Podcasts about cme

Crypto News: First U.S. XRP ETF Launches Sept. 18, CME to List Options on XRP Futures Oct. 13. SEC Makes Spot Crypto ETF Listing Process Easier, Approves Grayscale's Large-Cap Crypto Fund.Show Sponsor -

Michael Hein, MS, MD, MHCM, Associate Certified Coach (ACC), believes that when healthcare leaders don't fully understand complexity, it leads to burnout, turnover, and poor patient care—issues he considers preventable forms of human suffering. Healthcare is more complex than ever, and traditional top-down methods often exacerbate these challenges. Success today requires leaders who adapt, absorb uncertainty, and react quickly. For many, this means embracing new leadership mindsets. With over thirty years of experience in healthcare, Michael is Senior Vice President and an executive coach at MEDI Leadership, the top healthcare coaching firm in the US. Drawing from clinical and executive roles, he helps leaders make the mindset shifts needed for success in complexity.Previously, Michael was CEO of a nonmerger hospital network and Chief Medical Officer at Catholic Health Initiatives. He led transformations at the Veterans Health Administration and cofounded KPI Ninja, a healthcare data company.Michael holds degrees from the University of South Dakota, Harvard's T.H. Chan School of Public Health, and St. Cloud State University. He is a certified executive coach through the International Coaching Federation, trained at the Hudson Institute of Coaching. His experience bridges frontline care and strategic leadership, coaching leaders to drive sustainable change in complex organizations.His book, Shifting Toward Unorthodoxy: Ten Unconventional Mindsets that HelpHealthcare Leaders Succeed in a Complex World, encourages a shift from outdated leadership mindsets to adaptive ones. A lifelong athlete, Michael enjoys cycling and swimming.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.

“When you think about where we were as a country before Medicare and Medicaid were created and where we are now, it's an incredible story,” says Chiquita Brooks-LaSure, who until earlier this year was the administrator for the Centers for Medicare and Medicaid Services (CMS). In a recent essay for The Century Foundation, where she is now a senior fellow, Brooks-LaSure used the 60th anniversary of enactment of those foundational insurance programs to help put their impact on individual Americans, the healthcare system and society at large in perspective. One prominent example is the desegregation of hospitals, which was achieved in part by withholding reimbursements for care unless facilities served Blacks as well as whites. Another is making it possible for more people with disabilities to live at home instead of in institutional settings. But as you'll hear in this probing Raise the Line conversation with host Lindsey Smith, Brooks-LaSure worries that many gains in coverage and other progress made over the years through Medicare, Medicaid and the Child Health Insurance Program (CHIP) are at risk because of a new federal law that calls for a trillion dollar decrease in spending, resulting in potentially millions of people losing their coverage, cuts to clinical staff and medical services, and the closure of hospitals and clinics, especially in rural areas. “Most rural hospitals in this country are incredibly dependent on both Medicare and Medicaid to keep their doors open and there's an estimate that over 300 hospitals will close as a result of this legislation, so that, I think, is a place of incredible nervousness.” Whether you are a patient, provider, policymaker or health system leader, this is a great opportunity to learn from an expert source about the range of potential impacts that will flow from changes to critically important insurance programs that provide coverage to 40% of adults and nearly 50% of children in the U.S. Mentioned in this episode:The Century FoundationEssay on 60th Anniversary of Medicare & Medicaid If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

Welcome back to our quarterly Market Cap Game Show! Two past champions—Andy Cross and Yasser El-Shimy—take the stage to test their market-cap mettle (and yours) across ten public companies, vying for a spot in the 2026 March Market Cap Madness World Championships. From tech titans and international hotel brands to down home Texas fare and online car shopping, the matchups run from familiar to delightfully unexpected—plus plenty of banter. Can you outscore Andy, Yasser, or both? Play along, challenge your market cap intuition, and discover the surprising values of companies you know and love (and maybe a few you've never heard of!). Companies mentioned: ASR, CARG, CEG, CME, GOOG, LKQ, MAR, NXP, PGR, TXRH Sign up for The Motley Fool's Breakfast News here: ⁠www.fool.com/breakfastnews⁠ Order David's Rule Breaker Investing book here: ⁠https://www.amazon.com/gp/product/1804091219/ Host: David Gardner Guests: Andy Cross, Yasser El-Shimy Producers: Bart Shannon, Dan Boyd Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey listeners! Got plans for October 10th and 11th? Well, clear your calendars, because the FACTS About Fertility Virtual Conference is coming in hot and you won't want to miss it. Listen in today to Dr. Marguerite Duane and all the incredible work she is doing with FACTS, but also she is now the Director of the first ever Fertility Awareness Based Medical program in a medical school, Duquesne University! We're talking TWO days of inspiring talks, real connection, and expert insight—all from the comfort of your favorite sweatpants.

Can AI revolutionize behavioral health without replacing therapists?  Dr. Bradley Block and Dr. Tristan Gorrindo dives into the transformative potential of AI in mental health care. Drawing from his extensive experience, Dr. Gorrindo discusses how AI can assist with subclinical issues through coaching-like support, streamline administrative tasks like intake and note-taking, and enhance patient-clinician connections by freeing up time for meaningful interactions. While addressing fears of AI replacing physicians, he emphasizes the irreplaceable role of human therapists for severe mental illnesses, citing the importance of nonverbal cues and mirror neurons. Tune in for insights on AI's current applications, future potential, and how to stay informed via resources like LinkedIn.Three Actionable Takeaway:AI for Subclinical Support and Efficiency – AI tools, like chatbots, can provide coaching-style support for patients with mild issues (e.g., grief, stress) and handle administrative tasks (e.g., intake, note-taking), freeing clinicians to focus on severe cases like depression or psychosis. Dr. Gorrindo highlights that 50% of primary care visits involve behavioral health components, making AI a valuable tool for triaging and support.Preserving Human Connection – While AI can mimic empathy or mirror expressions, it struggles to replicate the neurobiological resonance (e.g., mirror neurons) critical for therapy in severe mental illnesses. Dr. Gorrindo notes that AI can enhance trust-building by offloading routine tasks, allowing clinicians to engage deeply with patients' stories, as seen in examples like vestibular neuritis consultations.Practical AI Integration – Tools like AI scribes and intake avatars (e.g., language-adaptive systems in Pennsylvania health systems) can be customized via prompt engineering to align with a clinician's style, similar to training a medical student. Dr. Gorrindo stresses using HIPAA-compliant platforms (e.g., Google Gemini with a BAA) and staying updated via professional networks like LinkedIn.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 GuestDr. Tristan Gorrindo is a board-certified child and adolescent psychiatrist, CEO of Forza Behavioral Consulting, and former Chief Medical Officer of Optum Behavioral Care, where he led one of the nation's largest behavioral health platforms. With over 25 publications and more than 100 national presentations, he advises health systems, payers, and organizations on behavioral health transformation, including value-based care, integrated delivery models, and digital innovations like AI. He remains active in national policy and clinical practice, emphasizing whole-person care that integrates physical and mental health needs.LinkedIn: http://linkedin.com/in/tristanlgAbout 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 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. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Featuring an interview with Dr Neel Pasricha, including the following topics: Anatomy and physiology of the cornea; intersection of ophthalmology and oncology for patients receiving antibody-drug conjugates (ADCs) (0:00) Association of corneal toxicities with ADCs (4:56) Dose and schedule modifications to mitigate ocular toxicities associated with belantamab mafodotin and other ADCs (9:02) Spectrum and severity of corneal toxicities associated with datopotamab deruxtecan (14:44) Role of optometrists and ophthalmologists in screening for and management of ocular toxicities (17:55) Other ocular toxicities associated with cancer therapies (24:26) Prevention and management of corneal toxicity (33:58) Preexisting ophthalmic conditions as potential risk factors for development of ocular toxicities with ADCs (43:39) General clinical pearls on the management of ocular toxicities with cancer therapies (48:04) CME information and select publications

Send us a textYou've got two leaders at the helm - one knows the medicine, the other knows the business. Sounds like a dream team, right? But what happens when they're not on the same page?Welcome to Medical Money Matters. Today we're diving into the art and science of clinical-administrative dyads - those essential partnerships that drive medical groups forward. When they work, they create clarity stability, and strength. When they falter, things get messy—fast.Whether you're a CEO paired with a Chief Medical Officer, a Board President working closely with a Practice Administrator, or you're part of a different leadership pair, this episode is for you. We're going to unpack what makes these partnerships work, what gets in their way, and how to build—or rebuild— a dyad relationship that can truly lead a practice with purpose.Please Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: http://21978609.hs-sites.com/newletter-subscriber Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 32.5 hours of online, on-demand CME-accredited training tailored just for busy physicians. Find it here: https://healtheps.com/physicians-edge-mastering-business-finance-in-your-medical-practice/ Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/

Dr Neel Pasricha from the University of California, San Franciso, reviews corneal and other ophthalmic toxicities associated with antibody-drug conjugates and other cancer therapies and strategies for their prevention and management. CME information and select publications here.

Dr Neel Pasricha from the University of California, San Franciso, reviews corneal and other ophthalmic toxicities associated with antibody-drug conjugates and other cancer therapies and strategies for their prevention and management. CME information and select publications here.

Grow your management tools for opioid withdrawal in the hospital. Investigate how to decide between methadone and buprenorphine, additional medications to manage symptoms and how and when to use short-acting opioids for management of withdrawal. We're joined by Ashish Thakrar, MD at the University of Pennsylvania.  Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Symptoms of opioid withdrawal Medications for the management of opioid withdrawal Buprenorphine precipitated withdrawal Starting Buprenorphine: Experiences and Strategies  Titrating Methadone: Dosage and Adjuncts Adjunctive short-acting opioids Emerging Trends in Drug Supply: Xylazine and Medetomidine Outro  Credits Producer, Show Notes: Zina Huxley-Reicher Infographics: Zina Huxley-Reicher MD and Zoya Surani Hosts: Carolyn Chan, MD MHS, Zina Huxley-Reicher MD, Shawn Cohen, MD Reviewer: Payel Jhoom Roy, MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Ashish Thakrar, MD MHSP Sponsor: Mint Mobile  Shop plans at MINTMOBILE.com/CURB Sponsor: Freed Use code: CURB50 to get $50 off your first month when you subscribe! Sponsor: FIGS  We've teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.

Dan Nathan is joined by Danny Moses and Terry Duffy, Chairman and CEO of CME Group, to discuss their partnership and market evolution. They talk about the growth in retail trading, the impact of technological advancements, and CME's new products like futures, event contracts, and binary contracts designed for retail investors. The discussion also covers the significance of risk management tools such as stop-losses, the recent rise in open positions in equity and interest rates at CME, and the broader implications of high national debt and technology disruption on the markets. They delve into the importance of timing in listing products, using Bitcoin's listing in 2017 as an example, and touch on the interconnectedness of global financial stability and market structure. —FOLLOW USYouTube: @RiskReversalMediaInstagram: @riskreversalmediaTwitter: @RiskReversalLinkedIn: RiskReversal Media

Show Notes:In this month's second episode, the conversation continues between Whitni Miller and Aleece Fosnight as they delve into the complexities of libido, hormones, and sexual health, emphasizing the importance of understanding the biopsychosocial model. They discuss the role of mental health in sexual desire, the impact of medical trauma on patient care, and the necessity for inclusive and trauma-informed healthcare environments. The conversation also highlights the need for comprehensive sex education and the challenges faced by queer individuals in accessing appropriate care. Finally, they explore future innovations in hormonal treatments and the importance of patient advocacy in navigating healthcare systems. Aleece Fosnight obtained a Master of Science in PA Studies from the University of Kentucky in 2011 and went on to receive her postgraduate certificate in sexuality counseling and education at the University of Michigan in 2014. She opened her own private practice, the Fosnight Center for Sexual Health, in Asheville, NC in June 2020. Her expertise includes urology, gynecology, pelvic health, gender affirming care, sexual medicine, hormones, and sexuality counseling. She is an AASECT certified sexuality counselor and educator, nationally certified menopause practitioner, Health At Every Size medical provider, trauma-informed and kink-aware. Ms. Fosnight is on multiple local, state, and national boards, a national speaker for several CME organizations, guest lecturer for several PA and medical school programs, and medical advisor for Aeroflow Urology and Uberlube. Learn More about The Fosnight Center:https://fosnightcenter.com/ Follow Aleece Fosnight:ALL Platforms - @sexmedPA or @fosnightcenter Learn More From Whitni:https://www.bde-moves.com Follow Whitni at:IG - @bde.movesFB - groups/bdemovesYouTube - Podcast Channel = @BDE-Moves Old Channel = @BdeTalksTikTok - @bdemoves

Featuring perspectives from Prof Rebecca A Dent, Dr Hans Lee, Dr Neel Pasricha and Dr Tiffany A Richards, including the following topics:  Introduction: The Patient Experience (0:00) Managing Ocular Toxicities Associated with Antibody-Drug Conjugates and Other Cancer Therapies — Dr Pasricha (10:28) Ocular Toxicities in Multiple Myeloma (45:33) Ocular Toxicities in Breast Cancer (50:34) CME information and select publications

Prof Rebecca A Dent from National Cancer Centre Singapore, Dr Hans Lee from Sara Cannon Research Institute in Nashville, Tennessee, Dr Neel Pasricha from the University of California, San Francisco, and Dr Tiffany A Richards from The University of Texas MD Anderson Cancer Center in Houston, discuss strategies to manage ocular toxicities associated with antibody-drug conjugates and other cancer therapies. CME information and select publications here.

Prof Rebecca A Dent from National Cancer Centre Singapore, Dr Hans Lee from Sara Cannon Research Institute in Nashville, Tennessee, Dr Neel Pasricha from the University of California, San Francisco, and Dr Tiffany A Richards from The University of Texas MD Anderson Cancer Center in Houston, discuss strategies to manage ocular toxicities associated with antibody-drug conjugates and other cancer therapies. CME information and select publications here.

Leave work on time•David's story: a skilled, compassionate paramedic who deeply connected with patients, especially during psychiatric crises.oStruggled to separate work from life.oRelied on alcohol as a coping mechanism, which ultimately cost him his life.•Core lesson: In emergency medicine, you must leave work at work—emotionally and physically—otherwise burnout and unhealthy coping are inevitable.•Healthy separation:oBalance connection with patients while avoiding over-identification.oRemember: “It is not your emergency.”•Practical strategies to get off on time:oCheck labs/imaging in real time.oComplete charting as you go.oPlan handoffs 1–2 hours before end of shift.oControl what's controllable—systems, shift crossover, advocate for better staffing.•Mental discipline:oSet down burdens from tragic or unjust cases (e.g., drunk drivers, preventable deaths).oFind something greater than yourself (faith, higher power, or another anchor) to release what you can't control.•Work–life balance:oCreate a clear line between work and home (physical transition, dedicated space, or ritual).oAccept that some seasons demand more grind, but don't let it become a lifestyle.oYour family will notice the time you miss more than your employer ever will.•Identity check:oYou are not your job title; resilience and character matter more.oOver-identifying with work justifies staying late and sacrificing home life.•Universal takeaway: No matter the field, burdens from work will bleed into family life unless you intentionally lay them down. Getting off on time = preserving resilience, family, and long-term health.Chapter 3: Take Care of Yourself Before You Take Care of Others•Past struggles:oPrioritized school and work over health.oPoor sleep, binge eating, energy drinks, inconsistent workouts.oLack of discipline → foggy brain, poor performance as a paramedic.•Core principle:oYou cannot care for others well if you neglect yourself.oIn EMS/ED, emergencies are unpredictable, but most patients are not crashing—there's time to hydrate, eat, and reset.•Practical applications:oDrink water, eat proper nutrition, and rest before/during shifts.oPrioritize morning routines (hydration, exercise, food) → sets the tone for the day.oMeal prep to avoid cafeteria junk food and impulsive choices.oCreate habits that are accessible (water bottles, packed meals).•Mindset shift:oCaring for yourself Support the showEverything 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. This is not medical advice. If you have personal health concerns, please seek professional care. Full 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

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

Poultry leads the move lower as chicken prices ease, but across the board, the markets are full of mixed signals. Beef stays strong, dairy keeps sliding, and pork and grains add their own twists.BEEF: Demand is cooling a touch with grinds, briskets, and flanks easing back, but ribeyes and tenderloins are still charging higher. Supplies remain too tight for a true correction, so any relief looks more like a pause than a pullback. Heading into the holidays, the pain point for consumers hasn't hit yet – and we may not be close.POULTRY: Avian flu is back in the headlines – six new cases this week, hitting nearly 300K turkeys, stirred up by cooler weather and migration. On the chicken side, it's all good news: supply is finally ahead of demand, bringing prices down across the board. The question is, how long will the balance last?GRAINS: Markets are holding steady with corn at $4.17, soy flat, and wheat unchanged. All eyes are on the USDA report out Friday – if crop yield estimates are trimmed, we could finally see a push higher. Until then, it's calm in the grain bin.PORK: Bellies finally slipped, closing at $172 – down $10 from last week – and should keep easing over the next few weeks. But with cold storage stocks very low, don't expect a major falloff. Meanwhile, butts and ribs are ticking higher, loins are steady, and pork still delivers solid value on the plate.DAIRY: It's week four of declines at the CME – barrel down 8, block off 7, and butter slipping another 3. The slide keeps rolling, and while it's unclear how long it will last, for now we'll take the ride. Savalfoods.com | Find us on Social Media: Instagram, Facebook, YouTube, Twitter, LinkedIn

Michael Hein, MS, MD, MHCM, Associate Certified Coach (ACC), believes that when healthcare leaders don't fully understand complexity, it leads to burnout, turnover, and poor patient care—issues he considers preventable forms of human suffering. Healthcare is more complex than ever, and traditional top-down methods often exacerbate these challenges. Success today requires leaders who adapt, absorb uncertainty, and react quickly. For many, this means embracing new leadership mindsets. With over thirty years of experience in healthcare, Michael is Senior Vice President and an executive coach at MEDI Leadership, the top healthcare coaching firm in the US. Drawing from clinical and executive roles, he helps leaders make the mindset shifts needed for success in complexity.Previously, Michael was CEO of a nonmerger hospital network and Chief Medical Officer at Catholic Health Initiatives. He led transformations at the Veterans Health Administration and cofounded KPI Ninja, a healthcare data company.Michael holds degrees from the University of South Dakota, Harvard's T.H. Chan School of Public Health, and St. Cloud State University. He is a certified executive coach through the International Coaching Federation, trained at the Hudson Institute of Coaching. His experience bridges frontline care and strategic leadership, coaching leaders to drive sustainable change in complex organizations.His book, Shifting Toward Unorthodoxy: Ten Unconventional Mindsets that HelpHealthcare Leaders Succeed in a Complex World, encourages a shift from outdated leadership mindsets to adaptive ones. A lifelong athlete, Michael enjoys cycling and swimming.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.

It seems there are news stories every week about the accelerating pace of innovation in gene therapy, but only about 50 therapies have been approved so far by the US Food and Drug Administration. Our guest today, Dr. Bobby Gaspar, leads a UK-based biotech company, Orchard Therapeutics, that developed one of those treatments using gene-modified stem cells in your blood that self-renew, so a single administration can give you potentially a lifelong effect. “Our approach is about correcting those hematopoietic stem cells and allowing them to give rise to cells that can then correct the disease,” explains Dr. Gaspar.  The therapy in focus is lenmeldy, the first approved treatment for metachromatic leukodystrophy, also known as MLD, a devastating inherited disorder that affects roughly 600 children worldwide. But Dr. Gaspar is optimistic that learnings from Orchard's work on MLD could be useful in treating much more common disorders including frontotemporal dementia, Crohn's disease and others. This highly informative conversation with host Lindsey Smith also explores the importance of newborn screening, community collaboration in advancing clinical trials for rare diseases, and a future in which each gene therapy will be used as a tool for specific applications.  “There will be many gene therapies available, some of which will become the standard of care for certain diseases, but it won't be for every disease.”Mentioned in this episode:Orchard Therapeutics If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

The Prepping Academy welcomes Forrest Garvin, founder of PrepperNet, Garvin Academy, and other entrepreneurial ventures that are countable. In today's episode, Forrest updates us on what he has been up to over the last year.  We also discuss the current happenings in  PrepperNet, where PrepperNet is heading in the future, and a general update on the status of Prepping 2025. Grid Down Comms Up http://www.youtube.com/@griddowncommsup Support the showPlease give us 5 Stars! www.preppingacademy.com Daily deals for preppers, survivalists, off-gridders, homesteaders & everyday Americans. The best gear & supplies—posted in one place, every dayCheck out https://prepperfinds.com Contact us: https://preppingacademy.com/contact/ www.preppernet.net Amazon Store: https://amzn.to/3lheTRTwww.forrestgarvin.com

What does it take to move from order-taker to trusted partner in CME writing? That's the single question driving this new season of Write Medicine. In this 15-minute teaser episode, Alex introduces the season theme—Craft to Confidence: A CME Writer's Season of Growth—and gives you a preview of what's ahead. You'll hear how guest interviews and solo tactical episodes will work together to help you build your skills, expand your visibility, and strengthen your confidence as a CME writer. Whether you're transitioning from academia, clinical practice, or another writing specialty, this season will give you both the craft tools and the career clarity to thrive in continuing medical education. Episodes to Look Forward To Designing for learning with Sarah Atwood Hot Seat Coaching on attracting content projects and integrating academic skills into CME Leveraging Milkshake Moments with Michelle Skidmore Identity, trauma, and resilience with Hope Lafferty Solo walk-throughs on interviewing SMEs, turning education gaps and needs into activity agendas, publishing manuscripts, and more This podcast uses the following third-party services for analysis: Podtrac - https://analytics.podtrac.com/privacy-policy-gdrp

Ataxia is a neurologic symptom that refers to incoordination of voluntary movement, typically causing gait dysfunction and imbalance. Genetic testing and counseling can be used to identify the type of ataxia and to assess the risk for unaffected family members. In this episode, Katie Grouse, MD, FAAN, speaks with Theresa A. Zesiewicz, MD, FAAN, author of the article “Ataxia” in the Continuum® August 2025 Movement Disorders issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Zesiewicz is a professor of neurology and director at the University of South Florida Ataxia Research Center, and the medical director at the University of South Florida Movement Disorders Neuromodulation Center at the University of South Florida and at the James A. Haley Veteran's Hospital in Tampa, Florida. Additional Resources Read the article: Ataxia 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 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 Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Theresa Zesiewicz about her article on ataxia, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, and please introduce yourself to our audience.  Dr Zesiewicz: Well, thank you, Dr Grouse. I'm Dr Theresa Zesiewicz, otherwise known as Dr Z, and I'm happy to be here. Dr Grouse: I have to say, I really enjoyed reading your article. It was a really great refresher for myself as a general neurologist on the topic of ataxia and a really great reminder on a great framework to approach diagnosis and management. But I wanted to start off by asking what you feel is the key message that you hope our listeners will take away from reading your article. Dr Zesiewicz: Yes, so, thanks. I think one of the key messages is that there has been an explosion and renaissance of genetic testing in the past 10 years that has really revolutionized the field of ataxia and has made diagnosis easier for us, more manageable, and hopefully will lead to treatments in the future. So, I think that's a major step forward for our field in terms of genetic techniques over the last 10 years, and even over the last 30 years. There's just been so many diseases that have been identified genetically. So, I think that's a really important take-home message. The other take-home message is that the first drug to treat Friedreich's ataxia, called omaveloxolone, came about about two years ago. This was also a really landmark discovery. As you know, a lot of these ataxias are very difficult to treat. Dr Grouse: Now pivoting back to thinking about the approach to diagnosis of ataxia, how does the timeline of the onset of ataxia symptoms inform your approach? Dr Zesiewicz: The timeline is important because ataxia can be acute, subacute or chronic in nature. And the timeline is important because, if it's acute, it may mean that the ataxia took place over seconds to hours. This may mean a toxic problem or a hypoxic problem. Whereas a chronic ataxia can occur over many years, and that can inform more of a neurodegenerative or more of a genetic etiology. So, taking a very detailed history on the patient is very important. Sometimes I ask them, what is the last time you remember that you walked normal? And that can be a wedding, that can be a graduation. Just some timeline, some point, that the patient actually walked correctly before they remember having to hold onto a railing or taking extra steps to make sure that they didn't fall down, that they didn't have imbalance. That sometimes that's a good way to ask the patient when is the last time they had a problem. And they can help you to try to figure out how long these symptoms have been going on. Dr Grouse: I really appreciate that advice. I will say that I agree, it can sometimes be really hard to get patients to really think back to when they really started to notice something was different. So, I like the idea of referencing back to a big event that may be more memorable to them. Now, given that framework of, you know, thinking through the timeline, could you walk us through your approach to the evaluation of a patient who presents to your clinic with that balance difficulties once you've established that? Dr Zesiewicz: Sure. So, the first thing is to determine whether the patient truly has ataxia. So, do they have imbalance? Do they have a wide base gait? That's very important because patients come in frequently to your clinic and they'll have balance problems, but they can have knee issues or hip issues, neuropathy, something like that. And sometimes what we say to the residents and the students is, usually ataxia or cerebellar symptoms go together with other problems, like ocular problems are really common in cerebellar syndromes. Or dysmetria, pass pointing, speech disorder like dysarthria. So, not only do you need to look at the gait, but you should look at the other symptoms surrounding the gait to see if you think that the patient actually has a cerebellar syndrome. Or do they have something like a vestibular ataxia which would have more vertigo? Or do they have a sensory ataxia, which would occur if a person closes his eyes or has more ataxia when he or she is in the dark? So, you have to think about what you're looking at is the cerebellar syndrome. And then once we look to see if the patient truly has a cerebellar syndrome, then we look at the age, we look at---as you said before, the timeline. Is this acute, subacute, or chronic? And usually I think of ataxia as falling into three categories. It's either acquired, it's either hereditary, or it's neurodegenerative. It can be hereditary. And if it's not hereditary, is it acquired, or is it something like a multiple system atrophy or a parkinsonism or something like that? So, we try to put that together and start to narrow down on the diagnosis, thinking about those parameters. Dr Grouse: That's really a helpful way to think through it. And it is true, it can get very complex when patients come in with balance difficulties. There's so many things you need to think about, but that is a great way to think about it. Of course, we know that most people who come in to the Movements Disorders clinic are getting MRI scans of their brains. But I'm curious, in which cases of patients with cerebellar ataxia do you find the MRI to be particularly helpful in the diagnosis? Dr Zesiewicz: So, an MRI can be very important. Not always, but- so, something like multiple system atrophy type C where you may see a hot cross bun sign or a pontine hyperintensity on the T2-weighted image, that would be helpful. But of course, that doesn't make the diagnosis. It's something that may help you with the diagnosis. In FXTAS, which is fragile X tremor/ataxia syndrome, the patient may have the middle cerebellar peduncle sign or the symmetric hyperintensity in the middle cerebellar peduncles, which is often visible but not always. Something like Wernicke's, where you see an abnormality of the mammillary bodies. Wilson's disease, which is quite rare, T2-weighted image may show hyperintensities in the putamen in something like Wilson's disease. Those are the main MRI abnormalities, I think, with ataxia. And then we look at the cerebellum itself. I mean, that seems self-evident, but if you look at a sagittal section of the MRI and you see just a really significant atrophy of the cerebellum, that's going to help you determine whether you really have a cerebellar syndrome. Dr Grouse: That's really encouraging to hear a good message for all of us who sometimes feel like maybe we're missing something. It's good to know that information can always come up down the line to make things more clear. Your article does a great review of spinal cerebellar ataxia, but I found it interesting learning about the more recently described syndrome of SCA 27B. Would you mind telling us more about that and other really common forms of SCA that's good to keep in mind? Dr Zesiewicz: Sure. So, there are now 49 types of spinal cerebellar ataxia that have been identified. The most common are the polyglutamine repeat diseases: so, spinocerebellar ataxia type 3 or type 2, type 6, are probably the most common. One of the most recent spinocerebellar ataxias to be genetically identified and clinically identified is spinocerebellar ataxia 27B. This is caused by a GAA expansion repeat in the first intron of the fibroblast growth factor on chromosome 13. And the symptoms do include ataxia, eye problems, downbeat nystagmus, other nystagmus, vertical, and diplopia. It appears to be a more common form of adult-onset ataxia, and probably more common than was originally thought. It may account for a substantial number of ataxias, like, a substantial percentage of ataxias that we didn't know about. So, this was really a amazing discovery on SCA 27B. Dr Grouse: Now a lot of us I think feel a little anxious when we think about genetic testing for ataxia simply because there's so many forms, things are changing quickly. Do you have a rule of thumb or a kind of a framework that we can think of as we approach how we should be thinking about getting genetic testing for the subset of patients? Dr Zesiewicz: Sure. And I think that this is where age comes into play a lot. So, if you have a child who's 10, 11, or 12 who's having balance problems in the schoolyard, does not have a history of ataxia in the family, the teachers are telling you that the child is not running correctly, they're having problems with physical education, that is someone who you would think about testing for Friedreich's ataxia. A preteen or a child, that would be one thing that would be important to test. When you talk to your patient, it's important to really take a detailed family history. Not just mom or dad, but ethnicity, grandparents, etc. And sometimes, once in a while, you come up with a known spinal cerebellar ataxia. Then you can just test for that. So, if a person is from Portugal or has Portugal background and they have ataxia and the parents had ataxia, you would think of spinal cerebellar ataxia type 3. Or if they're Brazilian, or if the person is from a certain area of Cuba and mom and dad had ataxia and that person has ataxia, you would think of spinal cerebellar ataxia type 2. Or if a person has ataxia and their parent had blindness or visual problems, you may be more likely to think of spinal cerebellar ataxia type 7, for example. If they have that---either they have a known genetic cause in in the family, first degree family, or they come from an area of the world in which we can pinpoint what type we think it is---you can go ahead and get those tests. If not, you can take an ataxia comprehensive panel. Many times now, if you take the panel and the panel is negative, it will reflex to the whole exome gene sequencing, where we're finding really unusual and more rare types of ataxia, which are very interesting. Spinal cerebellar ataxia type 32, spinal cerebellar ataxia type 36, I had a spinal cerebellar ataxia type 15. So, I think you should start with the age, then the family history, then where the person is from. And then, if none of those work out, you can get a comprehensive panel, and then go on to whole exome gene sequencing. Dr Grouse: That's really, really useful. Thank you so much for breaking that down in a really simple way that a lot of us can take with us. Pivoting a little bit now back towards different types of acquired ataxias, what are some typical lab tests that you recommend for that type of workup? Dr Zesiewicz: Again, if there's no genetic history and the person does not appear to have a neurodegenerative disease, we do test for acquired ataxias. Acquired ataxias can be complex. Many times, they are in the autoimmune family. So, what we start with are just basic labs like a CBC or a CMP, but then we tried to look at some of the other abnormalities that could cause ataxia. So, celiac disease, stiff person syndrome. So, you would look at anti-glutamic acid decarboxylase antibodies, Hashimoto's---so, antithyroglobulin antibodies or antithyroperoxidase antibodies would be helpful. You know, in a case of where the patients may have an underlying neoplasm, maybe even a paraneoplastic workup, such as an anti-Hu, anti-Yo, anti-Ri. A person has breast cancer, for example, you may want to take a paraneoplastic panel. I've been getting more of the anti-autoimmune encephalitis panels in some cases, that were- that are very interesting. And then, you know, things that sometimes we forget now like the syphilis test, thyroid-stimulating test, take a B12 and folate, for example. That would be important. Those are some of the labs. We just have on our electronic chart a group of acquired labs for ataxia. If we can't find any other reason, we just go ahead and try to get those. Dr Grouse: Now, I'm curious what you think is the most challenging aspect of diagnosing a patient with cerebellar ataxia? Dr Zesiewicz: So, for those of us who see many of these patients a day, some of the hardest patients are the ones that---regardless of the workup that we do, we've narrowed it down, it's not hereditary. You know, they've been through the whole exome gene sequencing and we've done the acquired ataxia workup. It doesn't appear to be that. And then we've looked for parkinsonism and neurodegenerative diseases, and it doesn't appear to be that either; like, the alpha-synuclein will be negative. Those are the toughest patients, where we think we've done everything and we still don't have the answer. So, I've had patients in whom I've taken care of family members years and years ago, they had a presumed diagnosis, and later on I've seen their children or other family members. And with the advent of the genetic tests that we have, like whole exome gene sequencing, we have now been able to give the patient and the family a definitive diagnosis that they didn't have 25 years ago. So, I would say don't give up hope. Retesting is important, and as science continues and we get more information and we make more landmark discoveries in genetics, you may be better able to diagnose the patient. Dr Grouse: I was wondering if you had any recommendations regarding either some tips and tricks, some pearls of wisdom you can impart to us regarding the work of ataxia, or conversely, any big pitfalls that you can help us avoid? I would love to hear about it. Dr Zesiewicz: Yeah, there's no easy way to treat or diagnose ataxia patients. I've always felt that the more patients you see- and sounds easy, but the more patients you see, the better you're going to become at it, and eventually things are going to fall into place. You'll begin to see similarities in patients, etc. I think it's important not only to make sure that a person has ataxia, but again, look at the other signs and symptoms that may point to ataxia that you'll see in a cerebellar syndrome. I think it's important to do a full neuroexam. If a person has spasticity, that may point you more towards a certain type of ataxia than if a person has no reflexes, for example, that we see in Friedreich's ataxia. Some of the ocular findings are very interesting as well. It's important to know if a person has a tremor. I've seen several Wilson's disease cases in my life with ataxia. They're very important. I think a full neuroexam and also a very detailed history would be very helpful. Dr Grouse: Tell us about some promising developments in the diagnosis and management of ataxia that we should be on the lookout for. Dr Zesiewicz: The first drug for Friedreich's ataxia was FDA-approved two years ago, which was an NRF2 activator, which was extremely exciting and promising. There are also several medications that are now in front of the FDA that may also be very promising and have gone through long clinical trials. There's a medication that's related to riluzole, which is a medication used for amyotrophic lateral sclerosis, that has been through about seven years of testing. That is before the FDA as well for spinal cerebellar ataxia. Friedreich's ataxia has now completed the first cardiac gene therapy program with AAV vectors, which- we're waiting for full results, but that's a cardiac test. But I would assume that in the future, neurological gene therapy is not far behind if we've already done cardiac gene therapy and Friedreich's ataxia. So, you know, some of these AAV vector-based genetic therapies may be very helpful, as well as ASO, antisense oligonucleotides, for example. And I think in the future, other things to think about are the CRISPR/Cas9 technology for potential treatment of ataxia. It is a very exciting time, and some major promising therapies have been realized in the past 2 to 3 years. Dr Grouse: Well, that's really exciting, and we'll all look forward to seeing these becoming more clinically applicable in the future. So, thank you so much for coming to talk with us today. Dr Zesiewicz: Thank you. Dr Grouse: Again, today I've been interviewing Dr Theresa Zesiewicz about her article on ataxia, 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.

How can hip-hop be used as a cultural lens to provide solutions to long-standing problems in our society?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 Manny Faces, an award-winning journalist and author. They discussed his new book "Hip Hop Can Save America! Inspiration for the Nation from a Culture of Innovation”, which challenges mainstream media's narrow portrayal of Hip Hop culture and argues that its methodologies and philosophies offer solutions to economic inequality, political dysfunction, and racial division.Manny Faces is an award-winning journalist, founding director of The Hip Hop Institute for Social Innovation, creator and host of the acclaimed podcasts "News Beat" and "Hip Hop Can Save America!", and author. He is a leading voice advocating for the unparalleled yet largely untapped ability of Hip Hop music and culture to help uplift humanity across the board, with a particular focus on improving the lives, livelihoods, and communities that birthed and have been nurturing Hip Hop from its inception.LINKSwww.mannyfaces.comIG/Threads: @mannyfacesofficialBlueSky: @mannyfaces.comTw/X: MannyFaces**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

What happens when a single bill threatens to leave 10+ million Americans uninsured and hospitals on the brink?In this episode, host Dr. Bradley Block reunites with Adam Block, PhD, to break down Trump's sweeping healthcare legislation, HR 1—dubbed the "big beautiful bill"—which consolidates multiple reforms into one massive package. He explains how indirect measures like increased paperwork, monthly re-enrollments, and work requirements will lead to 10+ million losing Medicaid and ACA coverage, without direct cuts. The discussion covers fraud, waste, and abuse in Medicaid, the role of AI in filling government gaps, and the bill's delayed rollout post-midterms. They also explore site-neutral payments' effects on hospitals and ambulatory centers, cross-subsidization for safety-net services, and why hospitals' razor-thin margins make them vulnerable. This episode is crucial for healthcare professionals preparing for higher uncompensated care, sicker patients, and systemic shifts in reimbursement and access.Three Actionable Takeaway:Monitor Policy Changes Closely – Stay informed on Medicaid work requirements and ACA enrollment shifts rolling out in 2027. Review your practice's payer mix and prepare for increased uninsured patients by advocating for state-level expansions or adjustments.Advocate for Your Practice – If you own or operate ambulatory surgery centers, assess the impact of site-neutral payments. Engage with hospital associations to push for subsidies that maintain safety-net services, ensuring cross-subsidization doesn't erode entirely.Prepare for Operational Strain – Anticipate higher uncompensated care and sicker presentations. Build contingency plans like AI-assisted administrative tools or partnerships with community resources to handle paperwork burdens and support vulnerable patients.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. Adam Block is a Harvard-trained health economist with over two decades of experience at the intersection of healthcare policy, hospitals, and insurance. He played a key role in drafting sections of the Affordable Care Act for Congress and writing foundational regulations for the Centers for Medicare & Medicaid Services (CMS) to establish health insurance exchanges. After five years in data analytics roles reporting to CFOs, he founded Charm Economics, a consulting firm focused on health economics, and serves as an associate professor of public health at New York Medical College. Dr. Block's expertise lies in navigating complex policy changes, reimbursement challenges, and systemic healthcare shifts, offering critical insights for physicians and providers.LinkedIn: linkedin.com/in/adameblockEmail: adam@charmeconomics.comWebsite: https://www.charmeconomics.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 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.

Listen as Drew leads the team (John, Tanner and Andy) through a round of This or That. We talk Breakfast, Benadryl and Dolly Parton. Don't forget we are the official podcast of the American College of Osteopathic Emergency Physicians. Visit acoep.org today to learn about an upcoming CME event and how you can see our show at one of our LIVE shows.

Grid Down Comms Up dives into the top ten prepping items for a natural disaster. According to NOAA, there were twenty-seven major natural disasters last year. They did 182 billion dollars in damage and caused 568 deaths. Of all the emergencies we prepare for, we are most likely to be caught up in a large-scale natural disaster. Will you be ready if one strikes your area? In today's episode, we look at the last five items on our list: defense, fuel, electricity, mental health, and building materials. We also toss in a bonus item for number eleven. Heavy equipment, while far from essential, is a game-changer if you can access it. If you are lucky enough to own some, keep them in working order and be able to help out. Remember, mental condition is a huge part of survival. If you or someone you know is at risk or experiencing a mental health crisis, reach out for help at the Suicide & Crisis Lifeline dial 988 or visit https://988lifeline.org/. Stay ready and prep on. Patrick" Support the showPlease give us 5 Stars! www.preppingacademy.com Daily deals for preppers, survivalists, off-gridders, homesteaders & everyday Americans. The best gear & supplies—posted in one place, every dayCheck out https://prepperfinds.com Contact us: https://preppingacademy.com/contact/ www.preppernet.net Amazon Store: https://amzn.to/3lheTRTwww.forrestgarvin.com

Send us a textPicture this: you're finalizing your residency, or you've spent years in practice and you're finally ready to strike out on your own. You have this forward-thinking amazing vision—a practice that reflects how you want to deliver care. A place built for patients, for community, perhaps for innovation. It's exciting. But here's the truth: owning your own practice isn't just about medicine—it's about running a business. And that means you need a roadmap that's complete, accurate, and realistic. That means a business plan with a financial pro forma and a timeline you can rely on.Having that plan isn't academic. It's the difference between a dream and an actual launch. With it in hand, finding a banking partner becomes a lot more straightforward. Banks want to see organization, evidence of planning, clarity around costs, revenues, how you get paid, and when you can pay them back. And because starting a medical practice is usually a once‑in‑a‑career experience—or maybe twice at most—working with a seasoned business consultant is essential. This is your big leap—don't just go it alone.So, today we're going to walk through what you absolutely need to build into that startup plan. We'll talk through how you'll structure your entity, how you'll forecast your finances, how contracting, credentialing, HR, and operations all fit together, and why a realistic timeline matters. To get the free startup checklist mentioned in this episode, please email dave@healtheps.com and he will send it to you.Please Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: http://21978609.hs-sites.com/newletter-subscriber Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 30+ hours of online, on-demand CME-accredited training tailored just for busy physicians. Find it here: https://healtheps.com/physicians-edge-mastering-business-finance-in-your-medical-practice/  Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/

Dr Komal Jhaveri from Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Virginia Kaklamani from UT Health San Antonio MD Anderson Cancer Center in Texas review available efficacy and safety data guiding the optimal integration of oral SERDs into clinical practice. CME information and select publications here.

In this high-yield episode of Curbsiders Addiction Medicine, we dive deep into a practical and compassionate approach to caring for patients using methamphetamines and/or living with methamphetamine use disorder. We explore the latest pharmacologic options, harm reduction strategies, contingency management, and innovative ideas for monitoring and supporting patients. Whether you're in primary care or other subspecialty settings, this episode is packed with pearls for every clinician with our amazing guest, Dr. Phillip Coffin, Director of the Center on Substance Use and Health in the SFDPH.  Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME! Credits Producer/Script Writer/Show Notes: Era Kryzhanovskaya, MD Infographic and Cover Art: Zoya Surani Hosts: Carolyn Chan, MD. MHS and Era Kryzhanovskaya, MD Reviewer: Sarah Leyde MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Dr. Phillip Coffin Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Four-tier approach to taking care of patients with methamphetamine use/use disorder Medications for treatment Psychosocial treatment Harm reduction New horizons in treatment  Outro Sponsor: Locumstory Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com Sponsor: Panacea Visit panaceafinancial.com and Panacea's Resource Library for free student loan articles, guides, and webinars built to help you make informed decisions. Sponsor: Grammarly  Download Grammarly for free at Grammarly.com/PODCAST

In this episode, hosts Drs. Peter Lu and Jason Silverman talk to Dr. Justine Turner about a non-biopsy approach to diagnosis for celiac disease in children. Dr. Turner is a Professor of Pediatrics and Divisional Director for the Division of Gastroenterology and Nutrition at the University of Alberta and also the medical lead for the Multidisciplinary Pediatric Celiac Disease Clinic at Stollery Children's Hospital in Edmonton. Learning Objectives:Review current clinical guidelines for the diagnosis of celiac disease in childrenUnderstand the potential pros and cons of a non-biopsy approach to diagnosis for celiac diseaseRecognize the potential impacts of serologic diagnosis for celiac disease on patients, their families and healthcare systemsLinks (to be added!!):Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and NutritionNASPGHAN Clinical Report on the Diagnosis and Treatment of Gluten-related DisordersEuropean Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020Positive Predictive Value of Tissue Transglutaminase IgA for Celiac DiseaseSupport the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Featuring perspectives from Dr Komal Jhaveri and Dr Virginia Kaklamani, including the following topics:  Introduction: ER-Positive Metastatic Breast Cancer — Bringing Research Data into Practice (0:00) Key Issues from the General Medical Oncologists (GMO) Survey (3:43) Faculty Cases and GMO Questions (44:43) CME information and select publications

In episode 64 we discuss an article about addictive screen use and suicide.  Xiao Y, Meng Y, Brown TT, Keyes KM, Mann JJ. Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths. JAMA. 2025;334(3):219–228.   We also discuss the impact of the first 100 days of the Trump administration on addiction treatment, and the DEA scheduling of 7-OH (hydroxymitrigynine).  Journal of Addiction Medicine: The First 100 Days: The Trump Administration and Changes to Addiction Policy  FDA: FDA Takes Steps to Restrict 7-OH Opioid Products Threatening American Consumers  ---  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

IntroductionMy first experience with a cardiac arrest as a new EMT → exhilarating, confirmed calling to emergency medicine.Early struggles: dropped out of college, lacked discipline, but EMT training provided a direction and purpose.Spent years balancing work as EMT/paramedic with school → long path to becoming a PA.Lessons from emergency medicine shaped clinical skills and mindset.Concept of standards:Standards = benchmarks, measurable expectations, non-negotiable habits.Different from principles (general truths) → standards are concrete, either met or not.Standards build consistency, resilience, and preparation.Personal struggles: binge eating, lack of discipline, repeated failures to meet daily goals.Turning point: completing 75 Hard program → developed discipline, consistency, higher personal standards.Standards spill over into clinical performance, family life, and personal growth.Emphasizes locus of control:Focus on what you can control, not external factors.Even in chaotic emergency medicine, there are controllable elements.Warns that neglected habits eventually become emergent problems (health, mindset, life).Family story: father's heart attack → personal wake-up call about health and discipline.Core message: Raising standards in personal life and medicine leads to thriving, not just surviving.Purpose: help others raise their own standards without taking 16 years to learn the lessons.Chapter 1: Do Not Seek to DiagnoseCase study: elderly woman with shortness of breath and chest pain.No pulmonary embolism, but fluid in lungs and around heart → problem found, but no definitive diagnosis yet.Highlight: in the ED, the goal is to rule out life-threatening conditions, not always find the exact cause.Key principle: Diagnosis is often less important than identifying and stabilizing dangerous conditions.Emergency medicine limits:Not every test or long-term treatment available.Focus on acute, life-threatening issues; leave underlying cause to specialists.Patients often expect answers and certainty, but ED care is about safety and ruling out the worst cases.Overdiagnosis problems:Incidental findings (lung nodules, brain aneurysms, ultrasound anomalies) → create stress, anxiety, or unnecessary proceSupport the showEverything 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. This is not medical advice. If you have personal health concerns, please seek professional care. Full 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

Crypto News: Blackrock buys more Bitcoin putting their holdings at 750K BTC. Ethereum and Solana treasury companies buy record amounts of the assets. CME reports XRP futures breaks record and Ripple is expanding RLUSD to Africa.Show Sponsor -

Summer's still sizzling in the beef market, but other proteins and dairy are slipping. From ribeye highs to butter slides, it's a week of high steaks and low falls across the board.BEEF: Signs point to the market finally cooling as we move through September – but it may be short-lived. Ribeyes, tenderloins, chucks, rounds, and grinds are still climbing, though thin meats like skirts and briskets are starting to slip. With herds small and Mexico still closed, high prices aren't going anywhere soon… moderation may be coming, but not just yet.POULTRY: Production stays strong – up about 1% – but prices are sliding for the second week straight. Wings, breasts, and tenders are all moving lower, making chicken a solid feature right now. Still, with one new avian flu case reported and cooler weather coming, could we see trouble ahead?GRAINS: Corn nudged back over $4 for the first time in three weeks as export demand looks solid and crop estimates soften a bit from “best ever” to “some issues.” Soy keeps trying to rally but can't quite get there, while wheat remains the bargain buy of the bunch.PORK: Bellies are stuck in the $180–$185 range, closing at $182 – but the next move looks lower, so it's not the time to load up. Butts and ribs are bouncing back after recent declines, while loins continue to be the standout value cut.DAIRY: Week three of a sliding CME – barrel down 1, block down 3, and butter off another 11 after last week's steep drop. It's not a massive slide, but the steady decline is adding up – will the dip deepen, or start to level out?Savalfoods.com | Find us on Social Media: Instagram, Facebook, YouTube, Twitter, LinkedIn

You are in for a dose of inspiration in this episode of Raise the Line as we introduce you to a rare disease patient who was a leading force in establishing the diagnosis for her own condition, who played a key role in launching the first phase three clinical trials for it, and who is now coordinating research into the disease and related disorders at one of the nation's top hospitals. Rebecca Salky, RN, was first afflicted at the age of four with MOGAD, an autoimmune disorder of the central nervous system that can cause paralysis, vision loss and seizures. In this fascinating conversation with host Lindsey Smith, Rebecca describes her long and challenging journey with MOGAD, her work at the Neuroimmunology Clinic and Research Lab at Massachusetts General Hospital, and the importance of finding a MOGAD community in her early twenties. “There's a sense of power and security when you have others on your side. You're not alone in this journey of the rare disease,” she explains. Be sure to stay tuned to learn about Rebecca's work in patient advocacy, her experience as a nurse, and the three things she thinks are missing in the care of rare disease patients as our Year of the Zebra series continues.Mentioned in this episode:The MOG ProjectNeuroimmunology Clinic & Research Lab at Mass General If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

Dr. Nisha Mehta, founder of Physician Side Gigs, and Dr. Jim Dahle, founder of The White Coat Investor, join host Dr. Jay Sridhar to discuss the One Big Beautiful Bill Act and its implications for physicians and ophthalmologists in particular. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Grid Down Comms Up dives into the top ten prepping items for a natural disaster. According to NOAA, there were twenty-seven major natural disasters last year. They did 182 billion dollars in damage and caused 568 deaths. Of all the emergencies we prepare for, we are most likely to be caught up in a large-scale natural disaster. Will you be ready if one strikes your area? In today's episode, we look at the first five items on our list. potable water, food, communications, medical, and chainsaws to meet our potential immediate needs and self-rescue when help isn't coming. In our next part two, we will continue with the final five items essential for natural disaster preparedness. Stay ready and prep on. Patrick" Support the showPlease give us 5 Stars! www.preppingacademy.com Daily deals for preppers, survivalists, off-gridders, homesteaders & everyday Americans. The best gear & supplies—posted in one place, every dayCheck out https://prepperfinds.com Contact us: https://preppingacademy.com/contact/ www.preppernet.net Amazon Store: https://amzn.to/3lheTRTwww.forrestgarvin.com

Have you ever fantasized about working from a seaside café in Italy or spending your mornings hiking the Alps before a day of virtual patient care? For many physicians, the dream of living abroad can feel out of reach—especially if continuing to practice medicine is important. But what if you didn't have to choose between your career and your sense of adventure? In this inspiring episode, I'm joined by Dr. Ashwini Bapat, a palliative care physician and co-founder of Hippocratic Adventures, a vibrant community for doctors dreaming of life and work outside the U.S. Dr. Bapat shares her own journey to Portugal, how she and her husband made it work professionally, and the many options available for physicians—from local employment abroad to telemedicine and hybrid models. Whether you're just starting to consider life in another country or actively mapping out your international move, this episode offers stories, strategies, and support to help you navigate the possibilities. In this episode we're talking about: How physicians can continue to work clinically while living outside the U.S. The most straightforward countries for U.S. physicians to work in clinically How telemedicine has opened up global flexibility for non-procedural specialties Common myths around practicing medicine from another country Important legal and licensing considerations for remote work and private practice Resources to help physicians interested in working while abroad The mindset shift that can turn “I can't” into “How can I?” Hippocratic Adventures Telemedicine & Beyond - Includes a list of companies where you can do telemedicine from outside the US.  IG: @hippocratic_adventures FB group (physician only): https://www.facebook.com/groups/936658356753142/ The CME-accredited course, Telepsychiatry From Abroad, opens for enrollment on September 23rd, 2025. This will be the final enrollment period in 2025. https://www.hippocraticadventures.com/telepsychiatryfromabroad/

Crypto News: SEC & CFTC issued a joint statement clarifying that SEC and CFTC-registered exchanges are not prohibited from facilitating the trading of certain spot crypto asset products which would allow the NYSE, Nasdaq, CBOE, CME, etc, to have spot trading for BTC, ETH, and more. Show Sponsor - ✅ VeChain is a versatile enterprise-grade L1 smart contract platform https://www.vechain.org/

Chorea describes involuntary movements that are random, abrupt, and unpredictable, flowing from one body part to another. The most common cause of genetic chorea in adults is Huntington disease, which requires comprehensive, multidisciplinary care as well as support for care partners, who may themselves be diagnosed with the disease. In this episode, Aaron Berkowitz, MD, PhD FAAN speaks with Kathryn P. L. Moore, MD, MSc, author of the article “Huntington Disease and Chorea” in the Continuum® August 2025 Movement Disorders issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology at the University of California San Francisco in the Department of Neurology in San Francisco, California. Dr. Moore is an assistant professor and director of the Parkinson's Disease and Movement Disorders Fellowship in the department of neurology at Duke University in Durham, North Carolina. Additional Resources Read the article: Huntington Disease and Chorea Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz Guest: @KatiePMooreMD 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 Berkowitz: This is Dr Aaron Berkowitz with Continuum Audio, and today I'm interviewing Dr Kathryn Moore about her article on diagnosis and management of Huntington disease and chorea, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, Dr Moore. Could you please introduce yourself to our audience? Dr Moore: Yeah, thank you so much. I'm so excited to be here. I'm Dr Moore. I'm an assistant professor of neurology at Duke University, where I work as a movement disorder specialist. I run our fellowship there and help with our residency program as well. So, I'm excited to speak with our listeners about chorea today. Dr Berkowitz: Fantastic. And we're excited to talk to you about chorea. So, as a general neurologist myself, I only see chorea pretty rarely compared to other movement disorders like tremor, myoclonus, maybe the occasional tic disorder. And like anything I don't see very often, I always have to look up the differential diagnosis and how to evaluate a patient with chorea. So, I was so glad to read your article. And next time I see a patient with chorea, I know I'll be referring to your article as a great reference to have a framework for how to approach it. I hope our readers will look at all these helpful tables on differential diagnosis based on distribution of chorea in the body, potential etiologies, time course of onset and evolution, associated drug-induced causes, what tests to send. So, I highly recommend our listeners read the article. Keep those tables handy for when a patient comes in with chorea. I'm excited to pick your brain about some of these topics today. First, how do you go about distinguishing chorea from other hyperkinetic movement disorders when you see a patient that you think might have chorea? Dr Moore: One of the wonderful things about being a movement disorder specialist is we spend a lot of time looking at movements and training our brain to make these distinctions. The things that I would be looking out for chorea is involuntary, uncontrolled movements that appear to be brief and flowing from one part of the body to another. So, if you can watch a patient and predict what movements they're going to do, this probably isn't chorea. And it should be flowing from one part of the body to another. So, not staying just in one part of the body or having sustained movements. It can be difficult to distinguish between a tic or dystonia or myoclonus. Those things tend to be more predictable and repetitive than the chorea, which tends to be really random and can look like dancing. Dr Berkowitz: That's very helpful. So, once you've decided the patient has chorea, what's your framework for thinking about the differential diagnosis of the cause of the patient's chorea? Dr Moore: Well, that could be really challenging. The differential for chorea is very broad, and so the two things that I tend to use are age of the patient and acuity of onset. And so, if you're thinking about acute onset of chorea, you're really looking at a structural lesion like a stroke or a systemic issue like infection, hyperglycemia, etc. Where a gradually progressive chorea tends to be genetic in nature. When you're thinking about the difference between a child and an adult, the most common cause of chorea in a child is Sydenham's chorea. And actually, the most common cause of chorea that I tend to see is Parkinson's disease medication. So, if anybody's seen dyskinesia in Parkinson's disease, you've seen chorea. But it's those two things that I'm using, the age of the patient and the acuity. Somewhere in the middle, though---so, if you have subacute onset of chorea---it's important to remember to think about autoimmune conditions or paraneoplastic conditions because these are treatable. Dr Berkowitz: That's very helpful. So, like in any chief concern in neurology, we're using the context like the age and then the time course. And then a number of other helpful points in your article about the distribution of chorea in the body. Any comments you'd like to make about- we have this very helpful table that I thought was very interesting. So, you really get deep into the nuances of chorea and the movement disorder specialist expert level. Are there any aspects of parts of the body affected by chorea or distribution of chorea across the body that help you hone your differential diagnosis? Dr Moore: Certainly. I think where the chorea is located in the body can be helpful, but not as helpful as other conditions where you're localizing a lesion or that sort of thing. Because you can have a systemic cause of chorea that causes a hemichorea; that you can have hyperglycemia causing a hemichorea, or even Sydenham's chorea being a hemichorea. But things that we think about, if the forehead is involved, I would think about Huntington's disease, although this is not pathognomonic. And if it's involving the face or the mouth, you can think about neuroacanthocytosis or, more commonly, tardive dyskinesia. Hemichorea would make me think about some of those systemic issues like hyperglycemia, Sydenham's chorea, those sorts of things, but I would rely more on the historical context and the acuity of presentation than the distribution itself. Dr Berkowitz: Got it. That's very helpful. So those can be helpful features, but not sort of specific for any particular condition. Dr Moore: Exactly. Dr Berkowitz: Yeah, I often see forehead chorea mentioned as sort of specific to Huntington's disease. Since I don't see much Huntington's disease myself, what does forehead chorea look like? What is the forehead doing? How do you recognize that there is chorea of the forehead? It's just sort of hard for me to imagine what it would look like. Dr Moore: It's really tricky. I think seeing the eyebrows go up and down or the brows furrow in an unpredictable way is really what we're looking for. And that can be hard if you're having a conversation. My forehead is certainly animated as we're talking about one of my favorite topics here. One of the tricks that I use with the fellows is to observe the forehead from the side, and there you can see the undulation of the forehead muscles. And that can be helpful as you're looking for these things. I think where it's most helpful to use the forehead is if you're trying to determine if someone with a psychiatric history has tardive dyskinesia or Huntington's disease, because there can be quite a lot of overlap there. And unfortunately, patients can have both conditions. And so, using the forehead movement can be helpful to maybe direct further testing for Huntington's disease. Dr Berkowitz: Oh, wow, that's a very helpful pearl. So, if you see, sort of, diffuse chorea throughout the body and the forehead is involved, to my understanding it may be less specific. But in the context of wondering, is the neuropsychiatric condition and movement disorder related by an underlying cause in the case of seeing orofacial dyskinesias, is the relationship a drug having caused a tardive dyskinesia or is the whole underlying process Huntington's, the absence of forehead might push you a little more towards tardive dyskinesia, presuming there is an appropriate implicated drug and the presence of forehead chorea would really clue you in more to Huntington's. Did I understand that pearl? Dr Moore: That's exactly right, and I'm glad you brought up the point about making sure, if you're considering tardive dyskinesia, that there has been an appropriate drug exposure. Because without that you can't make that diagnosis. Dr Berkowitz: That's a very helpful and interesting pearl, looking at the forehead from the side. That is a movement disorders pearl for sure. Sort of not just looking at the forehead from one angle and trying to figure out what it's doing, but going to look at the patient in profile and trying to sort it out. I love that. Okay. So, based on the differential diagnosis you would have crafted based on whether this is sort of acute, subacute, chronic, the age of the patient, whether it's unilateral, bilateral, which parts of the body. How do you go about the initial evaluation in terms of laboratory testing, imaging, etc.? Dr Moore: Well, certainly in an acute-onset patient, you're going to get a number of labs---and that's listed out for you in the paper---and consider imaging as well, looking for an infarct. One thing our learners will know is that sort of the typical answer to what's the infarct causing hemichorea would be the subthalamic nucleus. But really, those infarcts can be almost anywhere. There are case reports for infarcts in a wide variety of places in the brain leading to hemichorea. So, I think some general blood work and an MRI of the brain is a good place to start. For someone who has a more chronic course of the development of chorea, there are certain labs that I would get---and an MRI, because if you get an MRI and there's heavy metal deposition or other disease, structurally, that indicates a certain condition, that can help you pretty considerably. But otherwise, I'm looking for inflammatory markers, heavy metals, HIV, some general other things that are outlined, to help make sure that I'm not missing something that's treatable before I go down the route of genetic testing. And we may talk about this in a little bit, but if you start out with genetic testing and then you sort of have to back up and do more systemic testing, that can be very disjointed when it comes to good patient care. Dr Berkowitz: That's very helpful. So yeah, if it's acute, obviously this is the most straightforward scenario, acute and unilateral. We're imagining something lesional, as you said, either a stroke or---not sort of sudden, but fast, but not sudden---you might think of another structural lesion. Toxoplasmosis, right, has an affinity for the basal ganglia if you were seeing this in a patient who is immunocompromised. But in a case that, probably as you alluded to, sort of what we would see most commonly in practice, those still relatively rare, sort of subacute to chronic symmetric chorea. There's a long list of tests that are recommended. In your article and in other texts, I've read lupus testing, anti-phospholipid antibodies… but the list is long. I'll refer readers to your article. Out of curiosity as a specialist, how often do you see any of these labs come back revealing any underlying diagnosis in a patient who's otherwise healthy and just has developed chorea and comes to you with that chief concern? I feel like I've sent that mega-workup a few times; I'm obviously a general neurologist, but not nearly as many times as you have been. It's- I can't remember a time where something has come up, maybe an ANA one to forty or something like this that we don't think is relevant. But in your practice, how often do you end up finding a reversible cause in the laboratory testing versus ending up starting to go down the genetic testing route, which we'll talk about in a moment? Dr Moore: It's not common, but it is important that we capture these things. Because for a lot of those laboratory tests, there are treatments that are available, or other health implications if those come back positive. So, the case I think of is a polycythemia vera patient who had diffused subacute onset chorea and was able to be treated, was temporarily managed with medication for her chorea, and as her PV improved, she was able to come off those medications. As I was alluding to before---and I'm sure we'll talk about genetic testing---if you test for HD and it's negative, do you go down the route of additional expensive genetic testing, or do you then circle back and go, oops, I missed this treatable condition? As we talk about genetic testing as well, getting HD testing is a pretty involved process. And so, we want to make sure we are checking all those boxes before we move forward. So, it's not common, but we do catch some treatable conditions, and that's really important not to miss. Dr Berkowitz: That's very interesting. So, you diagnosed that polycythemia vera by blood smear, is that how you make the diagnosis? Dr Moore: Yes. Dr Berkowitz: And is that a once-in-a-career-so-far type of thing, or does that happen time to time? Dr Moore: For me, that's a once-so-far, but I don't doubt that I'll see it again. Dr Berkowitz: Great. And how about lupus and some of these other things we look for in the absence of other systemic features? Have you picked up any of these or heard of colleagues picking up something on laboratory testing? They said, oh, this patient came in for a referral for genetic testing, negative Huntington's disease. And good news, we found polycythemia vera; good news, we found undiagnosed lupus and we reversed it. I'm just curious, epidemiologically, seeing these long lists and not having the subspecialty practice that you do, how often you find a reversible cause like we do for neuropathy all the time, right? Oh, it's diabetes, it's B12---maybe not reversible, but preventing progression---or reversible dementia work up. You get so excited when you find low B12 and you replete the patient's B12, and they get better when they had been concerned they were developing an irreversible condition. How often does one in your subspecialty find a reversible cause on that initial mega-lab screen? Dr Moore: I think it's really uncommon, and maybe the folks that do are caught by someone else that never make it to Huntington's clinic, but I don't tend to see those cases. There are, of course, case reports and well-described in the literature about lupus and movement disorders and things of that nature, but that doesn't come to our clinic on a regular basis for sure. Dr Berkowitz: Got it. That's helpful to hear. Well, we've alluded to genetic testing a number of times now, so let's go ahead and talk about it. A lot of your article focuses on Huntington disease, and I was thinking about---in the course of our medical training in medical school, and then neurology residency, for those of us who don't become movement disorder experts like yourself---we learn a lot about Huntington disease. That's sort of the disease that causes chorea, until we later learned there are a whole number of diseases, not just the reversible causes we've been talking about, but a number of genetic diseases which you expertly reviewing your article. So, what are some of the red flags that suggest to you that a patient with chronically progressive chorea---and whom you're concerned for Huntington's or another genetic cause---what are some things you notice about the history, about the exam, the symptoms, the signs, the syndrome, that suggest to you that, actually, this one looks like it might not turn out to be HD. I think this patient might have something else. And as you have alluded to, how do you approach this? Do you send HD testing, wait for it to come back, and then go forward? Are there genetic panels for certain genetic causes of chorea? Do you skip just a whole exome sequencing, or will you miss some of the trinucleotide repeat conditions? How do you approach this in practice? Dr Moore: I'll try to tackle all that. One thing I will say is that a lot of patients with chorea, regardless of the cause, can look very similar to one another. So, if you're looking at chronic onset chorea, perhaps with some neuropsychiatric features, I'm going to most often think about HD because that's the most common cause. Certainly, as we mentioned before, if there's a lot of tongue protrusion, I would think about the acanthocytic conditions, neurocanthocytosis and McCloud syndrome. But generally in those conditions, we're looking at HD as the most likely cause. Certainly, if there is epilepsy or some other syndromic types of things going on, I may think more broadly. But it's important to know that while HD, as you mentioned, is the cause of chorea, many of our patients will have parkinsonism, tics, dystonia, a whole host of other movement phenomenologies. So, that wouldn't dissuade me from thinking about HD. When we think about the kind of patients that you're describing, upwards of 95% of those people will have Huntington's disease. And the process for genetic testing is fairly involved. The Huntington's Disease Society of America has organized a set of recommendations for providers to go about the process of genetic testing in a safe and supportive way for patients and their families. And so that's referred to in the article because it really is important and was devised by patients and families that are affected by this disease. And so, when we're thinking about genetic testing for HD, if I reveal that you have HD, this potentially affects your children and your parents and your siblings. You can have a lot of implications for the lives and health and finances of your family members. We also know that there is high suicidality in patients with HD, in patients who are at risk for HD; and there's even a higher risk of suicidality in patients who are at risk but test negative for HD. So, we do recommend a supportive environment for these patients and their families. And so, for presymptomatic patients or patients who are at risk and don't have chorea, this involves making sure we have, sort of, our ducks in a row, as it were, when we think about life insurance, and, do you have somebody supportive to be with you through this journey of genetic testing, no matter what the results are? So, oftentimes I'll say to folks, you know, there's this 20-page policy that I encourage you to look at, but there are Huntington's Disease Centers of Excellence across the country that are happy to help you with that process, to make sure that the patients are well supported. This is an individual genetic test because, as you mentioned, it is a CAG repeat disorder. And unfortunately, there is no chorea panel. So, if an HD test comes back negative, what we'll do then is think about what's called the HD phenocopies. As I mentioned before, some of these patients who look like they have HD will have a negative HD test. And so, what do you do then? Well, there's a handful of phenocopies---so, other genetic mutations that cause a very similar presentation. And so, we try to be smart, since there's not a panel, we try to be smart about how we choose which test to do next. So, for instance, there's a condition called DRPLA that is present in an African-American family here in my area, in North Carolina, as well as in Japan. And so, if someone comes from those backgrounds, we may decide that that's the next test that we're going to do. If they are white European descent, we may consider a different genetic test; or if they're sub-Saharan African, we may choose a different one from that. However, even if you do a really thorough job, all those blood tests, all those genetic tests, you will occasionally get patients that you can't find a diagnosis for. And so, it's important to know even when you do a good job, you may still not find the answer. And so, I think trying to do things with this complex of the presentation in a systematic way for yourself so you're not missing something. So, going back to our answer about, how do I look at lupus and polycythemia vera and all of that, to think about it in a systematic way. That when you get to the end and you say, well, I don't have an answer, you know you've tried. Dr Berkowitz: That's very helpful to hear your approach to these challenging scenarios, and also how to approach the potential challenging diagnosis for patients and their families getting this diagnosis, particularly in the presymptomatic phase. And your article touches on this with a lot of nuance and thoughtfulness. So, I encourage our listeners to have a read of that section as well. So, last here, just briefly in our final moments, you discuss in your article the various symptomatic treatments for chorea. We won't have time to go into all the details of all the many treatments you discussed, but just briefly, how do you decide which medication to start in an individual patient with chorea for symptomatic management? What are some of the considerations related to the underlying condition, potential side effect profiles of the particular medications, or any other considerations just broadly, generally, as you think about choosing one of the many medications that can be used to treat chorea? Dr Moore: Certainly. So, there is a group of FDA-approved medications, VMAT2 inhibitors, that we can choose from, or the off-label use of neuroleptics. And so, there's a lot of things that go into that. Some of that is insurance and cost and that sort of thing, and that can play a role. Others are side effects. So, for the VMAT2 inhibitors, they all do have a black box warning from the FDA about suicidality. And so, if a patient does struggle with mental health, has a history of suicidality, psychiatric admissions for that sort of thing, then I would be more cautious about using that medication. All patients are counseled about that, as are their families, to help us give them good support. So, the neuroleptics do not tend to have that side effect and can help with mood as well as the chorea and can be helpful in that way. And some of them, of course, will have beneficial side effects. So, olanzapine may help with appetite, which can be important in this disease. So, the big considerations would be the black box warning and suicidality, as well as, are we trying to just treat chorea or are we treating chorea and neuropsychiatric issues? Dr Berkowitz: Fantastic. Thank you for that overview. And again, for our listeners, there's a lot more detail about all of these medications, how they work, how they're used in different patient populations, their side effects, etc, to be reviewed in your excellent article. Again, today, I've been interviewing Dr Kathryn Moore about her article on diagnosis and management of Huntington's disease in chorea, 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 so much to our listeners for joining today. And thank you again, Dr Moore. Dr Moore: Thanks 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.

In this episode, host Dr. Bradley Block picks up with Dr. Cheryl Chase for part 2 on enhancing executive functioning for physicians and high-performers. They explore self-monitoring tools like tone tapes (or music playlists with varying intervals), buzzing devices, timers, and apps such as Brick for blocking distractions. Dr. Chase discusses visual timers for better time perception, productivity apps like ToDoist, Trello, and Notion, and prioritization using the Eisenhower matrix to sort tasks by urgency and importance. She emphasizes delegating to free up time and replenishing the "EF bucket" with mindfulness practices (e.g., box breathing), exercise, sipping glucose-rich beverages, sleep, and nurturing relationships. Drawing from Dr. Russ Barkley's insights, these strategies help anyone—not just those with ADHD—optimize focus, persist through tasks, and maintain work-life balance. This episode wraps up the series with essential tips for thriving in demanding roles.Three Actionable Takeaways:Enhance Self-Monitoring with Tools – Use tone tapes (or playlists with varying song lengths), buzzing watches, or timers to check in on your focus at random intervals; for distractions, try apps like Brick to physically lock social media until you complete tasks.Prioritize and Delegate Effectively – Apply the Eisenhower matrix to categorize tasks by urgency and importance, focusing on high-impact items first; delegate non-essential duties after investing time to teach others, freeing up your schedule for what matters most.Replenish Your EF Bucket – Before EF-heavy tasks, practice box breathing (inhale/hold/exhale/hold for 4 counts each) or mindful minutes; incorporate exercise (20-30 minutes, 2-3 times/week), sip glucose-rich beverages while working, prioritize sleep, diet, and social connections to boost cognitive fuel.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 GuestDr. 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.

Recap of the whirlwind month of August, management of expectations, response and awareness of parts to stay in self energy - with clarity of purpose and rejuvenation of the flagship CME & Coaching Program with This Osteopathic Life - reserve your spot today! https://amelia-bueche.mykajabi.com/this-osteopathic-life-coaching-cme-september-2025

Send us a textJoin me for a compelling conversation with leadership development expert, Laurie Baedke, FACHE, FACMPE where we unpack what Mentorship, Sponsorship and Coaching can mean to a medical group's bottom line. Laurie draws from her experience as a leadership development program founder, author, and international speaker as she shares with us the reasons why medical groups should double down on developing their teams, and building bench strength. In a time where margins are being squeezed, regulations are tightening and time is limited, Laurie makes a great case for developing your most precious resource: your people. Laurie can be reached at www.LaurieBaedke.com and on LinkedIn at https://www.linkedin.com/in/lauriebaedke/Please Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: http://21978609.hs-sites.com/newletter-subscriber Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 30+ hours of online, on-demand CME-accredited training tailored just for busy physicians. Find it here: https://healtheps.com/physicians-edge-mastering-business-finance-in-your-medical-practice/ Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/

Send us a textEver wonder why setting boundaries as a physician feels like trying to learn rocket science? You're brilliant, you've mastered complex medical concepts, yet saying "no" to one more request feels impossibly difficult. Here's the truth: You weren't taught how to set boundaries – you were actively trained to sacrifice yourself for others.The Car Manual RevelationPicture this: I'm sitting in my new electric car with my tech-savvy 13-year-old, trying to learn the features while driving. He's read the entire manual and is spewing facts about the parking system when all I need to know is where the windshield wiper button is. Sound familiar? That's exactly how most of us approach learning boundaries, self-care, and making our lives easier – we get overwhelmed with information instead of practical, immediately applicable skills.Why Boundary-Setting Feels Like Medical School All Over Again (But Worse)As physicians, we survived years of hierarchical learning where we were fed information and tested on facts. But here's what nobody told you: Adult learning is completely different, and understanding these principles is the key to finally mastering boundaries without the overwhelm and burnout.The 5 Adult Learning Principles That Will Transform Your Boundary Practice:1. Internal Motivation (Not External Pressure)You need crystal-clear reasons WHY you're setting boundaries. When that email request comes in asking you to take on "just one more thing," you better know exactly why you're saying no:"I need space to exist in my own life""I cannot add anything more without drowning""This isn't my responsibility at my licensure level"Without internal motivation, you'll cave every time. The overwhelm will win.2. Relevance (Immediately Applicable)Forget reading 10 books about boundary theory. You need to practice saying no to the next request that comes your way – even if it's small. That salesperson pushing you to "just sign here"? Perfect boundary practice. You don't need to wait for the "perfect" boundary moment.3. Experience (Hands-On Practice) You cannot learn boundaries from lectures about boundaries. You learn by feeling the discomfort of saying no and sitting with it. You learn by disappointing someone and discovering you both survive. You practice in low-stakes situations so you're ready for the high-stakes physician overwhelm moments.4. Task-Oriented (Not Information Overload) Stop consuming more boundary content and START practicing. Learn to do, then do more, then learn more. The physician who practices setting one small boundary daily will master this skill faster than the one who attends every wellness CME but never says no.5. Self-Directed (With Strategic Accountability)You're used to being accountable to everyone – patients, bosses, colleagues. Now you need to be accountable to yourself. This is where external support (like coaching) becomes crucial for breaking the physician burnout cycle.The Truth About Physician Overwhelm 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

In this episode of The Radiology Review Podcast, we cover pulmonary embolism (PE), an essential diagnosis to master for the radiology boards and for clinical practice. This high-yield review highlights imaging findings, pitfalls, and pearls across modalities, with a focus on CT pulmonary angiography (CTPA). Check out the free study guide on this episode at theradiologyreview.com. Useful Resources & LinksDiscounts to Boost Your Study ToolsExplore current savings for radiology learning resources:BoardVitals: 10% off with RADREVIEW; $100 off CME with RADREVIEW100.Medality/MRI Online: 10% off with code radreview.(Offers may vary by date—check the linked page for the latest) The Radiology ReviewView all available offers →The Radiology Review Insider (RRI)The RRI is free-access, non-peer-reviewed content authored by thought leaders. It includes perspectives on radiology education, personal essays, board-prep advice, and workflow strategies—great for expanding your understanding beyond cases. Learn more about the RRJ →Radiologist Gear GuideImprove your workstation ergonomics and productivity with tools like ergonomic mice, programmable keypads, studio microphones, and foot pedals—selected to streamline your reading-room workflow. Explore recommended gear →Mentioned in this episode:Board VitalsRadiology residents—get ready for the ABR CORE Exam with BoardVitals! Access over 1,300 high-yield questions, detailed explanations, and adaptive learning. Study anytime with the mobile app, customize by subject, and track progress. Plus, a 100% pass guarantee! Start your free trial at BoardVitals.com and use code RADREVIEW for 10% off Radiology question banks.

Show Notes:In this month's first episode, Whitni Miller, founder of BDE Moves, sits down with the founder of The Fosnight Center, Aleece Fosnight. They explore the multifaceted aspects of health, particularly focusing on sexual health, perimenopause, and the biopsychosocial model of care. They discuss the importance of recognizing women's worth beyond reproductive capabilities, the complexities of hormonal changes during perimenopause, and the need for inclusivity in healthcare for non-binary and trans individuals. They emphasize the significance of listening to patients and the necessity for more research in these areas. Aleece Fosnight obtained a Master of Science in PA Studies from the University of Kentucky in 2011 and went on to receive her postgraduate certificate in sexuality counseling and education at the University of Michigan in 2014. She opened her own private practice, the Fosnight Center for Sexual Health, in Asheville, NC in June 2020. Her expertise includes urology, gynecology, pelvic health, gender affirming care, sexual medicine, hormones, and sexuality counseling. She is an AASECT certified sexuality counselor and educator, nationally certified menopause practitioner, Health At Every Size medical provider, trauma-informed and kink-aware. Ms. Fosnight is on multiple local, state, and national boards, a national speaker for several CME organizations, guest lecturer for several PA and medical school programs, and medical advisor for Aeroflow Urology and Uberlube. Learn More about The Fosnight Center:https://fosnightcenter.com/ Follow Aleece Fosnight:ALL Platforms - @sexmedPA or @fosnightcenter Learn More From Whitni:https://www.bde-moves.com Follow Whitni at:IG - @bde.movesFB - groups/bdemovesYouTube - Podcast Channel = @BDE-Moves Old Channel = @BdeTalksTikTok - @bdemoves