Podcasts about cme

財經M平方從 Podcast 開始慢慢走向 YouTube，利用影像、視覺版希望提供更好的體驗，我們本週也開了問卷給大家問問題，這集就來替大家解惑！ 本集邀請創辦人 Rachel 與研究副總監 Vivianna 來聊聊，大家對於M平方、總經、市場行情、未來趨勢的種種疑問，快來聽聽 Rachel & Vivianna 怎麼解答吧！

Featuring perspectives from Dr Natalie S Callander and Dr Sagar Lonial, including the following topics:  Introduction (0:00) A Farmer with Myeloma; Is Myeloma the New Chronic Myeloid Leukemia? (2:06) Clinical Trials (12:34) Chimeric Antigen Receptor Therapy (16:11) Bispecific Antibodies (21:38) Antibody-Drug Conjugates; a Patient on Belantamab Mafodotin for 3 Years (30:45) Treatment Options for Relapsed Disease (40:46) Neuropathy (44:43) Alternative Therapies (48:36) 164 Questions (53:20) CME information and select publications

Featuring perspectives from Dr Haley Ellis and Dr James J Harding, including the following topics:  Introduction: Is Biliary Tract Cancer (BTC) the New Non-Small Cell Lung Cancer? … Why? (0:00) Case: A woman in her mid 70s with metastatic cholangiocarcinoma receives first-line gemcitabine/cisplatin with durvalumab — Warren S Brenner, MD (8:42) Case: A man in his late 70s with metastatic biliary cancer (HER2 IHC 2+) discontinues first-line chemotherapy/immunotherapy because of exacerbation of Crohn's disease — Neil Morganstein, MD (17:48) Case: A man in his early 70s with metastatic cholangiocarcinoma (FGFR2 rearrangement) receives gemcitabine/oxaliplatin with durvalumab and experiences a rapid clinical decline — Kimberly Ku, MD (27:14) Case: A woman in her late 40s with Stage IV recurrent cholangiocarcinoma (FGFR2 rearrangement) receives pemigatinib — Justin Peter Favaro, MD, PhD (40:15) Case: A woman in her early 60s with HER2-positive cholangiocarcinoma develops metastatic disease during adjuvant capecitabine therapy — Dr Morganstein (46:09) CME information and select publications

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A new conversation with Catherine Sweeney, PA-C, CCD, on bone health and updates for 2025, including some new treatments. Next week: join us at "Ortho on the Strip" for a conference entirely dedicated to APPs in orthopaedics. More at PAOS.org/CME!

Progressive supranuclear palsy and corticobasal syndrome are closely related neurodegenerative disorders that present with progressive parkinsonism and multiple other features that overlap clinically and neuropathologically. Early recognition is critical to provide appropriate treatment and supportive care. In this episode, Teshamae Monteith, MD, FAAN speaks with Nikolaus R. McFarland, MD, PhD, FAAN, author of the article “Progressive Supranuclear Palsy and Corticobasal Syndrome” in the Continuum® August 2025 Movement Disorders issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. McFarland is an associate professor of neurology at the University of Florida College of Medicine at the Norman Fixel Institute for Neurological Diseases in Gainesville, Florida. Additional Resources  Read the article: Progressive Supranuclear Palsy and Corticobasal Syndrome 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: @headacheMD Full episode transcript available here 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 Monteith: Hi, this is Dr Teshamae Monteith. Today I'm interviewing Dr Nikolaus McFarland about his article on progressive supranuclear palsy and cortical basilar syndrome, which appears in the August 2025 Continuum issue on movement disorders. Welcome, how are you? Dr Farland: I'm great. Thank you for inviting me to do this. This is a great opportunity. I had fun putting this article together, and it's part of my passion. Dr Monteith: Yes, I know that. You sit on the board with me in the Florida Society of Neurology and I've seen your lectures. You're very passionate about this. And so why don't you first start off with introducing yourself, and then tell us just a little bit about what got you interested in this field. Dr Farland: I'm Dr Nicholas McFarlane. I'm an associate professor at the University of Florida, and I work at the Norman Fixel Institute for Neurological Diseases. I am a director of a number of different centers. So, I actually direct the cure PSP Center of Care and the MSA Center of Excellence at the University of Florida; I also direct the Huntington's clinic there as well. But for many years my focus has been on atypical parkinsonisms. And, you know, I've treated these patients for years, and one of my focuses is actually these patients who suffer from progressive supranuclear palsy and corticobasal syndrome. So that's kind of what this review is all about. Dr Monteith: You probably were born excited, but I want to know what got you interested in this in particular? Dr Farland: So, what got me interested in this in particular was really the disease and the challenges that's involved in it. So, Parkinson's disease is pretty common, and we see a lot of that in our clinic. Yet many times, roughly about 10 to 15% of my patients present with these atypical disorders. And they're quite fascinating. They present in different ways. They're fairly uncommon. They're complex disorders that progress fairly rapidly, and they have multiple different features. They're sort of exciting to see clinically as a neurologist. I think they're really interesting from an academic standpoint, but also in the standpoint of really trying to bring together sort of a team. We have built a multidisciplinary team here at the University of Florida to take care of these patients. They require a number of folks on that team to take care of them. And so, what's exciting, really, is the challenge of treating these patients. There are very limited numbers of therapies that are available, and the current therapies that we have often really aren't great and over time they fail. And so, part of the challenge is actually doing research. And so, there's actually a lot of new research that's been going on in this field. Recently, there's been some revisions to the clinical criteria to help diagnose these disorders. So, that's really what's exciting. The field is really moving forward fairly rapidly with a number of new diagnostics, therapeutics coming out. And hopefully we can make a real difference for these patients. And so that's what really got me into this field, the challenge of trying to treat these patients, help them, advocate for them and make them better. Dr Monteith: And so, tell me what the essential points of this article. Dr Farland: So, the essential points, really, of this article is: number one, you know, just to recognize the new clinical criteria for both PSP and corticobasal syndrome, the diagnosis for these disorders or the phenotypic spectrum has really expanded over the years. So, we now recognize many different phenotypes of these disorders, and the diagnosis has gotten fairly complicated. And so, one of the goals of this article was to review those new diagnostic criteria and the different phenotypic ways these diseases present. I wanted to discuss, also, some of the neuropathology and clinicopathological overlap that's occurred in these diseases as well as some of the new diagnostic tests that are available. That's definitely growing. Some of the new studies that are out, in terms of research and clinical trials. And then wanted to review some of the approaches for treatment for neurologists. Particularly, we're hoping that, you know, this article educates folks. If you're a general neurologist, we're hoping that recognizing these diseases early on will prompt you to refer these patients to specialty clinics or movement disorder specialists early on so they can get appropriate care, confirm your diagnosis, as well as get them involved in trials if they are available. Dr Monteith: And how has the clinical criteria for PSP and cortical basilar syndrome changed? Dr Farland: I think I already mentioned there's been an evolution of the clinical criteria for PSP. There's new diagnostic criteria that were recently published, and it recognizes the multiple clinical phenotypes and the spectrum of the disease that's out there, which is much broader than we thought about. Corticobasal clinical criteria are the Dr Armstrong criteria from 2013. They have not been updated, but they are in the works of being updated. But it does recognize the classic presentation of corticobasal syndrome, plus a frontal executive predominant and then a variant that actually overlaps with PSP. So, there's a lot more overlap in these two diseases than we originally recognized. Dr Monteith: And so, you spoke a bit about FTD spectrum. So why don't you tell us a little bit about what that is? I know you mentioned multiple phenotypes. Dr Farland: What I really want to say is that both PSP and corticobasal syndrome, they're relatively rare, and what- sort of as to common features, they both are progressive Parkinson disorders, but they have variable features. While they're commonly associated with Parkinson's, they also fit within this frontotemporal lobar spectrum, having features that overlap both clinically and neuropathologically. I just want folks to understand that overlap. One of this pathological overlap here is the predominant Tau pathology in the brain, an increasing recognology- recognition of sort of the pathological heterogeneity within these disorders. So, there's an initial description, a classic of PSP, as Richardson syndrome. But now we recognize there are lots of different features to it and there are different ways it presents, and there's definitely a lot of clinical pathological overlap. Dr Monteith: Why don't we just talk about some red flags for PSP? Dr Farland: Yeah, sure. So, some of the red flags for PSP and even corticobasal syndrome are: number one is rapid progression with early onset of falls, gait difficulty, falling typically backwards, early speech and swallow problems that are more prominent than you see in Parkinson's disease, as well as eye gaze issues. So, ocular motor features, particularly vertical gaze palsy. In particular what we talk about is the supranuclear gaze palsy, and one of the most sensitive features that we've seen with these is downgaze limitation or slowed downgaze, and eventually a full vertical gaze palsy and followed supranuclear gaze palsy. So, there's some of the red flags that we see. So, while we think about the lack of response to levodopa frequently as something that's a red flag for Parkinson's, there are many times that we see Parkinson's patients, and about a quarter of them don't really respond. There's some features that don't respond to levodopa that may not be so specific, but also can be helpful in this disease. Dr Monteith: And what about the red flags for cortical basilar syndrome? Dr Farland: So, for cortical basilar syndrome, some of the red flags again are this rapidly depressive syndrome tends to be, at least in its classical present presentation, more asymmetric in its presentation of parkinsonism, with features including things like dystonic features, okay? For limb dystonia and apraxias---so, inability to do a learned behavior. One of those red flags is a patient who comes in and says, my hand doesn't work anymore, which is something extremely uncommon that you hear in Parkinson's disease. Most of those patients will present, say, I might have a tremor, but they very rarely will tell you that I can't use my hand. So look out for that sign. Dr Monteith: And let's talk a little bit about some of the advances in the fields you mentioned, evolving biomarker and imaging capacities. So, how are these advances useful in helping us understand these conditions, especially when there's so much heterogeneity? Dr Farland: I might start by talking a little bit about some of the clinical criteria that have advanced. Why don't we start there and just discuss some of the advances? I think in PSP, I think, originally we had both probable and possible diagnoses of PSP, and the diagnostic criteria were basically focused on what was what's called “classical PSP” or “Richardson syndrome”. But now we recognize that there are multiple phenotypes. There's an overlap with Parkinsonism that's slower in progression and morphs into PSP, the classical form. There's a frontal behavioral variant where patients present with that frontal behavioral kind of thing. There's a speech-language variant that can overlap with PSP. So they have prominent speech language, potentially even apraxia speech. So, recognition of these different phenotypes is sort of a new thing in this field. There's even overlap with cortical basal syndrome and PSP, and we note that the pathology can overlap as well. So, I think that's one of the things that have changed over time. And these were- recently came out in 2017 in a new publication in the Movement Disorders Society. So, in terms of diagnostic tests as well---and there's been quite a bit of evolution---really still to date, our best diagnostic test is imaging. MRI is really one of our best tests currently. Currently blood tests, spinal fluid, there's new biomarkers in terms of skin… they're still in the research phase and not necessarily very specific yet. So, we rely heavily on imaging still; and for PSP, what we're looking for largely are changes in the brain stem, and particularly focused on the midbrain. So disproportionate midbrain atrophy compared to the pons and the rest of the midbrain is a fairly specific intensive sign for PSP. Whereas in MSA we see more of a pontine atrophy compared to the midbrain. So that can be really helpful, and there are lots of different new measurements that can be done. PET scans are also being used as well. And there are new PET markers, but they still remain kind of research-based, but are becoming more and more prevalent and may be available soon for potential use. Although there's some overlap with PET tracers with Alzheimer's disease and different Tau isoforms. So, something to be wary about, but we will be seeing some of these soon coming out as well. More kind of up-to-date things include things like the spinal fluid as well as even some of the skin biopsies. And I think we've heard some word of recent studies that have come out that potentially in the very near future we might actually have some Tau protein tests that we can look at Tau either in spinal fluid or even in a skin biopsy. But again, still remains research-based and, we still need more information as to whether these tests can be reproducible and how sensitive or specific they are. Dr Monteith: It sounds like, when really approaching these patients, still, it's a lot of back to the history, back to the clinical and some basic imaging that we should be able to identify to distinguish these types of patients, and we're not quite where we need to be yet for biomarker. Dr Farland: I totally agree with you. I think it starts, really, with the clinical exam and that's our main focus here; and understanding some of the new clinical criteria which are more sensitive, but also specific, too. And they're really useful to look at. So, I think reviewing those; patients do progress, following them over time can be really useful. And then for diagnosis, getting imaging if you suspect a patient has an atypical presentation of parkinsonism, to look for signs or features that might be specific for these different disorders. Dr Monteith: Why don't we take a typical case, a typical patient that you would see in clinic, and walk us through the thought process---especially, maybe they presented somewhat early---and the different treatment approaches to helping the patient, and of course their family. Dr Farland: Yeah, sure. So, a typical patient might be someone who comes in with, like, a three year history of progressive gait problems and falling. And let's say the patient says, I'm falling backwards frequently. They may have had, like, a rib fracture, or they hit their head once, and they're describing some speech issues as well. Now they're relying on a walker and family members saying they rarely let them be by themselves. And there may be some slowing of their cognitive function and maybe a bit of withdrawal. So that's a typical patient. So, the approach here is really, what are some of the red flags? I think already you hear a red flag of a rapidly progressive disease. So, Parkinson's disease patients rarely have frequent falls within the first five years. So, this is within three years or less. You're already hearing early onset of gait problems and falling, and particularly falling backwards rather than forwards as often Parkinson's disease patients do. You're hearing early speech problems and maybe a subtle hint of cognitive slowing and some withdrawal. So, a lot of things that sort of are red flags. So, our approach really would be examining this patient really closely. Okay? We'd be listening to the history, looking at the patient. One thing is that some of these patients come in, they may be in a wheelchair already. That's a red flag for us. If they're wearing sunglasses---sometimes we see that patients, they have photosensitivity and they're in a chair and they're wearing sunglasses---you take the glasses off and you look at their face and they have that sort of a facial stare to them---not just the masked face, but the stare---and their eyes really aren't moving. So, another kind of clue, maybe this is probably something atypical, particularly PSP is what I'm thinking about. So, the approach is really, do a thorough exam. I always recommend looking at eye movements and starting with volitional saccades, not giving them a target necessarily, but asking them to look up and then look down. And then particularly look at the speed of downgaze and whether they actually have full versions down, are able to do that. That's probably your most sensitive test for a patient who has PSP. Not the upgaze, which can be- upgaze impairment in older patients can be nonspecific. So, look for that down gaze. So, if I can get out one message, that's one thing that can be easily done and examined fairly quickly for diagnosis of these patients. And then just look for signs of rigidity, bradykinesia, maybe even some myelopraxia, and then look at their gait carefully so that there's a high suspicion. Again, if there's some atypical features, imaging is really important. So, my next step would be probably getting an MRI to evaluate whether- do they have brain somatrophy or other widespread atrophy or other signs? You need to think about your differential diagnosis for some of these patients as well. So, common things are common; vascular disease, you can't have vascular parkinsonism or even signs of NPH. Both of those can present with progressive gait difficulty and falls. So, the gait may look more like Parkinson's rather than ataxic gait that we see in classic PSP, but still they have early gait issues, and that can be a mimicker of PSP, So looking for both of those things in your imaging. Think about sort of autoimmune potentially causes. So, if they have a really rapid progressive cause, there are some rare autoimmune things. There have been recent reports of things like IgLON5, although there's limited cases, but we're doing more screening for some of those autoimmune causes. And then even some infectious causes like Whipples, that are rarely present like this. Okay? And have other signs and features. Dr Monteith: So, let's say you diagnose this patient with PSP and you're assessing the patients to see how you can improve their quality of life. So, what are some potential symptomatic managements that will help our patient? Dr Farland: I recommend for most all of these patients… while the literature indicates that many patients with PSP, and especially corticobasal syndrome, don't respond well to levodopa. So, the classic treatment for parkinsonism. However, we all recommend a trial of levodopa. These patients may respond partially to doses of levodopa, and we try to push the doses a bit higher. So, the recommended trial is usually a dose up to roughly 1000 milligrams of levodopa per day. And give it some time, at least two, if not actually three months of a trial. If not well-tolerated, you can back off. If there's no response at all or no improvement, then slowly back off and taper patients off and ask them to tell you whether they feel like they're actually worsening. So, many patients, sometimes, don't recognize the improvements, or family members don't recognize it until we actually taper them back off. And they may end up saying there are some other things that even recognize. Even some nonmotor benefits can be seen with levodopa. In some cases, we do keep them on levodopa, but levodopa's our best therapy for this. Dopamine agonists, MAO inhibitors, have all been sort of tried and they've been studied, but often don't really help or fail to help benefit these patients and could be fraught with some other side effects. I think many people do also turn to Amantadine as a treatment for Parkinson's, gait problems, freezing, if you see it in these disorders. Yet Amantadine is fraught with issues of side effects, including cognitive issues, and I think is not well-tolerated. But there are the rare patient who actually does respond to this or claims they respond to this. By and large, these patients relentlessly progress, unfortunately. So, beside treatment of other symptoms, I think it's really important to recognize that they require supportive cares and therapy. So, starting those early on and getting your allied healthcares kind of involved. So that includes people like physical, occupational therapy for the gait issues, the falls, occupational therapy for doing daily activities. Speech language pathology can be really a critical player for these because of the early speech and language issues, as well as swallow difficulties. Swallow is compared quickly in these patients. And so, we do recommend the screening evaluation, then often following patients either every six- or even annually, at least, with a swallow evaluation. And we recommend the fluoroscopic-guided kind of modified barium swallow for these patients.  Dr Monteith: And how does that differ if, let's say, the patient had cortical basilar syndrome? What are some of the symptomatic treatments that would be high on your consideration? Dr Farland: So actually, these patients also have a very similar approach, and they often have some overlapping features. Maybe a little bit of difference in terms of the level of apraxia and some dystonic features that you see in corticobasal syndrome. So, as I mentioned earlier that these patients have a more typ- when they present, typically have a more asymmetric presentation. And one of the biggest issues is this limb apraxia. They may have abnormal movements as well as, like, the alien limb-type phenomena as well. So, the focus of therapy, while similar in the sense we focus on the parkinsonism, I do always try levodopa and try to ramp up the doses to see if it benefits. It does often fail, but it's definitely worth trying. The other focus of these patients is trying to treat symptoms. Dystonia, those features… in some cases, we can help; if it's painful or uncomfortable, muscle relaxants can be used. If it's vocal, things like Botox can be really helpful. Often times it is more palliative than actually restorative in terms of function, but still can be really helpful for patients who ask about pain and discomfort and trying to treat. And then of course, again, the focus on our supportive care. We need to build that network and build that team of folks, the therapists, the physical, occupational, and the speech therapist to help them. If they have language problems---like either in PSP or corticobasal---I'll also include my request to a speech language pathologist to work on cognitive function. That's a special, additional thing you have to ask for and then specifically request when you make a referral to a speech language pathologist. Dr Monteith: That is so important. I think keeping the simulation, keeping the social support, and I would probably guess that you would also include screening for sleep and mood disorder. Dr Farland: Absolutely. Mood disorders are really big in these diseases. Patients are suffering terribly. You do hear about labile mood in both of these diseases, particularly PSP; and even what's called pseudobulbar palsy, where the mood is not always congruent with the affect. So they may laugh or cry inappropriately, and particularly the crying can be very disturbing to family and caregivers to see that. And so, treating those things can be really important. So always asking about the mood issues. Depression in particular is something that we're very sensitive about, and there is a higher incidence of suicidal ideations. Asking about that and feeling and making sure that they are in a safe environment can be really important. Dr Monteith: Thank you so much. Dr Farland: Thank you. Dr Monteith: Today I've been interviewing Dr Nikolaus McFarland about his article on progressive supranuclear palsy and cortical basilar syndrome, which appears in the August 2025 Continuum issue on movement disorders. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining 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.

The hog market finally had a nice technical breakout yesterday. Listen in to Jeff and Mike discuss the CME fall and the cutout hanging in there. 

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/WMD865. CME credit will be available until August 20, 2026.At the Nexus of Sequential Care in Myeloma: Interprofessional and Patient Perspectives on GPRC5D-Directed Therapies In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Multiple Myeloma. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Johnson & Johnson.Disclosure information is available at the beginning of the video presentation.

This episode is sponsored by: My Financial CoachYou trained to save lives—who's helping you save your financial future? My Financial Coach connects physicians with CFP® Professionals who specialize in your complex needs. Whether it's crushing student loans, optimizing investments, or planning for retirement, you'll get a personalized strategy built around your goals. Save for a vacation home, fund your child's education, or prepare for life's surprises—with unbiased, advice-only planning through a flat monthly fee. No commissions. No conflicts. Just clarity.Visit myfinancialcoach.com/physiciansguidetodoctoring to meet your financial coach and find out if concierge planning is right for you._____________In this episode, host Dr. Bradley Block welcomes Dr. Cheryl Chase, to discuss common challenges faced by high-achieving physicians, such as task overload, time management struggles, procrastination, and balancing demanding caseloads with home life. Dr. Chase shares evidence-based strategies like habit-building techniques from Atomic Habits, pairing tasks with rewards, breaking down large projects, and setting boundaries to minimize distractions. She emphasizes that these tools, originally for neurodiverse clients, can enhance efficiency for all professionals pushing their limits. Tune in for part 1, with more on self-monitoring and persistence in part 2 next week. This episode is essential for physicians seeking to sharpen focus, reduce guilt, and reclaim work-life balance.Three Actionable Takeaways:Build Habits Over Willpower – For boring tasks like charting, make cues visible (e.g., set up your workspace for easy access), pair them with rewards (e.g., a favorite tea after completion), and eliminate aversive elements (e.g., adjust your environment to avoid distractions) to increase compliance without relying on sheer grit.Break Down Large Tasks and Minimize Distractions – Tackle complex projects like mandatory modules or side gigs by dividing them into small steps, setting timers or task goals, and using techniques like tone tapes (variable alarms) to self-check focus; reward persistence to maintain motivation.Set Firm Boundaries for Work-Life Balance – Establish clear rules for interruptions (e.g., airplane mode during deep work), secure reliable childcare to close mental "browser tabs," and communicate availability with family and colleagues to stay present at work or home without guilt.About the Show:Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the Guest:Dr. Cheryl Chase is a licensed clinical psychologist in Independence, Ohio, specializing in assessments and treatments for ADHD, learning disorders, and emotional challenges across the lifespan. She's an international speaker on executive functioning, dyslexia, co-regulation, and performance improvement in work and school settings. Her strategies help high-achievers, including physicians, enhance efficiency and balance.Website: https://chasingyourpotential.comAbout the host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts The Succeed In Medicine  podcast, focusing on personal and professional development for physiciansWant to be a guest? Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance.

Featuring an interview with Dr Sarah Sammons, including the following topics: Development of brain metastases in patients with HER2-positive and HER2-negative breast cancer (0:00) Local therapy approaches for the treatment of brain metastases (8:23) Treatment options for patients with HER2-positive breast cancer and CNS-only disease progression (16:36) Clinical presentation of leptomeningeal disease; management of functional sequelae associated with brain metastases (19:07) Investigational agents for the treatment of brain metastases in HER2-positive breast cancer (25:01) Case: A 65-year-old woman with ER-negative, HER2-positive metastatic breast cancer (mBC) develops a single 6-mm brain metastasis after 4 years of maintenance trastuzumab/pertuzumab (27:38) Screening for brain metastases; radiation necrosis as a side effect of radiation therapy (31:00) Case: A 39-year-old woman with ER-negative, HER2-positive mBC develops 7 new brain metastases 6 months into treatment with a taxane, trastuzumab and pertuzumab (34:30) CME information and select publications

Send us a textWelcome back to Ending Physician Overwhelm! As we head into the last week of August 2025 and prepare for back-to-school season, it's time to think about something we do constantly as physicians: learning.The Evolution of Medical LearningYou've been a professional learner your entire career. Medical school, residency, fellowship, boards, CME requirements - you've mastered the art of absorbing information and passing tests. But here's the question that might change everything: Who are you actually learning from?If you're like most of us who trained in the early 2000s, your medical education came primarily from older white men reading the same traditional journals and following conventional pathways. While this wasn't inherently wrong, it created a narrow lens that may no longer serve you - or your patients.Breaking Out of Traditional Learning BoxesAs medicine evolves, so should your sources of knowledge. Whether you're exploring:Obesity medicine (where traditional training left massive gaps)Menopause care (practically non-existent in most curricula thanks to the WHI study fallout)Lifestyle medicine approachesNew practice models that prioritize patient connectionYou need voices that reflect the reality of modern healthcare delivery, not just academic theory.The Current Medical Learning LandscapeHere's what's happening right now that affects how you learn:Traditional resources are under threat: With political forces dismantling institutions like ACIP and creating uncertainty around CDC guidance, you're losing historically reliable sources of information.AI is changing everything: Your residents and students are using AI tools that you may not fully understand, yet you're expected to guide them safely through this new landscape.Diversity of voices matters: The patients you serve come from all backgrounds - shouldn't your teachers reflect that diversity too?Finding Your New Learning PathAsk yourself these critical questions:Who is doing the work the way you want to do it?Are you open to being challenged and learning new approaches?Can you unlearn outdated information that's no longer serving your patients?How will you vet new sources of information in an era of compromised traditional resources?Practical Steps for Better LearningSeek out practitioners who:Are actively treating patients (not just publishing papers)Offer practical, real-world applicationsDiscuss the full picture including costs, side effects, and patient experienceChallenge traditional approaches with evidence-based alternativesConsider learning formats beyond traditional CME:Podcasts from practicing physiciansCourses from specialists doing the workMentorship from independent practitionersBooks and resources from diverse voices in medicineThe Power 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

Pediatrician Dr. Paul Bunch consults Dr. Kristen Reilly from the Division of Adolescent Medicine on adolescent substance use. Episode recorded on June 12, 2025.  Resources discussed in this episode: Community Practice Support Tool  S2BI  Crafft We are proud to offer CME and MOC Part 2 from Cincinnati Children's.  Credit is free and registration is required.  Please click here to claim CME credit via the post-test under "Launch Activity." Financial Disclosure:  The following relevant financial relationships have been disclosed: None All relevant financial relationships listed have been mitigated. Remaining persons in control of content have no relevant financial relationships. To Claim Credit: Click "Launch Activity." Click "Launch Website" to access and listen to the podcast. After listening to the entire podcast, click "Post Test" and complete.   Accreditation In support of improving patient care, Cincinnati Children's Hospital Medical Center 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. Specific accreditation information will be provided for each activity. Physician:  Cincinnati Children's designates this Enduring Material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  Nursing:  This activity is approved for a maximum 0.50 continuing nursing education (CNE) contact hours. ABP MOCpt2: Completion of this CME activity, which includes learner assessment and feedback, enables the learner to earn up to 0.50 points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. Cincinnati Children's submits MOC/CC credit for board diplomates. Credits AMA PRA Category 1 Credits™ (0.50 hours), ABP MOC Part 2 (0.50 hours), CME - Non-Physician (Attendance) (0.50 hours), Nursing CE (0.50 hours)      

Dr Sarah Sammons from Dana-Farber Cancer Institute in Boston, Massachusetts, discusses cases and reviews the current management of brain metastases in patients with HER2-positive breast cancer. CME information and select publications here.

What is the sandwich generation? How does ageism play into sandwich generation dynamics?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. Shirley Davis about the dynamics of the sandwich generation. They discuss tips on how to not just survive, but thrive as a member of the sandwich generation, the importance of mindset shifts and open communication, and setting boundaries.Dr. Shirley Davis is a sought-after global workforce expert, national board director for Make-A-Wish Foundation, and president and CEO of SDS Global Enterprises, a strategic development solutions firm that specializes in human resources strategy, talent management, leadership effectiveness, culture transformation, and diversity, equity and inclusion. Dr. Davis has over 30 years of business experience in a variety of senior executive leadership roles in Fortune 100 & 50 corporations and in her last role, served as vice president of global diversity and inclusion and workforce strategies for the world's largest human resources association, the Society for Human Resource Management.LINKSwww.drshirleydavis.comwww.linkedin.com/in/drshirleydaviswww.drshirleydavisfoundation.org**Our website www.consciousantiracism.comYou can learn more about Dr. Wener and her online meditation and tapping courses 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-healthcareJoin her Conscious Anti-Racism facebook group: www.facebook.com/groups/307196473283408Follow her on:Instagram at jillwenerMDLinkedIn at jillwenermd

In this episode of Bowel Sounds, hosts Dr. Jenn Lee and Dr. Peter Lu talk to Dr. Richard Wood, Chief of the Department of Pediatric Colorectal & Pelvic Reconstructive Surgery at Nationwide Children's Hospital and Professor of Surgery at The Ohio State University College of Medicine. We discuss identifying and caring for the child with an anorectal malformation.Learning objectivesRecognize the various types of anorectal malformations and the VACTERL association.Discuss the diagnosis of anorectal malformations, including the importance of early identification by the pediatrician or pediatric GI.Understand the role of the pediatrician or pediatric GI in the ongoing care of children with anorectal malformations even after surgery.ReferencesAnorectal Malformations Family GuidebookSupport 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.

For this episode join hosts John, Andy, and Tanner as they sit down with fitness coach Paul Clingan. Listen as we discuss how you can change your thoughts and actions about being healthier by nerding out a bit. Don't forget we are the official podcast of the American College of Osteopathic Emergency Physicians. Visit acoep.org to learn more, and sign up for an upcoming CME event!

Featuring a slide presentation and related discussion from Dr Sarah Sammons. CME information and select publications

Quick summaries of articles 51-60. Enjoy! 51. Fun Activities and Recovery Acuff, S. F., et al. A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery. Drug and Alcohol Dependence, 256, 111092. 52. Buprenorphine-precipitated Fentanyl Withdrawal Thakrar AP, et al. Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. JAMA Netw Open. 2024 Sep 3;7(9):e2435895. 53. Methadone Vs. Buprenorphine Nosyk B, Et al. Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder. JAMA. 2024 Oct 17. 54. High Daily Doses of Buprenorphine Axeen S, et al. Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization. JAMA Netw Open. 2024 Sep 3;7(9):e2435478. 55. How Buprenorphine Works in Pregnancy Caritis, Steve N. MD; et al. A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period. Journal of Addiction Medicine ():10.1097/ADM.0000000000001380, September 2, 2024. 56. How Many Quite Attempts Does It Take? Fontes RM, et al. Beyond the first try: How many quit attempts are necessary to achieve substance use cessation? Drug Alcohol Depend. 2024 Dec 8;267:112525. 57. What is Recovery? Zemore SE, et al. Understanding the Shared Meaning of Recovery From Substance Use Disorders: New Findings From the What is Recovery? Study. Subst Abuse. 2023 Sep 15;17:11782218231199372. 58. Semaglutide for Alcohol Use Disorder (The RCT) Hendershot CS, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025 Feb 12:e244789. 59. Low-Dose Buprenorphine Initiation (Micro-induction) Suen LW, et al. Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl. JAMA Netw Open. 2025 Jan 2;8(1):e2456253. 60. Lisdexamfetamine for methamphetamine use disorder Ezard N, et al LiMA Investigator Group. Lisdexamfetamine in the treatment of methamphetamine dependence: A randomised, placebo-controlled trial. Addiction. 2024 Dec 19. --- This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES. CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/ --- Original theme music: composed and performed by Benjamin Kennedy Audio editing: Michael Bonanno Executive producer: Dr. Patrick Beeman A podcast from Ars Longa Media --- This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice. The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group. --- Email: addictionmedicinejournalclub@gmail.com Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club Instagram: @AddictionMedJC Threads: @AddictionMedJC YouTube: addictionmedicinejournalclub Twitter/X: @AddictionMedJC --- Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. Learn more about your ad choices. Visit megaphone.fm/adchoices

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/AKJ865. CME credit will be available until August 19, 2026.Achieving Goals in Lipid Management: Then and Now In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc.Disclosure information is available at the beginning of the video presentation.

Sorry for the delay, we were on vacation on Friday. Market Updates for last week below!BEEF: Prices keep climbing across the board – ribeyes, tenderloins, chucks, and rounds are all on fire. With packers still losing money, production dropping, and the Southern border closed to live animal imports, pressure is building. Relief may come after Labor Day – but will it be too little, too late?POULTRY: Chicken stays strong with production up and demand steady – wings are flat for now while breasts and tenders ease a bit. Football season could give wings a lift, but the real watch is Avian Flu: after six clean weeks, a new case breaks the streak. Will cooler weather bring more trouble?GRAINS: Harvest is underway and while yields look good, they're not record-shattering just yet. Corn is holding under $4 for a third straight week, soy is showing some strength on export demand, and wheat is slipping. The market looks steady – but will exports or tariffs be the wild card?PORK: Bellies look like they've peaked, slipping back to $182 from last week's $194 – and likely heading lower into fall. With butts and loins down and ribs steady, pork remains one of the best buys on the menu. But is this the break buyers have been waiting for, or just a seasonal pause?DAIRY: After a couple of big weeks higher, the market eased back – barrel down 1½, block steady, and butter slipping just ½. The push has cooled for now, but will those gains start to melt further in the weeks ahead?Savalfoods.com | Find us on Social Media: Instagram, Facebook, YouTube, Twitter, LinkedIn

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/AKJ865. CME credit will be available until August 19, 2026.Achieving Goals in Lipid Management: Then and Now In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc.Disclosure information is available at the beginning of the video presentation.

We talk about stat vs routine EKG orders as well as metrics that they are always working to hit on timeWhen EKG's are not done on time the source of the problem needs to be found, sometimes it is the providers' fault for not realizing the EKG order had not been placed We talk about how we should communicate between provider and EKG tech and how much info we like to get as providersI talk about how providers need to become good at task switching frequently and this includes signing EKG'sWe talk about the responsibility of the PA or NP to sign EKG's (calling STEMI's or deciding not a STEMI) and how this responsibility is currently in the hands of the physicians onlySean talks about how important EKG's can still fall through the cracks at times and people will still point the blame all the way back to the EKG techIt's important to make sure you do your job well and then realize some things are out of your handsCheyenne talks about an experience she had with an end-of-life patient she cared forEven being just peripherally involved in a patient's care can really affect you emotionallyAvoiding burnout:Cheyenne likes to go to the gym or hang out at home with her dogsSean talks about how he avoids burnout doing a job that can sometimes be repetitiveSean also talks about the importance of calmness in front of patients, even when an EKG might be alarmingDon't sweat the small things, especially in the ED, everyone is under a lot of stress, and you can't allow a small comment from a stressed-out coworker to get under your skin and make you spiral Sean talks about some methods to reassure patients despite not being able to diagnose their EKG We talk about the importance of stress management in the ED so that you can think clearly about the next patientIt is not your emergency, we must be the calm in the stormSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

BIO:Ed Harrold is an author, inspirational leader, public speaker, coach and educator. Ed's mastery in the science of mindful breathing blends the fields of neuroscience and the wisdom of contemplative traditions into effective strategies to improve health, well-being and performance.   Ed is the author of Life With Breath IQ + EQ = NEW YOU & BodyMindBusiness: The Business Of BE'ing Within.Ed's Breath AS Medicine Trainings offer Continuing Education in the healthcare, health & wellness, fitness, allied health and sleep medicine communities.  His trainings were also a CME course with George Washington University School of Medicine & Health Sciences.  Ed's breathwork was studied by the Harvard Medical Research team with IEL.  Ed is the Breath Expert for Goldie Hawn's MindUP organization. Ed is a Breath Master on The Breath Source breathwork app (Android & IOS).  Learn more about Ed at www.edharrold.com SHOWNOTES:

Rosebud Restaurant Group is staging a renaissance. Crain's reporter Ally Marotti talks with host Amy Guth about the group's revival and a possible second act for Greektown.Plus: Trump signals Chicago's next up for D.C.-style National Guard deployment, developers reveal new Foundry Park details at former Lincoln Yards site, Northwestern and fired coach Pat Fitzgerald reach settlement, CME pushes the boundaries of retail trading with FanDuel bet and Navy Pier seeks ideas to revamp eastern end.

Featuring perspectives from Dr Stephen V Liu and Dr Charles Rudin, including the following topics:  Introduction (0:00) Case 1: Adjuvant Systemic Therapy? (1:15) Case 2: Lambert-Eaton Syndrome and Other Paraneoplastic Syndromes (4:16) Case 3: Small Cell Transformation of EGFR-Mutant Non-Small Cell Lung Cancer (9:54) Case 4: Trilaciclib in Extensive-Stage Disease (13:50) Comments: ASCO and Other Recent Datasets (18:05) Case 5: Short Disease-Free-Interval with Brain Metastases After Chemoradiation Therapy/Durvalumab … Lurbinectedin? (39:34) Case 6: Tarlatamab After Rapid Disease Progression on Chemotherapy/Atezolizumab (44:33) Case 7: Immune Effector Cell-Associated Neurotoxicity Syndrome on Tarlatamab with Brain Metastases (48:54) Case 8: Bispecific T-Cell Engager with Lurbinectedin on Protocol (56:38) CME information and select publications

Dr Stephen V Liu from Georgetown University Hospital in Washington, DC and Dr Charles Rudin from Memorial Sloan Kettering Cancer Center in New York discuss the role of approved and novel investigational therapies for patients with limited-stage and extensive-stage small cell lung cancer. CME information and select publications here.

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.0:00 Crop Tour Update4:21 CME / Fanduel Casino7:32 Russia Wheat Update10:21 Cattle Surge Again12:14 Fed Minutes13:59 Ethanol Production14:46 Flash Sale

In this episode of The PA Is In, Tracy Bingaman breaks down six surprising and game-changing features of Sermo, a clinician-only community designed specifically for APPs (PAs and NPs). From building real connections across the globe, to earning thousands through surveys, to engaging in raw and validating discussions with peers—you'll hear exactly how Sermo is offering more than just another networking app. Tune in to find out how it supports collaboration, connection, learning, and even cash flow for busy clinicians like you.JOIN SERMO & EARN $20 https://app.sermo.com:443/?sermoref=39d97a2c-f699-4f8b-b2f9-1eb131e18c75&utm_campaign=tell-a-friend SPONSORS

In July, the Centers for Medicare and Medicaid (CMS) proposed catastrophic changes to Medicare reimbursement systems that, if finalized, will significantly affect ophthalmology and all specialty care. The impact on cataract surgery reimbursements alone would amount to an 11% reduction in payment. In today's episode, host Dr. Andrew Pouw welcomes three guests to discuss these highly complex and concerning cuts: Dr. John McAllister, the Academy's Secretary for Federal Affairs; Brandy Keys, the Academy's Director of Health Policy; and Rebecca Hyder, the Academy's Vice President of Government Affairs. Listen, share, and advocate to help us prevent these changes. Related Academy Resources: Summary of CMS Medicare Physician Fee Schedule Impact of the Efficiency Adjustment Impact to Indirect Practice Expense (PE) For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Welcome to the Oncology Brothers podcast! In this episode, we kick off a three-part CME series focused on small cell lung cancer (SCLC). Joined by Dr. Hossein Borghaei, Chief of Thoracic Oncology at the Fox Chase Cancer Center. Together they dived into the evolving treatment landscape for SCLC, highlighting recent advancements and data from ASCO 2025. Episode Highlights: •⁠  ⁠Overview of the current standard of care for limited and extensive-stage SCLC. •⁠  ⁠Discussion on the role of concurrent chemoradiation therapy and the new standard of care involving immunotherapy. •⁠  ⁠Insights into the use of lurbinectedin in maintenance therapy and its impact on overall survival. •⁠  ⁠Exploration of the promising results from the DeLLphi study on tarlatamab, a bispecific antibody, and its implications for treatment. •⁠  ⁠The importance of patient selection and managing side effects in treatment decisions. Join us as we navigate the complexities of SCLC treatment and look forward to future advancements that may improve patient outcomes. Accreditation/Credit Designation Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Physicians' Education Resource®, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Acknowledgment of Commercial Support This activity is supported by an educational grant from Jazz Pharmaceuticals, Inc. Link to gain CME credits from this activity: https://www.gotoper.com/courses/breaking-down-the-latest-clinical-data-for-first-line-maintenance-and-rr-sclc  Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ #OncologyBrothers #SmallCellLungCancer #CME #ASCO2025 #LungCancer #Immunotherapy #CancerTreatment

Chuck Zodda and Paul Lane discuss which entity is more important to the stock market, the Fed of Nvidia. America's housing crisis is a job for congress. Some retirees are too frugal. CME teams with Fanduel to launch betting on financial markets. Landline phones are making a comeback, thanks to kids.

In this episode, Tom Varghese, MD, FACS, is joined by Timothy Pawlik, MD, FACS, from The Ohio State University. They discuss Dr Pawlik's recent article, “Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost,” in which the authors found that discharge against medical advice (DAMA) among surgical patients is associated with increased 30-day readmission, complication, fragmented care, and higher healthcare cost. DAMA patients were younger, socioeconomically vulnerable, and often had substance use or psychiatric disorders.     Disclosure Information: Drs Varghese and Pawlik have nothing to disclose.    To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.    #JACSOperativeWord 

Sam speaks with Catherine Sweeney, PA-C, CCD, about bone health. In part 1, we reshare an earlier conversation, and in Part 2, she'll talk to us about updates for 2025 including some new treatments. Join us at "Ortho on the Strip" for a conference entirely dedicated to APPs in orthopaedics. More at PAOS.org/CME!

Featuring an interview with Dr Shannon N Westin, including the following topics: Biomarker testing and utility in ovarian cancer (OC) (0:00) Selection of a PARP inhibitor for the treatment of OC (9:18) Addition of immunotherapy to up-front treatment of OC (15:50) Utility of minimal residual disease and circulating tumor DNA assays in OC (17:10) Selection of treatment for recurrent OC (21:46) Clinical decision-making involved with PARP inhibitors for endometrial cancer (EC) (28:22) Adjuvant therapy for EC (32:28) Utility of lenvatinib/pembrolizumab in EC (35:08) Clinical findings supporting the potential use of selinexor for EC (39:42) Key findings involving trastuzumab deruxtecan (T-DXd) for HER2-positive gynecologic cancers (43:22) Management of adverse effects associated with T-DXd (49:49) CME information and select publications

Multiple system atrophy is a rare, sporadic, adult-onset, progressive, and fatal neurodegenerative disease. Accurate and early diagnosis remains challenging because it presents with a variable combination of symptoms across the autonomic, extrapyramidal, cerebellar, and pyramidal systems. Advances in brain imaging, molecular biomarker research, and efforts to develop disease-modifying agents have shown promise to improve diagnosis and treatment. In this episode, Casey Albin, MD speaks with Tao Xie, MD, PhD, author of the article “Multiple System Atrophy” in the Continuum® August 2025 Movement Disorders 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. Xie is director of the Movement Disorder Program, chief of the Neurodegenerative Disease Section in the department of neurology at the University of Chicago Medicine in Chicago, Illinois. Additional Resources Read the article: Multiple System Atrophy 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 Full episode transcript available here 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 everyone, this is Dr Casey Albin. Today I'm interviewing Dr Tao Xie about his article on diagnosis and management of multiple system atrophy, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, and please introduce yourself to our audience. Dr Xie: Thank you so much, Dr Albin. My name is Tao Xie, and sometimes people also call me Tao Z. I'm a mood disorder neurologist, professor of neurology at the University of Chicago. I'm also in charge of the mood disorder program here, and I'm the section chief in the neurodegenerative disease in the Department of Neurology at the University of Chicago Medicine. Thank you for having me, Dr Albin and Dr Okun and the American Academy of Neurology. This is a great honor and pleasure to be involved in this education session. Dr Albin: We are delighted to have you, and thank you so much for the thoughtful approach to the diagnosis and management. I really want to encourage our listeners to check out this article. You know, one of the things that you emphasize is multiple system atrophy is a fairly rare condition. And I suspect that clinicians and trainees who even have a fair amount of exposure to movement disorders may not have encountered that many cases. And so, I was hoping that you could just start us off and walk us through what defines multiple system atrophy, and then maybe a little bit about how it's different from some of the more commonly encountered movement disorders. Dr Xie: This is a really good question, Dr Albin. Indeed, MSA---multisystem atrophy----is a rare disease. It is sporadic, adult-onset, progressive, fatal neurodegenerative disease. By the name MSA, multisystem atrophy. Clinically, it will present with multiple symptoms and signs involving multiple systems, including symptoms of autonomic dysfunction and symptoms of parkinsonism, which is polyresponsive to the levodopa treatment; and the symptom of cerebellar ataxia, and symptom of spasticity and other motor and nonmotor symptoms. And you may be wondering, what is the cause- underlying cause of these symptoms? Anatomically, we can find the area in the basal ganglia striatonigral system, particularly in the putamen and also in the cerebellar pontine inferior, all of the nuclear area and the specific area involved in the autonomic system in the brain stem and spinal cord: all become smaller. We call it atrophy. Because of the atrophy in this area, they are responsible for the symptom of parkinsonism if it is involved in the putamen and the cerebral ataxia, if it's involved in the pons and cerebral peduncle and the cerebellum. And all other area, if it's involved in the autonomic system can cause autonomic symptoms as well. So that's why we call it multisystem atrophy. And then what's the underlying cellular and subcellular pathological, a hallmark that is in fact caused by misfolded alpha-synuclein aggregate in the oligodontia site known as GCI---glial cytoplasmic increasing bodies---in the cells, and sometimes it can also be found in the neuronal cell as well in those areas, as mentioned, which causes the symptom. But clinically, the patient may not present all the symptoms at the same time. So, based on the predominant clinical symptom, if it's mainly levodopa, polyresponsive parkinsonism, then we call it MSAP. If it's mainly cerebellar ataxia, then we call it MSAC. But whether we call it MSP or MSC, they all got to have autonomic dysfunction. And also as the disease progresses, they can also present both phenotypes together. We call that mixed cerebellar ataxia and parkinsonism in the advanced stage of the disease. So, it is really a complicated disease. The complexity and the similarity to other mood disorders, including parkinsonism and the cerebellar ataxia, make it really difficult sometimes, particularly at the early stages of disease, to differentiate one from the other. So, that was challenging not only for other professionals, general neurologists and even for some movement disorder specialists, that could be difficult particularly if you aim to make an accurate and early diagnosis. Dr Albin: Absolutely. That is such a wealth of knowledge here. And I'm going to distill it just a little bit just to make sure that I understand this right. There is alpha-synuclein depositions, and it's really more widespread than one would see maybe in just Parkinson's disease. And with this, you are having patients present with maybe one of two subtypes of their clinical manifestations, either with a Parkinson's-predominant movement disorder pattern or a cerebellar ataxia type movement disorder pattern. Or maybe even mixed, which really, you know, we have to make things quite complicated, but they are all unified and having this shared importance of autonomic features to the diagnosis. Have I got that all sort of correct? Dr Xie: Correct. You really summarize well. Dr Albin: Fantastic. I mean, this is quite a complicated disease. I would pose to you sort of a case, and I imagine this is quite common to what you see in your clinic. And let's say, you know, a seventy-year-old woman comes to your clinic because she has had rigidity and poor balance. And she's had several falls already, almost always from ground level. And her family tells you she's quite woozy whenever she gets up from the chair and she tends to kind of fall over. But they noticed that she's been stiff,and they've actually brought her to their primary care doctor and he thought that she had Parkinson's disease. So, she started levodopa, but they're coming to you because they think that she probably needs a higher dose. It's just not working out very well for her. So how would you sort of take that history and sort of comb through some of the features that might make you more concerned that the patient actually has undiagnosed multiple systems atrophy? Dr Xie: This is a great case, because we oftentimes can encounter similar cases like this in the clinic. First of all, based on the history you described, it sounds like an atypical parkinsonism based on the slowness, rigidity, stiffness; and particularly the early onset of falls, which is very unusual for typical Parkinson disease. It occurs too early. If its loss of balance, postural instability, and fall occurred within three years of disease onset---usually the motor symptom onset---then it raises a red flag to suspect this must be some atypical Parkinson disorders, including multiple system atrophy. Particularly, pou also mentioned that the patient is poorly responsive to their levodopa therapy, which is very unusual because for Parkinson disease, idiopathic Parkinson disease, we typically expect patients would have a great response to the levodopa, particularly in the first 5 to 7 years. So to put it all together, this could be atypical parkinsonism, and I could not rule out the possibility of MSA. Then I need to check more about other symptoms including autonomic dysfunction, such as orthostatic hypertension, which is a blood pressure drop when the patient stands up from a lying-down position, or other autonomic dysfunctions such as urinary incontinence or severe urinary retention. So, in the meantime, I also have to put the other atypical Parkinson disorder on the differential diagnosis, such as PSP---progressive supranuclear palsy---and the DLBD---dementia with Lewy body disease.---Bear this in mind. So, I want to get more history and more thorough bedside assessment to rule in or rule out my diagnosis and differential diagnosis. Dr Albin: That's super helpful. So, looking for early falls, the prominence of autonomic dysfunction, and then that poor levodopa responsiveness while continuing to sort of keep a very broad differential diagnosis? Dr Xie: Correct. Dr Albin: One of the things that I just have to ask, because I so taken by this, is that you say in the article that some of these patients actually have preservation of smell. In medical school, we always learn that our Parkinson's disease patients kind of had that early loss of smell. Do you find that to be clinically relevant? Is that- does that anecdotally help? Dr Xie: This is a very interesting point because we know that the loss of smelling function is a risk effect, a prodromal effect, for the future development of Parkinson disease. But it is not the case for MSA. Strange enough, based on the literature and the studies, it is not common for the patient with MSA to present with anosmia. Some of the patients may have mild to moderate hyposmia, but not to the degree of anosmia. So, this is why even in the more recent diagnosis criteria, the MDS criteria published 2022, it even put the presence of anosmia in the exclusion criteria. So, highlight the importance of the smell function, which is well-preserved for the majority in MSA, into that category. So, this is a really interesting point and very important for us, particularly clinicians, to know the difference in the hyposmia, anosmia between the- we call it the PD, and the dementia Lewy bodies versus MSA. Dr Albin: Fascinating. And just such a cool little tidbit to take with us. So, the family, you know, you're talking to them and they say, oh yes, she has had several fainting episodes and we keep taking her to the primary care doctor because she's had urinary incontinence, and they thought maybe she had urinary tract infections. We've been dealing with that. And you're sort of thinking, hm, this is all kind of coming together, but I imagine it is still quite difficult to make this diagnosis based on history and physical alone. Walk our listeners through sort of how you're using MRI and DAT scan and maybe even some other biomarkers to help sort of solidify that diagnosis. Dr Xie: Yeah, that's a wonderful question. Yeah. First of all, UTI is very common for patients with MSA because of urinary retention, which puts them into a high risk of developing frequent UTI. That, for some patients, could be the very initial presentation of symptoms. In this case, if we check, we say UTI is not present or UTI is present but we treat it, then we check the blood pressure and we do find also hypertension---according to new diagnosis criteria, starting drop is 20mm mercury, but that's- the blood pressure drop is ten within three minutes. And also, in the meantime the patients present persistent urinary incontinence even after UTI was treated. And then the suspicion for MS is really high right at this point. But if you want increased certainty and a comfortable level on your diagnosis, then we also need to look at the brain MRI mark. This is a required according to the most recent MDS diagnosis criteria. The presence of the MRI marker typical for MSA is needed for the diagnosis of clinically established MSA, which holds the highest specificity in the clinical diagnosis. So then, we have- we're back to your question. We do need to look at the brain MRI to see whether evidence suggestive of atrophy around the putamen area, around the cerebellar pontine inferior olive area, is present or not. Dr Albin: Absolutely. That's super helpful. And I think clinicians will really take that to sort of helping to build a case and maybe recognizing some of this atypical Parkinson's disease as a different disease entity. Are there any other biomarkers in the pipeline that you're excited about that may give us even more clarity on this diagnosis? Dr Xie: Oh, yeah. This is a very exciting area. In terms of biomarker for the brain imaging, particularly brain MRI, in fact, today there's a landmark paper just published in the Java Neurology using AI, artificial intelligence or machine learning aid, diagnoses a patient with parkinsonism including Parkinson's disease, MSA, and PSP, with very high diagnostic accuracy ranging from 96% to 98%. And some of the cases even were standard for autopsy, with pathological verification at a very high accurate rate of 93.9%. This is quite amazing and can really open new diagnosis tools for us to diagnose this difficult disease; not only in an area with a bunch of mood disorder experts, but also in the rural area, in the area really in need of mood disorder experts. They can provide tremendous help to provide accurate, early diagnosis. Dr Albin: That's fantastic and I love that, increasing the access to this accurate diagnosis. What can't artificial intelligence do for us? That's just incredible. Dr Xie: And also, you know, this is just one example of how the brain biomarker can help us. Theres other---a fluid biomarker, molecular diagnostic tools, is also available. Just to give you an example, one thing we know over the past couple years is skin biopsy. Through the immunofluorescent reaction, we can detect whether the hallmark of abnormally folded, misfolded, and the phosphorate, the alpha-synuclein aggregate can be found just by this little pinch of skin biopsy. Even more advanced, there's another diagnosis tool we call the SAA, we call the seizure amplification assay, that can even help us to differentiate MSA from other alpha-synucleinopathy, including Parkinson disease and dementia with Lewy bodies. If we get a little sample from CSF, spinal cerebral fluids, even though this is probably still at the early stage, a lot of developments still ongoing, but this, this really shows you how exciting this area is now. We're really in a fast forward-moving path now. Dr Albin: It's really incredible. So, lots coming down the track in, sort of, MRI, but also with CSF diagnosis and skin biopsies. Really hoping that we can hone in some of those tools as they become more and more validated to make this diagnosis. Is that right? Dr Xie: Correct. Dr Albin: Amazing. We can talk all day about how you manage these in the clinic, and I really am going to direct our listeners to go and read your fantastic article, because you do such an elegant job talking about how this takes place in a multidisciplinary setting, if at all possible. But as a neurointensivist, I was telling you, we have so much trouble in the hospital. We have A-lines, and we have the ability to get rapid KUBs to look at Ilias, and we can have many people as lots of diagnosis, and we still have a lot of trouble treating autonomiclike symptoms. Really, really difficult. And so, I just wanted to kind of pick your brain, and I'll start with just the one of orthostatic hypotension. What are some of the tips that you have for, you know, clinicians that are dealing with this? Because I imagine that this is quite difficult to do without patients. Dr Xie: Exactly. This is indeed a very difficult symptom to deal with, particularly at an outpatient setting. But nowadays with the availability of more medication---to give an example, to treat patients with orthostatic hypertension, we have not only midodrine for the cortisol, we also have droxidopa and several others as well. And so, we have more tools at hand to treat the patient with orthostatic hypertension. But I think the key thing here, particularly for us to the patient at the outpatient setting: we need to educate the patient's family well about the natural history of the disease course. And we also need to tell them what's the indication and the potential side effect profile of any medication we prescribe to them so that they can understand what to expect and what to watch for. And in the meantime, we also need to keep really effective and timely communication channels, make sure that the treating physician and our team can be reached at any time when the patient and family need us so that we can be closely monitoring, their response, and also monitoring potential side effects as well to keep up the quality of care in that way. Dr Albin: Yeah, I imagine that that open communication plays a huge role in just making sure that patients are adapting to their symptoms, understanding that they can reach out if they have refractory symptoms, and that- I imagine this takes a lot of fine tuning over time. Dr Xie: Correct. Dr Albin: Well, this has just been such a delight to get to talk to you. I really feel like we could dive even deeper, but I know for the sake of time we have to kind of close out. Are there any final points that you wanted to share with our listeners before we end the interview? Dr Xie: I think for the patients, I want them to know that nowadays with advances in science and technology, particularly given a sample of rapid development in the diagnostic tools and the multidisciplinary and multisystemic approach to treatment, nowadays we can make an early and accurate diagnosis of the MSA, and also, we can provide better treatment. Even though so far it is still symptomatically, mainly, but in the near future we hope we can also discover disease-modifying treatment which can slow down, even pause or prevent the disease from happening. And for the treating physician and care team professionals, I just want them to know that you can make a difference and greatly help the patient and the family through your dedicated care and also through your active learning and innovative research. You can make a difference. Dr Albin: That's amazing and lots of hope for these patients. Right now, you can provide really great care to take care of them, make an early and accurate diagnosis; but on the horizon, there are really several things that are going to move the field forward, which is just so exciting. Again today, I've been really greatly honored and privileged to be able to talk to Dr Tao Xie about his article on diagnosis and management of multiple system atrophy, which appears in the August 2025 Continuum issue on movement disorders. Be sure to check out Continuum Audio episodes for this and other issues. And thank you again to our listeners for joining us today. Dr Xie: Thank you so much for having me. 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.

This episode is sponsored by: My Financial CoachYou trained to save lives—who's helping you save your financial future? My Financial Coach connects physicians with CFP® Professionals who specialize in your complex needs. Whether it's crushing student loans, optimizing investments, or planning for retirement, you'll get a personalized strategy built around your goals. Save for a vacation home, fund your child's education, or prepare for life's surprises—with unbiased, advice-only planning through a flat monthly fee. No commissions. No conflicts. Just clarity.Visit myfinancialcoach.com/physiciansguidetodoctoring to meet your financial coach and find out if concierge planning is right for you.———————In this episode, Dr. Bradley Block  welcomes Dr. Michael  Hersh, to explore the common challenge of career stagnation in medicine. After years of routine patient care, Dr.  Hersh found himself questioning, “Is this it?” Through coaching, he rediscovered joy by embracing new ventures like podcasting and coaching other physicians. He discusses strategies to combat burnout, including learning new skills, setting firm boundaries, and practicing self-compassion to balance work and family life. As host of Better Physician Life: How to Get Unstuck in Your Medical Career, Dr.  Hersh offers practical tools to help physicians redefine success, stay present, and find fulfillment. This episode is a must-listen for doctors feeling stuck and seeking renewed purpose.Three Actionable Takeaways:Embrace New Challenges – Combat stagnation by learning something new, like a hobby, side project, or podcasting, to reignite the joy of growth and keep your career dynamic.Set Firm Boundaries – Establish clear work-life boundaries, like reserving family time or managing EMR tasks strategically, to reduce stress and enhance presence at home.Practice Self-Compassion – Forgive yourself for missing occasional events (e.g., a child's concert) by focusing on your consistent presence, ensuring balance without guilt.About the ShowSucceed In Medicine  covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the GuestDr. Michael Hersh is a full-time gastroenterologist, physician coach, and host of Better Physician Life: How to Get Unstuck in Your Medical Career on the Doctor Podcast Network. With over 16 years in practice, he helps physicians overcome burnout, set meaningful goals, and achieve work-life balance through his coaching practice, Better Physician Life Coaching. Dr. Hersh's journey from career stagnation to renewed purpose inspires doctors to rethink success and embrace new opportunities.Website: betterphysicianlife.comPodcast: Better Physician Life: How to Get Unstuck in Your Medical CareerLinkedIn: https://www.linkedin.com/in/michael-hersh-mdInstagram: https://www.instagram.com/betterphysicianlifeAbout the hostDr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts The Succeed In Medicine  podcast, focusing on personal and professional development for physiciansWant to be a guest?Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter   This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance.

Markets correspondent Kristina Partsinevelos kicks off today's show with key market themes, followed by Rick Santelli on bond market movements from the CME. Charles Bobrinsky, Vice Chairman and Head of Investment Group at Ariel Investments, and Tim Urbanowicz from Innovator ETFs break down the latest market action.We preview Target earnings with Zihahn Ma from Bernstein. In a major autonomous vehicle development, Applied Intuition Co-Founder & CEO Qasar Younis joins us to discuss the company's new self-driving system launch and expansion into passenger vehicles.Plus, Angelica Peebles covers Viking Therapeutics, and Alan Ratner from Zelman & Associates analyzes Toll Brothers earnings and the broader housing market outlook. 

Dr Jacob Sands from Dana-Farber Cancer Institute in Boston, Massachusetts, discusses recent developments with TROP2-directed antibody-drug conjugates in the management of non-small cell lung cancer. CME information and select publications here.

Welcome to the show Sean and Cheyenne, EKG tech experience and scribe experienceSean talks about certifications and expectations that go beyond merely obtaining an EKG as well as the stress testing roleCheyenne talks about the role that scribes play in the EDScribing for providers is often used as a role to gain patient experience for medical school or PA schoolThey talk about how they got into scribing and EKG technician work and Sean talks about how it is also a role that is used as a steppingstone12 leads are complicated to interpret and require a lot of training and experience to get good at. They are even harder to interpret when the patient is not in front of youSTEMI's are the key EKG's to recognize because they are so time sensitive, but we don't see these frequently – it can be very helpful when the tech recognizes this and can recognize the urgencyKnowing early signs of impending problems on the 12 lead can be helpful for patient prioritization as wellBeing an EKG tech requires good resource utilization, sometimes there are not a ton of EKG techs available in the hospital, so they need to prioritize – communication is keyCommunication between roles is so important when we are trying to get quickly get imaging, labs, assessments and EKG simultaneously At the end of the day, the patient is the top priorityScribes do deal with a lot of stress, they must finish notes, write new notes and keep up with high volume, they like active communication with the providerSean talks about how a typical day can vary quite a bitSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Crypto News: BlackRock Bitcoin, Ether ETFs buy $1B as BTC price mostly fills CME gap. US Fed to end oversight program for banks' crypto activities. Wellgistics debuts XRP payments for independent US pharmacies. Show Sponsor -

Featuring an interview with Dr Jacob Sands, including the following topics: TROPION-Lung05 Trial: Datopotamab Deruxtecan for Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) with Actionable Genomic Alterations (0:00) Sands J et al. Datopotamab deruxtecan in advanced or metastatic non-small cell lung cancer with actionable genomic alterations: Results from the phase II TROPION-Lung05 study. J Clin Oncol 2025;43(10):1254-65. Abstract Phase III Randomized Clinical Trial Data with TROP2-Targeting Antibody-Drug Conjugates for Previously Treated Advanced NSCLC (6:52) Ahn M-J et al. Datopotamab deruxtecan versus docetaxel for previously treated advanced or metastatic non-small cell lung cancer: The randomized, open-label phase III TROPION-Lung01 study. J Clin Oncol 2025;43(3):260-72. Abstract Reinmuth N et al. Longer follow-up for survival and safety from the EVOKE-01 trial of sacituzumab govitecan (SG) vs docetaxel in patients (pts) with metastatic non-small cell lung cancer (mNSCLC). ASCO 2025;Abstract 8599. Paz-Ares LG et al. Sacituzumab govitecan (SG) vs docetaxel (doc) in patients (pts) with metastatic non-small cell lung cancer (mNSCLC) previously treated with platinum (PT)-based chemotherapy (chemo) and PD(L)-1 inhibitors (IO): Primary results from the phase 3 EVOKE-01 study. ASCO 2024;Abstract LBA8500. Evaluating TROP2 Expression Levels Through Normalized Membrane Ratio of TROP2 in the TROPION-Lung01 Trial (12:26) Garassino MC et al. Normalized membrane ratio of TROP2 by quantitative continuous scoring is predictive of clinical outcomes in TROPION-Lung01. WCLC 2024;Abstract PL02.11. CME information and select publications

BEEF: The summer beef rally isn't slowing down – low production and high demand are keeping prices on the move. Middle meats, chucks, rounds, and grinds are all climbing, setting us up for a pricey Labor Day BBQ. Will the market cool after the holiday, or will tight cattle supplies keep the heat on?POULTRY: Production is running 1% ahead of last year, with demand staying strong as chicken remains the go-to alternative to high beef prices. Wings are steady for now, but will football season send them higher? Six weeks with no new Avian Flu cases – let's keep it going.GRAINS: Corn prices remain under $4 with a record U.S. harvest on the horizon – great for feeders, rough for farmers. But with soy inching up on palm oil tariffs and wheat holding steady, could this calm market be setting the stage for a surprise turn?PORK: Bellies cracked the $200 mark before slipping back – still riding high for now. But with just a few more weeks of seasonal strength left, will the fall bring the big break buyers have been waiting for?DAIRY: Cheese keeps climbing – barrel up 6, block up 4 – but butter's the rebel, dropping 11 points. With baking season buying about to kick off, is the clock ticking on those lower butter prices?Savalfoods.com | Find us on Social Media: Instagram, Facebook, YouTube, Twitter, LinkedIn

Lisa (Elizabeth) Joyce Freeman serves as a Senior Advisor in the School of Medicine at Stanford University. She administratively supports the Stanford Medicine Center for Improvement. The goal of the Stanford Medicine Center for Improvement is to become the best at getting better Inspiring and accelerating the delivery of consistent, excellent care across Stanford Medicine measured by performance improvement in Safety, Quality, Patient Experience, and Cost Reduction (Collectively=Value) from today's baseline and ultimately developing a reputation as a national leader, to which others look for inspiration and as an educational resource. From 2001 through 2016, she was the Chief Executive Officer of the VA Palo Alto Health Care System (VAPAHCS). VAPAHCS is a $900M, 800 - bed federal health care system with three inpatient divisions and seven outpatient clinics serving 90,000 Veterans in 10 counties in Northern California. It is affiliated with Stanford University School of Medicine, has the second-largest research enterprise in VA ($58M), trains 1500 residents, internsand students yearly and is home to every specialized Veteran treatment modality offered in the VA system. She was responsible for all administrative and clinical aspects of VA Palo Alto, including strategy and master planning for facilities. She has a Bachelor of Science degree from the University of Notre Dame in Civil Engineering and a Master of Business Administration degree from Louisiana Tech University. She is a licensed professional engineer and a Fellow in the American College of Health Care Executives. She is the recipient of two Presidential Rank Awards, one at the meritorious level and the second at the distinguished level.Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3CME credit is available for up to 3 years after the stated release dateContact CEOD@bmhcc.org if you have any questions about claiming credit.

PrEP. For most patients, that's a simple drug regimen that can be prescribed after a negative HIV screen. Safe. Effective. Proactive protection to stop the spread of HIV infection in MSM, cisgender, and transgender individuals.Post-test for CME credits: https://elit.dkbmed.com/issues/228/test Hosted on Acast. See acast.com/privacy for more information.

Essential tremor is the most common movement disorder, although it is often misdiagnosed. A careful history and clinical examination for other neurologic findings, such as bradykinesia, dystonia, or evidence of peripheral neuropathy, can reveal potential alternative etiologies. Knowledge about epidemiology and associated health outcomes is important for counseling and monitoring for physical impairment and disability. In this episode, Lyell Jones, MD, FAAN, speaks with Ludy C. Shih, MD, MMSc, FAAN, author of the article “Essential Tremor” in the Continuum® August 2025 Movement Disorders issue. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Shih is clinical director of the Parkinson's Disease and Movement Disorders Center at Beth Israel Deaconess Medical Center in Boston, Massachusetts. Additional Resources Read the article: Essential Tremor 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: @LyellJ Guest: @ludyshihmd Full episode transcript available here 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 Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr Ludy Shih, who recently authored an article on essential tremor for our latest issue of Continuum on movement disorders. Dr Shih is an associate professor of neurology at Harvard Medical School and the clinical director of the Parkinson's Disease and Movement Disorder Center at Beth Israel Deaconess Medical Center in Boston. Dr Shih, welcome, and thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Shih: Thank you, Dr Jones, for having me. It's a real pleasure to be here on the podcast with you. I'm a neurologist, I trained in movement disorders fellowship, and I currently see patients and conduct clinical research. We offer a variety of treatments and diagnostic tests for our patients with movement disorders. And I have developed this interest, a clinical research interest in essential tremor. Dr Jones: And so, as an expert in essential tremor, the perfect person to write such a really spectacular article. And I can't wait for our listeners to hear more about it and our subscribers to read it. And let's get right to it. If you had, Dr Shih, a single most important message for our listeners about caring for patients with essential tremor, what would that message be? Dr Shih: Yeah, I think the takeaway that I've learned over the years is that people with essential tremor do develop quite a few other symptoms. And although we propose that essential tremor is this pure tremor disorder, they can experience a lot of different comorbidities. Now, there is some debate as to whether that is expected for essential tremor or is this some part of another syndrome, which we may talk about later in the interview. But the fact of the matter is, it's not a benign condition and people do experience some disability from it. Dr Jones: And I think that speaks to how the name of this disorder has evolved over time. right? You point out in your article, it used to be called benign essential tremor or benign familial tremor. But it's really not so straightforward as it. And fairly frequently these symptoms, the patient's tremor, can be functionally limiting, correct? Dr Shih: That is correct. In fact, the reason I probably started getting interested in essential tremor was because our center had been doing a lot of deep brain stimulation for essential tremor, which is remarkably effective, especially for tremor that reaches an amplitude that really no oral medication is going to satisfyingly treat. And if you have enough upper limb disability from this very large-amplitude tremor, a surgical option may make a lot of sense for a lot of patients. And yet, how did they get to that point? Do they continue to progress? These were the sort of interesting questions that got raised in my mind as I started to treat these folks. Dr Jones: We'll come back to treatment in just a minute here, because there are many options, and it sounds like the options are expanding. To start with the diagnosis- I mean, this is an extraordinarily common disorder. As you point out, it is the most common movement disorder in the US and maybe the world, and yet it seems to be underrecognized and frequently misdiagnosed. Why do you think that is? Dr Shih: Great question. It's been pretty consistent, with several case series over the decades showing a fairly high rate of quote/unquote “misdiagnosis.” And I think it speaks to two things, probably. One is that once someone sees a postural and kinetic tremor of the arms, immediately they think of essential tremor because it is quite common. But there's a whole host of things that it could actually be. And the biggest one that we also have to factor in is also the heterogeneity of the presentation of Parkinson's disease. Many people, and I think increasingly now these days, can present with not a whole lot of the other symptoms, but may present with an atypical tremor. And it becomes actually a little hard to sort out, well, do they have enough of these other symptoms for me to suspect Parkinson's, or is the nature of their tremor suspicious enough that it would just be so unusual that this stays essential tremor and doesn't eventually develop into Parkinson's disease? And I think those are the questions that we all still grapple with from time to time in some of our clinics. Dr Jones: Probably some other things related to it with, you know, our understanding of the pathophysiology and the availability of tests. And I do want to come back to those questions here in just a minute, but, you know, just the nomenclature of this disorder… I think our clinical listeners are familiar with our tendency in medicine to use words like essential or idiopathic to describe disorders or phenomena where we don't understand the precise underlying mechanism. When I'm working with our trainees, I call these “job-security terms” because it sounds less humbling than “you have a tremor and we don't know what causes it,” right? So, your article does a really nice job outlining the absence of a clear monogenic or Mendelian mechanism for essential tremor. Do you think we'll ever have a eureka moment in neurology for this disorder and maybe give it a different name? Dr Shih: It's a great question. I think as we're learning with a lot of our neurologic diseases---and including, I would even say, Parkinson's disease, to which ET gets compared to a lot---there's already now so much more known complexity to something that has a very specific idea and concept in people's minds. So, I tend to think we'll still be in an area where we'll have a lot of different causes of tremor, but I'm hopeful that we'll uncover some new mechanisms for which treating or addressing that mechanism would take care of the tremor in a way that we haven't been able to make as much progress on in the last few decades as maybe we would have thought given all the advances in in technology. Dr Jones: That's very helpful, and we'll be hopeful for that series of discoveries that lead us to that point. I think many of our listeners will be familiar with the utility---and, I think, even for most insurance companies, approval---for DAT scans to discriminate between essential tremor and Parkinsonian disorders. What about lab work? Are there any other disorders that you commonly screen for in patients who you suspect may have essential tremor? Dr Shih: Yeah, it's a great question. And I think, you know, I'm always mindful that what I'm seeing in my clinic may not always be representative of what's seen in the community or out in practice. I'll give an example. You know, most of the time when people come to the academic Medical Center, they're thinking, gosh, I've tried this or that. I've been on these medicines for the last ten years. But I've had essential tremor for twenty years. We get to benefit a little bit from all that history that's been laid down. And so, it's not as likely you're going to misdiagnose it. But once in a while, you'll get someone with tremor that just started a month ago or just started, you know, 2 or 3 months ago. And you have to still be thinking, well, I've got to get out of the specialist clinic mindset, and think, well, what else really could this be? And so, while it's true for everybody, moreso in those cases, in those recent onset cases, you really got to be looking for things like medications, electrolyte abnormalities, and new-onset thyroid disorder, for example, thyroid toxicosis. Dr Jones: Very helpful. And your article has a wonderful list of the conditions to consider, including the medications that might be used for those conditions that might result or unmask a tremor of a different cause. And I think being open-minded and not anchoring on essential tremor just because it's common, I think is a is a key point here. And another feature in your article that I really enjoyed was your step-by-step approach to tremor. What are those steps? Dr Shih: Well, I think you know first of all, tremor is such common terminology that even lay people, patients, nonclinicians will use the word “tremor.” And so, it can be tempting when the notes on your schedule says referred for tremor to sort of immediately jump to that. I think the first step is, is it tremor? And that's really something that the clinician first has to decide. And I think that's a really important step. A lot of things can look superficially like tremor, and you shouldn't even assume that another clinician knows what tremor looks like as opposed to, say, myoclonus. Or for example a tremor of the mouth; well, it actually could be orolingual or orobuccal dyskinesia, as in tardive dyskinesia. And another one that tremor can look like is ataxia. And so, I think- while they sound obvious to most neurologists, perhaps, I think that---especially in the area of myoclonus, where it can be quite repetitive, quite small amplitude in some conditions---it can really resemble a tremor. And so, there are examples of these where making that first decision of whether it's a tremor or not can really be a good sort of time-out to make sure you're going down the right path to begin with. And I think what's helpful is to think about some of the clinical definitions of a tremor. And tremor is really rhythmic, it's oscillatory. You should see an agonist and antagonist muscle group moving back and forth, to and fro. And then it's involuntary. And so, I think these descriptors can really help; and to help isolate, if you can describe it in your note, you can probably be more convinced that you're dealing with the tremor. The second step that I would encourage people to really consider: you've established it's a tremor. The most important part exam now becomes, really, the nontremor part of the exam. And it should be really comprehensive to think of what else could be accompanying this, because that's really how we make diagnosis of other things besides essential tremor. There really should be a minimum of evidence of parkinsonism, dystonia, neuropathy, ataxia- and the ataxia could be either from a peripheral or central nervous system etiology. Those are the big four or five things that, you know, I'm very keen to look for and will look pretty much in the head, neck, the axial sort of musculature, as well as the limbs. And I think this is very helpful in terms of identifying cases which turn out to have either, say, well, Parkinson's or even a typical Parkinson disorder; or even a genetic disorder, maybe even something like a fragile X tremor ataxia syndrome; or even a spinal cerebellar ataxia. These cases are rare, but I think if you uncover just enough ataxia, for example, that really shouldn't be there in a person, let's say, who's younger and also doesn't have a long history of tremor; you should be more suspicious that this is not essential tremor that you're dealing with. And then the last thing is, once you've identified the tremor and you're trying to establish, well, what should be done about the tremor, you really have to say what kind of tremor it is so that you can follow it, so you can convey to other people really what the disability is coming from the tremor and how severe the tremor is. So, I think an example of this is, often in the clinic, people will have their patients extend their arms and hands and kind of say, oh, it's an essential tremor, and that's kind of the end of the exam. But it doesn't give you the flavor. Sometimes you'll have a patient come in and have a fairly minimal postural tremor, but then you go out, take those extra few seconds to go grab a cup of water or two cups of water and have them pour or drink. And now all of a sudden you see this tremor is quite large-amplitude and very disabling. Now you have a better appreciation of what you really need to do for this patient, and it might not be present with just these very simple maneuvers that you have at bedside without props and items. And then the severity of it; you know, we're so used to saying mild, moderate, severe. I think what we've done in the Tremor Research Group to use and develop the Essential Tremor Rating Assessment Scale is to get people used to trying to estimate what size the tremor is. And you can do that by taking a ruler or developing a sense of what 1 centimeter, 2 centimeters, 3 centimeters looks like. I think it'd be tremendously helpful too, it's very easy and quick to convey severity in a given patient. Dr Jones: I appreciate you, you know, having a patient-centered approach to the- how this is affecting them and being quantitative in the assessment of the tremor. And that's a great segue to a key question that I run into and I think others run into, which is when to initiate therapy? You know, if you see a patient who, let's say they have a mild tremor or, you know, something that quantitatively is on the mild end of the spectrum, and you have, you know, a series of options… from a medication perspective, you have to say, well, when does this across that threshold of being more likely to benefit the patient than to harm the patient? How do you approach that question? What's your threshold for starting medication? Dr Shih: Yeah. You know, sometimes I will ask, because---and I know this sounds like a strange question---because I feel like my patients will come for a couple of different reasons. Sometimes it's usually one over the other. I think people can get concerned about a symptom of a tremor. So, I actually will ask them, was your goal to just get a sense for what this tremor is caused by? I understand that many people who develop tremor might be concerned it might be something like Parkinson's disease. Or is this also a tremor that is bothering you in day-to-day life? And often you will hear the former. No, I just wanted to get checked out and make sure you don't think it's Parkinson's. It doesn't bother me enough that I want to take medication. They're quite happy with that. And then the second scenario is more the, yeah, no, it bothers me and it's embarrassing. And that's a very common answer you may hear, may be embarrassing, people are noticing. It's funny in that many people with essential tremor don't come to see a doctor or even the neurologist for many years. And they will put up with it for a very long time. And they've adopted all sorts of compensatory strategies, and they've just been able to handle themselves very admirably with this, in some cases, very severe tremor. So, for some of them, it'll take a lot to come to the doctor, and then it becomes clear. They said, I think I'm at the point where I need to do something about this tremor. And so, I think those three buckets are often sort of where my patients fall into. And I think asking them directly will give you a sense of that. But you know, it can be a nice time to try some as-needed doses of something like Propranolol, or if it's something that you know that they're going to need something on day-to-day to get control of the tremor over time, there are other options for that as well. Dr Jones: Seems like a perfect scenario for shared decision-making. Is it bothersome enough to the patient to try the therapy? And I like that suggestion. That's a nice pearl that you could start with an a- needed beta blocker, right, with Propranolol. And this is a question that I think many of us struggle with as well. If you've followed a patient with essential tremor for some time and you've tried different medications and they've either lost effectiveness or have intolerable adverse effects, what is your threshold for referring a patient for at least considering a surgical neurostimulator therapy for their essential tremor? Dr Shih: Yeah, so surgical therapies for tremor have been around for a long time now, since 1997, which was when it was approved by the FDA for essential tremor and Parkinson tremor. And then obviously since then, we have a couple more options in the focus ultrasound thalamotomy, which is a lesioning technique. When you have been on several tremor medications, the list gets smaller and smaller. It- and then chance of likely satisfying benefit from some of these medications can be small and small as you pass through the first and second line agents and these would be the Propranolol and the primidone. And as you say, quite a few patients- it's estimated between 30 to 50% of these patients end up not tolerating these first two medications and end up discontinuing them. Some portion of that might also be due to the fact that some of our patients who have been living with essential tremor for decades now, to the point that their tremor is getting worse, are also getting older. And so, polypharmacy and/or some of the potential side effects of beta blockers and anticonvulsants like primidone may be harder to bear in an older adult. And then as you talk about in the article, there's some level of evidence for topiramate, and then from there a number of anticonvulsants or benzos, which have even weaker evidence for them. It's a personal decision. As I tell folks, look, this is not going to likely extend your life or save your life, but it's a quality of life issue. And of course, if there are other things going on in life that need to be taken care of and they need that kind of care and attention, then, you know, you don't need to be adding this to your plate. But if you are in the position where those other things are actually okay, but quality of life is really affected by your being unable to use your upper limbs in the way that you would like to… A lot of people's hobbies and applications are upper limb-based, and enjoying those things is really important. Then I think that this is something- a conversation that we begin and we begin by talking about yes, there are some risks involved, but fortunately this is the data we have on it, which is a fairly extensive experience in terms of this is the risk of, you know, surgery-related side effects. This is the risk of if you're having stimulation from DBS stimulation-related side effects, which can be adjustable. It's interesting, I was talking with colleagues, you know, after focused ultrasound thalamotomy was approved. That really led more people to come to the clinic and start having these discussions, because that seemed like a very the different sort of approach where hardware wasn't needed, but it was still a surgery. And so, it began that conversation again for a bunch of people to say, you know, what could I do? What could I tolerate? What would I accept in terms of risk and potential benefit? Dr Jones: Well, I think that's a great overview of a disorder where, you know, I think the neurologist's role is really indispensable. Right? I mean, you have to have this conversation not just once, this is a conversation that you have over time. And again, I really want to refer our listeners to this article. It's just a fantastic overview of a common disorder, but one where I think there are probably gaps where we can improve care. And Dr Shih, I want to thank you for joining us, and thank you for such a great discussion on essential tremor. I learned a lot from your article, and I learned even more from the interview today. I suspect our readers and listeners will too. Dr Shih: Well, thank you again for the invitation and the opportunity to kind of spread the word on this really common condition. Dr Jones: Again, we've been speaking with Dr Ludy Shih, author of a fantastic article on essential tremor in Continuum's latest issue on movement disorders. Please check it out, and thank you to our listeners for joining 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.

This episode is sponsored by: My Financial CoachYou trained to save lives—who's helping you save your financial future? My Financial Coach connects physicians with CFP® Professionals who specialize in your complex needs. Whether it's crushing student loans, optimizing investments, or planning for retirement, you'll get a personalized strategy built around your goals. Save for a vacation home, fund your child's education, or prepare for life's surprises—with unbiased, advice-only planning through a flat monthly fee. No commissions. No conflicts. Just clarity.Visit myfinancialcoach.com/physiciansguidetodoctoring to meet your financial coach and find out if concierge planning is right for you._______________In this episode, host Dr. Bradley Block welcomes Jonathan Jarry to tackle the persistent myth that medical error is the third leading cause of death in the US. Jarry traces the claim to a 2000 Institute of Medicine report and a 2016 BMJ paper co-authored by Dr. Marty Makary, exposing their flawed extrapolations from small, non-representative studies. He highlights issues like erroneous assumptions, small sample sizes, and the challenge of determining causality in deaths linked to errors. Jarry explains how this inflated statistic fuels fear, drives patients toward unproven alternative treatments, and erodes trust in healthcare. He offers practical ways to push back against the myth while acknowledging the need for improved patient safety systems. This episode is essential for healthcare professionals and patients seeking clarity on medical errors and their true impact.Three Actionable TakeawaysChallenge the Statistic with Facts – When confronted with the claim that medical error is the third leading cause of death, explain that it stems from flawed extrapolations (e.g., 62% of hospital deaths attributed to errors is unrealistic) and cite more reliable estimates (0.6%–5% of hospital deaths).Promote Patient Safety Transparently – Acknowledge medical errors as a real issue but emphasize ongoing efforts to improve safety, like rigorous error reporting systems, to maintain trust without dismissing legitimate concerns.Educate on Context – Share that small, non-representative studies (e.g., Medicare patients or regional data) were misused to inflate error rates, encouraging patients to seek evidence-based care rather than unproven alternatives.About the ShowSucceed In Medicine  covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the GuestJonathan Jarry is a science communicator with McGill University's Office for Science and Society (OSS), dedicated to separating sense from nonsense in science. With a background in clinical lab work and podcasting, he tackles pseudoscience and misinformation, making complex topics accessible. His work at OSS, established in 1999, focuses on debunking myths and promoting evidence-based understanding.Website: mcgill.ca/ossBlueSky: https://bsky.app/profile/jonathanjarry.bsky.socialAbout the host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts The Succeed In Medicine  podcast, focusing on personal and professional development for physiciansWant to be a guest?Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter  This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance.

Featuring an interview with Dr Jorge Cortes, including the following topics: Overview of common molecular profiles in newly diagnosed acute myeloid leukemia (AML) (0:00) Clinical presentation of AML with a FLT3 mutation; implications of clinical data from the Phase III RATIFY trial of the FLT3 inhibitor midostaurin (5:38) Potential incorporation of a FLT3 inhibitor with azacitidine/venetoclax for transplant-ineligible patients with FLT3-mutant AML (10:32) Clinical benefit with quizartinib for patients with FLT3-like genetic profile; selection of FLT3 inhibitor as a component of initial therapy for individuals with AML with a FLT3-ITD mutation (14:04) Overview of FDA-approved IDH inhibitors enasidenib, ivosidenib and olutasidenib; differentiation syndrome as a class effect of IDH inhibitors in AML (20:31) Case: A woman in her late 60s with newly diagnosed AML with FLT3-ITD and NPM1 mutations receives 7+3 chemotherapy in combination with quizartinib (31:07) Case: A patient in their late 70s with multiple comorbidities and newly diagnosed IDH1-mutant AML (37:53) CME information and select publications

In our last episode of the Bowel Sounds Summer School series (at least for this year), hosts Dr. Jason Silverman and Dr. Jennifer Lee have gathered highlights from past episodes on endoscopy to create an episode filled with clinical and teaching pearls.  Former expert guests Dr. Jenifer Lightdale, Dr. Catharine Walsh, and Dr. Looi Ee explain the elements of quality endoscopy, how to teach endoscopy, perform difficult colonoscopies, and even how to keep endoscopists healthy throughout their career.Be sure to also check out the great hands-on, colonoscopy skills and train the trainer workshops held during the NASPGHAN Annual Meeting each year!Our Bowel Sounds Summer School series includes four episodes 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:Review the technical and non-technical components of quality endoscopic procedures.Understand communication strategies that help preceptors effectively teach endoscopy skills to trainees.Review the relevant elements of ergonomics and systemic factors that can help prevent endoscopy-related injuries. Featured Episodes:Jenifer Lightdale - PEnQuINs and Making Pediatric Endoscopy Safer (November 2020)Catharine Walsh - Education in Endoscopy (November 2022)Looi Ee - The Challenging Colonoscopy: Down Under Edition (August 2023)Links:NASPGHAN/ESPGHAN Society Papers on Endoscopy (2022)Other Summer School Episodes:Bowel Sounds Summer School - Constipation in ChildrenBowel Sounds Summer School - Eosinophilic EsophagitisBowel SoundsSupport 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.

Drs. Kat Talcott and Sarwar Zahid join for a journal club episode. FA Image Generation (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2835600)Industry Trial Sponsorship and Results (https://www.ajo.com/article/S0002-9394(25)00325-3/fulltext)GLP-1 Agonists and Neovascular AMD (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2834964)Burnout Among Uveitis Specialists (https://www.ajo.com/article/S0002-9394(25)00342-3/abstract)Relevant Financial Disclosures: NoneYou can claim CME credits for prior episodes via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audi

For this episode hosts Tanner, John and Andy are joined by longtime guest Chris Colbert to discuss the 2 recent New York Times articles that addressed DO's and osteopathic medicine. Don't forget we are the official podcast of the American College of Osteopathic Emergency Physicians (ACOEP) to learn more about this organization and how to attend and upcoming CME event, visit acoep.org today!