Podcasts about cme

Joe's Premium Subscription: www.standardgrain.comGrain Markets and Other Stuff Links —Apple PodcastsSpotifyTikTokYouTubeFutures and options trading involves risk of loss and is not suitable for everyone.

Joe's Premium Subscription: www.standardgrain.comGrain Markets and Other Stuff Links —Apple PodcastsSpotifyTikTokYouTubeFutures and options trading involves risk of loss and is not suitable for everyone.

Caring for patients using mitragynine-derived substancesFamiliarize yourself with the differences in mitragynine-derived compounds. Understand how to identify and manage kratom use disorder and withdrawal from mitragynine-derived compounds. We're joined by Dr. Jonathan Tanawan (Profile).   Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME!Credits Written and Produced, with  Show Notes, Infographic, and Cover Art by Zina Huxley-Reicher, MD  Hosts: Carolyn Chan, MD. MHS and Zina Huxley-Reicher, MD Reviewer: Kento Sonoda, MD, MPH Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Jonathan Tanawan, MD Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Pharmacology of  kratom and other mitragynine-based compounds How to take a mitragynine-specific substance use history Defining a use disorder Withdrawal from kratom  Managing a use disorder with MOUD Legal landscape and regulation  Outro Sponsor: FreedGo to freed.ai and use code FREED50 for fifty dollars off your first month. Sponsor: FigsCurbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.  Sponsor: Continuing Education CompanyVisit CMEmeeting.org/curbsiders and use promo code Curb30 for 30% off all online courses and webcasts.

Featuring perspectives from Dr Floor J Backes, Dr Brian M Slomovitz and Dr Shannon N Westin, moderated by Dr Westin, including the following topics: Introduction (00:00) Current Up-Front Chemoimmunotherapeutic Approaches for Advanced Endometrial Cancer (EC) — Dr Backes (1:50) Current and Future Role of Anti-PD-1/PD-L1 Antibodies in Combination with Systemic Therapies Beyond Chemotherapy for Advanced EC — Dr Westin (33:15) Promising Agents Under Investigation for EC — Dr Slomovitz (1:01:41) CME information and select publications

Highlights from the PER® CME activity "Tumor Board: Evolving Immunotherapy Strategies for Stage I-III NSCLC" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Tina Cascone, MD, PhD; Puneeth Iyengar, MD, PhD; and Paula A. Ugalde Figueroa, MD; discuss evolving immunotherapy strategies for stage I to III non–small cell lung cancer (NSCLC), spanning surgical work-up and the shifting definition of resectability, perioperative immunotherapy trial data, the way that pathologic response guides treatment decisions, and the integration of radiation with immunotherapy in unresectable disease.Earn CME credit by completing the full accredited activity (available through June 30, 2027): https://www.gotoper.com/courses/tumor-board-evolving-immunotherapy-strategies-for-stage-i-iii-nsclc-1This podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from AstraZeneca Pharmaceuticals.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Link for CME credit coming soon! This episode examines a recent tragic case involving a teenage cheerleader and how it raises questions about energy drinks and cardiovascular health in young people. Host Holly Wayment and pediatric cardiologist Dr. Elaine Maldonado reviews what is known and unknown about high-caffeine beverages, common symptoms they can cause (palpitations, chest pain, racing heart), and the American Academy of Pediatrics' guidance that children generally should avoid caffeine. The conversation also highlights that some local high schools sell energy drinks in vending machines and even offer coffee bars on campus, making these products widely accessible to adolescents. Practical takeaways include lifestyle alternatives, red flags warranting urgent care (persistent fast heart rate, chest pain, passing out with exertion), and advice for pediatricians and families on counseling teens about caffeine use.

Featuring an interview with Prof Dr Sibylle Loibl, including the following topics: Perspectives on overall survival gains achieved over the years for patients with metastatic breast cancer (mBC) (0:00) Previous treatment and patient outcomes in the DESTINY-Breast09 trial of trastuzumab deruxtecan (T-DXd) with or without pertuzumab (5:35) Role of endocrine therapy in the treatment of hormone receptor-positive, HER2-positive mBC (8:01) Targeting the PI3K signaling pathway in HER2-positive mBC (11:08) Contraindications for T-DXd; T-DXd-associated gastrointestinal toxicities and interstitial lung disease (13:53) Optimal duration of and therapeutic partner for T-DXd as first-line maintenance therapy for patients with HER2-positive mBC (20:44) Case: A woman in her early 40s with metastatic relapse of HER2-positive breast cancer 2 years after completing neoadjuvant and adjuvant therapy (26:54) Role of exercise and weight control in the management of breast cancer; effect of pregnancy on the breast tumor immune environment (40:03) CME information and select publications

Featuring a slide presentation and related discussion from Prof Dr Sibylle Loibl, including the following topics: ·      Overview of the changing landscape of treatment for patients with HER2-positive metastatic breast cancer (mBC) (0:00) ·      Results from the CLEOPATRA, PATINA and HER2CLIMB-05 trials of first-line treatment and maintenance approaches for HER2-positive mBC (5:26) ·      Efficacy and safety findings from the Phase III DESTINY-Breast09 trial comparing trastuzumab deruxtecan with or without pertuzumab to taxane/trastuzumab/pertuzumab as first-line therapy for HER2-positive mBC (14:56) ·      Predictors of long-term benefit from first-line treatment with HER2-targeted agents; contribution of pertuzumab to the efficacy of first-line HER2-targeted combination regimens (22:57) ·      Control of brain metastases and CNS disease with first-line HER2-targeted regimens (26:31) CME information and select publications

Highlights from the PER® CME activity "Cases and Conversations: Applying the Evidence – Real-World Strategies to Optimize Care for Patients With Myelofibrosis" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Ruben Mesa, MD, FACP; Andrew Kuykendall, MD; and Sangeetha Venugopal, MD, MS; discuss evolving management strategies for patients with MF, and considerations for selecting therapy based on patient-related and disease-related factors.Earn CME credit by completing the full accredited activity (available through June 29, 2027): https://www.gotoper.com/courses/cases-and-conversations-applying-the-evidence-real-world-strategies-to-optimize-care-for-patients-with-myelofibrosis-jadnThis podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by educational grants from Bristol Myers Squibb and PharmaEssentia.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Listener Q&A: Apocalypse Superpowers, Cave Bugouts and the Stay Survived Sandwich We're answering another round of listener questions, and this one goes in every possible direction. Would we use an old diesel tractor to help stranded people after a CME? Is bugging out to a cave actually a good idea? Would we rather survive Jurassic Park or Predator? And which apocalypse superpower would be the most useful? We also get into camping lantern recommendations, embarrassing early prepping mistakes, keeping an offline phone or tablet in a Faraday bag, Flock cameras, surviving extreme heat versus extreme cold, celebrity man crushes, unfinished Casual Preppers film projects, and what we would change to make the podcast better. Then we create the ultimate Arby's collaboration: the Stay Survived Sandwich, featuring every meat on the menu, roughly 180 grams of protein, 3,500 calories, a 72-Hour Calorie Stick and emergency-ready packaging. Plus, grocery-store survival strategy, questionable childhood movie crushes, biblical survival, machete collections and more completely necessary preparedness discussion. Sponsors BattlBox Get 15% off your first BattlBox at survive.battlbox.com/casualpreppers LMNT Get a free LMNT Sample Pack with any purchase at DrinkLMNT.com/CasualPreppers ReadyPlan by MAD Gear Download ReadyPlan and build your family emergency plan at readyplanapp.com Use code CASUALPREPPERS for a discount. TacPack Use code CASUALPREPPERS and get a free $70 machine-made part from Next Level Armament at TacPack

Featuring perspectives from Dr Farrukh T Awan, Dr Brad S Kahl, Ms Robin Klebig and Ms Mollie Moran, moderated by Dr Kahl, including the following topics: Introduction: Biology of Non-Hodgkin Lymphoma (NHL) (00:00) Current Role of CD20 x CD3 Bispecific Antibodies in NHL (4:49) Role of Polatuzumab Vedotin in Diffuse Large B-Cell Lymphoma (DLBCL) (27:48) Optimal Application of Loncastuximab Tesirine for Patients with DLBCL and Follicular Lymphoma (41:43) Role of Bruton Tyrosine Kinase (BTK) Inhibitors Alone or with Anti-CD20 Antibodies for Patients with Newly Diagnosed Chronic Lymphocytic Leukemia (CLL) (1:00:43) Combining BTK Inhibitors with Bcl-2 Inhibitors (1:31:15) Current and Future Role of Noncovalent BTK Inhibitors in CLL (1:41:30) CME information and select publications

Highlights from the PER® CME activity "Tumor Board: Optimizing NSCLC Care—Leveraging the Latest Evidence on Targeted Therapy and Immuno-Oncology" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Justin Gainor, MD; Julia Rotow, MD; and Urs Weber, MD; discuss targeted therapies and immunotherapy to treat advanced non-small cell lung cancer (NSCLC).Earn CME credit by completing the full accredited activity (available through June 29, 2027): https://www.gotoper.com/courses/tumor-board-optimizing-nsclc-careleveraging-the-latest-evidence-on-targeted-therapy-and-immuno-oncology-1fgrThis podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by educational grants from BioNTech; Iovance Biotherapeutics, Inc; Lilly; Nuvation Bio; Revolution Medicines, Inc; and Rigel Pharmaceuticals.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

In this week's episode, Blood editor Dr. James Griffin interviews Drs. Haris Sohail and Lucas Kühne on their latest articles published in volume 147 issue 21 of Blood. In this CME article titled, "Retrospective, Real-World Study of IV Iron Use to Treat Iron deficiency Anemia During Acute Infection",  Sohail et al show that IV iron given during acute infection with iron deficiency anemia is associated with improved 14-day and 90-day survival as well as hemoglobin recovery. Although this report has the limitations of a retrospective study, these findings challenge current practice and support randomized trials that include patients with infection. In "Revisiting Clinical Response and Refractoriness in Immune Thrombotic Thrombocytopenic Purpura", Kühne et al show in a multicenter registry study of 204 patients that refractoriness during caplacizumab treatment in immune TTP is uncommon and, when observed, is typically associated with confounding clinical factors. These findings underscore the importance of careful clinical reassessment and evaluation for alternative etiologies in patients with delayed platelet recovery, rather than attributing such cases to true treatment resistance.

Featuring perspectives from Dr Ramez N Eskander, Dr Ursula Matulonis, Dr Kathleen N Moore, Dr Alexander B Olawaiye and Dr David M O'Malley, moderated by Dr Moore, including the following topics: Introduction (00:00) Current Role of PARP Inhibitors in the Management of Advanced Ovarian Cancer (OC) — Prof Eskander (2:40) Strategies Targeting Folate Receptor Alpha in Advanced OC — Dr Matulonis (27:41) Other Approved and Promising Investigational Antibody-Drug Conjugates for Advanced OC — Dr Moore (52:12) Other Novel Agents and Strategies for Advanced OC — Dr O'Malley (1:14:35) Diagnosis and Management of Adverse Events Associated with Common Therapies for Advanced OC — Dr Olawaiye (1:39:39) CME information and select publications

Highlights from the PER® CME activity "Oncology Town Hall: Updates From Chicago: Oral SERDs in HR+/HER2− Metastatic Breast Cancer–What the Latest Data Really Tell Us" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Virginia Kaklamani, MD, DSc; Kamel Abou Hussein, MD; Javier Cortés, MD, PhD; and Seth A. Wander, MD, PhD, discuss American Society of Clinical Oncology (ASCO) 2026 updates about data for oral selective estrogen receptor degraders (SERDs) to treat metastatic, HR-positive breast cancer.Earn CME credit by completing the full accredited activity (available through June 29, 2027): https://www.gotoper.com/courses/oncology-town-hall-updates-from-chicago-oral-serds-in-hrher2-metastatic-breast-cancerwhat-the-latest-data-really-tell-us This podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from Stemline Therapeutics, Inc.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Intracerebral hemorrhage carries high morbidity and mortality, but growing evidence highlights meaningful opportunities for prevention, risk reduction, and long-term recovery. This episode covers key strategies, including blood pressure management, interpretation of neuroimaging markers, and individualized decisions around antithrombotic therapy. It also emphasizes the prolonged recovery timeline and the importance of a holistic, patient-centered approach to improving outcomes. In this episode, Casey S. Albin, MD, FAAN, speaks with Wendy C. Ziai, MD, and Vishank A. Shah, MD, coauthors of the article "Intracerebral Hemorrhage" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Ziai is a professor of neurology and critical care medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland. Dr. Shah is an assistant professor of neurology and critical care medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland. Additional Resources Read the article: Intracerebral Hemorrhage Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Guest: @VishankShah3 Full episode transcript available here Dr Albin: A patient has suffered an intracerebral hemorrhage. They're taken to the neuro ICU, and they fortunately survive. But the journey does not end there. In fact, in some ways, the journey has just begun. Join us today as we unpack holistic care for ICH patients.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Albin: Hello to our audience. This is Dr. Casey Albin. Today, I'm interviewing Dr. Wendy Ziai and Dr. Vishank Shah about their article on intracerebral hemorrhage. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast. I am so delighted that both of you are joining. To begin, let's just do a brief introduction of who you are and, and a little bit of how you got interested in the topic.  Dr Ziai: Hi, I'm Wendy Ziai. Thank you for having me on this podcast. I am a professor of neurology at Johns Hopkins. I am a neurointensivist, and I think I got primarily interested in this topic through clinical trials that I have been a part of since my fellowship days.  Dr Shah: Hi, everyone. I'm, uh, Vishank Shah. I am also, uh, very thankful for being invited to be a part of this podcast. I'm also a neurointensivist at Hopkins and the fellowship program director here for neurocritical care, and I'm interested in recovery after ICH, and that's why I'm a part of this work.  Dr Albin: Welcome to you both. It is such a treat for me to get to interview fellow neurointensivist, particularly those who have such a wealth of experience. So, I am delighted to dive into this. All right. So, to set the stage for our audience, intracerebral hemorrhage has long been approached with pessimism. But your article really highlights that there are meaningful advantages in prevention and risk stratification and long-term recovery for these patients. Though you both are neurointensivist, this article really emphasizes primary prevention and the holistic long-term care for the survivors. And so, to begin, Dr. Shah, can you just lay out a little bit for our listeners the scope of intracerebral hemorrhage and its community impact?  Dr Shah: Yeah. So, you know, ICH is the second most common type of stroke. There are more than three million new cases of ICH globally each year, and it accounts for thirty percent of all stroke types, but it is the one that has the highest mortality, with more than forty to fifty percent of the patients dying in the first thirty days, and then continued long-term impact on both functional as well as outcomes, as well as survivorship after the early period. And it also disproportionately impacts lower socioeconomic, and then minority races like Blacks, Asians, as well as Hispanic ethnicity. And so, there's a lot of work that needs to be done to reduce the burden of this disease.  Dr Albin: Absolutely. I mean, these can really be devastating for families, and I really am appreciative of your highlighting that there's a lot of disparities, and there's a lot of work to be done to really increase equity to these patients. I think a lot of this goes into really the AAN's focus on brain health and trying to improve some of what we're doing to maintain brain health. And I really wanted to kind of drill down on this because for ICH, there's a lot that can be done upfront as we think about how do we counsel patients who may walk into the office about strategies to prevent ever becoming an intracerebral hemorrhage patient. So, Dr. Shah, can you walk us through a little bit about what neurologists in the community need to be doing to make sure that no one ends up with us in the neurointensive care unit?  Dr Shah: Yeah, sure. So, I think, you know, one of the most important risk factors is, of course, hypertension and long-standing uncontrolled hypertension. And so really recognizing the need for early onset screening with regular blood pressure monitoring at a very early age, particularly in the races that I discussed earlier. And then I think another big part, obesity, metabolic syndrome, and type two diabetes. And I think there's a lot of interesting new work that with the GLP-1 agonist, you know, in a large multicenter cohort studies showing that patients receiving these had a significantly lower reduction risk of ICH. And so, this might be a really important part that, you know, clinicians need to start increasingly recognizing and using in their practice. And then, of course, other risk factors that are common include smoking, diet high in sodium, exposure to air pollution, both indoor as well as outdoor. And so, mitigating all of these risk factors can also reduce the burden of ICH.  Dr Albin: Absolutely. And I really want to highlight that hypertension plays such an important role and that we as neurointensivist, as community neurologists, really need to be creative about ways that we can help people meet those blood pressure target and meeting people in the community where they are, making sure that they're not suffering from side effects from their medication that would prevent them from sticking with it long term. Dr. Ziai, anything else to add about what we can do in the community?  Dr Ziai: So, we really want to emphasize, even in the acute phase, that patients moving forward need to have targeted interventions to reduce blood pressure, smoking, enhance their physical activity, have a diet that is high in fruits and vegetables and low in alcohol and salt, and then promoting weight loss, of course.  Dr Albin: And Dr. Ziai, I'm gonna ask you a little bit about one of the things that maybe not all of our listeners have heard about is this APOE2, APOE4 genetic risk for intracerebral hemorrhage. What's going on there and, and should clinicians be testing for that? Dr Ziai: That's a great question, and it is not one that we currently test people for at least acute ICH presentation. APOE2 and A4- E4 alleles, these give patients a two to three times higher risk of ICH by increasing cerebral amyloid deposition. And if you happen to have APOE2 carrier ship status, then along with other risk factors like white matter disease and vascular risk factors, these predict the onset of new microbleeds even during very short follow-up periods of about two years. And as we know, having cerebral microbleeds are associated with an increased risk of all strokes, ischemic and ICH, but they are one of many MRI markers of small vessel disease, which along with cortical superficial siderosis, does significantly increase future ICH risk. And so even in people who've never had an ICH, if they happen to have an MRI, it may be reasonable to look at the MRI and incorporate this burden of small vessel disease, and especially these hemorrhagic markers into, uh, decision-making about interventions.  Dr Albin: That's a really excellent point. And so, I think that your article did a really beautiful job of thinking holistically about the patient, incorporating clinical markers of their risk for having ICH, but also those radiographic markers. I'm just gonna ask you to summarize those again one more time because not everyone will be familiar with these. So, when you're looking at an MRI, what are the things that you're particularly clued in on that would increase the patient's risk of future ICH?  Dr Ziai: In the past, what we're looking for really is markers of cerebral amyloid angiopathy, which significantly increase a person's risk for lobar hemorrhage in particular. And so, we have a set of criteria called the Boston Criteria, and there's a new version of these, version 2.0. And these, um, incorporate a number of imaging markers that provide a very high sensitivity and specificity to diagnose CAA after an ICH. But even if someone's never had an ICH, and they evaluate that risk-benefit ratio for different cardiovascular prevention strategies. And so, the markers that we're specifically interested in are, of course, microbleeds. But not just having microbleeds, but are they lobar or are they deep? Lobar having a higher risk for lobar ICH. How many microbleeds are there? Is it greater than five, or is it just one or two? Also, cortical superficial siderosis is a marker, a hemorrhagic marker, that does portend a significant increased risk of recurrent ICH, along with having a lobar ICH. And now we have these new markers, which are the white matter hyperintensity multi spot pattern, which requires these hyperintensities on flare imaging in the subcortical area, having greater than at least ten of these multi spots, and also having enlarged perivascular spaces in the centrum semiovale, and having at least twenty of those. And finally, white matter hyperintensities, which can be measured with the physica score or just by visualizing them. We can look at white matter hyperintensities as well as being a measure of small vessel disease.  Dr Albin: Got it. And so just to summarize, we're looking for small vessel disease markers because that puts our patients at higher risk of ongoing future bleeds. And then we're also looking for markers of particularly small vessel disease that's caused by cerebral amyloid angiopathy, which again, because it's having that protein deposition, that puts the patient at risk of those leptomeningeal very small vessels, putting the patient at risk of lobar ICH. Just confirming I've summarized this all correctly.  Dr Ziai: Yes. That was perfect.  Dr Albin: Amazing. Dr. Shah, I'm gonna go back to you. Let's say we have a patient. Let's say this is a sixty-five-year-old man who comes in and they want follow-up and they're... And you're trying to think about they've had an ICH in the past, and they are also at risk for ischemic disease. Let's say they, they have hypertension, they've had a smoking history. They have some risk for ischemic events. And you're trying to think about how do you balance those. Let's say the patient needs to be on aspirin but does have some of those high-risk features on their MRI. Is there any guidance on how we think through preventing them from having a recurrent bleed if they're a high-risk patient, also preventing them from having an ischemic event, which they might be at high risk for as well?  Dr Shah: Yes. So, I think, you know, the first step is of course trying to understand what was the type of bleed. I think that has a very important role, like you mentioned. If it's a lobar hemorrhage versus a deep hemorrhage, the risk of recurrent ICH and ischemic events is very variable. So lobar hemorrhages, there's obviously a higher risk of recurrent hemorrhage events, whereas deep hemorrhage is actually at or behaves sort of like small vessel ischemic strokes and have a higher risk of recurrent arterial ischemic events. So that distinction in itself can help you gauge which patients would be safe and would benefit from these therapies. To begin, and of course, looking for some of these markers on MRI that were mentioned by Dr. Ziai for recurrence of hemorrhage risk. In terms of antiplatelet, the, there is a lot more data now to guide treatment, and we have the RESTART as well as the ESTART trial that showed that starting an, a single antiplatelet after intracerebral hemorrhage did not increase the risk of hemorrhage recurrence. They were very variable in the timing when aspirin was started, and so that remains still a question about what is the safest time point to start aspirin. For example, in the ESTART trial, they started them very early, within the first three days, whereas in  the RESTART it was all the way up to two months after the hemorrhage. And so... But in general, the risk of recurrent ICH was very low with a single antiplatelet agent. And so, if it's needed for ischemic prevention, it's relatively safe broadly across all types of hemorrhages.  Dr Ziai: Yeah. I would just mention that there was also a subgroup analysis of the RESTART trial using MRI. And so, this more than likely included patients with CAA, since 40% of the hemorrhages were lobar in that study, and therefore seeing that there was no increased risk of recurrent ICH in RESTART, it is thought that putting patients back on their antiplatelet therapy is safe.  Dr Albin: That's a really huge takeaway pearl for our listeners, that regardless of whether it's a lobar bleed or a deep bleed, if there is a strong indication, you know, this is not just, oh, because someone gave them aspirin 81, but truly that there is a reason that they need to be on a single antiplatelet agent, it probably benefits them to be on that agent, and there's good data that there's not a huge increase in risk. Summarizing all of that?  Dr Ziai: Great.  Dr Albin: Now, things are gonna get a little bit tricky here, because what if the patient, what if they need to be on dual antiplatelet therapy? Or what if they need to be on anticoagulation? Dr. Ziai, I'll, I'll throw that to you. How do you tackle that patient population?  Dr Ziai: Yeah, the safety of dual antiplatelet therapy hasn't really been studied in patients who've had a prior ICH. Although, in people who've had previous strokes, putting them on dual antiplatelets doesn't seem to increase the risk of ICH, but it does increase extracranial hemorrhage. And so there may be other reasons not to put patients on dual antiplatelet agents. Patients who have cancer and also cardiovascular or cerebrovascular disease, putting them on dual antiplatelet therapy does seem to increase the risk for intracranial hemorrhage. So, I think there is enough of a bias against DAPT therapy in patients who have had an ICH that we would not recommend DAPT for patients with a prior ICH.  Dr Albin: Absolutely. And, and then what about, let's say they have atrial fibrillation, and you know that they have a high CHA2DS2-VASc score, and they are at very high risk of ischemic events, but they've also had a prior intracerebral hemorrhage. Walk us through a little bit, how should we approach that patient? Dr. Ziai, I'm gonna start with you again.  Dr Ziai: Sure. So again, looking at the MRI, which all patients with ICH should have nowadays. If patients do have these hemorrhagic findings, a lobar ICH, evidence of CSS, cortical superficial siderosis, especially if it's disseminated, and also lobar microbleeds, especially if there are greater than five, if they're multiple, then anticoagulation should really be avoided in those patients.  Dr Albin: Absolutely. So, I'm really hearing that when we have a patient with ICH, it is just critically important that we understand is this a hypertensive bleed or is this a lobar bleed that is probably related to cerebral amyloid angiopathy? And getting to that distinction is going to play a major role in our deciding whether or not the patient can be on DAPT or can be on anticoagulation. And then what are some of the strategies for patients that you're referring them to if they really cannot tolerate being on anticoagulation, but they have atrial fibrillation, and they do need some sort of ischemic stroke prevention?  Dr Shah: There's still a lot of controversy, even in non-lobar hemorrhages, about resuming anticoagulation and when that would be safe. HAF trial, there was a reduction in ischemic stroke recurrence, uh, but a significantly higher increase in hemorrhage recurrences. I think that trial included both deep and lobar hemorrhages. So, we still need more data, and I think the ASPIRE trial and maybe a meta-analysis would answer that eventually. But in the meantime, if a, specifically for lobar hemorrhages, which are, uh, thought to be CAA related, if they, uh, and the patient has AFib, you know, where anticoagulation would be contraindicated, a watchman device or, you know, AFib ablation may be some of the other strategies that can be looked into for those patients specifically.  Dr Albin: Right. I think that's a really important point to emphasize, that we don't just don't give up and say, "Oh, you're not a candidate for anticoagulation," but we really reach out to our cardiovascular friends and say, "Hey, what other procedures can you offer that will minimize the risk of recurrence?" You know, we don't want them to have an ischemic event, but we also know long-term that there would be a real risk of anticoagulation. Just reminder to our listeners that there are new procedures, and our cardiology colleagues are always doing new trials and new devices, and so we should really leverage their expertise here. I am in the final minutes gonna just switch gears a little bit from talking about sort of the nitty-gritty of secondary ischemic prevention and secondary hemorrhagic stroke prevention and thinking about there has been this degree of pessimism around ICH patients, and that, you know, they have a much more severe outcome than our patients with ischemic strokes. I think that that is probably a myth that we need to do some debunking around, and I think maybe we need to reframe in terms of thinking about just the trajectory. So, Dr. Shah, walk us through a little bit about what we can expect about the recovery trajectory in ICH compared to those patients who have an ischemic stroke. Dr Shah: Yes. From some newer data and studies, it is becoming clear that recovery after ICH is much slower than we expect. In general, for ischemic stroke, recovery is measured within the first few weeks to up to 90 days. But in ICH, we now know that patients can keep recovering all the way up to six months and even beyond. In general, from just a, a study of heart recovery that occurs after ischemic stroke, there's a steep recovery in the first seven days, and then sort of after that, patients still continue to recover, but it, it starts plateauing where up to 90 days. Whereas with ICH, there is not much recovery in the first 7 to 30 days, but after that, there is a recovery that occurs significantly between day 30 and day 180, and then some patients continue to recover all the way up to one year. The more severe the hemorrhage, the slower the recovery, but there's still some evidence to suggest that even severe hemorrhage patients can recover all the way up to one year out and beyond. This is, of course, in terms of functional recovery.  Dr Albin: I think that's a really important point for our audience. Many of the listeners are residents, they're fellows, they're seeing these patients in the hospital, and they may not see a whole lot of improvement over even 30 days. But to keep in mind that just because the patient has not had a dramatic recovery within that first month that they may be in the ICU and then on the floor does not mean that that patient will never have recovery, and that we reset our expectations that recovery is possible, it's just gonna be slower. And I think that that's not only important for the healthcare team to take in mind, but also for patients and their families to know there is hope here. It's just gonna be slower. Dr. Ziai, looking ahead, what developments in this are you most excited about that you think will move the needle for care for the long-term outcomes and the prevention for these patients? What's ahead in, in ICH?  Dr Ziai: Yeah, I think the research that's going on is very exciting at the moment. We just saw the presentation at the World Stroke Organization conference in the fall of the TRIDENT trial, Triple therapy prevention of Recurrent intracerebral Disease events, meaning strokes. And these investigators found that a single pill, a fixed dose of three blood pressure-lowering agents actually was successful in significantly reducing the risk of recurrent stroke in patients who have had a history of ICH and have just normal or low-grade hypertension. So rather than having patients on multiple antihypertensive agents, it may be possible to have them on a single pill, and may dramatically reduce their stroke risk. So that's exciting. There is also a trial ongoing, ASPIRING, testing whether antiplatelet monotherapy after 24 hours only can reduce the risk of all serious vascular events in ICH survivors. So very early antiplatelets. The SATURN trial, we didn't talk about statins yet, but it is comparing continuation versus discontinuation of statin therapy in ICH patients. And then we have ongoing epidemiological studies that are really needed to understand this interaction between the cardiovascular prevention strategies, the antithrombotic use, the blood pressure targets, and these high-risk neuroimaging markers for ICH. And I think that's gonna be key, personalizing the interventions for these patients.  Dr Albin: So, I love that. And what I'm hearing is that it's really important to think about the personalized approach as well as how do we simplify things. We know that blood pressure control is critically important to the primary and secondary prevention of ICH, but we have to make it easy for patients to do so. Dr. Shah, I want to end with kind of understanding, you know, this was an unusual topic for neurointensivists to talk about. This was really about prevention. It was about long-term survivorship. It was about not what's happening in the neuro ICU. How did you guys get interested in sort of that aspect of care?  Dr Shah: Yeah, so that's a great question. Dr. Ziai has been my mentor since I was in fellowship, so now about eight years that I've been working with her, and this was a project that I started in fellowship with under her mentorship, looking at long-term recovery in ICH patients, and specifically severe patients. Happy that work has received a lot of recognition. It was published in JAMA Neurology. We looked at patients with severe intracerebral and intraventricular hemorrhage, those that survived with an mRS of four and five at day 30, and what happened to them over the course of the year. There was really not much data on recovery after ICH. And we were very surprised to see that up to 40% of patients that were an mRS of four and five, so really, really severely disabled at day 30, recovered to an mRS of zero to three by one year. About one-third of that group that recovered actually achieved functional independence with an mRS of zero to two, which was very surprising, really breaking the myths around the pessimism with ICH. We found that a lot of the baseline comorbidities like diabetes, white matter disease, as well as what happens to them during the acute hospitalization, were adding all of that information to the severity of the hemorrhage significantly improved our ability to predict long-term recovery after ICH. And so that's kind of how we got interested in this work, looking at how factors in the care that we provide in the ICU, as well as what the patients come in with, how all of that could be modified to promote recovery in these patients that are often been forgotten.  Dr Albin: I think that there's one takeaway to our listeners is that this is really a place where there's a lot of hope for recovery, and that the nihilism that has really surrounded ICH is a thing of the past, and we have to move forward with thinking about how do we proactively impact the recovery and counsel the patients and give them hope. Because just as your research shows, there really is the ability that they can attain that functional independence, which is absolutely astounding. It's really amazing. Again, today I've been interviewing Dr. Wendy Ziai and Dr. Vishank Shah about their article on intracerebral hemorrhage. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Please be sure to check out Continuum Audio episodes from this and other issues. Please go and check out. They have a wonderful article with lots of tables and figures, so much data. And again, thank you to our listeners for joining us today. Thank you, Dr. Ziai and Dr. Shah.  Dr Ziai: Thanks very much.  Dr Shah: Thank you.   Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

AUA2026: Focus on: ADT in the Modern Era - Balancing Cancer Control and Cardiovascular Safety CME Available: https://cme.auanet.org/URL/FOCUS265ONL LEARNING OBJECTIVES: After participating in this CME activity, participants will be able to: 1. Integrate cardiovascular (CV) risk assessment into ADT initiation by applying key findings from the REVELUTION-1 trial to identify patients at elevated risk for atherosclerosis and MACE. 2. Compare and apply the CV safety profiles of LHRH agonists versus GnRH receptor antagonists to guide personalized ADT selection in patients with varying CV risk. 3. Implement streamlined monitoring strategies for men on oral ADT, including testosterone levels, lipid and blood pressure evaluation, and surveillance for early CV risk indicators. 4. Collaborate with cardiology and primary care to optimize statin use and coordinate CV risk-reduction strategies for prostate cancer patients receiving ADT. 5. Strengthen shared decision making and adherence by incorporating discussions of oncologic benefit, CV risk, and mitigation strategies into routine oral ADT counseling and follow-up. ACKNOWLEDGEMENTS: Support provided by independent educational grants from: Pfizer, Inc Sumitomo Pharma America, Inc.

How can we change the narrative about what it means and what it takes for people to be safe? How can we restore the protections of citizens from the harm and violence caused by the state? How can academic research lead to real change?In this series on healthcare and social disparities, Dr. Jill Wener, a board-certified Internal Medicine specialist, anti-racism educator, meditation expert, and tapping practitioner, interviews experts and gives her own insights into multiple fields relating to social justice and anti-racism. In this episode, Jill interviews Dr. Terence Keel, author of Divine Variations: How Christian Thought Became Racial Science.They dive into his research around falsified death reports for people that were killed by state or police violence during arrests or while in custody. Listen as they discuss how there are committed communities who have been doing this activist work, who are already doing it, and the importance of getting more people in numbers to build power to make real change.Dr. Terence Keel is a Professor at the University of California, Los Angeles in the Department of African American Studies and the UCLA Institute for Society and Genetics. He also directs the UCLA Lab for BioCritical Studies and serves as the Advisor for Structural Competency and Innovation for the UCLA Simulation Center at the David Geffen School of Medicine. After earning a BA in Theology from Xavier, he received a Master of Theological Studies from Harvard Divinity School and completed a PhD from Harvard University working with the Committee on the Study of Religion, the Department of the History of Science, and the Department of African American Studies.LINKSwww.terencekeel.com**You can learn more about Dr. Wener's coaching, EFT/Tapping and meditation offerings at www.jillwener.com, and you can learn more about her online social justice course, Conscious Anti Racism: Tools for Self-Discovery, Accountability, and Meaningful Change at https://theresttechnique.com/courses/conscious-anti-racism.If you're a healthcare worker looking for a CME-accredited course, check out Conscious Anti-Racism: Tools for Self-Discovery, Accountability, and Meaningful Change in Healthcare at www.theresttechnique.com/courses/conscious-anti-racism-healthcareFollow her on:Instagram at jillwenerMDLinkedIn at jillwenermd

In this episode, we discuss geomagnetic storms, extreme electromagnetic events known as coronal mass ejections that would destroy every satellite around the planet, wipe out power grids and most if not all of our electronics. The Carrington event that happened in 1859 destroyed the only electrical system at that point, the telegraph, across all of North America. An event such as that now would have catastrophic, even civilization-ending impacts. Scientists predict an event like the Carrington event happens every 100 to every 500 years. And the Carrington event is small compared to pre-history events. Yet despite the profound impact and the likelihood, public awareness remains low, there is little political action, little has been done to harden our power grid or plan for such an event. Since recording this episode in 2024, we have witnessed numerous X-class flares and geomagnetic storms triggering Northern Lights across the Northern Hemisphere. To talk about geomagnetic storms, their impact, the likelihood, the fragility of our global power grids and some solutions, is Distinguished. Professor of Electronics and Computer Engineering, Edl Schamiloglu. Edl is the Distinguished and specializes in extreme electromagnetic phenomena.   For related content and to find out more about HC Group, a search firm dedicated to the energy & commodities sector, visit https://www.hcgroup.global

Featuring an interview with Dr Mark Jeng and Dr Joshua K Sabari, including the following topics: ·      Case: A woman in her late 90s with recurrent HER2-mutant metastatic non-small cell lung cancer (NSCLC) receives third-line zongertinib (0:00) ·      Case: A woman in her early 60s with multiregimen-recurrent HER2-mutant metastatic NSCLC experiences a response to zongertinib (8:07) ·      Case: A man in his mid 80s experiences metastatic recurrence after resection of PD-L1-positive, HER2-mutant metastatic NSCLC (17:50) CME information and select publications

Send us Fan MailMost physician owners don't think about calling an attorney until something has gone wrong. But what if your legal counsel could help you avoid problems before they ever happen?In this episode of Medical Money Matters, I have the pleasure of welcoming my good friend, Joe Carlisle, partner at Dunn Carney LLP, for a conversation about the role legal counsel should play in every successful medical practice. Joe shares practical advice on how physicians and healthcare leaders can build stronger relationships with their attorneys, recognize when to seek legal guidance, and use legal counsel as a proactive strategic partner—not just an emergency resource.We also explore what it means to build a true "board of trusted advisors" and why every independent practice benefits from surrounding itself with experienced professionals who can help navigate today's increasingly complex healthcare environment.Whether you're a new practice owner or a seasoned healthcare executive, you'll come away with actionable insights that can help protect your practice, strengthen your decision-making, and position your organization for long-term success. You can find Joe at: https://www.linkedin.com/in/joe-carlisle-71067265/ or at https://www.dunncarney.com/people/joe-w-carlislePlease Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: https://share.hsforms.com/1FMup6xLPSpeA8hB77caYQwd32sx?hsCtaAttrib=171926995377 Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 32.5 hours of online, on-demand CME-accredited training tailored just for busy physicians. Promo pricing available now: https://education.healtheps.com/offers/Ry3zfLYp/checkout?coupon_code=PHYSEDGE3000 Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/    

Highlights from the PER® CME activity "Cases and Conversations: Optimizing Oral SERD-Based Therapy After CDK4/6 Inhibition in HR+/HER2– MBC" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Virginia Kaklamani, MD, DSc; Antonio Giordano, MD, PhD; Nadia Harbeck, MD, PhD; and Sarah Sammons, MD, discuss the use of oral SERD-based therapy in the treatment of HR+/HER2– metastatic breast cancer through a series of clinical cases. Earn CME credit by completing the full accredited activity (available through June 30, 2027): https://www.gotoper.com/courses/cases-and-conversations-optimizing-oral-serd-based-therapy-after-cdk46-inhibition-in-hrher2-mbc-xv6m This podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from Stemline Therapeutics, Inc.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Treatment options for patients with multiple myeloma are rapidly evolving. In this podcast episode, Jesus Berdeja, MD, and Amrita Krishnan, MD, FCAP, discuss GPRC5D-directed treatment options for patients with relapsed/refractory multiple myeloma, with a focus on talquetamab, a GPRC5D-directed bispecific antibody. Topic areas covered include: Clinical trial updates and discussion of how findings may translate into clinical practice and FDA approvals Treatment sequencing and patient selection Step-up dosing and what to expect in terms of toxicity management when using a GPRC5D-targeted therapy with on-target, off-tumor effects Presenters: Jesus Berdeja, MD Director of Myeloma Research Greco-Hainsworth Centers for Research  Partner Tennessee Oncology Nashville, Tennessee Amrita Krishnan, MD, FCAP Nason Hollingworth Family Chair in Myeloma Director, Judy and Bernard Briskin Center for Myeloma Professor Hematology/HCT Executive Director of Hematology City of Hope Orange County Irvine, California Content based on an online CME program supported by an educational grant from Johnson & Johnson. Get access to all of our new podcasts by subscribing to the Decera Clinical Education Oncology Podcast on Apple Podcasts, YouTube Music, or Spotify. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

CME credits: 0.25 Valid until: 14-07-2027 Claim your CME credit at https://reachmd.com/programs/cme/no-patient-with-ckd-left-behind-new-horizons-in-patients-with-ckd-regardless-of-diabetes-status/49260/ A growing body of evidence presented at ERA 2026 is reshaping the conversation around chronic kidney disease management, regardless of diabetes status. In this expert interview, Dr. Katherine Tuttle and Dr. Brendon Neuen examine emerging data on nonsteroidal mineralocorticoid receptor antagonists and discuss how recent findings may expand treatment considerations for patients with chronic kidney disease (CKD), including those without diabetes. Through expert analysis of key studies and a patient perspective, the faculty explore the evolving cardiorenal landscape, practical implications for clinical practice, and opportunities to address persistent unmet needs across the CKD spectrum.=

Bowel Sounds Summer School is BACK!  In our first Summer School episode this season, hosts Dr. Peter Lu and Dr. Jordan Whatley have taken highlights from past episodes on abdominal pain and put them into a special episode jam-packed with clinical pearls.Former expert guests Dr. Miguel Saps, Dr. Sam Nurko, Dr. Miranda van Tilburg, Dr. Ann Ming Yeh, Dr. Bruno Chumpitazi, Kirsten Jones, RD, and Dr. Neha Santucci explain to us how they evaluate and treat the child with abdominal pain.Our Bowel Sounds Summer School series will include four episodes each summer on big topics in our field, artisanally crafted for the ears of learners of all stages from the young student to the seasoned attending.Learning Objectives:1. Understand the importance of making a positive diagnosis for a child with an abdominal pain-predominant disorder of gut-brain interaction (DGBI).2. Recognize the role of lifestyle modification, dietary changes, and supplements in the treatment of children with chronic abdominal pain.3. Review the behavioral and pharmacological therapies available for children with chronic abdominal pain.References:ESPGHAN/NASPGHAN Guidelines for Treatment of Irritable Bowel Syndrome and Functional Abdominal PainFeatured Episodes:Miguel Saps - Functional Abdominal PainMiranda van Tilburg - Behavioral Treatment of Functional Abdominal PainBruno Chumpitazi & Kirsten Jones - Using the Low-FODMAP Diet for Children with IBSNeha Santucci - Functional Abdominal Pain in "Organic" GI DiseasesSamuel Nurko - Using Neuromodulator Medications for Functional Abdominal PainAnn Ming Yeh - Non-Medication Treatment for Children with Abdominal Pain and NauseaSend us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Featuring perspectives from Dr Harold J Burstein and Dr Joyce O'Shaughnessy, including the following topics: Introduction: ODAC — April 30, 2026 (00:00) Adjuvant CDK4/6 Inhibitors (13:03) Adjuvant Oral Selective Estrogen Receptor Degraders (21:53) Premenopausal Patients (30:52) Duration of Adjuvant Endocrine Treatment (38:44) Genomic Predictors of Chemotherapy Benefit (47:19) Neoadjuvant Treatment (55:13) CME information and select publications

Highlights from the PER® CME activity "Medical Crossfire®: Closing Clinical Practice Gaps in Hepatobiliary Cancer With Emerging Immunotherapies and Delivery Innovations" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Ghassan Abou-Alfa, MD, JD, MBA, PhD (hc), Riad Salem, MD, MBA, Rachna T. Shroff, MD, MS, FASCO, and Arndt Vogel, MD, PhD discuss closing clinical practice gaps in hepatobiliary cancer with emerging immunotherapies and delivery innovations.Earn CME credit by completing the full accredited activity (available through June 30, 2027): https://www.gotoper.com/courses/medical-crossfire-closing-clinical-practice-gaps-in-hepatobiliary-cancer-with-emerging-immunotherapies-and-delivery-innovations-h754 This podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from AstraZeneca Pharmaceuticals.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BPW865. CME credit will be available until July 17, 2027.Combining Our Efforts for Patients With High-Risk ASCVD: Applying New Guidelines to Address the Challenge of Lipid Management In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an independent educational grant from Merck & Co., Inc., Rahway, NJ, USA.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/FJQ865. CME credit will be available until June 24, 2027.New Kids on the Block in Pretreated Metastatic EGFRm NSCLC: Emerging Strategies to Overcome Resistance In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BPW865. CME credit will be available until July 17, 2027.Combining Our Efforts for Patients With High-Risk ASCVD: Applying New Guidelines to Address the Challenge of Lipid Management In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an independent educational grant from Merck & Co., Inc., Rahway, NJ, USA.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/FJQ865. CME credit will be available until June 24, 2027.New Kids on the Block in Pretreated Metastatic EGFRm NSCLC: Emerging Strategies to Overcome Resistance In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/FJQ865. CME credit will be available until June 24, 2027.New Kids on the Block in Pretreated Metastatic EGFRm NSCLC: Emerging Strategies to Overcome Resistance In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/FJQ865. CME credit will be available until June 24, 2027.New Kids on the Block in Pretreated Metastatic EGFRm NSCLC: Emerging Strategies to Overcome Resistance In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/FJQ865. CME credit will be available until June 24, 2027.New Kids on the Block in Pretreated Metastatic EGFRm NSCLC: Emerging Strategies to Overcome Resistance In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/FJQ865. CME credit will be available until June 24, 2027.New Kids on the Block in Pretreated Metastatic EGFRm NSCLC: Emerging Strategies to Overcome Resistance In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/BPW865. CME credit will be available until July 17, 2027.Combining Our Efforts for Patients With High-Risk ASCVD: Applying New Guidelines to Address the Challenge of Lipid Management In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an independent educational grant from Merck & Co., Inc., Rahway, NJ, USA.Disclosure information is available at the beginning of the video presentation.

Featuring perspectives from Dr Floor J Backes, Dr Matthew A Powell and Dr Ritu Salani, moderated by Dr Salani, including the following topics: Case: A woman in her late 60s presents with mismatch repair-deficient metastatic endometrial cancer(00:00) Perspectives on neoadjuvant immunotherapy for microsatellite instability-high endometrial cancer (06:25) CME information and select publications

Featuring an interview with Dr Jamie E Chaft, including the following topics: Case: A man in his early 70s with a 40 to 50 pack-year history of smoking and cT2bN1 squamous cell carcinoma of the lung with PD-L1 60% treated with induction therapy and surgery (00:00) Available clinical data with immunotherapy in the neoadjuvant, perioperative and adjuvant settings (07:45) Factors in the selection of adjuvant immunotherapy, including circulating tumor DNA (11:39) Evolving approaches to management, including systemic therapy, surgery and radiation therapy techniques (19:28) Case: A woman in her early 60s with nonmetastatic non-small cell lung cancer (NSCLC) and an EGFR exon 19 deletion who is enrolled in the NeoADAURA study (24:03) Importance of clinical trials in the adjuvant setting (33:02) Data surrounding treatment in the neoadjuvant setting; key implications of the NeoADAURA study (35:41) Case: A man in his late 60s with a history of smoking and Stage III T4N3 NSCLC not otherwise specified with low PD-L1 expression, high tumor mutation burden, microsatellite stability and an STK11 mutation (41:34) Selecting patients for the NeoADAURA study treatment approach; deciding between chemoimmunotherapy and chemoradiation therapy (51:01) CME information and select publications

Featuring perspectives from Dr Floor J Backes, Dr Matthew A Powell and Dr Ritu Salani, moderated by Dr Salani, including the following topics: Case: A woman in her late 70s with de novo metastatic mismatch repair-proficient metastatic endometrioid endometrial cancer (00:00) Molecular analyses in the assessment and management of endometrial cancer (07:33) CME information and select publications

An “existential threat” is something that is deadly — whether to individuals, or entire societies. Or even the whole world. Some of them, like nuclear war, or a solar CME ‘extinction event,’ we may not be able to do anything about. But there are others that we CAN understand, and even avoid. The important related question is, “do we have the knowledge – and will – to DO it?” “What I learned from FYING…or, ‘Existential Threats That People Just DON’T Think About’…Enough”

Jill Wener, MD is a board-certified Internist, ICF-certified professional coach, certified EFT/tapping practitioner and trainer, anti-racism educator, DEI consultant, trauma specialist, allyship coach, and expert in physician wellness. Jill is passionate about helping people take responsibility for their problems and teaching them practical, easy, rewarding, and trauma-informed tools to take self-improvement to the next level. Jill is the co-creator of the CME-accredited Conscious Anti-Racism training programs, the host of the Conscious Anti-Racism podcast, and the co-author of the best-selling Conscious Anti-Racism book. She has created CME-accredited EFT/tapping and meditation courses. Jill has worked with clients such as Georgia Aquarium, Dana Farber Cancer Institute, Yale University, the Accreditation Council for Graduate Medical Education, Seattle Children's Hospital, Centene, Santa Clara Medical Society, Rush University Medical Center, ChenMed, the Pittsburgh Business Group on Health, Emory University, Atkins Global, and the National Alliance for Healthcare Purchaser Coalitions.

Host Dr. Jay Sridhar welcomes Dr. Steven Gedde, the incoming CEO of the American Board of Ophthalmology (ABO), to discuss his outlook on medical education and the evolving board certification process. As medical knowledge now doubles approximately every 60 days, Dr. Gedde envisions the ABO shifting its focus from testing facts to assessing skills like communication, professionalism, and the use of technology. Although current surgical assessments focus on knowledge and decision-making, future evaluations may leverage AI and virtual reality to test technical competence.  For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.  

Featuring perspectives from Dr Christopher Flowers, Dr Matthew Lunning, Dr Sonali M Smith and Dr Brad S Kahl, moderated by Dr Kahl, including the following topics: Rational Incorporation of CD79b-Targeted Antibody-Drug Conjugates into the Management of Newly Diagnosed and Relapsed/Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL) — Dr Flowers (00:00) - Clinical Utility of CD19-Directed Monoclonal Antibodies in the Treatment of DLBCL and Follicular Lymphoma (FL) — Dr Smith (31:41) - Optimal Use of CD19-Directed Antibody-Drug Conjugates for R/R DLBCL and FL — Dr Lunning (01:03:23) - Current and Future Role of Bruton Tyrosine Kinase Inhibition in Therapy for Non-Hodgkin Lymphoma — Dr Kahl (01:26:48) CME information and select publications

Highlights from the PER® CME activity "Show Me the Data™: Redefining Treatment Paradigms in Triple-Negative Breast Cancer Across the Disease Continuum" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Hope S. Rugo, MD, FASCO; Neil M. Iyengar, MD; Heather McArthur, MD, MPH; and Jason Aboudi Mouabbi, MD; discuss the latest data to inform management of patients with early-stage triple negative breast cancer (TNBC).Earn CME credit by completing the full accredited activity (available through June 30, 2027): https://www.gotoper.com/courses/show-me-the-data-redefining-treatment-paradigms-in-triple-negative-breast-cancer-across-the-disease-continuum-h5knThis podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by educational grants from AstraZeneca Pharmaceuticals; BioNTech; Daiichi Sankyo, Inc.; and Merck Sharp & Dohme LLC.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Featuring perspectives from Prof Giuseppe Curigliano, Prof Rebecca A Dent, Dr Erika Hamilton, Prof Nadia Harbeck and Dr Hope S Rugo, moderated by Dr Rugo, including the following topics: Introduction (00:00) Evolving Role of Antibody-Drug Conjugates (ADCs) in the Management of Metastatic Triple-Negative Breast Cancer — Prof Dent (02:57) Integrating ADCs into the Management of HER2-Positive Metastatic Breast Cancer (mBC) — Prof Curigliano (29:01) Role of ADCs in the Management of Endocrine-Resistant Hormone Receptor-Positive mBC — Dr Rugo (52:36) Emerging Utility of ADCs for Localized Breast Cancer — Prof Harbeck (01:14:36) Tolerability Considerations with ADCs for Breast Cancer — Dr Hamilton (01:38:10) CME information and select publications

Stroke in children and younger adults differs significantly from adult stroke, with varied presentations and a broader range of underlying causes such as congenital heart disease and arteriopathies. This episode highlights key diagnostic considerations and evolving approaches to treatment in these younger populations. In this episode, Aaron L. Berkowitz, MD, PhD, FAAN, speaks with Thalia S. Field, MD, FRCPC, MHSc, coauthor of the article "Stroke in Children and Younger Adults" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology in the Department of Neurology at the University of California, San Francisco, in San Francisco, California. Dr. Field is a professor at the University of British Columbia and the Sauder Family Heart and Stroke Professor of Stroke Research, and a stroke neurologist at the Vancouver Stroke Program, Vancouver Coastal Health in Vancouver, British Columbia, Canada. Additional Resources Read the article: Stroke in Children and Younger Adults Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz Full episode transcript available here Dr Berkowitz: Most neurologists are used to evaluating and treating adults with stroke since it's one of the most common neurologic conditions. But stroke can also occur in children, in infants, and even in utero. Today, I have the privilege of interviewing Dr. Thalia Field to talk about pediatric stroke.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Berkowitz: This is Dr. Aaron Berkowitz, and today I'm interviewing Dr. Thalia Field about her article on stroke in children and younger adults. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast, Dr. Field, and could you please introduce yourself to our audience?  Dr Field: Well, thanks so much. It's a pleasure to, uh, be speaking to you. I'm a stroke neurologist, and I treat adults generally. My wonderful colleague, Thivya Selvanathan, who's a neonatal neurologist, co-wrote the chapter with me. We do, unfortunately, have to treat some children with stroke collaboratively and I do advise on those cases. My practice is about one-quarter clinical, so I treat patients with acute stroke, look after them on the wards, see patients in stroke prevention clinic, and the rest of my time is mainly research and some administrative work and teaching. I run the clinical trials program for the Vancouver Stroke Program, and I do research of my own, mainly focused on stroke in younger adults. We previously did a trial and registry on cerebral venous thrombosis, and more recently, I've been running a national study looking at brain health in adults and children with congenital heart disease.  Dr Berkowitz: Fantastic. Wow, that is a lot that you do, and we'll look forward to the results of some of those studies. So, when adults suffer a stroke, they typically present with sudden onset focal neurologic deficits, very common scenario we're consulted on.  And one thing you and your colleague talk about in the article is that strokes can present differently in infants and in young children. Can you talk a little bit about the differing clinical presentations of stroke in the youngest young as compared to our usual experience treating the older adults?  Dr Field: Sure. So, you know, speaking about this as someone who doesn't see the children directly but has had the opportunity to discuss these patients with my colleagues and, like we all do, learn about it during our training, I think one of the distinctions, especially with neonates, is that it's generally not a presentation with focal neurologic deficits. Often these babies will have seizures or encephalopathy as their main presentation, and sometimes we're only finding out after the fact if they're presenting with developmental delay or early preference for handedness and hypotonia, things like that. So, in very young children, that's a distinction. And in older children, there can be sudden onset deficits and, and unfortunately, sometimes these are mistaken for other conditions that are more common in children, like seizures. But sometimes you can have a more indolent course, say, with something like a focal cerebral arteriopathy or something like that. So, it depends on the scenario, but the big difference primarily is in neonates, as far as I understand.  Dr Berkowitz: Perfect. That's very helpful. So as an adult neurologist, when I think about causes of stroke or teach sort of the categories of causes of stroke to our residents and students, when we think about the evaluation of stroke, I divide them broadly into causes related to the heart, causes related to the blood vessels, and causes related to the blood with, in the adult world, the most common things, of course, being atrial fibrillation for the heart, atherosclerosis for the blood vessels, and then risk factors for atherosclerosis in the blood, diabetes, hyperlipidemia, very rarely picking up a hypercoagulable disorder in the blood column. And reading your article, it seems that, correct me if I'm wrong, stroke in young adults, stroke in the pediatric population can basically be organized into those same broad categories, heart, blood vessels, and blood, just that there's many more conditions on the differential diagnosis that you would consider in young adults to begin with and then children and then neonates as we get into the younger and younger population. So, I'd like to talk about each of these sort of buckets of etiology in turn and ask you about some of the causes we would consider in young adults and children in each of these, and then as they come up, probably ask you more questions about how frequently we find these sorts of things, how frequently they're the cause of stroke treatment, et cetera. So, let's start with the heart. As I said, in adults, we're mostly looking for rhythm disorders, right, atrial fibrillation. Sometimes we'll pick up a patent foramen ovale or PFO or other structural abnormalities, but mostly we're thinking about atrial fibrillation. But reading your paper, I was struck by the huge variety of conditions that you might be looking for in the heart in children or infants with stroke. So, can you tell us a little more about cardiac etiologies of stroke in the young?  Dr Field: Yeah. So, I'd say unlike in older adults, where it tends more often to be a rhythm disorder, in children and adults who are younger, it's primarily a structural cause, and congenital heart disease being the most common. And it changes a little bit from younger adults shifting downwards in age to younger children in terms of the fact that often if we're seeing an adult with stroke related to congenital heart disease, it can be a paradoxical embolism from a previously undiagnosed PFO. Not in all cases, but fortunately this is improving over time. You know, generally people with diagnoses of more severe congenital heart disease are followed up from childhood and people are aware of the diagnosis, and hopefully they're being managed and watched for things like premature arrhythmias or depressed heart function or other things that can develop and require their own distinct antithrombotic management, for example. In young children, however, more severe causes of congenital heart disease tend to more frequently be associated with stroke. And in many cases, those strokes can be early on in life or associated, say, with perioperative complications or other iatrogenic-related causes in, in that way. Again, congenital heart disease can be associated with stroke at, at any point in the life course. But as adult neurologists, most frequently we're seeing very simple lesions like PFO with large shunts, and in children, it tends to be the more complex causes of congenital heart disease.  Dr Berkowitz: Got it. So, let's move on to the blood vessels. Again, in adults, we're usually thinking about atherosclerotic disease, be that of the cervical arteries or of the intracranial arteries. But in your paper, a lot of discussion about the various vasculopathies, arteriopathies that can be cause of stroke in younger adults and in children. Could you talk a little bit more about some of the vasculopathies and vascular conditions that are causes of stroke in the younger population?  Dr Field: Sure. Before I do that, I will say that especially in older younger adults, particularly over the age of thirty-five, and you know, kind of makes me shudder that that's an older younger adult. But, um, in, in any case, certainly conventional vascular risk factors are more common in this population with stroke, especially in those who don't have PFO-associated stroke. Like conventional atherosclerosis, you know, certainly is a cause of stroke in younger adults. But that being said, certainly other vascular causes and vasculopathy in particular is a much more common cause of stroke in younger adults and, and children than it is in older adults. In particular, dissection is an extremely common cause of stroke in younger adults. Generally cervical artery dissection from non-inflammatory vasculopathy, usually on, sometimes on the FMD fibromuscular dysplasia spectrum and, and sometimes, you know, provoked by minor trauma or something post-infectious that may make the vessels a little bit more susceptible. And in younger children, this inflammatory focal cerebral arteriopathy is a distinct cause that is a common cause of stroke in, in young children. There are other causes that can affect the blood vessels, you know, rarer things like vasculitis and vasculopathies that can develop in the context, say, of sickle cell anemia. But in general, as a bucket, vessels are still very important, but the pathology tends to shift.  Dr Berkowitz: Got it. And you, um, alluded to a point that I wanted to ask you about. You mentioned the sort of, there's stroke in the young, and then where do you draw the line at young? Less than sixty, less than thirty-five, and then we've also talked about strokes as young as before the age of birth. Yeah, I'm remembering, is it the Helsinki study, one of the early large series of stroke in younger individuals? I think that, was it eighteen to forty-nine in that or fifty-nine? I don't remember the exact age, but being struck reading that paper as a resident and thinking about the workup for exotic causes we do, right, and when a young patient has a stroke. And correct me if I'm wrong, the most common etiologies of stroke in that series, and I'm curious the other large series yourself have been involved with, have still been vascular risk factors and arrhythmias and things that we, even common, quote unquote, common things in the young, such as dissection or hypercoagulable states. Uh, the things that we sort of tend to think about first are actually less common. But acknowledging that that paper has folks up to the late forties when the vascular risk factors may be, um, unfortunately kicking in earlier, uh, and earlier due to dietary and lifestyle factors. So is that true, or do you have sort of an age cutoff when it's, we say stroke in the young, people sort of think, "Oh, they'd work someone up differently if they're less than sixty, and they have no vascular risk factors or few vascular risk factors." When do we start getting into the kind of younger population where atherosclerosis and cardiac arrhythmias are not number one and two?  Dr Field: I'd say first of all, you and I must have trained around the same time because I was also in my training, really struck by the results of the Helsinki study going, "Wow, I, I really didn't know how much of a role these conventional vascular risk factors still play." And I think we're seeing that information reiterated, unfortunately, like even with higher prevalences and more attributable risk in some of the newer series. There are newer European series looking at stroke in younger adults, and more recently, there's been one that we mentioned in the article from the Florida Stroke Registry. And it's true that generally the burden is in the older younger adults. But what I would say overall in terms of kind of how things guide the workup, you need to look at the patient and consider things. I mean, obviously you don't want to miss things that can be treated differently and identified by tests easily. You know, things like ruling out syphilis or antiphospholipid antibody disease in, in younger patients. You really want to make sure that that's not something that, that you'd miss because, you know, obviously your treatment is going to change. However, certainly we start with the basics for stroke workup in any patient that's coming in. At my center, CT angiography. Some centers it may be MR angiography and echocardiography. We take a careful history. We look at the blood work. We look at the vascular risk factor burden. We find out if there's kind of any worrisome personal history, family history, look at their general health context. I think that really helps to guide how far we go in a particular workup, and it also helps to direct the other investigations and types of follow-up we need to do. For example, if a patient has a fairly suspicious story for dissection, let's say they're getting over a cold, and they went to the gym, and, you know, there was a sudden movement that they did that really produced headache and neck pain, and there's an obvious cervical artery dissection. I'm not going to go too far down testing them for rare infections and doing advanced cardiac imaging unless something shows up on their initial echo, for example. But I will make an effort to do more detailed vascular imaging of the rest of their body, find out careful family history. If there's additional manifestations of a non-inflammatory vasculopathy elsewhere, say consider sending them to medical genetics, or obviously, if this is, you know, a second event, your flags raise even more. So, it really depends on the patient. If I find out that there's, you know, a family history of premature cardiac disease and things like that, you know, obviously we're gonna be keeping a close eye on their cholesterol, making sure that we're not identifying, for example, familial hypercholesterolemia, which is, you know, something that comes up not infrequently where we'll see an LDL in an untreated patient of more than five. I apologize, you're gonna have to do the conversion to American units on that. But there are things we identify and, you know, again, you don't want to fall solely on heuristics and your preconceived notion of, of the patient. You do have to consider the results of the investigations that you do order. But I think you can certainly be mindful in terms of how you direct your workup and in turn, how you direct your follow-up.  Dr Berkowitz: That's great to hear your approach. Yeah, as you said, our approach always begins with the same, coming back to these three categories, right? Doing some type of structural imaging of the heart, rhythm monitoring for the heart, and then vascular imaging of the head and neck. And then I was going to ask you, and you sort of began to answer this question. Yeah. What's next and how far do you go? I think most people think the expanded stroke workup in the young is at a minimum, a TEE if there's been no signal thus far on the original workup. I just mentioned and you spoke about, and then probably hypercoagulable testing and only sending arterial side if there's no shunt and venous and arterial side if there's a shunt. Is that your second pass approach or did I miss anything, or are there other nuances there that are helpful to discuss?  Dr Field: No, I think that's generally in keeping with what I do. I think with TEE being very important. I mean, the first pass are arterial stuff. Really, it's antiphospholipid antibodies and, and making sure there's no cancer. Like you said, only if there's a shunt do I pursue other venous hypercoagulability testing. Again, you [chuckles] kind of reiterate, go through with the history, make sure there's kind of no red flags. And sometimes, obviously, you do your best reasonable job with the first pass workup, and you will find out when someone presents with a second event that it's something very unexpected. Maybe first manifestation, someone with no obvious history and very initially normal-looking imaging, say with, with CATASL or something like Fabry's disease or something where you would consider it if there was kind of a more classical picture. But it wouldn't be something you would do kind of on your first or even second pass workup in the absence of any sort of clinical suspicion, family history, or something along those lines.  Dr Berkowitz: I'm curious just as far as rough percentage. I feel like many of these patients we see it's a patient who's young and who's had a stroke, and the initial first pass has been unremarkable, and we do our TEE, and we do our hypercoagulable workup. Again, antiphospholipid antibodies only if it's-- there's no shunt. And if there's a shunt, adding on some of the venous hypercoagulability protein C, protein S, factor five, Leiden, et cetera. A lot of the times I feel like we don't find anything. What's your sort of general gestalt? Again, as a general neurologist who does a lot of inpatient neurology, I feel like when these cases come up, it's not that common that you say, "Oh, I actually diagnosed protein S deficiency." Or every once in a while, diagnose an antiphospholipid antibody, or you'll find a PFO on TEE. You didn't find on TT. I've maybe found one fibroelastoma in many years. How often do you find something? How often is it just as an adult a cryptogenic stroke in a young adult or child?  Dr Field: So much of what we see is PFO-related, dissection-related, conventional vascular risk factor-related. We do send referrals to medical genetics. Sometimes we'll do testing for rare things like Fabry's or consider other diagnoses. But I mean, those tend to be the exceptions. About one in four to one in five young adults with stroke end up with this cryptogenic label. I like to keep them on my radar for a few reasons. I think, one, it produces tremendous anxiety for them to not have a cause of stroke identified and just to kind of have a generic approach to secondary prevention. So, I think just to kind of keep an eye on them, manage their anxieties each year, make sure there's kind of no updates in, in terms of general secondary preventionAnd sometimes just things dawn on you later or there are new conditions, say things like, you know, DADA2, this, you know, adenosine deaminase deficiency. You know, there are new diagnoses that, that come on the radar. And sometimes treatments change. You know, for example, when I was starting my early career, the evidence hadn't yet been in place for PFO closure, and then all of a sudden, the paradigm completely changed. And you want to make sure that you can get in touch with those patients to reconsider your approach at the time. So I realize that not everybody has the luxury of extended follow-up with their patients, but I think often you can kind of encourage them or their healthcare team or just, you know, patient themselves to keep in touch periodically just to make sure that there haven't been any changes in treatment paradigms or just with your own awareness of particular, you know, diagnoses or, or just kind of readdressing the situation, uh, a year after and seeing if there's anything that may have occurred to you in the interim.  Dr Berkowitz: Perfect. Really illuminating to hear your approach to these challenging cases. And as you said here and then a couple of times, I think, in this interview is in many of these cases it's your first pass, maybe even your second pass, you haven't found anything. And the key is, unfortunately, as distressing as it may be for the patient as well as for us to not have an answer, to just keep following these patients. And sometimes you really can't sort it out until something else happens, either neurologically or systemically, where you say, "Oh, that's what this was." But there would've been no way to know it from the first presentation. So, we've talked a lot about the diagnosis of causes of stroke in younger adults and children. And in the last minute or two here, I just wanted to talk a little bit about treatment. You mentioned early on that you're involved in thrombectomy cases in children. What's the state of evidence or at least state of practice in terms of offering therapies like thrombolysis and thrombectomy in our patient population? I guess it would be under 18, right, who is not studied in the major trials. Do we have evidence and, or in the absence of evidence, what's sort of the, the expert guidance on treating young adults under 18 and children with some of these acute therapies?  Dr Field: So, trying to keep up with the literature on this. You know, certainly the evidence has been more established in a small trial and pediatric registries for use of tPA, tissue plasminogen activator, in children just because, you know, it's been around much longer. In terms of tenecteplase, which I, I really think signifies a, a practice shift in adult stroke because of its, you know, non-inferior efficacy and ease of use and potentially better rates of recanalization over time. In children, to my knowledge, that evidence base is, is limited to case series and anecdotal shifts in availability of drug and, and different practices. So, the evidence base is not particularly strong for tenecteplase in children who are identified within a reasonable amount of time who are still otherwise candidates for thrombolysis, you know, thrombolysis in children. Children who are a little bit older, I think, can't remember the exact age, but generally very young, like neonates, children who are under the age of two, I believe. I would want to double-check that thrombolysis is less commonly used and just because the safety has not really been that well-established. And for thrombectomy, it's now recommended to use thrombectomy in otherwise eligible children in the newest AHA guidelines. It gets a little bit more controversial in very young children. Under the age of six, there's less of an evidence base and, and often it will depend on people's level of comfort in terms of the size of the arteries. It's my understanding that once you get to about age six, the artery diameter is similar to that in fully grown people. But in younger children, I think just because of the catheters, there can be risk of, of injury. So, it's more of a case-by-case conversation with your interventionalist for younger children. And again, the evidence to intervene is not there for very, very young babies, for example.  Dr Berkowitz: That's very helpful to hear the current state of the evidence and the current state of practice, acknowledging, of course, there's not that much evidence, and these are relatively uncommon occurrences, fortunately, for children, but making it challenging for practitioners and practices may, um, vary based on different institutional protocols. So again, today I've been interviewing Dr. Thalia Field about her article on stroke in children and younger adults. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining us today.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Featuring an interview with Dr Floor J Backes, including the following topics: Overview of the treatment landscape of endometrial cancer (00:00) Immunotherapy for advanced endometrial cancer (03:58) Contraindications for immunotherapy (18:15) PARP inhibitors for endometrial cancer (20:12) Management of localized endometrial cancer (28:23) Novel strategies under investigation for endometrial cancer (42:27) CME information and select publications

Send us Fan MailHave you ever looked around your practice and wondered why good people keep leaving? Maybe you've blamed the job market, younger generations, higher salaries across town, or the simple fact that healthcare has become harder than ever. While all of those things certainly play a role, what if I told you that your staffing problem isn't really a staffing problem at all?More often than not, turnover is actually a systems problem.Practices with strong systems consistently retain people longer than practices that rely on good intentions and heroic managers. They create clarity. They reduce frustration. They help people succeed. And when people succeed, they're much more likely to stay.Today we're continuing the conversation we started in our last episode about building a culture of accountability. Because accountability doesn't exist in a vacuum. It depends on systems. You can't expect people to be accountable if you've never given them a clear roadmap for success.Please Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: https://share.hsforms.com/1FMup6xLPSpeA8hB77caYQwd32sx?hsCtaAttrib=171926995377 Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 32.5 hours of online, on-demand CME-accredited training tailored just for busy physicians. Promo pricing available now: https://education.healtheps.com/offers/Ry3zfLYp/checkout?coupon_code=PHYSEDGE3000 Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/    

Highlights from the PER® CME activity "Medical Crossfire®: Precision Oncology in NSCLC – Translating HER2 and TROP2 Innovation into Practice-Changing Care" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, focusing on precision oncology in non-small cell lung cancer (NSCLC), experts Helena Yu, MD; Jacob Sands, MD; and Sarah Goldberg MD, MPH; will discuss the rapidly evolving landscape of Human Epidermal growth factor Receptor 2 (HER2)- and Trophoblast cell-surface antigen 2 (TROP2)-directed therapies in NSCLC. The podcast covers the spectrum of targeted agents from antibody-drug conjugates (ADCs) to novel HER2-selective tyrosine kinase inhibitors (TKIs), along with key clinical trial data and practical strategies for managing the unique adverse event profiles associated with these treatments.Earn CME credit by completing the full accredited activity (available through June 30, 2027): https://www.gotoper.com/courses/medical-crossfire-precision-oncology-in-nsclc-translating-her2-and-trop2-innovation-into-practice-changing-care-mr5qThis podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by educational grants from AstraZeneca Pharmaceuticals; Daiichi Sankyo, Inc.; and Gilead Sciences, Inc.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

Send us Fan MailRaise your hand if you've hit December and suddenly realized your CME credits are nowhere close to where they need to be. Yeah. Me too. That particular flavor of end-of-year panic is incredibly common, and it doesn't have to keep happening.In this episode, we dig into the unsexy but necessary work of getting a handle on your CME, your board certifications, and all the credentialing requirements that somehow always feel like they sneak up on us. Not because we're disorganized, but because no one else is managing this for us, and we're already running at capacity.We talk through how to figure out exactly what you're responsible for reporting and where it needs to go, how to think about CME formats that actually fit the way you work, and how to stop leaving credit on the table for education you're already doing at the point of care. I also share a little experiment I ran using an AI tool to fill out a CME reporting form, and what surprised me about how it handled the task.The goal isn't to add another thing to your plate. It's to build a small, repeatable system so that the documentation catches up to the work you're already doing.Hit play. Let's end the December scramble for good.If this resonates and you want support actually building systems that make your professional life more sustainable, let's talk. Schedule a free discovery call here: https://calendly.com/healthierforgood/coaching-discovery-callConnect with Megan:Instagram: @MeganMeloMDWebsite: healthierforgood.comEmail: megan@healthierforgood.com Support the showTo learn more about my coaching practice and group offerings, head over to www.healthierforgood.com. I help Physicians and Allied Health Professional women to let go of toxic perfectionist and people-pleasing habits that leave them frustrated and exhausted. If you are ready to learn skills that help you set boundaries and prioritize yourself, without becoming a cynical a-hole, come work with me.Want to contact me directly?Email: megan@healthierforgood.comFollow me on Instagram!@MeganMeloMD