of porn viewers are women. Every second 28,258 users are watching pornography on the internet. In this episode I am joined by my friend Dr. Caleb Jacobson who is an internationally recognized clinical psychologist, sex therapist, and biblical scholar. He chairs the AASECT Special Interest Group on Sexuality and Religion, and is the host of the very popular Sex Therapy Podcast.  Dr. Kanwal Bawa is Cleveland Clinic trained and a pioneer in the field of skin rejuvenation, hair restoration and sexual wellness. She has a state-of-the-art practice in Boca Raton, Florida called Bawa Medical. She earned the moniker Dr. Sex Fairy due to her incredible advances in the fields of both intimate and sexual wellness. Her patients fly to her from all over the world for vaginal rejuvenation, penis enlargement, Erectile Dysfunction, enhanced performance, increased libido and more. She also provides virtual consultations for those who are unable to travel to her for in-office treatments.   To schedule a virtual or in-office consultation: https://www.bawamedical.com/contact/ To learn more about sexual wellness: https://www.bawamedical.com/sexual-health/ TikTok: https://vm.tiktok.com/ZTdC5M5Me/ Instagram: https://www.instagram.com/therealdrsexfairy/ Facebook: https://www.facebook.com/doctorsexfairy Clubhouse: https://www.clubhouse.com/@drsexfairy

Eat Plant Based Starting At A Young Age And You'll Have A Minimal Likelihood Of Developing Prostate Cancer - Caldwell Esselstyn Jr., MD - Interview Caldwell B. Esselstyn Jr., M.D • http://www.dresselstyn.com/site/• Book - Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure Caldwell B. Esselstyn, Jr., received his B.A. from Yale University and his M.D. from Western Reserve University. In 1956, pulling the No. 6 oar as a member of the victorious United States rowing team, he was awarded a gold medal at the Olympic Games. He was trained as a surgeon at the Cleveland Clinic and at St. George's Hospital in London. In 1968, as an Army surgeon in Vietnam, he was awarded the Bronze Star.Dr. Esselstyn has been associated with the Cleveland Clinic since 1968. During that time, he has served as President of the Staff and as a member of the Board of Governors. He chaired the Clinic's Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery. He is a Fellow of the American College of Cardiology. In 1991, Dr. Esselstyn served as President of the American Association of Endocrine Surgeons, That same year he organized the first National Conference on the Elimination of Coronary Artery Disease, which was held in Tucson, Arizona. In 1997, he chaired a follow-up conference, the Summit on Cholesterol and Coronary Disease, which brought together more than 500 physicians and health-care workers in Lake Buena Vista, Florida. In April, 2005, Dr. Esselstyn became the first recipient of the Benjamin Spock Award for Compassion in Medicine. He received the Distinguished Alumnus Award from the Cleveland Clinic Alumni Association in 2009. In September 2010, he received the Greater Cleveland Sports Hall of Fame Award. Dr. Esselstyn received the 2013 Deerfield Academy Alumni Association Heritage Award In Recognition of Outstanding Achievement & Service, and the 2013 Yale University George H.W. Bush '48 Lifetime of Leadership Award. Dr. Esselstyn has also received the 2015 Plantrician Project Luminary Award, the Case Western Reserve University School of Medicine 2016 Distinguished Alumni Award, and the American College of Lifestyle Medicine 2016 Lifetime Achievement Award. #CaldwellEsselstyn #TheRealTruthAboutHealth  #WholeFood #Vegan #Vegetarian #PlantBasedNutrition CLICK HERE - To Checkout Our MEMBERSHIP CLUB: http://www.realtruthtalks.com  • Social Media ChannelsFacebook: https://www.facebook.com/TRTAHConferenceInstagram : https://www.instagram.com/therealtruthabouthealth/ Twitter: https://twitter.com/RTAHealth Linkedin: https://www.linkedin.com/company/the-real-truth-about-health-conference/ Youtube: https://www.youtube.com/c/TheRealTruthAboutHealth    • Check out our Podcasts  Visit us on Apple Podcast and Itunes search:  The Real Truth About Health Free 17 Day Live Online Conference Podcast Amazon: https://music.amazon.com/podcasts/23a037be-99dd-4099-b9e0-1cad50774b5a/real-truth-about-health-live-online-conference-podcastSpotify: https://open.spotify.com/show/0RZbS2BafJIEzHYyThm83J Google:https://www.google.com/podcasts?feed=aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS8yM0ZqRWNTMg%3D%3DStitcher: https://www.stitcher.com/podcast/real-truth-about-health-live-online-conference-podcastAudacy: https://go.audacy.com/partner-podcast-listen-real-truth-about-health-live-online-conference-podcastiHeartRadio: https://www.iheart.com/podcast/269-real-truth-about-health-li-85932821/ Deezer: https://www.deezer.com/us/show/2867272 Reason: https://reason.fm/podcast/real-truth-about-health-live-online-conference-podcast • Other Video ChannelsYoutube:https://www.youtube.com/c/TheRealTruthAboutHealthVimeo:https://vimeo.com/channels/1733189Rumble:  https://rumble.com/c/c-1111513 Facebook:https://www.facebook.com/TRTAHConference/videos/?ref=page_internal DailyMotion: https://www.dailymotion.com/TheRealTruthAboutHealth BitChute:https://www.bitchute.com/channel/JQryXTPDOMih/ Disclaimer:Medical and Health information changes constantly. Therefore, the information provided in this podcast should not be considered current, complete, or exhaustive. Reliance on any information provided in this podcast is solely at your own risk. The Real Truth About Health does not recommend or endorse any specific tests, products, procedures, or opinions referenced in the following podcasts, nor does it exercise any authority or editorial control over that material. The Real Truth About Health provides a forum for discussion of public health issues. The views and opinions of our panelists do not necessarily reflect those of The Real Truth About Health and are provided by those panelists in their individual capacities. The Real Truth About Health has not reviewed or evaluated those statements or claims. 

This episode is brought to you by Gut Food, ButcherBox, and Paleovalley.Heart disease is the number-one killer in the world, and it is often thought of as a cholesterol problem. When you take a closer look, however, there are other factors that drive this chronic disease that can't be fixed by the most commonly prescribed medication: statin drugs. The way you eat, how much you exercise, how you manage stress, and more all contribute to heart disease. In this episode, I talk with Dr. Aseem Malhotra, Dr. Stanley Hazen, and Dr. Cindy Geyer about why heart disease is easier to prevent than to reverse, why statins are not the answer in most cases, and how the gut microbiome is connected to heart health. Dr. Aseem Malhotra is an NHS-trained consultant, cardiologist, and visiting professor of Evidence-Based Medicine at the Bahiana School of Medicine and Public Health in Salvador, Brazil. He is a pioneer of the lifestyle medicine movement in the UK and in 2018 was ranked by software company Onalytica as the number-one doctor in the world influencing obesity thinking. He is the author of, The Pioppi Diet, coauthored with Donal O'Neill, The 21-Day Immunity Plan, and, A Statin-Free Life.Dr. Stanley Hazen is both the chair of the Department of Cellular & Molecular Medicine at the Lerner Research Institute and section head of Preventive Cardiology & Rehabilitation at the Heart and Vascular Institute of the Cleveland Clinic. He's published more than 400 peer-reviewed articles and has over 50 patents from his pioneering discoveries in atherosclerosis and inflammatory disease. Dr. Hazen made the seminal discovery linking microbial pathways to the pathogenesis of cardiovascular disease.Dr. Cindy Geyer received her Bachelor of Science and her Doctor of Medicine degrees, with honors, from the Ohio State University. She completed her residency in internal medicine at Strong Memorial Hospital in Rochester, NY, and is triple board certified in internal medicine, integrative medicine, and lifestyle medicine. She joined The Ultrawellness Center in 2021 after practicing and serving as the medical director at Canyon Ranch for 23 years. This episode is brought to you by Gut Food, ButcherBox, and Paleovalley.Gut Food uses the power of three critical gut-supporting components—prebiotics, probiotics, and polyphenols—and five ingredients at clinically validated dosages to help reduce inflammation, support the growth of beneficial gut bacteria, improve digestion and bloating, and support mood & energy. Check it out at gutfood.com.If you sign up today, ButcherBox will give you two ribeye steaks for free in your first box—just go to butcherbox.com/farmacy.Paleovalley is offering my listeners 15% off their entire first order. Just go to paleovalley.com/hyman.Full-length episodes of these interviews can be found here:Dr. Aseem MalhotraDr. Stanley HazenDr. Cindy Geyer See acast.com/privacy for privacy and opt-out information.

Riding a bicycle is no more dangerous than it was 50 years ago, but data from the Cleveland Clinic shows wearing a helmet can reduce the risk of head injury by as much as 85-percent.

Bloomberg, 1st Naturopathic Cardiologist ~ Decker Weiss, NMD, FASA and naturopathic cardiologist, travels around the world training physicians and pharmacists on safer ways to use fewer prescriptions and provide more vitality to their patients with natural medicines. A pioneer in the application of effective natural alternatives to bypass and angioplasty, Dr. Weiss has helped over 10,000 patients with his definitive holistic approach to cardiovascular disease management.  Dr. Weiss was named one of the Leading Physicians of the World by International Association of Health Care Providers and the International Association of Cardiologists, an honor that is given to under a 1000 physicians worldwide each year. He is the first in his professional to speak and educate for the Cleveland Clinic. His clients include seven U.S. Congressman & Senators & a former U.S. Vice President. Dr Weiss is the first naturopathic physician to complete a residency program in the Columbia Hospital System, the Arizona Heart Hospital and the prestigious Arizona Heart Institute. He is also the first Naturopathic physician to be on staff at a conventional hospital, the Arizona Heart Hospital, where he has served for nine years. He is also the founder of the Scottsdale Heart Institute. © 2022 All Rights Reserved© 2022 Building Abundant Success!!Join Me on ~ iHeart Radio @ https://tinyurl.com/iHeartBASSpot Me on Spotify: https://tinyurl.com/yxuy23baAmazon Music ~ https://tinyurl.com/AmzBAS 

According to a Cleveland Clinic survey, 65% of male participants say they avoid the doctor. A Mercy physician discusses the importance of preventive care.

Neurologist/Neuro-oncologist in Cleveland Clinic's Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Glen Stevens, DO, PhD, joins the Cancer Advances podcast to talk about the treatment of recurrent glioblastoma. Listen as Dr. Stevens discusses how a study mixing old principles with a new technique may disrupt the BBB, allowing chemotherapy to reach tumor cells.

Guest Bio: Christine Porath is a tenured professor at Georgetown University's McDonough School of Business. She's the author of Mastering Civility and co-author of The Cost of Bad Behavior. She is also a consultant working with leading organizations to help people and communities thrive. Her speaking and consulting clients include Google, United Nations, World Bank, Microsoft, Genentech, Marriott, 3M, Verizon, Ford, World Health Organization, and Cleveland Clinic. Highlights “What are the costs of these small interactions between people, that can make them feel disrespected or small?” [6:44] Christine Porath asks the big question that makes up research on the need for community in the workplace. “I stepped out of the shower and my back went out...I could not move, and it ended up being that the stress was exacerbated by toxic management. This fear based, intense pressure cooker that put unrealistic expectations on me.” [7:29] Marcel shares a story from his personal past and how toxic management caused physical injury due to stress.  “We looked at witnesses, and it was taking them off track just as much. Their performance was declining by about 33%.” [16:42] When discussing the consequences in her research, Christine shares some statistics on productivity all the way down to the witnesses of negative interactions beyond those directly involved. “Nearly 50% said because they would be at a disadvantage if they were civil or respectful at work. They thought they would be less leader like.” [18:14] Christine shares some interesting insights on the reason behind rude or negative behavior in the workplace.  “I'm really curious, on what you saw as maybe one or two of the worst examples of incivility in the research.” [20:46] Marcel, intrigued by Christine's research in negative behavior in the workplace, lines up space for Christine to share some examples involving public belittling of employees during meetings. “74% of people are actually more engaged, 81% are more likely to stay with the company…83% reported higher thriving at work and a sense of being more energized, alive, and growing.” [24:14] Marcel lists some eye-opening stats on the positive impact of a strong community at work. Christine comments on the difference it would make for employees to prioritize working in an environment with a sense of community. “Everyday they would meet in this film room, and it wouldn't be about the X's and O's, the strategies, the game. It was this idea of sharing information, and being vulnerable, and talking about things that mattered.”[31:10] Christine explains an example of Uniting People, with a story of coach Phil Jackson and the Chicago Bulls.  “It's these moments, that if you're mindful which is hard these days, can really make a difference to people.” [38:49] Christine talks about the impact of small moments in acknowledging and respecting people, like with her story of Empathy at Cleveland Clinic. “Given how important culture is whether you're PTA, or a school, or a local organization, we should prioritize culture and think about how do we continue to strive to get better?” [43:01] Sharing about Boosting Wellness, Christine gives examples of small but impactful ways to improve culture in the workplace. “There's community in so many ways, but people don't think about community in a work sense.” [49:00] Closing out today's episode, Marcel connects community as an important extension of love in the workplace.  Resources: Christine Porath Christine Porath (@PorathC) / Twitter Christine Porath - Professor of Management - Georgetown University | LinkedIn  Mastering Community: The Surprising Ways Coming Together Moves Us from Surviving to Thriving

Dr. Bruce Cohen from the Cleveland Clinic in Ohio discusses his perspective on the use of hyperbaric oxygen therapy, also known as HBOT, for people with mitochondrial disease. Hyperbaric oxygen therapy is the use of 100% oxygen at a level higher than the atmosphere. HBOT is controversial, and has long been used to treat some conditions, such as carbon monoxide poisoning, burn inuries, and decompression sickness. However, some studies propose that HBOT may play a positive role with other conditions, such as autism, cerebral palsy, brain injury, multiple sclerosis and others. Some patients and parents ask, "Is hyperbaric oxygen therapy safe for a person with the diagnosis of mitochondrial disease?" About the Speaker Dr. Bruce Cohen, from the Cleveland Clinic in Ohio, is well known in the mitochondrial disease community. In addition to his background in mitochondrial medicine, Dr. Cohen has an extensive background in conducting clinical trials for cancer treatment.

Join us with Dr. Sumit Parikh, Director of the Cleveland Clinic Neurogenetics, Metabolic and Mitochondrial Disease program, and past president of the Mitochondrial Medicine Society. Learn more about the 2014-2015 publications based on collaborations and consensus surveys completed by the Mitochondrial Medicine Society. The landmark series of publications is the first to address existing standards of care and most common approaches to diagnosis, use of supplements and symptom management by leaders in mitochondrial medicine around the US. Key points: Mitochondrial medicine's complexity bring unique challenges to physicians The practice of Mitochondrial Medicine has varied from provider-to-provider Patients and families deserve uniformity in regards to diagnosis and treatment The MMS Consensus Project was conceived with this goal in mind About The Speaker Dr. Parikh is the Director of the Cleveland Clinic Neurogenetics, Metabolic & Mitochondrial disease program. His clinical and research interests include the genetic diagnosis and treatment of patients with mitochondrial cytopathies, inborn errors of metabolism, cognitive and developmental regression, autism, leukodystrophies and developmental delays. He is part of the North American Mitochondrial Disease Research Consortium (NAMDC) and the Primary Investigator for the Pearson Syndrome Natural History study. He is an invited lecturer at national meetings and hospitals. He completed his residency in pediatrics and fellowship in child neurology at the Children's Hospital of Pittsburgh and received additional training in genetics and metabolism at Cleveland Clinic and Centers for Inherited Diseases of Metabolism. Dr. Parikh has had the privilege of having Bruce Cohen, Charles Hoppel and Marvin Natowicz serve as his teachers during that time. He joined the Cleveland Clinic in 2004. Since 2007, Dr. Parikh has been selected as one of "America's Best Doctors." He serves as Scientific & Medical Advisor to the United Mitochondrial Disease Foundation, Cyclic Vomiting Syndrome Association and the International Foundation for CDKL5 Research. He is the Past President of the Mitochondrial Medicine Society. He is an invited faculty member of the North American Metabolic Academy. He was on the scientific planning committee of the Child Neurology Society and is an ad hoc reviewer for the Journal of Child Neurology, Journal of Inherited Metabolic Disease and Molecular Genetics & Metabolism.

In this mini episode of the podcast recorded at the Cannes Lions International Festival of Creativity, Stephen Madden sits down with Paul Matsen, chief marketing and communications officer for the Cleveland Clinic, about his impressions of the festival, lessons learned from the pandemic, as well as a panel session the two took part in.

GuestDr. Seth BauerClinical Pharmacist, Department of Pharmacy, Cleveland Clinic, Clinical Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine;HostMarilyn N. Bulloch, PharmD, BCPS, FCCMAssociate Clinical Professor and Director of Strategic OperationsHarrison College of Pharmacy | Auburn University

Protein shakes can be a great after exercise beverage or serve as a meal replacement. Julia Zumpano, a registered dietician from the Preventive Cardiology Program at Cleveland Clinic explains that the most important thing to consider is the nutritional make up of your shake. It should have enough protein, amino acids, fiber and not a lot of added sugar. Some protein shakes come ready-to-drink, which can be good option if you are on the go. Protein powders can be good on their own mixed with water or other base. You may choose to make them into a smoothie by adding other ingredients; it will keep you fuller, longer.

Are men being fair to women? Are women being fair to men? Can we really fix our partner? What does that even mean? In this episode I talk to Heather Leigh, host of The Man Fixer podcast, and my friend Ken. Heather discusses issues from a man's point of view, and Ken is a man I have unsuccessfully tried to fix for years, albeit as a friend. Tune in for a great conversation. Dr. Kanwal Bawa is Cleveland Clinic trained and a pioneer in the field of skin rejuvenation, hair restoration and sexual wellness. She has a state-of-the-art practice in Boca Raton, Florida called Bawa Medical. She earned the moniker Dr. Sex Fairy due to her incredible advances in the fields of both intimate and sexual wellness. Her patients fly to her from all over the world for vaginal rejuvenation, penis enlargement, Erectile Dysfunction, enhanced performance, increased libido and more. She also provides virtual consultations for those who are unable to travel to her for in-office treatments.   To schedule a virtual or in-office consultation: https://www.bawamedical.com/contact/ To learn more about sexual wellness: https://www.bawamedical.com/ sexual-health/ TikTok: https://vm.tiktok.com/ZTdC5M5Me/ Instagram: https://www.instagram.com/therealdrsexfairy/ Facebook: https://www.facebook.com/doctorsexfairy Clubhouse: https://www.clubhouse.com/@drsexfairy

CardioNerds Tommy Das (Program Director of the CardioNerds Academy and cardiology fellow at Cleveland Clinic), Rick Ferraro (cardiology fellow at the Johns Hopkins Hospital), and Dr. Xiaoming Jia (Cardiology Fellow at Baylor College Medicine) take a closer look at the mechanism of icosapent ethyl in triglyceride lowering and ASCVD risk reduction with Dr. Michael Shapiro, the Fred M. Parrish professor of cardiology at Wake Forest University and Director of the Center for Preventative Cardiology at Wake Forest Baptist Health. Audio editing by CardioNerds Academy Intern, student doctor Akiva Rosenzveig. This episode is part of the CardioNerds Lipids Series which is a comprehensive series lead by co-chairs Dr. Rick Ferraro and Dr. Tommy Das and is developed in collaboration with the American Society For Preventive Cardiology (ASPC). Relevant disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Cardiovascular Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Icosapent Ethyl Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are two major Omega-3 fatty acids found in fish oil. While both have been shown to lower triglycerides, only purified EPA formulations have been shown to reduce ASCVD risk.Mechanisms of triglyceride (TG) lowering by icosapent ethyl are multiple and include reduction of hepatic VLDL production, stimulation of lipoprotein lipase activity, increased chylomicron clearance, reduced lipogenesis, increased beta oxidation, and reduced delivery of fatty acids to the liver.There was only modest reduction of triglycerides in REDUCE-IT and JELIS despite association with significant reduction in cardiovascular outcome events, suggesting likely mechanisms outside of triglyceride lowering that may contribute to ASCVD reduction.While there was an increased signal for peripheral edema and atrial fibrillation associated with icosapent ethyl in prior trials, overall side effect rates were very low.Icosapent ethyl is considered to be cost-effective based on cost-effective analysis. Show notes - Icosapent Ethyl EPA and DHA have differing biological properties that may explain differences in ASCVD risk reduction observed in cardiovascular outcome trials 1.The REDUCE-IT trial, which enrolled secondary prevention and high-risk primary prevention patients with elevated triglycerides who were on statin therapy, showed significant reduction of major adverse cardiovascular events in the icosapent ethyl group compared with a mineral oil placebo2. Only modest reductions of TG were seen in the REDUCE-IT and JELIS trials despite association with significant reduction in events 2,3.  Potential mechanisms contributing favorable effects of EPA on ASCVD risk reduction include inhibition of cholesterol crystal formation, stabilization of membrane structures, reversal of endothelial dysfunction, inhibition of lipoprotein and membrane lipid oxidation 4.Pleotropic effects of EPA include influence on platelet aggregation, lower thromboxane activity, increased prostaglandin level, and effects on blood pressure, insulin resistance and inflammation.Triglycerides are a surrogate for triglycerides-rich lipoproteins, which are likely causally associated with ASCVD 5.There is increased signal for bleeding, lower extremity edema, and atrial fibrillation with icosapent ethyl but overall side effect rates are very low 2.In order to ensure higher rates of medication access and adherence, clinicians must be cognizant of the cost to the patient. In practice, it is important to have a structured approach to improve insurance approval rate for medications that require prior authorizationsWith icosapent ethyl, cost effectiveness analyses have shown the medication is cost-effect for ASCVD risk reduction in secondary...

A person reports sporadic episodes of unexplained goosebumps all down one side of the body. No other symptoms are present: no pain, tingling, numbness, or anything. Is it dysautonomia? Is it a weird kind of seizure? What are goosebumps good for, anyway? It turns out they might be more important than we thought.   Sponsors:     Books of Discovery: www.booksofdiscovery.com     Anatomy Trains: www.anatomytrains.com     Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                    Recent Articles by Ruth:          “Unpacking the Long Haul,” Massage & Bodywork magazine, January/February 2022, page 35, www.massageandbodyworkdigital.com/i/1439667-january-february-2022/36.   “Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy,” Massage & Bodywork magazine, September/October 2021, page 33, http://www.massageandbodyworkdigital.com/i/1402696-september-october-2021/34.           “Pharmacology Basics for Massage Therapists,” Massage & Bodywork magazine, July/August 2021, page 32, www.massageandbodyworkdigital.com/i/1384577-july-august-2021/34.       Resources:    Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app   Ask a Scientist: Why doesn't your face get goosebumps? (no date). Available at: https://www.pressconnects.com/story/news/local/aroundtown/2016/02/06/ask-scientist-face-get-goosebumps/79935204/ (Accessed: 25 May 2022).   Goosebumps on Skin: When You're Not Cold and More (2017) Healthline. Available at: https://www.healthline.com/health/goosebumps-on-skin (Accessed: 25 May 2022).   Kurita, T. et al. (2013) ‘Pilomotor seizures in temporal lobe epilepsy: A case report with sequential changes in magnetic resonance imaging', Epilepsy & Behavior Case Reports, 1, pp. 142–145. doi:10.1016/j.ebcr.2013.08.003.   MD, R.H.S. (2020) Wondering about goosebumps? Of course you are, Harvard Health. Available at: https://www.health.harvard.edu/blog/wondering-about-goosebumps-of-course-you-are-2020080320688 (Accessed: 25 May 2022).   Temporal Lobe Epilepsy (TLE): Causes, Symptoms & Treatment (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/17778-temporal-lobe-seizures (Accessed: 25 May 2022).   The hair-raising reason for goosebumps: The same cell types that cause goosebumps are responsible for controlling hair growth (no date) ScienceDaily. Available at: https://www.sciencedaily.com/releases/2020/07/200720112325.htm (Accessed: 25 May 2022).   What goosebumps are for (2020) National Institutes of Health (NIH). Available at: https://www.nih.gov/news-events/nih-research-matters/what-goosebumps-are (Accessed: 25 May 2022).     About our Sponsor:   Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.       Website: anatomytrains.com       Email: info@anatomytrains.com              Facebook: facebook.com/AnatomyTrains     Instagram: www.instagram.com/anatomytrainsofficial    YouTube: https://www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA  

Catecholamine is used in patients with septic shock to augment hemodynamics and achieve goal mean arterial pressure. Ludwig H. Lin, MD, is joined by Gretchen L. Sacha BCCCP, PharmD, to discuss this retrospective observational study to evaluate the associations of catecholamine dose, lactate concentration, and timing from shock onset at vasopressin initiation with in-hospital mortality. (Sacha G, et al. Crit Care Med. 2022;50:614-623). Dr. Sacha is a critical care clinical specialist at Cleveland Clinic in Cleveland, Ohio. This podcast is sponsored by Sound Physicians.

Byron Lee, MD, PhD, a urologist in Cleveland Clinic's Glickman Urological and Kidney Institute joins the Cancer Advances podcast to discuss expanding surgical options for patients with bladder cancer. Listen as Dr. Lee compares robotic surgery verses open surgery and what we are doing to improve patient outcomes.

Dr. Christy talks to Dr. Mary Rensel, a neuroimmunologist at Cleveland Clinic and creator of the time-management system Brain Fresh, talks about the reasons physicians – especially women – are leaving medicine right now, and what we can do about it.

A low sodium diet may mean making some big changes in the way you eat. Sodium is found naturally in some foods but is also added to many foods, which can make lowering your intake challenging. Julia Zumpano, a registered dietician from the Preventive Cardiology Program at Cleveland Clinic, explains the current recommendations for sodium intake and how to get started lowering your intake. It is important to read nutrition labels to ensure you are not going over your recommended limit.

Sex is complicated for us all but it seems to be more so for single mothers. In this episode I am joined by my friend Eva who, like me, is a single mother. We are both successful women navigating the world of dating in our 40s. We are not alone. According to the U.S. Census Bureau of the 11 million single parent families with children, nearly 80 percent are headed by single mothers. Join me as we discuss the joys and sorrows of single moms, and our experiences trying to date. Dr. Kanwal Bawa is Cleveland Clinic trained and a pioneer in the field of skin rejuvenation, hair restoration and sexual wellness. She has a state-of-the-art practice in Boca Raton, Florida called Bawa Medical. She earned the moniker Dr. Sex Fairy due to her incredible advances in the fields of both intimate and sexual wellness. Her patients fly to her from all over the world for vaginal rejuvenation, penis enlargement, Erectile Dysfunction, enhanced performance, increased libido and more. She also provides virtual consultations for those who are unable to travel to her for in-office treatments.   To schedule a virtual or in-office consultation: https://www.bawamedical.com/contact/ To learn more about sexual wellness: https://www.bawamedical.com/sexual-health/ TikTok:https://vm.tiktok.com/ZTdC5M5Me/ Instagram:https://www.instagram.com/therealdrsexfairy/ Facebook:https://www.facebook.com/doctorsexfairy Clubhouse:https://www.clubhouse.com/@drsexfairy

Dr. Prather opens the show with a COVID-19 update about the future of vaccine mandates. Then, we share three patient success stories from Dr. Prather's office that will inspire you on your own health journey. In this episode, you'll find out:—How 14 states, including Indiana, require that businesses allow their employees religious and medical exemptions from vaccine mandates.—The necessity of public pushback to defeat vaccine mandates and demand health freedom from the government. —Why Dr. Prather says "the science and the data don't support the vaccine".—The reason the government has had a tunnel-vision approach to vaccines being the solution to the pandemic and ignored all other treatments.—The new vaccine that is a potential alternative to the new Pfizer and Moderna vaccines that is more along the lines of traditional vaccines. —The shocking COVID results being seen in Australia after they strictly followed a strategy of lockdowns and vaccine mandates.—What policy the airlines are trying to change concerning international travel. —Why Pam decided to come see Dr. Prather after suffering from extreme stress and discovered for the first time that she has Scoliosis. And why she says, "I didn't know I could feel this good" until she experienced the treatments at Holistic Integration. —How Katy went to almost 20 different specialists for help after a random neck fracture, including The Cleveland Clinic and The Mayo Clinic, and found no answers until she came to Dr. Prather's office. And how she's so excited to be WALKING again after being close to needing a wheelchair. —And in a special treat for long-time patients of Dr. Prather, we will be joined by Pat, a beloved employee in Dr. Prather's office who retired after 17-years. Hear how she first came to Dr. Prather as a patient after being diagnosed with Lupus and why her general practitioner said she wouldn't be alive today if it weren't for Dr. Prather.www.TheVoiceOfHealthRadio.com

Some Of The Absolute Key Things That Seem To Delay Progression Into Dementia And Alzheimer's - Caldwell Esselstyn Jr., MD - Interview Caldwell B. Esselstyn Jr., M.D • http://www.dresselstyn.com/site/• Book - Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure Caldwell B. Esselstyn, Jr., received his B.A. from Yale University and his M.D. from Western Reserve University. In 1956, pulling the No. 6 oar as a member of the victorious United States rowing team, he was awarded a gold medal at the Olympic Games. He was trained as a surgeon at the Cleveland Clinic and at St. George's Hospital in London. In 1968, as an Army surgeon in Vietnam, he was awarded the Bronze Star.Dr. Esselstyn has been associated with the Cleveland Clinic since 1968. During that time, he has served as President of the Staff and as a member of the Board of Governors. He chaired the Clinic's Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery. He is a Fellow of the American College of Cardiology. In 1991, Dr. Esselstyn served as President of the American Association of Endocrine Surgeons, That same year he organized the first National Conference on the Elimination of Coronary Artery Disease, which was held in Tucson, Arizona. In 1997, he chaired a follow-up conference, the Summit on Cholesterol and Coronary Disease, which brought together more than 500 physicians and health-care workers in Lake Buena Vista, Florida. In April, 2005, Dr. Esselstyn became the first recipient of the Benjamin Spock Award for Compassion in Medicine. He received the Distinguished Alumnus Award from the Cleveland Clinic Alumni Association in 2009. In September 2010, he received the Greater Cleveland Sports Hall of Fame Award. Dr. Esselstyn received the 2013 Deerfield Academy Alumni Association Heritage Award In Recognition of Outstanding Achievement & Service, and the 2013 Yale University George H.W. Bush '48 Lifetime of Leadership Award. Dr. Esselstyn has also received the 2015 Plantrician Project Luminary Award, the Case Western Reserve University School of Medicine 2016 Distinguished Alumni Award, and the American College of Lifestyle Medicine 2016 Lifetime Achievement Award. #CaldwellEsselstyn #TheRealTruthAboutHealth  #WholeFood #Vegan #Vegetarian #PlantBasedNutrition CLICK HERE - To Checkout Our MEMBERSHIP CLUB: http://www.realtruthtalks.com  • Social Media ChannelsFacebook: https://www.facebook.com/TRTAHConferenceInstagram : https://www.instagram.com/therealtruthabouthealth/ Twitter: https://twitter.com/RTAHealth Linkedin: https://www.linkedin.com/company/the-real-truth-about-health-conference/ Youtube: https://www.youtube.com/c/TheRealTruthAboutHealth    • Check out our Podcasts  Visit us on Apple Podcast and Itunes search:  The Real Truth About Health Free 17 Day Live Online Conference Podcast Amazon: https://music.amazon.com/podcasts/23a037be-99dd-4099-b9e0-1cad50774b5a/real-truth-about-health-live-online-conference-podcastSpotify: https://open.spotify.com/show/0RZbS2BafJIEzHYyThm83J Google:https://www.google.com/podcasts?feed=aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS8yM0ZqRWNTMg%3D%3DStitcher: https://www.stitcher.com/podcast/real-truth-about-health-live-online-conference-podcastAudacy: https://go.audacy.com/partner-podcast-listen-real-truth-about-health-live-online-conference-podcastiHeartRadio: https://www.iheart.com/podcast/269-real-truth-about-health-li-85932821/Deezer: https://www.deezer.com/us/show/2867272 Reason: https://reason.fm/podcast/real-truth-about-health-live-online-conference-podcast • Other Video ChannelsYoutube:https://www.youtube.com/c/TheRealTruthAboutHealthVimeo:https://vimeo.com/channels/1733189Rumble:  https://rumble.com/c/c-1111513 Facebook:https://www.facebook.com/TRTAHConference/videos/?ref=page_internal DailyMotion: https://www.dailymotion.com/TheRealTruthAboutHealth BitChute:https://www.bitchute.com/channel/JQryXTPDOMih/ Disclaimer:Medical and Health information changes constantly. Therefore, the information provided in this podcast should not be considered current, complete, or exhaustive. Reliance on any information provided in this podcast is solely at your own risk. The Real Truth About Health does not recommend or endorse any specific tests, products, procedures, or opinions referenced in the following podcasts, nor does it exercise any authority or editorial control over that material. The Real Truth About Health provides a forum for discussion of public health issues. The views and opinions of our panelists do not necessarily reflect those of The Real Truth About Health and are provided by those panelists in their individual capacities. The Real Truth About Health has not reviewed or evaluated those statements or claims. 

BRN AM  |  The link between dental health and mental health | Dr. Susan Albers, Clinical Psychologist, Cleveland Clinic  | www.broadcastretirementnetwork.com

This episode is all about Holistic Hot Girl! Angela breaks down the show segments and talks about the rebranding. This episode also provides a brief introduction to Reiki, with information from the Cleveland Clinic found here: https://my.clevelandclinic.org/health/treatments/21080-reiki-self-treatment For more content be sure to follow @holistichotgirlpod on Instagram and subscribe wherever you listen! --- Send in a voice message: https://anchor.fm/angela-van-pelt/message Support this podcast: https://anchor.fm/angela-van-pelt/support

Jose was an electrical engineer, a self-described atheist and closed minded skeptic when, at age 46, after a minor accident at work, he was administered medication in the ER that he was severely allergic to. That mundane mistake changed Jose's life completely as the damage to his lungs from the reaction to the medication became severe and he was brought back to the ER where he flat lined for a total of 5 minutes. There, he experienced a journey that shattered his materialist perspective and every belief in ‘science' he had held dear.Jose's life changed dramatically as a result of this near-death experience. He endured a long and gruelling physical and emotional recovery, spending years in counselling trying to reconcile what had happened to him. He was introduced to IANDS and finally embraced his experience and new life path. He began creating art as a way to share his experience and as a form of meditation.Jose developed the breakthrough mindfulness practice, Inner Immersion, which is engineered to help others shed the layers which keep them from connecting with their true selves, without words or dogma. To date, Jose has worked with over a thousand people with the Inner Immersion Modality and has had success working with addiction, PTSD, releasing blocks and trauma as well as in the personal development and transformational fields.Jose's transformational ‘ascension' art has exhibited in galleries across the US and Canada. His work hangs in private and corporate collections worldwide and in permanent installations in the prestigious Cleveland Clinic collection, the Nicklaus Children's Dan Marino Outpatient Centre in Florida, and other healing centres across the US and Canada. His limited edition book, Ethereal, is collaboration with Canada's celebrated printer and book designer, Robert Reid. Ethereal offers the reader a glimpse, through the art and his wife, Anastasia's poetry, into the ineffable world beyond the veil.Jose has co-founded Immersive Arts, a collaborative of art and design professionals to offer centering, calming experiences in institutional and corporate settings, while providing the platform for deeper quantitative research into the art's impact on health and wellbeing outcomes. Jose is also a co-founder of Consciousness Café, a space to explore consciousness and some of the BIG questions, find resources and like minded community.Jose is a member of the Association of Transformational Leaders. He lives in British Columbia with his wife, Anastasia, and their youngest daughter, Gabrielle. He travels regularly to speak on his near death experience and on the effect of art on healing and wellness.

Petar Bajic, MD, is a urologist in the Center for Men's Health at the Cleveland Clinic's Glickman Urological and Kidney Institute, specializing in men's health and sexual medicine. He joins the Butts & Guts podcast as the special guest on this episode to discuss how certain diet and lifestyle changes can help men who experience Erectile Dysfunction (ED).

This is the first installment of the special TBI Tuesday series. Every Tuesday for the next 6 weeks, I'll share chapters from my book TBI or CTE: What the Hell is Wrong with Me? and discuss them afterward. This week I play the prologue and Chapters 1 and 2, narrated by Derek Dysart. Here is the website for the Cleveland Clinic -https://my.clevelandclinic.org/locations/nevada Here's the JRE podcast with Dr. Mark Gordon - https://vimeo.com/271460457  

Deadly wrong-way crash in Cincinnati; Governor DeWine awards new funding to some local law enforcement agencies; relief from the baby formula shortage could be in the near future; breast cancer research at Cleveland Clinic yields promising new drug.

You might have learned in elementary school that when you sneeze, you should cover your mouth to avoid spreading germs. But it's possible that no one ever told you what would happen if you kept the sneeze in. It turns out, the simple habit of holding in a sneeze can wreak havoc beyond belief on your body! According to The Cleveland Clinic, sneezing can send mucus flying at a rate of up to 100 mph. Picture that for a second, and you'll get an idea of the power a sneeze carries. So, when you stifle it, what happens? Learn more about your ad choices. Visit megaphone.fm/adchoices

This piece is highlighted because of its significance. Please check out the rest of TopMedTalk's coverage of the conference on our website - www.topmedtalk.com Regular listeners will appreciate the importance of the PeriOperative ISchemic Evaluation-3 Trial (POISE-3). Here we highlight a conversation containing late breaking news on the subject. The New England Journal of Medicine is here: https://www.nejm.org/doi/full/10.1056/NEJMoa2201171 Presented by Desiree Chappell and Monty Mythen with their guests Frederic Michard, MD of MiCo Consulting and Daniel Sessler, Michael Cudahy Professor and Chair at Cleveland Clinic, Director of The Outcomes Research Consortium.

A welcome return to TopMedTalk for two big names both of whom made a huge impact with their previous appearances, links to which are here: Dan Sessler is here: https://topmedtalk.libsyn.com/topmedtalks-to-dan-sessler-0 Frederic Michard is here: https://topmedtalk.libsyn.com/topmedtalk-wireless-wearables-on-the-ward-the-new-www-revolution Presented by Desiree Chappell and Monty Mythen with their guests Frederic Michard, MD of MiCo Consulting and Daniel Sessler, Michael Cudahy Professor and Chair at Cleveland Clinic, Director of The Outcomes Research Consortium.

There is a lot of confusion when it comes to non-heterosexual orientation. June is LGBTQ+ Pride Month and I took this opportunity to invite my friend Robert Boo to the podcast. Robert is the CEO of Ft. Lauderdale's iconic Pride Center. What is the difference between all the different terms used to describe the LGBTQ+ community? What are the various issues faced by them today? Are attitudes changing? What are the resources for HIV+ people? We are very different yet we are all the same. At the end of the day, love is love, and we are all colors of the same rainbow.  Dr. Kanwal Bawa is Cleveland Clinic trained and a pioneer in the field of skin rejuvenation, hair restoration and sexual wellness. She has a state-of-the-art practice in Boca Raton, Florida called Bawa Medical. She earned the moniker Dr. Sex Fairy due to her incredible advances in the fields of both intimate and sexual wellness. Her patients fly to her from all over the world for vaginal rejuvenation, penis enlargement, Erectile Dysfunction, enhanced performance, increased libido and more. She also provides virtual consultations for those who are unable to travel to her for in-office treatments. To schedule a virtual or in-office consultation: https://www.bawamedical.com/contact/ To learn more about sexual wellness: https://www.bawamedical.com/sexual-health/ TikTok: https://vm.tiktok.com/ZTdC5M5Me/ Instagram: https://www.instagram.com/therealdrsexfairy/ Facebook: https://www.facebook.com/doctorsexfairy Clubhouse: https://www.clubhouse.com/@drsexfairy

An interview with Dr. Pauline Funchain from Cleveland Clinic in Cleveland, OH, author on "Systemic Therapy for Melanoma: ASCO Guideline Rapid Recommendation Update." Dr. Funchain reviews recent evidence and updated recommendations from the ASCO Expert Panel for the use of tebentafusp in patients with metastatic uveal melanoma. For more information, visit www.asco.org/melanoma-guidelines.   TRANSCRIPT Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I am interviewing Dr. Pauline Funchain from Cleveland Clinic in Cleveland, Ohio, author on Systemic Therapy for Melanoma: ASCO Guideline Rapid Recommendation Update. Thank you for being here, Dr. Funchain. Dr. Pauline Funchain: It's great to be here with you, Brittany. Thank you! Brittany Harvey: First, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The full conflict of interest information for this guideline panel is available online with the publication of the guideline in the Journal of Clinical Oncology. Dr. Funchain, do you have any relevant disclosures that are directly related to this guideline topic? Dr. Pauline Funchain: I do not have relevant disclosures that relate to this guideline topic. Brittany Harvey: Great, thank you. Then getting into the rapid update, what prompted this rapid update to the Systemic Therapy for Melanoma: ASCO Guideline published in 2020? Dr. Pauline: So, earlier this year, on January 25th, the FDA approved tebentafusp for metastatic uveal melanoma. So, this is the first FDA approval for metastatic uveal melanoma. We felt it was really important to put out a rapid update to let both clinicians know about the therapy and also so that more patients can get access to it as quickly as possible. Brittany Harvey: Understood. So, then based on this new FDA approval, what are the updated recommendations for patients with uveal melanoma? Dr. Pauline Funchain: So, any patients who have a previously untreated metastatic uveal melanoma, and also who are HLA-A*02:01 positive, this group of patients should be offered tebentafusp as systemic therapy. This is the only systemic therapy that has been shown to prolong overall survival in patients with metastatic uveal melanoma. And if you look at the kind of benefit that was seen, patients who were on tebentafusp had a median overall survival of 21.7 months versus 16 months in comparison to investigator's choice. In this case, that was either single agent pembrolizumab, ipilimumab, or dacarbazine. So, it is a pretty significant overall survival benefit. Brittany Harvey: Great! Thank you for reviewing those updated recommendations and the data behind them. So, what should clinicians know as they implement this updated recommendation? Dr. Pauline Funchain: So, they should know that there was a great overall survival benefit seen, but it doesn't correlate with the objective response rate that was seen in the trial. So, for patients who were treated with tebentafusp, the objective response rate was 9%. And for those patients who were treated with the investigator's choice, again, that was single agent pembrolizumab, ipilimumab, or dacarbazine, the response rate was 5%. So, that margin was not very different in terms of objective response rate when looking at RECIST-based criteria, so radiologic criteria for response, but the survival was clearly seen. And interestingly, even in those patients that had radiologic progression, there was an improved survival for those patients who were on tebentafusp versus investigator's choice. So, there is some kind of survival benefit that may not correlate with what is seen on imaging. So, clinicians should know that they may not see a dramatic response in terms of tumor size on imaging, but patients may still benefit from the therapy. Brittany Harvey: Understood. So, then you've just talked a little bit about responses in patients. So, how does this guideline update affect patients with melanoma? Dr. Pauline Funchain: So, despite a difference in response rate, long story short, there is an overall survival difference. So, really, this is the first overall survival difference that we have seen in metastatic uveal melanoma. It is really exciting. It is finally an approved drug for metastatic uveal melanoma, which did not have any approved or standard of care, systemic drugs. So, this is a really big win for a rare disease. I think, in terms of the general melanoma field and also the cancer field in general, this is really an exciting first-in-class drug on two different fronts. It is the first approved T-cell receptor therapy. It is also the first bispecific protein and it works differently than other immunotherapies we have seen. So, hopefully, this is something we see more of in other cancers. Brittany Harvey: Definitely, it's good to see that these patients finally have an option and we'll look forward to research in other cancers as well. So, then finally, Dr. Funchain, what are the outstanding questions regarding systemic therapy for melanoma? Dr. Pauline Funchain: Well, there are multiple questions that are outstanding. I think, for metastatic uveal melanoma, I think there are a lot of questions about the dissociation between the radiologic response and survival. I think there are questions about knowing when to stop tebentafusp if it's not working because we don't really have a good sense of what we should be using to know if this is not the right therapy for that patient. I think we would love to know what the biomarkers of response are, and we may need different ways of looking for how to judge if a patient is benefiting from tebentafusp and other systemic therapies. And I think that there's still a big question in uveal melanoma about whether we start with systemic therapy or local therapy. I don't think that's been answered. Now, in terms of the entire guideline, I think for melanoma in general, there are new data that are emerging and have been recently published and we will be looking forward to the next ASCO guideline in systemic therapy for melanoma because I think that there are a lot of emerging data that need to be addressed. Brittany Harvey: Definitely. We'll look forward to that new research in uveal melanoma and to reviewing the updated data with the guideline panel for the next edition of the systemic therapy for melanoma guideline. So, I want to thank you so much for your work to rapidly updating this guideline, and thank you for your time today, Dr. Funchain. Dr. Pauline Funchain: Thank you for having me. It is really meaningful to us to be able to offer education and get the word out about therapies that can help our patients. Brittany Harvey: Agreed. And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast series. To read the full rapid recommendation update, go to www.asco.org/melanoma-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available on iTunes or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Peter Rasmussen, MD, cerebral vascular surgeon and Chief Clinical Officer of Virtual Second Opinions by Cleveland Clinic, joins the Cancer Advances podcast to discuss the benefits of Virtual Second Opinions. Listen as Dr. Rasmussen talks about this service at Cleveland Clinic and our goal to give patients the best opinion on what they can do now and in the future.

A first-of-its-kind study from Cleveland Clinic showed that the presenting clinical phenotype of Alzheimer's disease or Lewy body dementia — along with neuropathology and a patient's age and sex — predicted the likelihood of subsequently developing specific behavioral and psychological symptoms. In this episode, Jagan Pillai, MD, PhD discusses these findings and what they mean for the future of dementia practice and research.

Dr. Michael Roizen is the Cleveland Clinic's first Chief Wellness Officer, and the author of four New York Times best-sellers.  He's won several awards in the medical community, given over 1200 lectures, and made appearances on Oprah, The Today Show, CNN, CBS, Good Morning America, and more, he writes a daily newspaper column and has run a radio show known as YOU The Owner's Manual for over 20 years. When people ask him what he does for fun, he says: “I read medicine.” He was also the co-chair of the 2021 Global Wellness Summit in Boston, where a number of expert doctors and academics discussed the intersection of healthcare and self-care. He used to claim that 60 is the new 40, but his latest talk, “90 is the new 40,” sent ripples through the summit attendees. We're going to explore what insights brought him to make this outrageous-seeming claim about the near future. Dr Roizen's passion for medicine started at a young age and he remembers the moment vividly. At nine years old he was terribly sick, so his family took him to the doctor. One shot and six hours later he felt great, and he knew that he wanted to be the person who made other people feel better as well. A realistic roadmap for The Global Wellness Institute's “Wellness Moonshot” goal of eliminating preventable disease,  Dr. Roizen has identified six areas – which he calls the  “six normals” – that  if you get them to a healthy level you can reduce your risk of chronic disease by 80-90%. These areas are normal blood pressure, good cholesterol, good blood sugar, obesity, not smoking, and stress management.  He adds that – if you simply see a primary care practitioner and keep your immunizations up to date – you reduce your risk for chronic disease even more!  ' He's also on the leading edge of the areas of research that are going to make all of the difference, including stem cells, autophagy, epigenetic reboot, hormone replacement, reduced tissue regeneration As crazy as this might sound at first, it's not only possible, it is probable. The research shows us how to do it—now it's just a matter of getting the resources and information into the hands of as many people as possible, which is what Dr. Michael Roizen is focused on today. To learn more, visit Dr. Michael Roizen's at https://my.clevelandclinic.org/staff/6161-michael-roizen (my.ClevelandClinic.org) Topics: The difference between wellness and healthcare Making wellness appealing and understandable Making healthy choices fun The health pandemic deadlier than COVID-19 The “six normals plus two” that can drastically reduce preventable disease Four important components of physical activity Fourteen areas of research that lead to longevity Practical steps to improve your health at home Resources: Twitter: https://twitter.com/drmikeroizen (@drmikeroizen) Listen: https://radiomd.com/show/you-the-owners-manual-radio-show (YOU: The Owner's Manual) https://www.amazon.com/Great-Age-Reboot-Cracking-Longevity/dp/1426221517 (The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow) https://www.amazon.com/RealAge-Are-You-Young-Can-ebook/dp/B0040GJDX0 (RealAge: Are You as Young as You Can Be?) https://www.amazon.com/AgeProof-Living-Without-Running-Breaking-ebook/dp/B01HZFB65A (AgeProof: Living Longer Without Running Out of Money or Breaking a Hip) https://www.amazon.com/What-Eat-When-Strategic-Improve-ebook/dp/B07DZHQ67B/ (What to Eat When: A Strategic Plan to Improve Your Health and Life Through Food) Hosted by http://www.swelltheagency.com (Kim Marshall.)

Anatomic pathology has evolved dramatically in the last 100 years, moving from an entirely subjective practice to a standardized, evidence-based discipline.  Who were the pioneers in developing this modern approach? How have testing processes and laboratory technology changed over time? And what can we learn from the last century of anatomic pathology to help us move the profession forward? On this episode of Inside the Lab, our hosts Ms. Kelly Swails and Dr. Dan Milner are joined by Dr. Sanjay Mukhopadhyay, MD, Director of Pulmonary Pathology at the Cleveland Clinic and Associate Editor of the American Journal of Clinical Pathology, and Dr. William Schreiber, MD, MASCP, Professor in the Department of Pathology and Lab Medicine at the University of British Columbia and Clinical Director of Chemistry at LifeLabs, to discuss the history of pathology and laboratory medicine. Our panelists explain who and what inspired the marked increase in scientific rigor in our profession and explore how the role of the pathologist has changed over time. They speak to how instrumentation has evolved since 1922, describing the diversity of technology in the lab today and the many iterations of molecular testing in surgical pathology and the clinical lab. Listen in for  insight on promoting diversity of thought in pathology and laboratory medicine and get their predictions around the disruptive innovation coming to anatomic pathology in the next 100 years. Topics Covered  · Pioneers in developing modern anatomic pathology's standardized, evidence-based approach· How immunohistochemistry and molecular pathology led to a marked increase in scientific rigor in laboratory medicine· How the role of the pathologist has changed over time to be directly involved in patient care decisions · How instrumentation has changed in the clinical lab over the last 100 years · The diversity of technology in the laboratory today and how automation benefits patients· The evolution of molecular testing in surgical pathology and laboratory medicine and how it's impacted microbiology, genetics and cancer diagnoses· How molecular testing has evolved from conventional cytogenetics to FISH testing to PCR testing (and now to next-generation sequencing)· Where the laboratory has been ahead of the curve on diversity and where we have room for improvement· Dr. Mukhopadhyay's and Dr. Schreiber's predictions around AI and non-invasive diagnostics in future of pathology and laboratory medicine· Transformative vs. disruptive innovation and why anatomic pathology is ripe for disruption Connect with ASCPASCPASCP on FacebookASCP on InstagramASCP on Twitter Connect with Dr. MukhopadhyayDr. Mukhopadhyay on TwitterDr. Mukhopadhyay on LinkedIn Connect with Dr. SchreiberDr. Schreiber at the University of British ColumbiaDr. Schreiber at LifeLabs Connect with Ms. Swails & Dr. MilnerMs. Swails on Twitter Dr. Milner on TwitterResources  Inside the Lab in the ASCP Store 

Kelly connects with the amazing Dr. Adrienne Boissy about her work for both The Cleveland Clinic and Qualtrics: always looking to lead with empathy. “People can't help if they don't realize you're suffering.” “Laughter is critically important.” “Perhaps we are all survivors of brokenness.”

How is it that we find ourselves 40-50+ and single? This is not how it was supposed to be. What does it mean when a man has never been married and had no children at that age? Is this a major red flag? How have dating and marriage changed over the past few decades? In this episode I talk to Jonathan Sheer, host of the podcast I Know Jonathan Sheer. Tune in for more.  Dr. Kanwal Bawa is Cleveland Clinic trained and a pioneer in the field of skin rejuvenation, hair restoration and sexual wellness. She has a state-of-the-art practice in Boca Raton, Florida called Bawa Medical. She earned the moniker Dr. Sex Fairy due to her incredible advances in the fields of both intimate and sexual wellness.  Her patients fly to her from all over the world for vaginal rejuvenation, penis enlargement, Erectile Dysfunction, enhanced performance, increased libido and more. She also provides virtual consultations for those who are unable to travel to her for in-office treatments.  To schedule a virtual or in-office consultation: https://www.bawamedical.com/contact/  To learn more about sexual wellness: https://www.bawamedical.com/sexual-health/  TikTok: https://vm.tiktok.com/ZTdC5M5Me/  Instagram: https://www.instagram.com/therealdrsexfairy/  Facebook: https://www.facebook.com/doctorsexfairy  Clubhouse: https://www.clubhouse.com/@drsexfairy

In honor of Women's Health Month, Dr. Jessica Caldwell joins the podcast to discuss sex differences in aging and Alzheimer's disease. She explains some of the ways women experience aging and Alzheimer's disease differently than men and how she incorporates research findings into patient care.  Guest: Jessica Caldwell, PhD, director, Women's Alzheimer's Movement Prevention Center, Cleveland Clinic in Las Vegas, assistant professor, Case Western Reserve University Episode Topics 2:59 What are the sex differences in experiencing normal aging and in experiencing Alzheimer's disease? 7:33 Why are women more affected by Alzheimer's disease than men? 10:03 Are there other theories that have been speculated but aren't true regarding the differences between men and women aging? 23:18 What type of prevention approaches do you discuss in your clinic? Show Notes The Women's Alzheimer's Movement Prevention Center at Cleveland Clinic in Las Vegas is the world's first Alzheimer's prevention center exclusively for women. Learn more at their website. Read the referenced studies by Dr. Caldwell on differences in brain health across sexes through the National Library of Medicine's website, specifically the 2021 study on tau protein differences, the 2018 study on amyloid level differences, and the 2022 study on cortical thickness differences.  The Alzheimer's Association has a women's and Alzheimer's webpage to learn more. The US Department of Health & Human Services Office on Women's Health sponsors National Women's Health Week.

Stephanie Norman, CNP, is the special guest on this episode of Butts & Guts. She is a certified nurse practitioner in Cleveland Clinic's Department of Colorectal Surgery. Listen as she discusses the role of advanced practice providers (APPs) in surgical treatment and what type of care they can provide to patients.

It's another session of CardioNerds Rounds! In these rounds, Co-Chairs, Dr. Karan Desai and Dr. Natalie Stokes and Dr. Tiffany Dong (FIT at Cleveland Clinic) joins Dr. Randall Starling (Professor of Medicine and Director of Heart Transplant and Mechanical Circulatory Support at Cleveland Clinic) to discuss the nuances of guideline directed medical therapy (GDMT) through real cases. As a past president of the Heart Failure Society of America (HFSA) and author on several guidelines, Dr. Starling gives us man pearls on GDMT. Come round with us today by listening to the episodes and joining future sessions of #CardsRounds! This episode is supported with unrestricted funding from Zoll LifeVest. A special thank you to Mitzy Applegate and Ivan Chevere for their production skills that help make CardioNerds Rounds such an amazing success. All CardioNerds content is planned, produced, and reviewed solely by CardioNerds. Case details are altered to protect patient health information. CardioNerds Rounds is co-chaired by Dr. Karan Desai and Dr. Natalie Stokes.  Speaker disclosures: None Cases discussed and Show Notes • References • Production Team CardioNerds Rounds PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Show notes - CardioNerds Rounds: Challenging Cases - Modern Guideline Directed Therapy in Heart Failure with Dr. Randall Starling Case #1 Synopsis: A man in his 60s with known genetic MYPBC3 cardiomyopathy and heart failure with a reduced ejection fraction of 30% presents with worsening dyspnea on exertion over the past 6 months. His past medical history also included atrial fibrillation with prior ablation and sick sinus syndrome with pacemaker implantation. Medications are listed below. He underwent an elective right heart catheterization prior to defibrillator upgrade for primary prevention. At the time of right heart catheterization, his blood pressure was 153/99 with a heart rate of 60. His RHC demonstrated a RA pressure of 15mmHg, RV 52/16, PA 59/32 (mean 41), and PCWP 28 with Fick CO/CI of 2.8 L/min and index of 1.2 L/min/m2. His SVR  was 1900 dynes/s/cm-5. He was admitted to the cardiac ICU and started on nitroprusside that was transitioned to a regimen of Sacubitril-Valsartan and Eplerenone. His final RHC numbers were RA 7, PA 46/18/29, PCWP 16 and Fick CO/CI 6.1/2.6. His discharge medications are shown below. Takeaways from Case #1 Unless there are contraindications (cardiogenic shock or AV block), continue a patient's home beta blocker to maintain the neurohormonal blockade benefits. A low cardiac index should be interpreted in the full context of the patient, including their symptoms, other markers of perfusion (e.g., urine output, mentation, serum lactate), and mean arterial pressure before holding or stopping beta blockade. Carvedilol, metoprolol succinate and bisoprolol are all evidence-based options for beta blockers in heart failure with reduced ejection fraction.If there is concern of lowering blood pressure too much with Sacubitril/Valsartan, one method is to trial low dose of valsartan first and then transition to Sac/Val. Note, in the PARADIGM-HF trial, the initial exclusion criteria for starting Sac/Val included no symptomatic hypotension and SBP ≥ 100. At subsequent up-titration visits, the blood pressure criteria was decreased to SBP ≥ 95.In multiple studies, protocol-driven titration of GDMT has shown to improve clinical outcomes, yet titration remains poor. The following image from Greene et al. in JACC shows that in contemporary US outpatient practices that GDMT titration is poor with few patients reaching target dosing. Case #2 Synopsis: A 43 year-old male with a past medical history of familial dilated cardiomyopathy requiring HVAD placement two years prior now comes in with low flow alarms.

Adam Brown, MD, is a rheumatologist at Cleveland Clinic and the host of the Rheuminations podcast. For the med students out there, we discuss why someone would choose rheumatology and why they are frequently the smartest doctors in the hospital. We discuss the basics of arthritis, how to interpret an ANA and why we shouldn't be so laser-focused on our own organ systems if a patient isn't improving as expected. We also discuss why gout is such an underappreciated phenomenon. Dr. Brown went to med school at the University of New Mexico and then did residency Georgetown in Internal Medicine. He then did fellowships in rheumatology and vasculitis, both at Cleveland Clinic, where he currently practices. He authored Rheumatology Made Ridiculously Simple, a herculean feat for such a complex specialty. Find this and all episodes on your favorite podcast platform at PhysiciansGuidetoDoctoring.com Please be sure to leave a five-star review, a nice comment and SHARE!!!

Have you ever had a tension headache? The slow-building creep of debilitating tension that freezes your neck in place? With a bonus headache that wraps all the way around your brain? It sucks.

CardioNerds Tommy Das (Program Director of the CardioNerds Academy and cardiology fellow at Cleveland Clinic), Rick Ferraro (cardiology fellow at the Johns Hopkins Hospital), and Dr. Aliza Hussain (cardiology fellow at Baylor College Medicine) take a deep dive on the REDUCE-IT trial with Dr. Peter Toth, director of preventive cardiology at the CGH medical center in Sterling, Illinois, clinical professor in family and community medicine at the University of Illinois School of Medicine, and past president of the National Lipid Association and the American Board of Clinical Lipidology.  Special introduction to CardioNerds Clinical Trialist Dr. Jeff Wang (Emory University). Audio editing by CardioNerds academy intern, Shivani Reddy. This episode is part of the CardioNerds Lipids Series which is a comprehensive series lead by co-chairs Dr. Rick Ferraro and Dr. Tommy Das and is developed in collaboration with the American Society For Preventive Cardiology (ASPC). Relevant disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Cardiovascular Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - REDUCE-IT The Reduction of Cardiovascular Events with EPA-Intervention Trial (REDUCE-IT) trial was a large randomized controlled trial that showed a significant reduction in atherosclerotic cardiovascular disease (ASCVD) events with use of icosapent ethyl ester in secondary prevention patients and high risk primary prevention patients with diabetes and residual elevated triglycerides between 135 to 499 mg/dL on top of maximally tolerated statin therapy1. Despite the use of high intensity statin therapy, considerable residual risk for future atherosclerotic cardiovascular disease exists in patients with ASCVD.Elevated triglycerides (TGs) are an important marker of increased residual ASCVD risk2.There are two primary types of Omega-3 fish oils: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Omege-3 fish oils have been shown to lower triglyceride levels.Low-dose combination EPA and DHA has not exhibited incremental cardiovascular benefit in either primary prevention and secondary prevention patients on top of statin therapy3-5.REDUCE-IT showed the use of high dose EPA in patients with either ASCVD or DM and one additional risk factor, and relatively well-controlled LDL-C levels on maximally tolerated statin therapy and residual hypertriglyceridemia (TG 135-499 mg/dL) results in significant reductions in cardiovascular events over a median follow-up period of 4.9 years1. Show notes - REDUCE-IT Multiple epidemiologic and Mendelian randomization studies have established elevated triglyceride (TG) levels as an important risk factor for atherosclerotic cardiovascular events6-8. However previous clinical trials using TG-lowering medication such as niacin, fibrates and low dose omega-3 fish oil have not shown to reduce cardiovascular events when added to statin therapy in patients with or without ASCVD,9,10.The JELIS trial first demonstrated a significant reduction in cardiovascular events when 1.8g daily of eicosapentaenoic acid (EPA) was added to low-intensity statin therapy in patients with ASCVD and hypercholesterolemia, However, the trial was limited due to open label design without placebo, use of low doses of background statin therapy, and geographic/demographic limitations to participants in Japan11.In a large international multicenter randomized controlled trial, the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT) randomized 8,179 patients with established atherosclerotic heart disease or diabetes and an additional risk factor, on maximally tolerated statin therapy, to 4 gm/day of icosapent ethyl (a highly purified and stable EPA ethyl ester) or miner...