Podcasts about cme

On this episode, we're joined by Dr. Sapna Shah-Haque, a practicing internist in rural Kansas and the host of The Worth Physician podcast — a powerful platform dedicated to elevating physician voices and addressing burnout, well-being, and systemic challenges in healthcare.Dr. Shah-Haque shares her unconventional journey from electrical engineering to medicine, and how personal tragedy — including her mother's stroke and the loss of a close physician friend to suicide — led her to confront burnout, which she calls a form of "moral injury." These experiences not only reshaped her career, but also sparked a commitment to self-care, healing, and community through storytelling.We discuss the importance of putting on your own oxygen mask first, the dangers of private equity's growing influence in healthcare, the rise of AI and her vision for the future: expanding her podcast with a co-host, exploring CME integration, and potentially launching a physician retreat focused on renewal and connection.Dr. Shah-Haque' s voice is both honest and hopeful — a much-needed reminder that doctors are human, too.To learn more on Dr. Shah-Haque visit them at theworthyphysician.com___________________________________________________________________________________________Serious about growing your healthcare practice? DM: Andre Wright, MBA Email: andre@thewrightconsult.com Schedule a chat HERE Our digital marketing agency: The WRIGHTConsult Don't miss out at a chance to take your healthcare practice to the next level with our award winning programs. Let's grow your practice. Connect with Your Company Health Linkedin TikTok Find us on all the major podcast platforms including the ones below! Spotify Apple Amazon

Beef is still riding high – tight supply, strong demand, and prices climbing week after week. But is relief finally in sight? You might want to stock up before the July 4th smoke clears…

Peter A. Schein is the co-founder and CEO of OCLI.org in Menlo Park, California. He is a contributing author to the 5th edition of Organizational Culture and Leadership (2017). With Edgar H. Schein he is co-author of Humble Leadership (2018, 2nd ed. 2023), The Corporate Culture Survival Guide, 3rd ed. (2019), Humble Inquiry, (2nd ed. 2021 and 3rd ed. 2025), and Career Anchors Reimagined (2023). Peter's work brings 30 years of technology industry experience in marketing, corporate development, and strategy, at large and small IT companies including Apple, Sun Microsystems and numerous start-ups. While forging new strategies and merging smaller entities into a larger company, Peter developed a keen focus on the organizational development challenges faced by innovation-driven enterprises. Peter was educated at Stanford University (BA in social anthropology with honors and distinction), Northwestern University (Kellogg MBA), and the USC Marshall School of Business (HCEO Certificate).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.

Dr Neeraj Agarwal from the University of Utah Huntsman Cancer Institute in Salt Lake City, Dr Andrew J Armstrong from Duke Cancer Institute in Durham, North Carolina, Dr Himisha Beltran from Dana-Farber Cancer Institute in Boston, Massachusetts, Dr Fred Saad from the University of Montreal Hospital Center in Québec, Canada, and Dr Rana R McKay from the UC San Diego Moores Cancer Center discuss recent updates on available and novel treatment strategies for prostate cancer. CME information and select publications here.

Featuring perspectives from Dr Neeraj Agarwal, Dr Andrew J Armstrong, Dr Himisha Beltran, Dr Rana R McKay and Dr Fred Saad, moderated by Dr McKay, including the following topics: Introduction (0:00) Evolving Management of Nonmetastatic Hormone-Sensitive Prostate Cancer (HSPC) — Dr Saad (2:12) Current Treatment for Metastatic HSPC — Dr Armstrong (26:12) Role of PARP Inhibition in Metastatic Castration-Resistant Prostate Cancer (mCRPC) — Dr Agarwal (49:31) Current and Future Use of Radiopharmaceuticals for mCRPC — Dr McKay (1:12:51) Promising Novel Agents and Strategies Under Investigation for the Management of Prostate Cancer — Dr Beltran (1:36:11) CME information and select publications

How do you design CME that reaches the communities most affected by HIV—and not just the clinicians who already have access? If you're a CME professional grappling with how to address layered issues like stigma, housing insecurity, or racial disparities, you're not alone. This episode dives into what it takes to create truly inclusive education—especially when traditional strategies fall short. Whether you're designing education for clinicians or collaborating with community partners, you'll find actionable ideas to bring your programming closer to the ground. Specifically, you'll learn: How to build authentic partnerships with community leaders who can serve as trusted bridges between healthcare providers and hard-to-reach populations. The essential infrastructure you need to establish before launching community-based programs, from setting up referral networks that ensure patients don't fall through cracks after screening to tracking both clinical outcomes and demographic data that funders require. A proven framework for developing educational content with cultural humility and how to work with expert faculty who understand nuanced communication challenges. Connect with Dean

Featuring an interview with Dr Patrick Y Wen, including the following topics: Glioma classification (0:00) Efficacy and safety of vorasidenib in the management of IDH-mutant gliomas (4:50) Case: A woman in her early 30s with a Grade 2 astrocytoma and an IDH R132H mutation and residual disease postoperatively (11:55) Case: A man in his early 40s experiencing stable disease with vorasidenib after subtotal resection (21:46) Ongoing trial investigating vorasidenib in IDH-mutant gliomas (27:30) Current and emergent strategies for the management of glioblastoma (31:27) Optimizing patient care and quality of life (46:24) CME information and select publications

Dr Patrick Wen from the Dana-Farber Cancer Institute in Boston, Massachusetts, discusses the current and future management of IDH-mutant gliomas. CME information and select publications here.

In this Friends of NPACE Podcast, Dr. Amy Bruno PhD, ANP-BC joins host Terri Schmitt to discuss important statistics on migraine headaches, diagnosis, and first stages of treatment. This podcast is supported by a generous educational grant by Haleon. This podcast is available for 0.5 CE Category 1 CME credit and 0.5 pharmacology credits. | 0.50 credits (0.50 Pharmacology) | Nurse Practitioner Associates for Continuing Education is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation Earn 0.5 CE/CME Credit (0.5 Pharmacology CE) upon completion of this podcast episode. To redeem your CE/CME credit visit the NPACE Learning Center where this episode is available for free with a CE/CME certificate redeemable upon completion.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AZC865. CME credit will be available until 19 June 2026.Navigating the Layers of Complexity in R/R B-Cell Cancers: From Clinical Prognosis to Emerging Therapeutic Prospects in CLL/SLL, MCL, and DLBCL In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AZC865. CME credit will be available until 19 June 2026.Navigating the Layers of Complexity in R/R B-Cell Cancers: From Clinical Prognosis to Emerging Therapeutic Prospects in CLL/SLL, MCL, and DLBCL In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc.Disclosure information is available at the beginning of the video presentation.

Dr. Feldman on LOSS AVERSION -Facial discoid dermatosis -De-roofing: Most cost effective than excision in HS -Dermasphere clip show: Episodes 151-159! -Join Luke's CME experience on Jak inhibitors! ⁠rushu.gathered.com/invite/ELe31Enb69⁠Learn more about the U of U Dermatology ECHO model!physicians.utah.edu/echo/dermatolog…20the%20session.Want to donate to the cause? Do so here!
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Featuring a slide presentation and related discussion from Dr Patrick Y Wen, including the following topics: Classification and pathologic diagnosis of gliomas (0:00) Role of IDH inhibitors in the management of low-grade gliomas (6:37) Ongoing trials and remaining questions in the management of IDH-mutant gliomas (19:53) CME information and select publications

Dr Patrick Wen from the Dana-Farber Cancer Institute in Boston, Massachusetts, discusses the current and future management of IDH-mutant gliomas. CME information and select publications here.

Bryan Jepson MD and CFP, author of The Physician's Path to True Wealth: 12 steps to gaining control over your money and your time – you can find it on Amazon and at this website for free Bryan Jepson MD, CFP® | physician financeDisclaimers:This is not specific financial advice, this is general education. Talk with your own advisor or schedule with Bryan to get specific advice The easiest, most straightforward way to start creating assets is to invest in your 401kDebt to fund a liability is bad debt, it takes money out of your pocketDebt that leads to more money in your pocket is good debt, but this requires wisdom in choosing your degree and education pathThere are a couple of methodologies to pay off debt, the snowball method vs the avalanche method. Snowball goes smallest debt to largest. Avalanche goes from highest interest to lowest interest. Use the one that will actually work for YOU and will make you be consistentThe 4% rule: generally, when you can live off 4% of your investments per year, you have enough for retirementSo, if you need 100K to live off in retirement, you need 2.5 million in investmentsWhy does everyone need a will? If you have kids, it allows you to designate a guardian should you die. It also allows you to allocate where your assets goWhat is the importance of giving away money?Giving can be looked at through a couple different lenes. When you give, you are blessed in return. Or maybe you can view it as good karmaBryan talks about how relationships are an important aspect of life and giving allows for meaningful relationships with something you value. Donate money but also your timeWhen you are rich, you don't have the cushion to give. When you are wealthy, you have the ability to give to othersFinance is simple but not easy because you need discipline. You don't have to get far into the weeds to be successfulBryans book has the foundation you need to understand financeBryan talks about the difference between a financial advisor and a certified financial planner Bryan gives his opinion on whole life insurance vs term insuranceSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Thanks for listening!

Featuring perspectives from Prof Nicolas Girard, Dr Jonathan Goldman, Dr Pasi A Jänne, Dr Suresh S Ramalingam, Dr Joshua K Sabari and Dr Helena Yu, moderated by Dr Yu, including the following topics: Introduction (0:00) Evolving First-Line Treatment for Metastatic EGFR Mutation-Positive Non-Small Cell Lung Cancer (NSCLC) — Dr Yu (1:47) EGFR-Targeted Approaches for Relapsed EGFR-Mutant NSCLC; Strategies to Facilitate Delivery of Recently Approved Agents — Dr Sabari (23:48) Potential Utility of TROP2-Targeted Therapy in the Management of EGFR-Mutant NSCLC — Dr Ramalingam (45:16) Contemporary Care for Patients with Nonmetastatic EGFR-Mutant NSCLC — Dr Goldman (1:03:56) Current and Future Management of EGFR Exon 20 Mutation-Positive NSCLC — Prof Girard (1:24:40) Emerging Role of HER3-Targeted Therapy in the Management of EGFR-Mutant NSCLC — Dr Jänne (1:43:46) CME information and select publications

Prof Nicolas Girard, Dr Jonathan Goldman, Dr Pasi Jänne, Dr Suresh Ramalingam, Dr Joshua Sabari and moderator Dr Helena Yu present data informing treatment decision-making for EGFR-mutated NSCLC at the 2025 ASCO annual meeting. CME information and select publications here.

I've spent my career helping teams and leaders navigate change—not by pushing harder, but by making the process easier, smarter, and, dare I say, even enjoyable. As the Operational Excellence Leader for two Viant Medical sites (New Hampshire and Michigan), I drive continuous improvement in high-stakes manufacturing environments. But my real passion? Helping change leaders like you overcome resistance and create lasting impact with less struggle and more confidence. That's why I launched my coaching and consulting business—to help you break through obstacles and find the path of ease to real, meaningful change.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.

Featuring perspectives from Dr Geoffrey Y Ku and Dr Zev Wainberg, including the following topics: Introduction: ASCO Preview (0:00) HER2-Positive Gastroesophageal Cancers (19:03) Immunotherapy in HER2-Negative Advanced Gastroesophageal Cancers (36:11) Immunotherapy in Microsatellite Instability-High Gastroesophageal Cancers (44:04) CLDN18.2-Positive Advanced Gastroesophageal Cancers (51:30) CME information and select publications

This week, Matt and Ashley are joined by Bart Charles from Atlantic Forest Products, one of the top cash and futures traders in North America. We dig into what we're doing with our current positions and what we see ahead in the lumber market. From May housing numbers to the looming increase in Canadian CVD and AD duties, we cover the major forces shaping the near- term outlook. We also unpack the CME premium and what it means for basis, mill behavior in the cash market, and where customer inventories stand today. This episode is loaded with insights you won't hear anywhere else. If you're in the business of buying or selling construction lumber, this is a must- listen. Contact the show participants at: Charles@AtlanticForest.com MattBeymer@HamptonLumber.com Ashley@Sitkainc.com

Dr Geoffrey Y Ku from the Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Zev Wainberg from the UCLA School of Medicine discuss patient cases and summarize current treatment approaches for gastroesophageal cancer. CME information and select publications here.

Dr Geoffrey Y Ku from the Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Zev Wainberg from the UCLA School of Medicine discuss patient cases and summarize current treatment approaches for gastroesophageal cancer. CME information and select publications here.

Featuring perspectives from Prof Meletios-Athanasios (Thanos) C Dimopoulos and Dr Robert Z Orlowski, including the following topics: Introduction: ASCO 2025 Preview (0:00) Anti-CD38 Antibodies (10:12) Belantamab Mafodotin (29:45) CAR T-Cell Therapy (40:57) Bispecific Antibodies (47:33) Other Novel Agents (56:46) CME information and select publications

Prof Meletios-Athanasios (Thanos) C Dimopoulos from the National and Kapodistrian University of Athens and Alexandra Hospital in Athens, Greece, and Dr Robert Z Orlowski from The University of Texas MD Anderson Cancer Center in Houston, Texas, provide their perspectives on relevant new clinical data in multiple myeloma and their application to disease treatment. CME information and select publications here.

Are you a freelance CME writer juggling too many project types and wondering if it's time to finally “niche down”? In the world of continuing medical education (CME), clarity and focus aren't just nice to have—they're essential for sustainable business growth. If you're feeling stretched thin, jumping between clients and therapeutic areas, this episode explores how finding a niche can reduce overwhelm, streamline your process, and even attract the kinds of clients who value what you do most. Here's what you'll gain from this episode: A practical definition of what a niche is—and what it isn't—so you can stop second-guessing yourself. Examples of how different niches can emerge from your background, preferences, or even your favorite types of client relationships. A step-by-step approach to experimenting your way into a niche, without the pressure to get it “perfect” from the start. Tune in now to learn how niching can simplify your business, supercharge your marketing, and help you find work that truly energizes you. LINKS Grab the Niche Discovery Checklist Signup for Summer Script Camp If you are looking for ongoing CME content strategy tips, tools, and tactics, subscribe to the Write Medicine Insider newsletter. Get TextExpander

Idiopathic intracranial hypertension (IIH) is characterized by symptoms and signs of unexplained elevated intracranial pressure (ICP) in an alert and awake patient. The condition has potentially devastating effects on vision, headache burden, increased cardiovascular disease risk, sleep disturbance, and depression.  In this episode, Teshamae Monteith, MD, FAAN speaks with Aileen A. Antonio, MD, FAAN, author of the article “Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Antonio is an associate program director of the Hauenstein Neurosciences Residency Program at Trinity Health Grand Rapids and an assistant clinical professor at the Michigan State University College of Osteopathic Medicine in Lansang, Michigan. Additional Resources Read the article: Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @aiee_antonio Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: Hi, this is Dr Teshamae Monteith. Today I'm interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the June 2025 Continuum issue on disorders of CSF dynamics.  Hi, how are you? Dr Antonio: Hi, good afternoon. Dr Monteith: Thank you for being on the podcast. Dr Antonio: Thank you for inviting me, and it's such an honor to write for the Continuum. Dr Monteith: So why don't you start off with introducing yourself? Dr Antonio: So as mentioned, I'm Aileen Antonio. I am a neuro-ophthalmologist, dually trained in both ophthalmology and neurology. I'm practicing in Grand Rapids, Michigan Trinity Health, and I'm also the associate program director for our neurology residency program. Dr Monteith: So, it sounds like the residents get a lot of neuro-ophthalmology by chance in your curriculum. Dr Antonio: For sure. They do get fed that a lot. Dr Monteith: So why don't you tell me what the objective of your article was? Dr Antonio: Yes. So idiopathic intracranial hypertension, or IIH, is a condition where there's increased intracranial pressure, but without an obvious cause. And with this article, we want our readers---and our listeners right now---to recognize that the typical symptoms and learning about the IIH diagnostic criteria are key to avoiding errors, overdiagnosis, or sometimes even misdiagnosis or underdiagnosis. Thus, we help make the most of our healthcare resources. Early diagnosis and management are crucial to prevent disability from intractable headaches or even vision loss, and it's also important to know when to refer the patients to the appropriate specialists early on. Dr Monteith: So, it sounds like your central points are really getting that diagnosis early and managing the patients and knowing how to triage patients to reduce morbidity and complications. Is that correct? Dr Antonio: That is correct and very succinct, yes. Dr Monteith: And so, are there any more recent advances in the diagnosis of IIH? Dr Antonio: Yes. And one of the tools that we've been using is what we call the optical coherence tomography. A lot of people, neurologists, physicians, PCP, ER doctors; how many among those physicians are well-versed in doing an eye exam, looking at the optic disc? And this is a great tool because it is noninvasive, it is high resolution imaging technique that allows us to look at the optic nerve without even dilating the eye. And we can measure that retinal nerve fiber layer, or RNFL; and that helps us quantify the swelling that is visible or inherent in that optic nerve. And we can even follow that and monitor that over time. So, this gives us another way of looking at their vision and getting that insight as to how healthy is their vision still, along with the other formal visual tests that we do, including perimetry or visual field testing. And then all of these help in catching potentially early changes, early worsening, that may happen; and then we can intervene more easily. Dr Monteith: Great. So, it sounds like there's a lot of benefits to this newer technology for our patients. Dr Antonio: That is correct. Dr Monteith: So, I read in the article about the increased incidence of IIH, and I have to say that I completely agree with you because I'm seeing so much of it in my clinic, even as a headache specialist. And I had a talk with a colleague who said that the incidence of SIH and IIH are similar. And I was like, there's no way. Because I see, I can see several people with IIH just in one day. That's not uncommon. So, tell me what your thoughts are on the incidence, the rising incidence of IIH; and we understand that it's the condition associated with obesity, but it sounds like you have some other underlying drivers of this problem. Dr Antonio: Yes, that is correct. So, as you mentioned, IIH tends to affect women of childbearing age with obesity. And it's interesting because as you've seen that trend, we see more of these IIH cases recently, which seem to correlate with that rising rate of obesity. And the other thing, too, is that this trend can readily add to the burden of managing IIH, because not only are we dealing with the headaches or the potential loss of vision, but also it adds to the burden of healthcare costs because of the other potential comorbidities that may come with it, like cardiovascular risk factors, PCOS, and sleep apnea. Dr Monteith: So why don't we just talk about the diagnosis of IIH? Dr Antonio: IIH, idiopathic intracranial hypertension, is also called pseudotumor cerebri.  It's essentially a condition where a person experiences increased intracranial pressure, but without any obvious cause. And the tricky part is that the patients, they're usually fully awake and alert. So, there's no obvious tumor, brain tumor or injury that causes the increased ICP. It's really, really important to rule out other conditions that might cause these similar symptoms; again, like brain tumors or even the cerebral venous sinus thrombosis. Many patients will have headaches or visual disturbances like transient visual obscurations---we call them TVOs---or double vision or diplopia. The diplopia is usually related to a sixth nerve palsy or an abducens palsy. Some may also experience some back pain or what we call pulsatile tinnitus, which is that pulse synchronous ringing in their ears. The biggest sign that we see in the clinic would be that papilledema; and papilledema is a term that we only use, specifically use, for those optic nerve edema changes that is only associated with increased intracranial pressure. So, performing of endoscopy and good eye exam is crucial in these patients. We usually use the modified Dandy criteria to diagnose IIH. And again, I cannot emphasize too much that it's really important to rule out other secondary causes to that increased intracranial pressure. So, after that thorough neurologic and eye evaluation with neuroimaging, we do a lumbar puncture to measure the opening pressure and to analyze the cerebrospinal fluid. Dr Monteith: One thing I learned from your article, really just kind of seeing all of the symptoms that you mentioned, the radicular pain, but also- and I think I've seen some papers on this, the cognitive dysfunction associated with IIH. So, it's a broader symptom complex I think than people realize. Dr Antonio: That is correct. Dr Monteith: So, you mentioned TVOs. Tell me, you know, if I was a patient, how would you try and elicit that from me? Dr Antonio: So, I would usually just ask the patient, while you're sitting down just watching TV---some of my patients are even driving as this happens---they would suddenly have these episodes of blacking out of vision, graying out of vision, vision loss, or blurred vision that would just happen, from seconds to less than a minute, usually. And they can happen in one eye or the other eye or both eyes, and even multiple times a day. I had a patient, it was happening 50 times a day for her. It's important to note that there is no pain associated with it most of the time. The other thing too is that it's different from the aura that patients with migraines would have, because those auras are usually scintillating and would have what we call the positive phenomena: the flashing lights, the iridescence, and even the fortification that they see in their vision. So definitely TVOs are not the migraine auras. Sometimes the TVOs can also be triggered by sudden changes in head positions or even a change in posture, like standing up quickly. The difference, though, between that and, like, the graying out of vision or the tunneling vision associated with orthostatic hypotension, is that the orthostatic hypotension would also have that feeling of lightheadedness and dizziness that would come with it. Dr Monteith: Great. So, if someone feels lightheaded, less likely to be a TVO if they're bending down and they have that grain of vision. Dr Antonio: That is correct. Dr Monteith: Definitely see patients like that in clinic. And if they have fluoride IIH, I'm like, I'll call it a TVO; if they don't, I'm like, it's probably more likely to be dizziness-related. And then we also have patient migraines that have blurriness that's nonspecific, not necessarily associated with aura. But I think in those patients, it's usually not seconds long, it's usually probably longer episodes of blurriness. Would you agree there, or…? Dr Antonio: I would agree there, and usually the visual aura would precede the headache that is very characteristic of their migraine, very stereotypical for their migraines. And then it would dissipate slowly over time as well. With TVOs, they're brisk and would not last, usually, more than a minute. Dr Monteith: So, why don't we talk about routine imaging? Obviously, ordering an MRI, and I read also getting an MRV is important. Dr Antonio: It is very important because, one: I would say IIH is also a diagnosis of exclusion. We need to make sure that the increased ICP is not because of a brain tumor or not because of cerebral venous sinus thrombosis. So, it's important to get the MRI of the brain as well as the MRV of the head. Dr Monteith: Do you do that for all patients' MRV, and how often do you add on an orbital study? Dr Antonio: I usually do not add on an orbital study because it's not really going to change my management at that point. I really get that MRI of the brain. Now the MRV, for most of my patients, I would order it already just because the population that I see, I don't want to lose them. And sometimes it's that follow-up, and that is the difficult part; and it's an easy add on to the study that I'm going to order. Again, it depends with the patient population that you have as well, and of course the other symptoms that may come with it. Dr Monteith: So, why don't we talk a little bit about CSF reading and how these set values, because we get people that have readings of 250 millimeters of water quite frequently and very nonspecific, questionable IIH. And so, talk to me about the set value. Dr Antonio: Right. So, the modified Dandy criteria has shown that, again, we consider intracranial pressure to be elevated for adults if it's above 250 millimeters water; and then for kids if it's above 280 millimeters of water. Knowing that these are taken in the left lateral decubitus position, and assuming also that the patients were awake and not sedated during the measurement of the CSF pressure. The important thing to know about that is, sometimes when we get LPs under fluoroscopy or under sedation, then these can cause false elevation because of the hypercapnia that elevated carbon dioxide, and then the hypoventilation that happens when a patient is under sedation. Dr Monteith: You know, sometimes you see people with opening pressures a little bit higher than 25 and they're asymptomatic. Well, the problem with these opening pressure values is that they can vary somewhat even across the day. People around 25, you can be normal, have no symptoms, and have opening pressure around 25- or 250; and so, I'm just asking about your approach to the CSF values. Dr Antonio: So again, at the end of the day, what's important is putting everything together. It's the gestalt of how we look at the patient. I actually had an attending tell me that there is no patient that read the medical textbook. So, the, the important thing, again, is putting everything together. And what I've also seen is that some patients would tell me, oh, I had an opening pressure of 50. Does that mean I'm in a dire situation? And they're so worried and they just attach to numbers. And for me, what's important would be, what are your symptoms? Is your headache, right, really bad, intractable? Number two: are you losing vision, or are you at that cusp where your optic nerve swelling or papilledema is so severe that it may soon lead to vision loss? So, putting all of these together and then getting the neuroimaging, getting the LP. I tell my residents it's like icing on the cake. We know already what we're dealing with, but then when we get that confirmation of that number… and sometimes it's borderline, but this is the art of neurology. This is the art of medicine and putting everything together and making sure that we care and manage it accordingly. Dr Monteith: Let's talk a little bit about IIH without papilledema. Dr Antonio: So, let's backtrack. So, when a patient will fit most of the modified Dandy criteria for IIH, but they don't have the papilledema or they don't have abducens palsy, the diagnosis then becomes tricky. And in these kinds of cases, Dr Friedman and her colleagues, when they did research on this, suggested that we might consider the diagnosis of IIH. And she calls this idiopathic intracranial hypertension without papilledema, IIHWOP. They say that if they meet the other criteria for modified Dandy but show at least three typical findings on MRI---so that flattening of the posterior globe, the tortuosity of the optic nerves, the empty sella or the partially empty sella, and even the narrowing of the transverse venous sinuses---so if you have three of these, then potentially you can call these cases as idiopathic intracranial hypertension without papilledema. Dr Monteith: Plus, the opening pressure elevation. I think that's key, right? Getting that as well. Dr Antonio: Yes. Sometimes IIHWOP may still be a gray area. It's a debate even among neuro-ophthalmologists, and I bet even among the headache specialists. Dr Monteith: Well, I know that I've had some of these conversations, and it's clear that people think this is very much overdiagnosed. So, that's why I wanted to plug in the LP with that as well. Dr Antonio: Right. And again, we have not seen yet whether is, this a spectrum, right? Of that same disease just manifesting differently, or are they just sharing a same pathway and then diverging? But what I want to emphasize also is that the treatment trials that we've had for IIH do not include IIHWOP patients. Dr Monteith: That is an important one. So why don't you wrap this up and tell our listeners what you want them to know? Now's the time. Dr Antonio: So, the- again, with IIH, with idiopathic intracranial hypertension, what is important is that we diagnose these patients early. And I think that some of the issues that come into play in dealing with these patients with IIH is that, one: we may have anchoring bias. Just because we see a female with obesity, of reproductive age, with intractable headaches, it does not always mean that what we're dealing with is IIH. The other thing, too, is that your tools are already available to you in your clinic in diagnosing IIH, short of the opening pressure when you get the lumbar puncture. And I need to emphasize the importance of doing your own fundoscopy and looking for that papilledema in these patients who present to you with intractable headaches or abducens palsy. What I want people to remember is that idiopathic intracranial hypertension is not optic nerve sheath distension. So, these are the stuff that you see on neuroimaging incidentally, not because you sent them, because they have papilledema, or because they have new headaches and other symptoms like that. And the important thing is doing your exam and looking at your patients. Dr Monteith: Today, I've been interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Thank you again. Dr Antonio: Thank you. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

In this CME podcast episode, Dr. Andrew Cutler interviews Dr. Phillip Coffin, Director of the Center on Substance Use and Health in San Francisco, CA, about the management of stimulant use disorders. They explore the challenges of treatment and highlight the importance of harm reduction strategies to enhance patients' quality of life.  CME credit is available to NEI Members only.   Target Audience: This activity has been developed for the healthcare team or individual prescriber specializing in mental health. All other healthcare team members interested in psychopharmacology are welcome for advanced study. Learning Objectives: After completing this educational activity, you should be better able to: Summarize pharmacologic and behavioral treatment strategies for stimulant use disorders, particularly methamphetamine and cocaine Evaluate the evidence base for current and investigational medications used in clinical trials and real-world settings Apply harm reduction principles and integrated care models to improve outcomes for patients with stimulant use disorders in diverse clinical settings Accreditation: In support of improving patient care, this activity has been planned and implemented by HMP Education and Neuroscience Education Institute (NEI). HMP Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.   Activity Overview: This activity is available with synchronized audio and is best supported via a computer or device with current versions of the following browsers: Mozilla Firefox, Google Chrome, or Safari. A PDF reader is required for print publications. A post-test score of 70% or higher is required to receive CME/CE credit.   Estimated Time to Complete: 1 hour Released: June 18, 2025*   Expiration: June 17, 2028 *NEI and HMP Education maintain a record of participation for six (6) years. CME/CE Credits and Certificate Instructions: After listening to the podcast, to take the optional posttest and receive CME/CE credit, click: https://nei.global/POD25-02.  Credit Designations: The following are being offered for this activity: Physician: ACCME AMA PRA Category 1 Credits™ HMP Education designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurse: ANCC contact hours This continuing nursing education activity awards 1.00 contact hour. Provider approved by the California Board of Registered Nursing, Provider #18006 for 1.00 contact hour. Nurse Practitioner: ACCME AMA PRA Category 1 Credit™ American Academy of Nurse Practitioners National Certification Program accepts AMA PRA Category 1 Credits™ from organizations accredited by the ACCME. The content in this activity pertaining to pharmacology is worth 1.00 continuing education hour of pharmacotherapeutics. Pharmacy: ACPE application-based contact hours This internet enduring, knowledge-based activity has been approved for a maximum of 1.00 contact hour (.10 CEU). The official record of credit will be in the CPE Monitor system. Following ACPE Policy, NEI and HMP Education must transmit your claim to CPE Monitor within 60 days from the date you complete this CPE activity and are unable to report your claimed credit after this 60-day period. Ensure your profile includes your DOB and NABP ID. Physician Associate/Assistant: AAPA Category 1 CME credits HMP Education has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credits for activities planned in accordance with the AAPA CME Criteria. This internet enduring activity is designated for 1.00 AAPA Category 1 credit. Approval is valid until June 17, 2028. PAs should only claim credit commensurate with the extent of their participation. Psychology: APA CE credits Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs. This activity awards 1.00 CE Credit. Social Work: ASWB-ACE CE credits As a Jointly Accredited Organization, HMP Education is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this internet enduring course receive 1.00 general continuing education credit. Non-Physician Member of the Healthcare Team: Certificate of Participation HMP Education awards hours of participation (consistent with the designated number of AMA PRA Category 1 Credit™) to a participant who successfully completes this educational activity. Peer Review: The content was peer-reviewed by an MD, LFAPA specializing in psychiatry, forensic, addiction to ensure the scientific accuracy and medical relevance of information presented and its independence from commercial bias. NEI and HMP Education takes responsibility for the content, quality, and scientific integrity of this CME/CE activity. Disclosures: All individuals in a position to influence or control content are required to disclose any relevant financial relationships. Any relevant financial relationships were mitigated prior to the activity being planned, developed, or presented. Disclosures are from the original live presentation, unless otherwise noted. Faculty Author / Presenter Andrew J. Cutler, MD Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, State University of New York Upstate Medical University, Syracuse, NY Chief Medical Officer, Neuroscience Education Institute, Malvern, PA Consultant/Advisor: AbbVie, Acadia, Alfasigma, Alkermes, Axsome, Biogen, BioXcel, Boehringer Ingelheim, Brii Biosciences, Cerevel, Corium, Delpor, Evolution Research, Idorsia, Intra-Cellular, Ironshore, Janssen, Jazz, Karuna, Lundbeck, LivaNova, Luye, MapLight Therapeutics, Neumora, Neurocrine, NeuroSigma, Noven, Otsuka, Relmada, Reviva, Sage Therapeutics, Sumitomo (Sunovion), Supernus, Takeda, Teva, Tris Pharma, VistaGen Therapeutics Speakers Bureau: AbbVie, Acadia, Alfasigma, Alkermes, Axsome, BioXcel, Corium, Idorsia, Intra-Cellular, Ironshore, Janssen, Lundbeck, Neurocrine, Noven, Otsuka, Sumitomot (Sunovion), Supernus, Takeda, Teva, Tris Pharma, Vanda Data Safety Monitoring Board (DSMB): COMPASS Pathways, Freedom Biosciences Faculty Author / Presenter Phillip Coffin, MD, MIA Director of Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA No financial relationships to disclose. The remaining Planning Committee members, Content Editors, Peer Reviewer, and NEI planners/staff have no financial relationships to disclose. NEI and HMP Education planners and staff include Gabriela Alarcón, PhD, Ali Holladay, Andrea Zimmerman, EdD, CHCP, Brielle Calleo, Stephen Daniels and Bahgwan Bahroo, MD, LFAPA. Disclosure of Off-Label Use: This educational activity may include discussion of unlabeled and/or investigational uses of agents that are not currently labeled for such use by the FDA. Please consult the product prescribing information for full disclosure of labeled uses. Cultural Linguistic Competency and Implicit Bias: A variety of resources addressing cultural and linguistic competencies and strategies for understanding and reducing implicit bias can be found in this handout—download me. Accessibility Statement For questions regarding this educational activity, or to cancel your account, please email customerservice@neiglobal.com. Support: This activity is supported solely by the provider, NEI.

How do you decide when to move from first-line to second-line treatment for primary biliary cholangitis (PBC)? In this podcast, listen as experts Alan Bonder, MD, AGAF, and Aparna Goel, MD, discuss this question and more, including:How and when to measure treatment responseEvidence-based goals of therapyConsiderations for second-line treatmentNew agents for second-line treatment: PPAR agonistsPresenters:Alan Bonder, MD, AGAFAssociate Professor of MedicineMedical Director of Liver TransplantDepartment of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBoston, MassachusettsAparna Goel, MDAssociate Clinical Professor of MedicineDivision of Gastroenterology and HepatologyStanford UniversityPalo Alto, CaliforniaContent based on an online CME program supported by independent educational grants from Gilead Sciences, Inc., and Ipsen Biopharmaceuticals, Inc​.To learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.Supported by educational grants from Gilead Sciences, Inc. and Ipsen Biopharmaceuticals, Inc

In this podcast, listen as experts Alan Bonder, MD, AGAF, and Aparna Goel, MD, discuss how they assess the symptoms of primary biliary cholangitis (PBC) and explore how new therapeutic agents may help alleviate symptom burden. Topics include:Strategies and tools for assessing pruritusNonpharmacologic and pharmacologic management of pruritusSecond-line agents and their impact on pruritusInvestigational treatments for pruritusPresenters:Alan Bonder, MD, AGAFAssociate Professor of MedicineMedical Director of Liver TransplantDepartment of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBoston, MassachusettsAparna Goel, MDAssociate Clinical Professor of MedicineDivision of Gastroenterology and HepatologyStanford UniversityPalo Alto, CaliforniaContent based on an online CME program supported by independent educational grants from Gilead Sciences, Inc., and Ipsen Biopharmaceuticals, Inc​.To learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.

In this episode of Grid Down Comms Up on the Prepping Academy, Patrick looks at tactical and team communications and strategic communications in a disaster. Team communications are a simple concept, but become surprisingly complex when users enter the equation. Frequency coordination and interference are a reality of a large-scale disaster scene. We discuss how that impacts operations and how we can avoid some of those issues. Strategic communication is frequently overlooked by the prepping and survival community, usually due to the lone wolf mentality. In a disaster, you aren't going to be the lone wolf; you may even be the voice of your community. Having the skills and tools to quickly and effectively relay the needs of those around you is critical to helping those who are trying to help you. In this episode, we look at some details and facts of communications to support the logistical log train to keep your community going in a disaster.  Join PrepperNet.Net - https://www.preppernet.netPrepperNet is an organization of like-minded individuals who believe in personal responsibility, individual freedoms and preparing for disasters of all origins.PrepperNet Support the showPlease give us 5 Stars! www.preppingacademy.com Contact us: https://preppingacademy.com/contact/ www.preppernet.net Amazon Store: https://amzn.to/3lheTRTwww.forrestgarvin.com

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/DNY865. CME credit will be available until June 11, 2026.From Wheals to Wellness: Transforming Chronic Spontaneous Urticaria Care With Emerging SolutionsThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.This activity is developed in collaboration with our educational partner, PVI, PeerView Institute for Medical Education.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/DNY865. CME credit will be available until June 11, 2026.From Wheals to Wellness: Transforming Chronic Spontaneous Urticaria Care With Emerging SolutionsThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.This activity is developed in collaboration with our educational partner, PVI, PeerView Institute for Medical Education.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

Dive into practical, evidence-based approaches to managing pain in patients with opioid use disorder, bust common myths, and explore strategies to support patients. This episode will enhance your skills in providing holistic, patient-centered care. We're joined by Dr. Jessica Merlin, @JessicaMerlinMD (University of Pittsburgh).  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, Show Notes, Infographics: Carolyn Chan MD, MHS Hosts: Carolyn Chan, MD, MHS and Shawn Cohen MD Reviewer: Payel Jhoom Roy MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Jessica Merlin MD, PhD, MBA Sponsor: JournalFeed Try JournalFeed free for 7 days — and get 20% off your first year with code CURB25 at journalfeed.org/curb. Sponsor: Freed Usecode: CURB50 to get $50 off your first month when you subscribe at freed.ai Sponsor: Mint Mobile Get your summer savings and shop premium wireless plans at MINTMOBILE.com/CURB

In this episode of Bowel Sounds, hosts Dr. Temara Hajjat and Dr. Peter Lu speak with Dr. Gayle Diamond, a pediatric gastroenterologist at Children's Hospital of Philadelphia, about identifying and managing food protein-induced enterocolitis syndrome (FPIES). Learning objectivesIdentify the symptoms, etiology, and work up done for FPIESDiscuss the difference between FPIES vs. IgE-mediated food allergy vs. Milk protein-induced enterocolitis. Discuss the management of FPIES.Support 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.

In episode 61 we discuss pregnancy outcomes with bup/nlx compared to bup alone. Straub L, et al. Comparative Safety of In Utero Exposure to Buprenorphine Combined With Naloxone vs Buprenorphine Alone. JAMA. 2024 Sep 10;332(10):805-816. doi: 10.1001/jama.2024.11501. We also discuss the elimination of SAMHSA and methamphetamine-related deaths. STAT News:Trump's mental health and addiction problem New York Times:As Fentanyl Deaths Slow, Meth Comes for Maine --- 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 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

Dive into practical, evidence-based approaches to managing pain in patients with opioid use disorder, bust common myths, and explore strategies to support patients. This episode will enhance your skills in providing holistic, patient-centered care. We're joined by Dr. Jessica Merlin, @JessicaMerlinMD (University of Pittsburgh).  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, Show Notes, Infographics: Carolyn Chan MD, MHS Hosts: Carolyn Chan, MD, MHS and Shawn Cohen MD Reviewer: Payel Jhoom Roy MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Jessica Merlin MD, PhD, MBA Sponsor: JournalFeed Try JournalFeed free for 7 days — and get 20% off your first year with code CURB25 at journalfeed.org/curb. Sponsor: Freed Usecode: CURB50 to get $50 off your first month when you subscribe at freed.ai Sponsor: Mint Mobile Get your summer savings and shop premium wireless plans at MINTMOBILE.com/CURB.

Bryan Jepson MD and CFP, author of The Physician's Path to True Wealth: 12 steps to gaining control over your money and your time – you can find it on Amazon and at this website for free Bryan Jepson MD, CFP® | physician financeDisclaimers:This is not specific financial advice, this is general education. Talk with your own advisor or schedule with Bryan to get specific advice The earlier you can get financially literate and work on a plan the betterBryan is an emergency medicine physician, along his journey in medicine he also spent 5 years working in Autism before coming back to EM full timeThe covid pandemic and a feeling of stagnation and desire to keep learning prompted Bryan to pursue a master's degree in finance Bryan finds familiarity in his role as a physician to his role as a financial planner. You listen to the client and come up with a plan that fits their needsBryan talks about the difference between riches and wealth; discretionary income is the income above your mandatory expenses – and what you do with that extra income is how you become wealthy or richRiches are the material things you may spend that money on, car, house, toysWealth is the money you could spend but instead save or invest insteadThe goal is to create assets so that your income is no longer needed. Buying back your timeWhen you have true wealth, you can make decisions with your timeWorking towards being financially independent prevents burnoutChoosing to work vs working because you have to is easier, and makes you a better providerKey attributes to develop to be financially successful: Be patient – assets grow slowly. Be consistent in investing. It is boring. Be honest with what you know and what you don't know so you can spend some time educating yourself. Courage, because it does take some risk taking to invest instead of just savingIf you keep all your money in cash, you are guaranteed to lose purchasing powerThe longer your time frame the better the stock market will perform for youCreating discretionary income is difficult at lower incomes levels. But I do still believe you can retire from EMS. One way that I was able to save and invest as a paramedic was working overtimeHaving higher incomes does speed things along but it is not the cure for financial problems because we all have a tendency to spend what we make – fundamentally it's the same problemWe talk about the vehicles we drive and how we have utilized them to save more moneyBut spend money on Support the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

In this episode of Grid Down Comms Up on the Prepping Academy, Patrick looks at some of the technical communications failures during the hurricane, from radio programming disasters, broken equipment, and poor engineering practice. We look at them all. If you want to be the person who learns from others' mistakes, get out a pen and paper to take notes now, so you don't mess it up when others didJoin PrepperNet.Net - https://www.preppernet.netPrepperNet is an organization of like-minded individuals who believe in personal responsibility, individual freedoms and preparing for disasters of all origins.PrepperNet Support the showPlease give us 5 Stars! www.preppingacademy.com Contact us: https://preppingacademy.com/contact/ www.preppernet.net Amazon Store: https://amzn.to/3lheTRTwww.forrestgarvin.com

Featuring perspectives from Prof Claire Harrison and Dr John Mascarenhas, including the following topics: Introduction (0:00) New Biology of Myelofibrosis (1:55) Novel Regulatory T-Cell Infusion Therapy (14:57) Myelofibrosis 2025: JAK Inhibitors (Ruxolitinib) (20:39) BET Inhibitors: Pelabresib (42:03) Navtemadlin (53:20) CME information and select publications

Burnout in medicine: When was burnout at its peak for doctors? Why are doctors so burnt out? What causes burnout in health care? Is there a National Burnout Study? Our guest is Michael Tutty, PhD, group vice president of Professional Satisfaction and Practice Sustainability at the American Medical Association. AMA CXO Todd Unger hosts.

BEEFBeef remains pricey and hard to find – and even with harvest back up, prices are still climbing. Are we finally nearing a cooldown, or will thin meats keep leading this market higher into July?POULTRYChicken is still the go-to protein, but are we seeing the first signs of a shift? Breast prices dip slightly, tenders rise again, and wings climb – plus, a glimmer of good news on the avian flu front.GRAINSGrain markets are idling in neutral, with only slight bumps across corn, soy, and wheat. With strong supply and good weather, what would it take to finally shake these markets loose?PORKThe pork market is sizzling – bellies are on a summer run and bacon's about to get pricey. Will anything cool it down, or are we just getting started?Savalfoods.com | Find us on Social Media: Instagram, Facebook, YouTube, Twitter, LinkedIn

Darren Walsh is Director & Leadership Coach at Making Lean Work Ltd. A leading management consultancy specializing in helping business leaders and managers unlock the transformative power of continuous improvement. He has over 30 years of experience, working with some of the best in automotive, aerospace, medical devices, energy, technology, financial services, and business improvement. He graduated with a master's degree from Lean Enterprise Research Centre, and his insights have been featured in industry-leading publications and conferences.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.

Host Dr. Ben Young invites Drs. Roni Levin and Evan Silverstein to review the current state of amblyopia treatment, ranging from the mainstays of patching and atropine drops to novel advances such as dichoptic therapy. Below are some references regarding dichoptic therapy that were discussed in this episode: Xiao S, Angjeli E, Wu HC, Gaier ED, et al. Luminopia Pivotal Trial Group. Randomized controlled trial of a dichoptic digital therapeutic for amblyopia. Ophthalmology. 2022 Jan;129(1):77-85. Wygnanski-Jaffe T, Kushner BJ, Moshkovitz A, Belkin M, Yehezkel O. CureSight Pivotal Trial Group. An eye-tracking-based dichoptic home treatment for amblyopia: A multicenter randomized clinical trial. Ophthalmology. 2023 Mar;130(3):274-285. Koc I, Bagheri S, Chau RK, Hoyek S, et al. Cost-effectiveness analysis of digital therapeutics for amblyopia. Ophthalmology. 2025 Jun;132(6):654-660. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Pediatrician Dr. Jill Schaffeld consults Dr. Cheryl Bayart from the Cincinnati Children's Division of Dermatology on infantile hemangiomas.  Episode recorded on March 13, 2025. Resources discussed in this episode: - Infantile Hemangiomas CME & MOC Part 2 We are proud to offer CME and MOC Part 2 from Cincinnati Children's.  Credit is free and registration is required.  Please click here to claim CME credit via the post-test under "Launch Activity." Financial Disclosure:  The following relevant financial relationships have been disclosed: None All relevant financial relationships listed have been mitigated. Remaining persons in control of content have no relevant financial relationships. Accreditation In support of improving patient care, Cincinnati Children's Hospital Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Specific accreditation information will be provided for each activity. Physicians: Cincinnati Children's designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing: This activity is approved for a maximum 0.5 continuing nursing education (CNE) contact hours. ABP MOC pt2: Successful completion of this CME activity, which includes participation in the activity and individual assessment of and feedback to the learner, enables the learner to earn up to 0.5 MOC points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit. Credits AMA PRA Category 1 Credits™ (0.50 hours), ABP MOC Part 2 (0.50 hours), CME - Non-Physician (Attendance) (0.50 hours), Nursing CE (0.50 hours)

Professor Claire Harrison from the Guy's and St Thomas' NHS Foundation Trust in London, United Kingdom, and Dr John Mascarenas from The Tisch Cancer Institute in New York, New York, provide their perspectives on relevant new clinical data in myelofibrosis and discuss their application to treatment. CME information and select publications here.

Recently, sophisticated myelographic techniques to precisely subtype and localize CSF leaks have been developed and refined. These techniques improve the detection of various types of CSF leaks thereby enabling targeted therapies. In this episode, Katie Grouse, MD, FAAN, speaks with Ajay A. Madhavan, MD, author of the article “Radiographic Evaluation of Spontaneous Intracranial Hypotension” in the Continuum® June 2025 Disorders of CSF Dynamics 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. Madhavan is assistant professor of radiology at the Mayo Clinic in Rochester, Minnesota. Additional Resources Read the article: Radiographic Evaluation of Spontaneous Intracranial Hypotension 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 Ajay Madhavan about his article on Radiographic Evaluation of Spontaneous Intracranial Hypotension, which he wrote with Dr Levi Chazen. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr Madhavan:  Hi, thanks a lot, Katie. Yeah, so I'm Ajay Madhaven. I'm a neuroradiologist at the Mayo Clinic in Rochester, Minnesota. I did all my training here, so, I've been here for a long time. And I have a lot of interest in spinal CSF leaks, and I do a lot of that work. And so I'm really excited to be talking about this article with you. Dr Grouse:  I'm really excited too. And in fact, it's such a pleasure to have you here talking today on this topic. I know a lot's changed in this field, and I'm sure many of our listeners are really interested in learning about the developments and imaging techniques to improve detection and treatment of CSF leaks, especially since maybe we've learned about this in training. I want to start by asking you what you think is the most important takeaway from your article. Dr Madhavan:  Yeah, that's a great question. I think---and you kind of already alluded to it---I think the main thing is, I hope people recognize that this field has really changed a lot in the last five to ten years, through a lot of multi-institutional collaboration and also collaboration between different specialties. We've learned a lot about different types of spinal CSF leaks, how we can recognize the disease, particularly the types of myelography that we need to be using to accurately localize and treat these leaks. Those are the things that have really evolved in the last five to ten years, and they've really helped us improve these patients' lives. Dr Grouse:  Can you remind us of the different common types of spinal leaks that can cause spontaneous intracranial hypotension? Dr Madhavan:  Yeah, so there are a number of different spinal CSF leaks, types, and I would say the three most common ones that really most people should try to be aware of and cognizant of are: first, ventral dural tears. So those are, like, just physical holes in the dura. And they're usually caused by little bone spurs that come from the vertebral columns. So, they're often patients who have some degenerative changes in their spine. And those are really very common. Another type of spinal CSF leak that we commonly see is a lateral dural tear. So that's like the same thing in a slightly different location. So instead of being in the front, it's off to the side of the dura laterally. And so, it's also just a hole in the dura. And then the third and most recently discovered type of spinal CSF leak is a CSF-venous fistula. So those are direct connections between the subarachnoid space and little paraspinal vein. And it took us a long time to even realize that this was a real pathology. But now that it's been recognized, we've found that this is actually quite common. So those three types of leaks are probably the three most common that we see. And there's certainly others out there, but I would say over 90% of them fall into one of those three categories. Dr Grouse:  That's a great review, thank you. Just as another quick review, as we talk more about this topic, can you remind us of some of the most common or typical brain imaging findings that you'll see in cases of spontaneous intracranial hypotension? Dr Madhavan:  Yeah, absolutely. So, when you do a brain MRI in a patient who has spontaneous intracranial hypotension, you will usually, though not always, see typical brain MRI abnormalities. And I kind of think of those as falling into three different categories. So, the first one I think of is dural enhancement or thickening. So that's enlargement or engorgement of the dura, the pachymeninges, and enhancement on postgadolinium imaging. So, that's kind of the first category. The second is that, when you lose spinal fluid volume, other things often expand to take up the space. So, for example, you can get distension or enlargement of the dural venous sinuses, and sometimes you can also get subdural food collections or hematomas. They can arise spontaneously. And I kind of think of those as, you know, you, you've lost the cerebrospinal fluid volume and something else is kind of filling up the space. And then the third category is called brain sagging. And that's a constellation of findings where the posterior fossa structures and the pituitary gland in the cell have become abnormal because you've lost the fluid that normally cushions those structures and causes them to float up. For example, the brain stem will sag down, the distance between the mammillary body and the ponds may become reduced. The suprasellar cistern space may be reduced such that the optic chiasm becomes very close to the pituitary gland, and the prepontine cistern may also become reduced in size. And there are various measurements that can be used to determine whether something is subtly abnormal. But just generally speaking, those are really the three categories of brain MRI abnormalities you'll see. Dr Grouse:  That was a great review. And of course, I think in many times when we are thinking about or suspecting this diagnosis, we may be lucky to find those imaging findings to reinforce a diagnosis. Because as it turns out, after reading your article, I was really surprised to find out that in as many as 19% of cases we actually see normal brain imaging, which really was a surprise to me, I have to say. And I think that this really encompasses why spontaneous intercranial hypotension is such a difficult diagnosis to make. I think a lot of us struggle with how far to take the workup when, you know, spontaneous intercranial hypotension is clinically suspected, but multiple imaging studies are normal. Do you have any guidance on how to approach these more difficult cases? Dr Madhavan:  So, that's a really good question. And you know, it's- as you can imagine, that's a topic that comes up in most meetings where people discuss this, and it's been a continued challenge. And so, like you said, about 19 or 20% of patients who have this disease can have a, a normal brain MRI. And we've tried to do some work to figure out why that is and how we can identify patients who still have the disease. And I can just provide, I guess, some tips that have helped me in my clinical practice. One thing is, if I ever see a patient with a normal brain MRI where this disease is clinically suspected---for example, maybe they have orthostatic headaches or other very typical symptoms and we don't know why, but their brain MRI is normal---the first thing I do is I try to look back at their old imaging. So many times, these patients who present to us at Mayo, who, when we do their MRI scan here, their brain MRI looks normal… if you really look back at imaging that they've had done elsewhere---maybe even two to three years prior---at the time their symptoms started, they actually had some abnormalities. So, I might see that a patient, two years ago, had dural enhancement that spontaneously resolved; but now they still have symptoms of SIH and they may still have a CSF leak that we can find and treat, but their brain MRI has, for whatever reason, normalized. So, I always start by looking back at old imaging, and I found that to be very helpful. The other thing is, if you see a patient with a normal brain MRI, it's also important to look at their spine MRI because that can provide clues that might suggest that they could still have a spinal CSF leak. And the two things I look for on the spine MRI: one, if there's any extradural CSF. So, spinal fluid outside of where it's supposed to be within the confines of the subarachnoid space. And you know, really, if you see extradural CSF, you know they probably have a spinal fluid leak somewhere. Even if their brain MRI is normal, that just gives you the information that there is a dural tear probably somewhere. And so, in those patients we'll definitely still proceed to myelography or other testing, even if they have a normal brain MRI. And then the last thing I look for is whether or not they have prominent meningeal diverticula. Patients with CSF venous fistulas almost always have one or more prominent diverticula on their spine along the nerve root sleeves. And that's probably because most of these fistulas come from nerve root sleeve diverticula. We don't completely understand the pathogenesis of CSF venous fistulas, but they're clearly associated with meningeal diverticula. So, if I see a patient who has a normal brain MRI, but I see on their spine MRI that they have many meningeal diverticula that are relatively prominent, that makes me more inclined to be a little bit more aggressive in doing myelography to find a CSF leak. And then I look at other demographic features, too. So, for example, elevated BMI and older age are associated with CSF venous fistulas. So, that can help you determine whether or not it's warranted to go on to more advanced imaging, too. So those are all just a variety of different things that we've used to help us. Dr Grouse:  Thank you for sharing that. I wanted to go on to say that, you know, reading your article, of course, as you mentioned, you alluded to the fact there's lots of new imaging modalities out there. It was very illuminating and just an excellent resource for the options that exist and when they're useful. You did a great job summarizing it. And I encourage our readers to check out your article, to refresh themselves, update themselves on what's happened in this space. And of course, we can't summarize them all today, but I was wondering if you could possibly walk us through a hypothetical case of a patient who comes in with a history very suspicious for SIH? How would you approach this patient? Say you have gotten imaging that suggested that there is a spinal fluid leak and now you have to figure out where it is. Dr Madhavan:  Yeah. So, you know, I think the most typical scenario it'll be a patient who has been seen by one of my excellent neurology colleagues and they've done a brain MRI and they've made the diagnosis through a combination of clinical information and brain MRI finding. And then the next thing we'll do always is, we'll obtain a spine MRI. So, I think of the purpose of the spine MRI as to determine what type of spinal fluid leak they have. On the spine MRI, if you see extradural CSF, those patients essentially always will have a dural tear. And it may be a ventral dural tear or a lateral dural tear. But if you see extradural CSF, that is pretty much what they have. And conversely, if you don't see extradural CSF---if you just see, for example, many meningeal diverticula, but you don't see anything else particularly abnormal---most of those patients have a CSF venous fistula, just common things being common. So I use the spine MRI to determine what type of leak they have. And then the next thing I think about is, okay, I'm going to do a myelogram on this patient. How do I want to position them? Because it turns out that positioning is probably the most important factor for finding these spinal fluid leaks. You have to have the patient positioned correctly to find the leak that you're trying to localize. And so, if I suspect they have a ventral dural tear, I will always position those patients prone for their myelogram. And I might do one of many different types of myelograms. And, you know, the article talks about things like digital subtraction myelography and dynamic CT myelography. And you can find any of these leaks with any of those techniques, but you just have to have the patient positioned correctly. So, if I think I have a ventral dural tear, I'll put them prone for the myelogram. If I think they have a lateral dural tear, I'll put them in the cubitus position for the myelogram. And also, if they- if I think they have a CSF-venous fistula, I'll also put them in the decubitus position. Obviously if you're putting them in the decubitus position, you have to decide whether it's going to be left or right side down. So that may require a two-day exam. Sometimes you don't have to; in many cases, we're able to just do everything in one day. But those are all the different factors I think about when I'm trying to determine how I'm going to work those patients up further. So, I really use the spine MRI chiefly to think about what type of leak they're going to have and how I'm going to plan the myelogram. Dr Grouse:  That's really great. And it's, I think, really nice to emphasize how much the positioning matters in all this, which I think is not something we've been classically taught as far as the diagnosis of spinal leaks. Another thing I'm really interested in your opinion on is, you talked a lot about how to optimize and what can make you successful at diagnosis. I'm curious what you think one of the easiest mistakes to make or, you know, that we should hopefully avoid when treating patients with this disease. Dr Madhavan:  Yeah. And I think, you know, one other thing that's been discussed a lot in this topic… you know, we've talked about the patients with a normal brain MRI. Another barrier or challenge particularly with CSF-venous fistulas is, sometimes they can be very subtle on imaging. So, it's not always you see it very definitive CSF-venous fistula where you can say, like, there's no question, that's a fistula. There are many times where we do a good-quality myelogram and we see something that looks, like, possible for a CSF venous fistula, or probable. If I had to put a number on it, maybe there's a 50 to 70% chance of real. So, in those cases, we end up wondering, like, should we treat this suspected leak? And I think one common mistake  or one thing that needs to be looked at further is, how do we handle these patients where we don't know whether the fistula is real or not? That's usually something where I will have a discussion with the patient, and I'm usually just very upfront with him about my interpretation of the imaging. I'll just tell them, we did a good-quality myelogram. You did a great job. We got good images. I don't see anything definitive, but I see this thing that I think has maybe a 60% chance of being real. And then I'll confer with one of my neurology colleagues and we'll decide whether it's worth treating that or not. And we'll just be very upfront with a patient about whether- about the likelihood of its success and what their long-term prognosis is. And oftentimes we let them make the decision. But I think that remains to be one of the big challenges is, how do we treat these patients who have suspected leaks that are not definitive on imaging. Dr Grouse:  That sounds absolutely like an important area where there can be problems, so I appreciate that insight. I'm interested what you think in your article would come as the biggest surprise to our listeners who may not have kept up as much with all of the changes that have happened in recent years? Dr Madhavan:  One of the things that was certainly, at least, a surprise to me as I was going through my training and learning about this topic is how diverse myelography has really become. You know, when I was a radiology resident, I learned about myelography as this thing that we've been doing for 30 to 40 years. And historically we've used myelograms just to look for degenerative changes: disc bulges, you know, disc herniations and things like that. Now that MRI is more prevalent, we don't use it as much, but it has turned out that it has a very big role in patients with spinal fluid leaks. Furthermore, something that I've learned is just how diverse these different types of myelograms have become. It used to kind of be just that a myelogram is a myelogram is a myelogram, but now we have different types of positioning, different types of equipment that we use. We vary the timing between contrast injection and imaging to optimize success for finding spinal fluid leaks. So, I think many times I talk to people who may not be as familiar with this field and they're surprised at just how diverse that has become and how sophisticated some of the various myelographic techniques have become and how much that really makes a difference in being able to accurately diagnose these patients. Dr Grouse:  Well, I can say it was a surprise to me. Even as someone who does treat quite a few patients with this condition, I was surprised to see the breadth of different options that have become available. And then kind of a follow-up to that, what do you think the current area of controversy is in this area of diagnosis and treatment? Dr Madhavan:  The biggest ones are ones you've sort of already alluded to. So, one big one is, how far do we go in patients who have a normal brain MRI who still have a clinical suspicion of the disease? And sometimes it's really hard, because sometimes you will find patients who clinically have a very strong case for having spontaneous intracranial hypotension. You look at them, they have very acute-onset orthostatic headaches. There's no better explanation for their symptoms that we know of. And it's hard to know what to do with those patients, because some of them want to continue to undergo diagnostic workup, but you can only do so many myelograms and you can only do so much with this diagnostic workup that requires some radiation dose before it becomes very challenging. That's a major point of just, I guess, ongoing research as to what can we do better for that subset of patients. Fortunately, it's not all of them, it's a subset of them, but I think we could help those patients better in the future as we learn more about the disease. So that's one. And the other one is treating these equivocal findings, like I discussed.  And where should our threshold be to treat a patient, and what type of treatment should we do in patients where we don't know whether a leak is real? Should we just do a very noninvasive- relatively noninvasive blood patch? Do we do an embolization where we're leaving a foreign body there? Is it worth sending those patients to surgery? Those are all unanswered questions and things that continue to spark ongoing debate. Dr Grouse:  Do you think that there's going to be any new big breakthroughs, or even, do you know of any big developments on the horizon that we should be keeping our eyes out for? Dr Madhavan:  You know, I think for me the biggest thing is, imaging is dramatically improving. We talked a little bit about photon counting detector CT in our article, and that's one of the newest and best techniques for imaging these patients because it has very, very high resolution, it has a lower radiation dose, it has allowed us to find leaks that we were not able to find before. And there are other high-resolution modalities that are emerging and becoming more accessible to things like cone beam CT which we do in addition to digital subtraction myelography. And on top of that, we've started to use AI-based tools to make images look a lot better. So, there are various AI algorithms that have come out that allow us to remove artifacts from imaging. They help us image patients with a bigger body habitus better without running into a lot of imaging artifacts. They help us reduce noise in imaging. They can just give us better-quality images and aid us in the diagnosis. For me as a radiologist, those are some of the most exciting things. We're finding less invasive ways with less radiation to better diagnose these patients with just better-quality imaging. Dr Grouse:  Well, that is definitely something to be excited about. So, I just want to thank you so much for talking with us today. It's been such an interesting, informative discussion and a real privilege to talk with you about this important topic. Dr Madhavan:  Yeah, thanks so much. I really appreciate the time to talk with you, and I look forward to seeing the article out there and hopefully getting some interesting questions. Dr Grouse:  Again, today I've been interviewing Dr Ajay Madhavan about his article on Radiographic Evaluation of Spontaneous Intracranial Hypotension, which he wrote with Dr Levi Chasen. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. 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.

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