Podcasts about CNS

We have FDA changes to the labels of Axi-Cel (to allow for its use in primary CNS lymphoma) and 5-flourouracil (pre-treatment DPYD testing). Also, pembrolizumab nets another approval, this time in conjunction with paclitaxel for platinum-resistant ovarian cancer (limited to PD-L1 CPS of 1% of greater)

What happens when a 20 year mental health veteran has her own existential crisis then undergoes her own psychedelic therapy? In Inna Zelikman's case, it completely transformed how she practices medicine.Inna Zelikman, RN, MS, ANP, PMH-NP, is the Director of Integrative Mental Health at Recovery Without Walls and a MAPS certified MDMA practitioner. Five years ago, her own psychedelic healing journey changed everything about how she sees and treats patients. Now she's challenging the cookie cutter protocols that dominate our field in favor of what she calls an "organic" approach to treatment.In this conversation, Inna shares her comprehensive patient assessment strategies, the medication categories that secretly block healing (even though they're not contraindications), and why some patients have profound psychedelic experiences but can still struggle.From consulting with psilocybin centers in Oregon to treating ketamine addiction, Inna offers a nuanced perspective on the complexities of psychedelic medicine and why proper preparation, support, and integration actually matter for lasting results.What You'll Learn:

Clients hitting walls, losing focus, and quitting on the most meaningful reps too soon? Is it the client's fault or the trainer's, without even realizing it? Paradox Strength President Janaya Skye returns to the podcast to talk about something that many trainers don't realize: if you ignore your central nervous system, you're leaving a lot on the table. We dive into how your CNS can affect your workouts and client sessions, what happens – and what to do – when your clients start tuning out instructions, why that happens, and some specific, real-life situations and how to approach them. Make sure that you get those last, greatest reps in to really get the most out of your sessions — tune in to this one! ━━━━━━━━━━━━ Get a FREE course to grow your strength training business here ━━━━━━━━━━━━ Get NEW Precision-Engineered MedX Machines here ━━━━━━━━━━━━ For the complete show notes, links, and resources, click here

Synopsis: At JPM 2026 in San Francisco, Alok Tayi welcomes Michelle Werner, CEO of Alltrna, to Biotech 2050 for a powerful conversation at the intersection of personal mission, platform biology, and rare-disease drug development. Michelle traces her two-decade career across Bristol Myers Squibb, AstraZeneca, and Novartis—and the moment everything changed when her child was diagnosed with a rare disease. That experience led her to Alltrna and its pioneering engineered tRNA platform, designed to correct nonsense mutations across hundreds—potentially thousands—of genetic disorders with a single therapeutic approach. Together, Alok and Michelle explore how tRNAs work, why “stop-codon disease” could redefine rare-disease classification, and how basket trials borrowed from oncology may accelerate development. They dive into delivery strategy, portfolio expansion into CNS and muscle disorders, regulatory innovation, and how AI is reshaping molecular design—offering a rare look at what it takes to build a first-in-class modality from the ground up. Biography: Michelle is a seasoned pharmaceutical executive with more than 20 years in the industry spanning commercial and research & development (R&D) responsibilities. Prior to Alltrna, Michelle served as Worldwide Franchise Head, Solid Tumors at Novartis Oncology, where she was responsible for delivering the disease area strategies across multiple tumors and led business development efforts resulting in a doubling of long-term portfolio value for the franchise. Previous to Novartis, Michelle was a senior leader at AstraZeneca and as Global Franchise Head in Hematology, she was critical in launching multiple indications worldwide for CALQUENCE®. Prior to this, Michelle was Head of US Oncology, where she led the business through dramatic growth in both team and revenue through eight-plus product launches. Previous to AstraZeneca, Michelle was with Bristol-Myers Squibb for 10 years in various positions of increasing responsibility including roles in sales, marketing, and market access in the US and UK, and above market in Europe (based in France) and global almost exclusively in oncology. Michelle started her professional career in R&D, working hands-on with patients at the Oncology Clinical Trials Unit at Harvard Medical School before moving into industry in clinical operations. Outside of her corporate responsibilities, Michelle is a wife and mother to three children and is a member of the rare disease community. She is currently serving a Board appointment for the non-profit organization Rare Disease Renegades, a purpose that fuels her passions both personally and professionally.

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Mind Pump Fit Tip: How to Lean Bulk for Lean Gains (Build Muscle, Not Body Fat). (2:38) Easy-to-digest vegan protein shakes. (22:15) Speaking identity. (24:04) Getting too much attention? (30:37) Father first. (32:37) Laser focused on ketones. (37:06) The latest GLP-1 propaganda and the dangers. (40:28) Fun Facts with Justin: Rat Utopia Experiment. (46:57) How extreme intelligence is more correlated to mental illness. (52:30) Being stuck in the past, and pick-up spots for the middle-aged crowd. (1:00:00) #Quah question #1 – How do you know if you're getting actual muscle gain or CNS adaptation? Been lifting for 10+ years. (1:10:53) #Quah question #2 – You've mentioned the bi-weekly method for strength training and cardio for best results. If you were to juggle between two MAPS programs with this method, which two would you bounce between for someone who just genuinely enjoys the benefits of both? (1:13:28) #Quah question #3 – What are some exercises I can do as someone with scoliosis? I want to get back into strength training. (1:17:07) #Quah question #4 – What is a good age to introduce weight training for kids? I have 10- and 7-year-old girls who do recreational sports. (1:18:46) Related Links/Products Mentioned Use code MINDPUMP for an exclusive offer for Mind Pump listeners of 15% OFF! New customers only. "If you're trying to feel a little more put together, or you just want some easy wins in your day, this combo is such a good place to start." Visit: https://huel.com/MINDPUMP  30% OFF your subscription order PLUS receive a free gift with your second shipment—fun surprises like a free 6-pack, Ketone-IQ merch, and more! Or find Ketone-IQ at Target stores nationwide. Visit: https://ketone.com/MINDPUMP February Promotion: Feb 1 - Feb 14th - The Couple's Bundle (Aesthetic, HIIT, Muscle Mommy, No BS 6-Pack Abs), $498 value, only $197!  Visit: https://www.mpvalentine.com  Mind Pump Store Mind Pump #2160: Macro Counting Master Class Mind Pump #2690: The NEW DIET Everyone Is Using For Fat Loss Fig and Eagle Model ex-wife who revealed NFL husband Matt Kalil's manhood size cites 'free speech' in bid to toss lawsuit Kelly Stafford Posts Security Cam Video of Husband Matthew Getting Home at 2:20 AM After NFC Title Loss 'Ozempic Vulva': How GLP-1 Drugs May Lead to Vaginal Changes This Old Experiment With Mice Led to Bleak Predictions for Humanity's Future 7 Surprising Correlations Between Intelligence and Mental Health Visit Fatty15 for an exclusive offer for Mind Pump listeners! ** You can get an additional 15% off their 90-day subscription Starter Kit with code MINDPUMP. Fatty15 is on a mission to optimize your C15 levels to help support your long-term health and wellness - especially as you age. Mind Pump # 2547: Stop Trying to Get Your Kids in Shape! Do This Instead! Mind Pump Podcast – YouTube Mind Pump Free Resources People Mentioned Scott Donnell (@imscottdonnell) Instagram LAUREN FITZ, M.D. (@drlaurenfitz) Instagram Dr. William Seeds (@williamseedsmd) Instagram Dr. Tyna Moore (@drtyna) Instagram   Corinne Schmiedhauser (@mindpumpcorinne) Instagram  

Listen Online: About this episode: In this thought-provoking conversation, Ann Louise Gittleman sits down with neurologist Dr. Thomas Guttuso, Jr., author of The Promise of Lithium, to explore the emerging role of carefully dosed lithium in neurodegenerative disease. Why is Parkinson's now the fastest-growing neurological disease? Dr. Guttuso explains what's driving the surge, how Parkinson's differs from Parkinsonism, and why men are diagnosed more often than women. He also introduces what he calls the brain's “Bermuda Triangle” — a vulnerable region tied to progressive neuron loss — and shares insight into a promising blood marker, neurofilament light (NFL), that may help track early damage. From there, the conversation turns to why dose and form are everything when it comes to lithium — and how the small amounts he uses clinically differ dramatically from the psychiatric doses most people associate with the mineral. He also addresses timing, prevention, L-Dopa, and whether early support could change the trajectory of these conditions. If you're concerned about Alzheimer's, Parkinson's, stroke, MS, or simply protecting long-term brain health, this interview offers a grounded and science-driven perspective on a mineral that may hold broader implications than many realize.  Check out Dr. Guttoso’s book at https://amzn.to/3YUgv4p and the form of lithium he recommends at https://amzn.to/4k7xDxE. The post The Promise of Lithium for Alzheimer's, Parkinson's and MS first appeared on Ann Louise Gittleman, PhD, CNS.

We review diagnosing and managing bacterial meningitis in the ED. Hosts: Sarah Fetterolf, MD Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Meningitis_2_0.mp3 Download Leave a Comment Tags: CNS Infections, Infectious Diseases, Neurology Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 Patient Presentation & Workup Patient: 36-year-old male, currently shelter-domiciled, presenting with 3 weeks of generalized weakness, fevers, weight loss, and headaches. Vitals (Initial): BP 147/98, HR 150s, Temp 100.2°F, RR 18, O2 99% RA. Clinical Evolution: Initial assessment noted cachexia and a large ventral hernia. Following initial workup, the patient became acutely altered (A&O x0) and febrile to 102.9°F. Physical Exam Findings: Brudzinski Sign: Positive (knees flexed upward upon passive neck flexion). Kernig Sign: Discussed as highly specific (resistance/pain during knee extension with hip flexed at 90°). Meningeal Triad: Fever, nuchal rigidity, and AMS (present in 40% of cases; 95% of patients have at least two of the four cardinal symptoms including headache). Imaging: Chest X-ray: Scattered opacities (pneumonia) and a small pneumothorax. CT Abdomen/Pelvis: Confirmed asplenia (secondary to 2011 GSW/exploratory laparotomy). Head CT: Ventricle enlargement concerning for obstructive hydrocephalus and diffuse sulcal effacement. CSF Analysis & Microbiology Bacterial Meningitis Opening Pressure: Elevated (Normal is 1000–2000/mm3 WBC); dominated by neutrophils (>80% PMN). Glucose: Low (

Dr. Sonam Puri discusses the full update to the living guideline on stage IV NSCLC with driver alterations. She shares a new overarching recommendation on biomarking testing and explains the new recommendations and the supporting evidence for first-line and subsequent therapies for patients with stage IV NSCLC and driver alterations including EGFR, MET, ROS1, and HER2. Dr. Puri talks about the importance of this guideline and rapidly evolving areas of research that will impact future updates. Read the full living guideline update "Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2026.3.0" at www.asco.org/thoracic-cancer-guidelines TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/thoracic-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02822    Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Sonam Puri from Moffitt Cancer Center, co-chair on "Therapy for Stage IV Non-Small Cell Lung Cancer with Driver Alterations: ASCO Living Guideline, Version 2026.3.0." It's great to have you here today, Dr. Puri. Dr. Sonam Puri: Thanks, Brittany. Brittany Harvey: And then just before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Puri, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, to dive into the content that we're here today to talk about, Dr. Puri, this living clinical practice guideline for systemic therapy for patients with stage IV non-small cell lung cancer with driver alterations is updated on an ongoing basis. So, what data prompted this latest update to the recommendations? Dr. Sonam Puri: So Brittany, non-small cell lung cancer is one of the fastest-moving areas in oncology right now, particularly when it comes to targeted therapy for driver alterations. New data are emerging continuously from clinical trials, regulatory approvals, real-world experience, which is exactly why these are living guidelines. The goal is to rapidly integrate important advances as they happen, rather than waiting for years for a traditional update. Since the last full update of the ASCO Stage IV Non-small Cell Lung Cancer Guideline with Driver Alterations published in 2024, there have been seven new regulatory approvals and changes in first-line therapy for some driver alterations. [This version] of the "Stage IV Non-small Cell Lung Cancer Guidelines with Driver Alterations" represents a full update, which means that the panel reviewed and refreshed every applicable section of the guideline to reflect the most current evidence across therapies including sequencing and clinical decision-making. This is to ensure that clinicians have up-to-date practical guidelines that keep pace with how quickly the field is evolving. Brittany Harvey: Absolutely. As you mentioned, this is a very fast-moving space and this full update helps condense all of those versions that the panel reviewed before into one document, along with additional approvals and new trials that you reviewed during this time period. So then, the first aspect of the guideline is there's a new overarching recommendation on biomarker testing. Could you speak a little bit to that updated recommendation? Dr. Sonam Puri: Yeah, definitely. So the panel has discussed and provided recommendations on comprehensive biomarker testing and its importance in all patients diagnosed with non-small cell lung cancer. Ideally, biomarker testing should include a broad-based next-generation sequencing panel, rather than single-gene tests, along with immunohistochemistry for important markers such as PD-L1, HER2, and MET. These results really drive treatment decisions, both in frontline settings for all patients diagnosed with non-small cell lung cancer and in subsequent line settings for patients with non-small cell lung cancer harboring certain targetable alterations. Specifically in the frontline setting, it helps determine whether a patient should receive upfront targeted therapy or immunotherapy-based approach. We now have strong data that shows that complete molecular profiling results before starting first-line therapy is associated with better overall survival and actually more cost-effective care. Using both tissue and blood-based testing can improve likelihood of getting actionable results in a timely way, and we've also provided guidance on platforms that include RNA sequencing, which are specifically helpful for identifying gene fusions that might be otherwise missed with other platforms. On the flip side, outside of a truly resource-limited setting, single-gene PCR testing really should not be routine anymore. This is what the panel recommends. It's less sensitive and inefficient and increases the risk of missing important actionable alterations. Brittany Harvey: Understood. I appreciate you reviewing that recommendation. It really helps identify critical individual factors to match the best treatment option to each individual patient. So then, following that recommendation, what are the updated recommendations on first-line therapy for patients with stage IV non-small cell lung cancer with a driver alteration? Dr. Sonam Puri: Since the last full update in 2024, there have been four additional interim updates which were published across 2024 and 2025. Compared to the last version, there have been several updates which have been included in this full update. One of the most important shifts has been in first-line treatment of patients with non-small cell lung cancer harboring the classical, or what we call as typical, EGFR mutation. The current version of the recommendation is based on the updated survival data from the phase III FLAURA2 and MARIPOSA studies, based on which the panel recommended to offer either osimertinib combined with platinum-pemetrexed chemotherapy or the combination of amivantamab plus lazertinib in the first-line treatment of classical EGFR mutations. And these recommendations, as I mentioned, are grounded in the results of the FLAURA2 and MARIPOSA trials, both of which demonstrated improvement in progression-free survival and overall survival compared to osimertinib alone in patients with common EGFR mutations. That being said, the panel actually spent significant time discussing the toxicities associated with these treatments as well. These combination approaches come with higher toxicity, longer infusion time, increased treatment frequency. So while combination therapy is now recommended as preferred, the panel has recommended that osimertinib monotherapy remains a reasonable option, particularly for patients with poor performance status and for those who are not interested in treatment intensification after knowing the risks and benefits. Brittany Harvey: Absolutely. It's important to consider both those benefits and risks of those adverse events that you mentioned to match appropriately individualized patient care. So then, beyond those recommendations for first-line therapy, what is new for second-line and subsequent therapies? Dr. Sonam Puri: So this is a section that saw several major updates, particularly again in the EGFR space. The first was an update on treatment after progression on osimertinib for patients with classical EGFR mutation. Here the panel recommends the combination of amivantamab plus chemotherapy, and this recommendation was based on the phase III MARIPOSA-2 trial, which compared amivantamab plus chemotherapy with chemotherapy alone with progression-free survival as the primary endpoint. The study met its primary endpoint, showing an improvement in median PFS with the combination of amivantamab plus chemotherapy compared to chemotherapy alone. And as expected, the combination was associated with higher toxicity. So, although the panel recommends this regimen, the panel emphasizes that patients should be counseled on the side effects which may be moderate to severe with the combination therapy approach. In addition, a new recommendation was added for patients who are not candidates for amivantamab plus chemotherapy. In those cases, platinum-based chemotherapy with or without continuation of osimertinib may be offered, and the option of continuing osimertinib with chemotherapy was recommended and supported by data from a recently presented phase III COMPEL study, which randomized 98 patients with EGFR exon 19 deletion or L858R-mutated advanced non-small cell lung cancer who had experienced no CNS progression on first-line osimertinib, and these patients were randomized to receive platinum-pemetrexed chemotherapy with osimertinib or placebo. Although this study was small, it demonstrated a PFS benefit with continuation of osimertinib with chemotherapy, and this approach may be appropriate for patients without CNS progression who prefer or require alternatives to more intensive treatment strategies. Next was an update on options for patients with EGFR-mutated lung cancer after progression on osimertinib and platinum-based chemotherapy. Here the panel recommended that for patients whose disease has progressed after both osimertinib and platinum-based chemotherapy, a new drug known as datopotamab deruxtecan can be offered as a treatment option. And this treatment recommendation was based on evaluation of pooled data from the TROPION-Lung01 and TROPION-Lung05 study, in which in the pooled analysis about 114 patients with EGFR-mutant non-small cell lung cancer were treated with Dato-DXd, 57% of whom had received three or more prior lines of treatment, and what was observed was an overall response rate of 45% with a median duration of response of 6.5 months. So definitely promising results. Next, we focused on updates to subsequent therapy options for patients with another type of EGFR mutation known as EGFR exon 20 insertion mutations. In this section, the panel added sunvozertinib as a subsequent line option after progression on platinum-based chemotherapy with or without amivantamab. Sunvozertinib is an oral, irreversible, and selective EGFR tyrosine kinase inhibitor with efficacy demonstrated in the phase II WU-KONG6 study conducted in Chinese patient population. In this study, amongst 104 patients with platinum-pretreated EGFR exon 20 mutated non-small cell lung cancer, the observed response rate was 61%. Staying in the EGFR space, the panel added a recommendation for patients with acquired MET amplification following progression on EGFR TKI therapy. In these situations, the panel recommended that treatment may be offered with osimertinib in combination with either tepotinib or savolitinib. As our listeners may know, MET amplification occurs in approximately 10% to 15% of patients with EGFR-mutated non-small cell lung cancer when they progress on third-generation EGFR TKIs, and detection of MET amplification is done with various methods, such as tissue-based methods like FISH, NGS, and IHC, as well as ctDNA-based NGS with variable cut-offs. Over the last few years, several studies have informed this recommendation. I'm going to be discussing some of them. In the phase II ORCHARD trial, 32 patients with MET-amplified non-small cell lung cancer after progression on first-line osimertinib were evaluated, where the combination of osimertinib plus savolitinib achieved an overall response rate of 47% with a duration of response of 14.5 months. More recently, the phase II SAVANNAH trial reported outcomes in 80 patients with MET-amplified tumors after progression on osimertinib, and in this patient population, the combination of savolitinib and osimertinib achieved an overall response rate of 56% with a median PFS of 7.4 months. And lastly, the phase II single-arm INSIGHT 2 trial assessed the efficacy of osimertinib plus tepotinib in patients with advanced EGFR-mutant non-small cell lung cancer who had disease progression following first-line osimertinib therapy. And in this study, in a cohort of 98 patients with MET-amplified tumors confirmed by central testing, the overall response rate with the combination was 50% with a duration of response of 8.5 months. So definitely informing this guideline recommendation. Next, we had an update on recommendation in patients with ROS1-rearranged non-small cell lung cancer. For patients with ROS1-rearranged non-small cell lung cancer, the panel recommended specifically for patients who progressed after first-line ROS1 TKIs, the addition of taletrectinib as a new option alongside repotrectinib. And this recommendation was based on analysis of the results of the TRUST-I and TRUST-II studies, which showed that amongst 113 tyrosine kinase inhibitor-pretreated patients, taletrectinib achieved a confirmed overall response rate of 55.8% with a median duration of response of 16.6 months and a median PFS of 9.7 months, a very promising agent. Finally, for patients with HER2 exon 20 mutated non-small cell lung cancer, the panel added two new oral HER2 tyrosine kinase inhibitors, zongertinib and sevabertinib, as options in addition to T-DXd and after exposure to T-DXd. These recommendations are based on early phase data from two trials: the phase I Beamion LUNG-01 study, which evaluated zongertinib, and the phase I/II SOHO-01 study that evaluated sevabertinib. In this study, zongertinib demonstrated an overall response rate of 71% in previously treated patients, with an overall response rate of 48% amongst patients who had received prior HER2-directed ADCs including T-DXd. Sevabertinib in its early phase study showed an overall response rate of 64% in previously treated but HER2 therapy-naive patients, and an overall response rate of 38% in patients previously exposed to HER2-directed therapy. The panel believes that both agents had manageable toxicity profile and represent meaningful new options for this patient population. Brittany Harvey: Certainly, it's an active space of research, and I appreciate you reviewing the evidence underpinning all of these recommendations for our listeners. So, it's great to have these new options for patients in the later-line settings. And given all of these updates in both the first and the later-line settings, what should clinicians know as they implement this latest living guideline update, and how do these changes impact patients with non-small cell lung cancer? Dr. Sonam Puri: Some great questions, Brittany. I think for clinicians when implementing this update, I think about two practical steps. First is reiterating the importance of comprehensive biomarker testing. That is the only way to identify key drivers and resistance mechanisms that we are now targeting. And second, picking a first-line strategy that balances efficacy and toxicity and patient preference for your specific patient. I think informed decision-making, shared decision-making is more important than any time right now. It has always been important, but definitely very important now. For patients, this guideline brings recommendations on more personalized treatment options for both first-line and post-progression settings, which potentially means better outcomes. But it is also very important for our patients to continue to have informed conversations about side effects, time commitment, and what matters most to them with their providers. The panel in this version of the guideline specifically acknowledges the real-world barriers that prevent patients from receiving guideline-concordant therapy, including challenges with access to comprehensive molecular testing and treatment availability, and the panel emphasizes on the importance of shared decision-making, and we provide practical discussion points to help clinicians navigate these conversations with the patient. In addition, the panel has also addressed common real-world clinical complexities, such as treating elderly or frail patients, managing multiple chronic conditions, considerations around pregnancy and fertility, and certain disease scenarios such as oligoprogression or oligometastatic disease. And where available, the guideline summarizes this existing data to support informed individual decision-making in these complex situations. Brittany Harvey: Shared decision-making is really paramount, especially with all of the options and weighing the risks and benefits and considering the individual circumstances of each patient that comes before a clinician. We've talked a lot about all of the new studies that the panel has reviewed, but what other studies or areas of research is the panel examining for future updates to this living guideline as it continues to be updated on an ongoing basis? Dr. Sonam Puri: Yes, definitely, so much to look forward to, right? Looking ahead, the panel is closely monitoring several rapidly evolving areas that are likely to shape future updates of the guideline. This includes emerging data from ongoing later-phase studies, particularly the studies that are evaluating these new targeted agents moving to earlier lines of therapy, alongside studies evaluating additional combination strategies or more refined approaches to treatment sequencing. We're also closely watching advances in biomarker testing, the evolving understanding of resistance mechanisms, development of new targets, and promising therapeutic agents. I think ultimately the living guideline exists to help clinicians and patients navigate this rapidly evolving field, and we would like to ensure that scientific advances are rapidly translated into better, more personalized patient care. Brittany Harvey: Definitely. We'll look forward to those updates from those ongoing trials and future areas of research that you mentioned to provide better options for patients with non-small cell lung cancer and a driver alteration. So I want to thank you so much for your work to rapidly and continuously update this guideline, and thank you for your time today, Dr. Puri. Dr. Sonam Puri: Thanks so much. Thanks so much for the opportunity. Brittany Harvey: And finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. There's also a companion episode with Dr. Reuss on the related living guideline on stage IV non-small cell lung cancer without driver alterations that listeners can find in their feeds as well. And if you've enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

As awareness of perimenopause- and menopause-related health concerns grows, Neda Gioia, OD, CNS, IFMCP, FOWNS says it is time for the eye care industry to recognize how profoundly hormonal shifts can affect vision and ocular comfort.Dr. Gioia said women experience hormonal transitions that differ significantly from men, yet health care systems do not consistently account for those biological differences. “Men and women are biologically different. We know this,” she says. “The discussion is why are we not actually navigating this difference with our health care system?”

Podcast Miniseries: Cultivating a Culture – Growing a Healthy Neurosurgical Workplace Ep. 3: Leadership at a Scale Guest: Elad Levy Hosts: Brian Gantwerker & Chris Newman In this episode, we sit down with former CNS president and current Chair of the University of Buffalo Department of Neurosurgery Dr. Elad Levy for a wide ranging discussion on leading the CNS. Dr. Levy shares his insights on leadership transitions, setting an agenda, balancing the various opinions in the room, and the lessons learned from his experiences.

Send us a textDr. Chris Oswald, DC, CNS, is Head of Medical Affairs for Pure Encapsulations ( https://www.pureencapsulations.com/ ), part of Nestlé Health Science family. He is a chiropractor, certified nutrition specialist and certified functional medicine practitioner and has been treating patients since 2007. At Pure Encapsulations, Dr. Oswald leads medical education, scientific strategy, and innovation across well-known professional brands including Pure Encapsulations, Douglas Labs, Klean Athlete, Genestra, and others. In this role, he sits at the intersection of clinical science, practitioner education, and product innovation — translating complex evidence into practical tools that help healthcare professionals practice more confident, personalized nutritional medicine. Dr. Oswald's clinical work, in combination with his work in professional dietary supplement companies, gives him unique insight into the creation of clinically useful tools and education to support the unique needs of clinicians and patients in functional, integrative and natural health.Before joining Pure Encapsulations, Dr. Oswald held senior leadership roles across the nutraceutical and health tech landscape, including Chief Science Officer, Head of Product Innovation and R&D, Head of Operations, Interim Head of Sales, and VP of Nutraceuticals at companies like January AI and Further Food. Across those roles, he's led everything from supply chain and regulatory strategy to product development, claims substantiation, and national practitioner education.At the core of Dr. Oswald's work is a consistent theme: bridging rigorous science, real-world clinical practice, and responsible commercialization — all with the goal of improving patient outcomes and advancing the future of personalized, integrative healthcare.#ChrisOswald #PureEncapsulations #NestleHealthScience #FunctionalMedicine #Nutrition #DietarySupplements #Nutraceuticals #PureGenomics #DeniseFurness #Nutrigenomics #Genetics #Epigenetics #PersonalizedHealth #BiologicalAgeProtocol #BiologicalAging #Telomeres #Proteomics #Metabolomics #Biomarkers #Glycans#STEM #Innovation #Science #Technology #Research #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #Podcasting #ViralPodcastSupport the show

To celebrate 101 episodes, I sit with Leonard H. Calabrese, DO, to discuss his unique career in Rheumatology, spanning immunology, HIV, MECFS, IRES, CNS vasculitis and more. We also discuss how medical history shaped our careers.  ·        Intro 0:12 ·        Welcome Leonard H. Calabrese, DO 3:11 ·        A quick friendship begins over medical history 4:14 ·        How Healio Rheuminations began and where the show is now 5:38 ·        How Dr. Calabrese got interested in medical history 7:11 ·        Serotherapy 10:52 ·        Why patients get certain diseases 12:33 ·        Dr. Calabrese's career trajectory 14:43 ·        One day in 1981… 17:52 ·        A few things happened in the 90's 20:20 ·        Tell us about CNS vasculitis 21:53 ·        Don't be afraid to reinvent yourself 24:30 ·        Checkpoint inhibitors 25:09 ·        How do you keep up? 26:43 ·        Placebo science 28:25 ·        Do you think we'll ever be able to answer where diseases come from? 29:33 ·        Thank you, Dr. Calabrese 31:01 ·        Thanks for listening 31:26 We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

In this episode of Athlete's Compass, hosts Paul Warloski, Dr. Paul Laursen, and Marjaana Rakai explore the overlooked yet critical elements of pre-race preparation: warmups and openers. Drawing on science and experience, they break down concepts like post-activation potentiation (PAP), the Q10 temperature effect, VO2 kinetics, and how proper timing, intensity, and individual context can make or break race performance. The trio shares personal anecdotes, training data insights, and cautionary tales (including cold-water swims gone wrong), helping athletes navigate both physiological and psychological readiness strategies. Whether you're a crit racer, triathlete, or weekend warrior, this episode will change the way you approach race day — and the day before.Key TakeawaysPost-Activation Potentiation (PAP) boosts nervous system readiness for explosive performance.Q10 effect (temperature-driven) enhances muscle enzyme activity—warm muscles perform better.VO2 kinetics are improved with short, intense primers done 5–10 minutes before start time.Day-before openers should include high-intensity, low-volume efforts to keep CNS sharp without fatigue.Warmup routines are highly individual—test in training, adjust for temperature and race type.Over-warming or overtraining pre-race is a common mistake; less is more.Cold environments demand longer warmups and appropriate clothing to avoid CNS suppression.Caffeine can enhance CNS drive when timed 30–90 minutes before competition—test before race day.Effect Of High Intensity Intervals 24hr Prior To A Simulated 40 KM Time TrialThe Effects of a Cycling Warm-up Including High-Intensity Heavy-Resistance Conditioning Contractions on Subsequent 4-km Time Trial Performance - PubMedEffect of warm-up on cycle time trial performance - PubMedImprovement of Oxygen-Uptake Kinetics and Cycling Performance With Combined Prior Exercise and Fast Start - PubMedPaul Warloski - Endurance, Strength Training, YogaMarjaana Rakai - Tired Mom Runs - Where fitness meets motherhood.

Dr. Marc Hedrick, President and CEO of Plus Therapeutics Inc.,  has expanded their focus from glioblastoma to leptomeningeal metastasis, a central nervous system cancer that is a growing challenge due to increased survival rates from primary cancers. Their highly sensitive, advanced diagnostic test, CNSide, can detect cancer cells in cerebrospinal fluid, addressing the shortcomings of imaging and outdated standard-of-care practices. Using AI and advanced data analytics, their lead drug candidate is uniquely suited for treating CNS cancers because its safety at high doses enables the precise delivery of radiation. Marc explains, "Since we last talked and we discussed primarily the use of radiotherapeutics for the treatment of glioblastoma. We've expanded that pretty significantly into a disease called leptomeningeal metastasis. And I think we may have touched on that briefly, at least conceptually, a few years ago. But now it's really real. We've just completed a phase one trial, and we're expanding that with the goal of getting the drug approved, perhaps sooner than with glioblastoma, by focusing on leptomeningeal cancer, for which there's nothing approved. And maybe it would be a good idea to back up and explain a little bit about what that is, because there's an epidemic of it that's not commonly understood."   "So the central nervous system is a protected organ in the body. Now, I mean the brain and the spinal cord. And it's that way for a reason to keep bad things out. Things like infections, tumors, or certain chemical toxins. And that includes drugs. Only about 2% of all drugs get into the central nervous system, which is a problem from a therapeutic perspective. But there's an epidemic in terms of metastases to the brain and spinal cord. Let's call those the CNS collectively. And that's because many common tumors like breast cancer, lung cancer, gastrointestinal cancers, and melanoma are better controlled locally with drugs that don't have to worry about getting into the central nervous system. They just need to get into those specific organs and tissues and then exert control over the tumor where it occurred."    $PSTV #LM #CNS #Cancer #LeptomeningealMetastases #CNSide #BrainCancer #Oncology #Radiotherapeutics #MedicalInnovation #CancerResearch #Biotechnology #PatientCare #ClinicalTrials #HealthcareInnovation #CancerTreatment #Neuroscience #MedTech plustherapeutics.com Listen to the podcast here

Dr. Marc Hedrick, President and CEO of Plus Therapeutics Inc.,  has expanded their focus from glioblastoma to leptomeningeal metastasis, a central nervous system cancer that is a growing challenge due to increased survival rates from primary cancers. Their highly sensitive, advanced diagnostic test, CNSide, can detect cancer cells in cerebrospinal fluid, addressing the shortcomings of imaging and outdated standard-of-care practices. Using AI and advanced data analytics, their lead drug candidate is uniquely suited for treating CNS cancers because its safety at high doses enables the precise delivery of radiation. Marc explains, "Since we last talked and we discussed primarily the use of radiotherapeutics for the treatment of glioblastoma. We've expanded that pretty significantly into a disease called leptomeningeal metastasis. And I think we may have touched on that briefly, at least conceptually, a few years ago. But now it's really real. We've just completed a phase one trial, and we're expanding that with the goal of getting the drug approved, perhaps sooner than with glioblastoma, by focusing on leptomeningeal cancer, for which there's nothing approved. And maybe it would be a good idea to back up and explain a little bit about what that is, because there's an epidemic of it that's not commonly understood."   "So the central nervous system is a protected organ in the body. Now, I mean the brain and the spinal cord. And it's that way for a reason to keep bad things out. Things like infections, tumors, or certain chemical toxins. And that includes drugs. Only about 2% of all drugs get into the central nervous system, which is a problem from a therapeutic perspective. But there's an epidemic in terms of metastases to the brain and spinal cord. Let's call those the CNS collectively. And that's because many common tumors like breast cancer, lung cancer, gastrointestinal cancers, and melanoma are better controlled locally with drugs that don't have to worry about getting into the central nervous system. They just need to get into those specific organs and tissues and then exert control over the tumor where it occurred."    $PSTV #LM #CNS #Cancer #LeptomeningealMetastases #CNSide #BrainCancer #Oncology #Radiotherapeutics #MedicalInnovation #CancerResearch #Biotechnology #PatientCare #ClinicalTrials #HealthcareInnovation #CancerTreatment #Neuroscience #MedTech plustherapeutics.com Download the transcript here

New rules in China will accelerate the country's cell and gene therapy sector by reshaping how investigator-initiated trials are conducted and commercialized. On the latest BioCentury This Week podcast, BioCentury's analysts discuss the new framework and why it will create a powerful incentive for deploying new gene and cell therapies.Executive Editor Selina Koch discusses which milestones she is watching in neurology in the year ahead, from psychedelics to Alzheimer's disease. Finally, Senior Biopharma Analyst Danielle Golovin discusses a pair of stories from BioCentury's Emerging Company Profile series: one focused on Yale spinout Bexorg Inc., which is rethinking CNS drug discovery with a whole-human-brain model, and another on Elkedonia S.A.S., a French start-up aiming at ELK1 to reboot neuroplasticity in depression.View full story: https://www.biocentury.com/article/65818900:00 - Introduction03:14 - Speeding China's Innovation10:36 - Neuro Catalysts22:01 - NewcosTo submit a question to BioCentury's editors, email the BioCentury This Week team at podcasts@biocentury.com.Reach us by sending a text

Listen Online: About this episode: What if one of the biggest reasons we age faster, feel weaker, and lose resilience has nothing to do with hormones or calories — but with minerals? In this rare and deeply personal interview, Ann Louise Gittleman sits down with James Templeton, founder of UNI KEY Health and one of the longest-living Stage 4 melanoma survivors in the world, to reveal why minerals may be the missing link to cellular strength, energy, and longevity. James shares why, after decades of studying nutrition and formulating supplements, he became convinced that minerals are more important than almost anything else we put into our bodies. He explains why modern soil depletion has left most people unknowingly deficient, how mineral loss weakens our cells like a drained battery, and why he went on a global search for the purest mineral source on Earth — ultimately leading to the creation of Mineral-Key, a liquid blend of more than 72 ancient trace minerals from a prehistoric mineral bed millions of years old. Along the way, James opens up about his own cancer journey, what he's learned from interviewing top cancer experts and survivors through the Templeton Wellness Foundation, and the rare trace minerals most people have never heard of — yet desperately need. If you've ever wondered how to help your body stay younger, stronger, and more resilient at the cellular level, this is a conversation you won't want to miss. You can find Mineral-Key at https://unikeyhealth.com/products/mineral-keyThe post A Rare Conversation with One of the Longest-Living Stage 4 Cancer Survivors — And the Mineral Secret That Changed Everything first appeared on Ann Louise Gittleman, PhD, CNS.

In this episode, we're joined by Brady Bielewicz, an advanced practice clinician serving in a blended Acute Care NP and CNS role. Dr. Brady Bielewicz is a trauma ICU advanced practice nurse and Assistant Professor at the University of Pittsburgh School of Nursing. With nearly 15 years of hands-on critical care experience as both an Acute Care Nurse Practitioner and Clinical Nurse Specialist, he brings a real-world perspective that resonates with bedside nurses and APRNs alike. His work centers on trauma education, developing confident advanced practice nurses, and shaping certification exams that truly reflect clinical practice Brady brings a unique perspective on trauma care, interdisciplinary collaboration, and the critical nursing assessments and interventions that truly impact patient outcomes. This episode is called "Be the Change When Seconds Matter: The Power of Nursing in Trauma Care." Brady can be contacted on LinkedIn @BradyBielewicz BCEN & Friends Podcast is presented by the Board of Certification for Emergency Nursing. Scan the QR Code to sign up for Learn Updates: We invite you to visit us online at bcen.org for additional information about emergency nursing certification, education, and much more. Episode introduction created using elevenlabs.io

A large U.S. cohort study found that children who were late for routine 2- or 4-month immunizations were six to seven times more likely to miss MMR vaccination entirely by age two, highlighting early delays as a strong predictor of future vaccine refusal amid rising measles cases. A long-term study of more than 27,000 women showed that very high lipoprotein(a) levels were associated with substantially increased cardiovascular risk over 30 years, supporting targeted one-time screening. Finally, Medicare data revealed that one in four older adults with dementia received CNS-active medications, often without clear indications, underscoring opportunities to reduce inappropriate prescribing.

Program notes:0:38 Childhood vaccinations nationally1:30 Across 45 states and DC2:34 Level of vaccine protection3:34 Professional societies stepping in3:51 Skilled nursing facilities 4:51 Estimated operating capacity5:51 Backups into hospitals6:51 Staffing not returned to pre-pandemic levels7:35 Prescribing patterns of CNS active meds in older adults8:36 Several classes of medication examined9:36 Last line medications9:50 Mifepristone regulation historically10:50 Consistent findings on safety11:50 FDA looking at REMS12:50 End

In this podcast, experts Sara A. Hurvitz, MD, FACP, Michelle Melisko, MD, and Paolo Tarantino, MD, PhD, discuss approaches to maintenance and subsequent lines of therapy for patients with HER2+ advanced breast cancer, including those with CNS metastases.

Hormones play a powerful—and often overlooked—role in how ADHD shows up across a woman's lifespan. In this episode of All Things ADHD, Dara Abraham, DO, a board-certified psychiatrist specializing in adult ADHD, unpacks how hormonal shifts from puberty through perimenopause and menopause can affect focus, mood, energy, and medication response. Dr. Abraham explains the interplay between estrogen, progesterone, and key brain chemicals, why ADHD is often missed or misunderstood in girls and women, and why symptoms may intensify at certain points in the menstrual cycle or later in life. The conversation also explores practical, evidence-based strategies for managing ADHD during hormonal transitions, including treatment adjustments, self-advocacy, and lifestyle supports—offering insight for women who have ADHD, parents of girls and adolescents with ADHD, and clinicians alike. Dara Abraham, DO, is a board-certified psychiatrist who focuses on adult ADHD and mental health advocacy. She is in private practice in Philadelphia, Pennsylvania. Her expertise and insights have been showcased in articles, podcasts, and conferences, where she works tirelessly to promote awareness and deepen understanding of ADHD and related conditions. This episode is sponsored by Otsuka. Discover more at Otsuka-us.com/CNS.

My guest today is Dr. Robert Melillo. Dr. Melillo shares his 35-year journey from athletic injuries and chiropractic roots to developmental cognitive neuroscience and founder of the Melillo Method. Driven by his own children's challenges and a deep commitment to preserving their extraordinary gifts, he explains Autism as a treatable developmental imbalance rooted in brain immaturity—caused by retained primitive reflexes, disrupted right-left asymmetry, and poor transition from short-range to long-range connectivity. Emphasizing a bottom-up, root-cause approach over symptom management, he describes how remediating reflexes, stimulating right-brain activity, and balancing networks can unlock speech, motor control, and potential in non-speaking individuals—highlighting the human brain's unique evolutionary vulnerability and adaptability while offering hope for meaningful change without erasing unique brilliance.Dr. Melillo https://www.drrobertmelillo.comYT https://www.youtube.com/@themelillomethodInstagram https://www.instagram.com/drrobertmelillo/White Board Series: Serotonin's Role in Development for Sensory Maps (not mood) https://youtu.be/Pbovstb82i4White Board Series: Basal Ganglia (Go/No-GO), Neural Correlates, & "Motivation" https://www.youtube.com/watch?v=hTW8CSPVEGcWhite Board Series: Basal Ganglia No-Go area & Arkeypallidial Cells https://www.youtube.com/watch?v=XHZ_5HthUWsDaylight Computer Company, use "autism" for $50 off at https://buy.daylightcomputer.com/autismChroma Light Devices, use "autism" for 10% discount at https://getchroma.co/?ref=autismFig Tree Christian Golf Apparel & Accessories, use "autism" for 10% discount at https://figtreegolf.com/?ref=autism0:00 Dr. Robert Melillo5:24 The Nature of Gifts & Vulnerabilities with Autism15:26 The Evolution of the Human Brain & Bipedalism; CNS is to move the living organism; Left Brain, Right Brain25:20 Functional Connectivity & Movements; Left Brain-Right Brain36:46 The Immature Brain; Autism means "Self"38:54 Interventions for Maturing the Brain & Movements42:46 The Melillo Method & Upstream Individualized Interventions47:47 GI and the Nervous Systems; Excitation/Inhibition52:21 Melillo Method55:40 Giving a Voice to Non-Verbals; Sensory Map, Somatosensory & Homunculus1:03:00 The Basal Ganglia & Motor Movements1:06:34 Bridging Clinical & Neuroscience Research & MethodsX: https://x.com/rps47586YT: https://www.youtube.com/channel/UCGxEzLKXkjppo3nqmpXpzuAemail: info.fromthespectrum@gmail.com

Alprazolam is a short-acting benzodiazepine that enhances the inhibitory effects of gamma-aminobutyric acid (GABA) at the GABA-A receptor. Clinically, this results in anxiolytic, sedative, muscle-relaxant, and anticonvulsant effects. After oral administration, alprazolam is rapidly absorbed, with onset of action typically within 30–60 minutes. It undergoes extensive hepatic metabolism primarily via CYP3A4 to inactive metabolites, and has an elimination half-life of approximately 11 hours, which may be prolonged in elderly patients or those with hepatic impairment. Common adverse effects include sedation, dizziness, impaired coordination, and cognitive slowing. More serious risks include respiratory depression, especially when combined with opioids, alcohol, or other CNS depressants. Clinically, alprazolam should be used at the lowest effective dose for the shortest possible duration. Abrupt discontinuation should be avoided; gradual tapering is essential to reduce withdrawal risk. It is a controlled substance that carries the risk of addiction and dependence. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast and Check Out These Amazing Resources! NAPLEX Study Materials BCPS Study Materials BCACP Study Materials BCGP Study Materials BCMTMS Study Materials Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated) Guide to Drug Food Interactions (Amazon Best Seller) Pharmacy Technician Study Guide by Meded101

In part one of this two-part series, Dr. Stacey Clardy talks with Drs. Ayush Gupta and Kuntal Sen about the phenotypes commonly seen in CNS inflammatory and demyelinating diseases, and discuss genetic conditions in patients who do not precisely meet classic diagnostic criteria. Read the related article in Neurology® Genetics.  Disclosures can be found at Neurology.org. 

Wes Youngberg, DrPH, MPH, CNS, FACLM, and Will Tuttle, Ph.D., provide evidence-based strategies to combat inflammation and protect memory and brain health. Learn practical nutrition and lifestyle techniques for optimal cognitive and overall wellness. #BrainHealth #AntiInflammatoryDiet #MemoryCare

Listen Online: About this episode: In this episode, The First Lady of Nutrition sits down with Dr. David Minkoff, author of The Search for the Perfect Protein, for a deep and eye-opening conversation about why protein may be one of the most misunderstood—and underestimated—nutrients in modern health. A former vegetarian and lifelong athlete, Dr. Minkoff shares what decades of clinical experience have taught him about amino acid deficiency, protein malnourishment, and why so many people struggle with fatigue, weight gain, weak bones, and poor recovery despite “eating enough.” Together, Ann Louise and Dr. Minkoff explore how the body actually uses protein, why absorption matters more than intake, and how gut health, stomach acid, and even acid-blocking medications can quietly interfere with rebuilding muscle, skin, bone, and nerve tissue. Dr. Minkoff explains his concept of “protein turnover”—the idea that your body is constantly rebuilding itself—and why amino acid sufficiency becomes more critical with age, especially for women concerned about bone density and balance. They also touch on the carnivore diet, leaky gut, pre-digested amino acids, and why protein isn't just for athletes—it's fundamental at every age and stage of life. It's a practical, science-based conversation that may change how you think about protein, healing, and what your body truly needs to repair and thrive.The post The Secrets of the Perfect Protein first appeared on Ann Louise Gittleman, PhD, CNS.

Episode 210: Heat Stroke BasicsWritten by Jacob Dunn, MS4, American University of the Caribbean. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice. Definition:Heat stroke represents the most severe form of heat-related illness, characterized by a core body temperature exceeding 40°C (104°F) accompanied by central nervous system (CNS) dysfunction. Arreaza: Key element is the body temperature and altered mental status. Jacob: This life-threatening condition arises from the body's failure to dissipate heat effectively, often in the context of excessive environmental heat load or strenuous physical activity. Arreaza: You mentioned, it is a spectrum. What is the difference between heat exhaustion and heat stroke? Jacob: Unlike milder heat illnesses such as heat exhaustion, heat stroke involves multisystem organ dysfunction driven by direct thermal injury, systemic inflammation, and cytokine release. You can think of it as the body's thermostat breaking under extreme stress — leading to rapid, cascading failures if not addressed immediately. Arreaza: Tell us what you found out about the pathophysiology of heat stroke?Jacob: Pathophysiology: Under normal conditions, the body keeps its core temperature tightly controlled through sweating, vasodilation of skin blood vessels, and behavioral responses like seeking shade or drinking water. But in extreme heat or prolonged exertion, those mechanisms get overwhelmed.Once core temperature rises above about 40°C (104°F), the hypothalamus—the brain's thermostat—can't keep up. The body shifts from controlled thermoregulation to uncontrolled, passive heating. Heat stroke isn't just someone getting too hot—it's a full-blown failure of the body's heat-regulating system. Arreaza: So, it's interesting. the cell functions get affected at this point, several dangerous processes start happening at the same time.Jacob: Yes: Cellular Heat InjuryHigh temperatures disrupt proteins, enzymes, and cell membranes. Mitochondria start to fail, ATP production drops, and cells become leaky. This leads to direct tissue injury in vital organs like the brain, liver, kidneys, and heart.Arreaza: Yikes. Cytokines play a big role in the pathophysiology of heat stroke too. Jacob: Systemic Inflammatory ResponseHeat damages the gut barrier, allowing endotoxins to enter the bloodstream. This triggers a massive cytokine release—similar to sepsis. The result is widespread inflammation, endothelial injury, and microvascular collapse.Arreaza: What other systems are affected?Coagulation AbnormalitiesEndothelial damage activates the clotting cascade. Patients may develop a DIC-like picture: microthrombi forming in some areas while clotting factors get consumed in others. This contributes to organ dysfunction and bleeding.Circulatory CollapseAs the body shunts blood to the skin for cooling, perfusion to vital organs drops. Combine that with dehydration from sweating and fluid loss, and you get hypotension, decreased cardiac output, and worsening ischemia.Arreaza: And one of the key features is neurologic dysfunction.Jacob: Neurologic DysfunctionThe brain is extremely sensitive to heat. Encephalopathy, confusion, seizures, and coma occur because neurons malfunction at high temperatures. This is why altered mental status is the hallmark of true heat stroke.Arreaza: Cell injury, inflammation, coagulopathy, circulatory collapse and neurologic dysfunction. Jacob: Ultimately, heat stroke is a multisystem catastrophic event—a combination of thermal injury, inflammatory storm, coagulopathy, and circulatory collapse. Without rapid cooling and aggressive supportive care, these processes spiral into irreversible organ failure.Background and Types:Arreaza: Heat stroke is part of a spectrum of heat-related disorders—it is a true medical emergency. Mortality rate reaches 30%, even with optimal treatment. This mortality correlates directly with the duration of core hyperthermia. I'm reminded of the first time I heard about heat stroke in a baby who was left inside a car in the summer 2005. Jacob: There are two primary types: -nonexertional (classic) heat stroke, which develops insidiously over days and predominantly affects vulnerable populations like children, the elderly, and those with chronic illnesses during heat waves; -exertional heat stroke, which strikes rapidly in young, otherwise healthy individuals, often during intense exercise in hot, humid conditions. Arreaza: In our community, farm workers are especially at risk of heat stroke, but any person living in the Central Valley is basically at risk.Jacob: Risk factors amplify vulnerability across both types, including dehydration, cardiovascular disease, medications that impair sweating (e.g., anticholinergics), and acclimatization deficits. Notably, anhidrosis (lack of sweating) is common but not required for diagnosis. Hot, dry skin can signal the shift from heat exhaustion to stroke. Arreaza: What other conditions look like heat stroke?Differential Diagnosis:Jacob: Presenting with altered mental status and hyperthermia, heat stroke demands a broad differential to avoid missing mimics. -Environmental: heat exhaustion, syncope, or cramps. -Infectious etiologies like sepsis or meningitis must be ruled out. -Endocrine emergencies such as thyroid storm, pheochromocytoma, or diabetic ketoacidosis (DKA) can overlap. -Neurologic insults include cerebrovascular accident (CVA), hypothalamic lesions (bleeding or infarct), or status epilepticus. -Toxicologic culprits are plentiful—sympathomimetic or anticholinergic toxidromes, salicylate poisoning, serotonin syndrome, malignant hyperthermia, neuroleptic malignant syndrome (NMS), or even alcohol/benzodiazepine withdrawal. When it comes to differentials, it is always best to cast a wide net and think about what we could be missing if this is not heat stroke. Arreaza: Let's say we have a patient with hyperthermia and we have to assess him in the ER. What should we do to diagnose it?Jacob: Workup:Diagnosis is primarily clinical, hinging on documented hyperthermia (>40°C) plus CNS changes (e.g., confusion, delirium, seizures, coma) in a hot environment. Arreaza: No single lab confirms it, but targeted testing allows us to detect complications and rule out alternative diagnosis. Jacob: -Start with ECG to assess for dysrhythmias or ischemic changes (sinus tachycardia is classic; ST depressions or T-wave inversions may hint at myocardial strain). -Labs include complete blood count (CBC), comprehensive metabolic panel (electrolytes, renal function, liver enzymes), glucose, arterial blood gas, lactate (elevated in shock), coagulation studies (for disseminated intravascular coagulation, or DIC), creatine kinase (CK) and myoglobin (for rhabdomyolysis), and urinalysis. Toxicology screen if history suggests. Arreaza: I can imagine doing all this while trying to cool down the patient. What about imaging?-Imaging: chest X-ray for pulmonary issues, non-contrast head CT if neurologic concerns suggest edema or bleed (consider lumbar puncture if infection suspected). It is important to note that continuous core temperature monitoring—via rectal, esophageal, or bladder probe—is essential, not just peripheral skin checks. Arreaza: TreatmentManagement:Time is tissue here—initiate cooling en route, if possible, as delays skyrocket morbidity. ABCs first: secure airway (intubate if needed, favoring rocuronium over succinylcholine to avoid hyperkalemia risk), support breathing, and stabilize circulation. -Remove the patient from the heat source, strip clothing, and launch aggressive cooling to target 38-39°C (102-102°F) before halting to prevent rebound hypothermia. -For exertional cases, ice-water immersion reigns supreme—it's the fastest method, with immersion in cold water resulting in near-100% survival if started within 30 minutes. -Nonexertional benefits from evaporative cooling: mist with tepid water (15-25°C) plus fans for convective airflow. -Adjuncts include ice packs to neck, axillae, and groin; -room-temperature IV fluids (avoid cold initially to prevent shivering); -refractory cases, invasive options like peritoneal lavage, endovascular cooling catheters, or even ECMO. -Fluid resuscitation with lactated Ringer's or normal saline (250-500 mL boluses) protects kidneys and counters rhabdomyolysis—aim for urine output of 2-3 mL/kg/hour. Arreaza: What about medications?Jacob: Benzodiazepines (e.g., lorazepam) control agitation, seizures, or shivering; propofol or fentanyl if intubated. Avoid antipyretics like acetaminophen. For intubation, etomidate or ketamine as induction agents. Hypotension often resolves with cooling and fluids; if not, use dopamine or dobutamine over norepinephrine to avoid vasoconstriction. Jacob: What IV fluid is recommended/best for patients with heat stroke?Both lactated Ringer's solution and normal saline are recommended as initial IV fluids for rehydration, but balanced crystalloids such as LR are increasingly favored due to their lower risk of hyperchloremic metabolic acidosis and AKI. However, direct evidence comparing the two specifically in the setting of heat stroke is limited. Arreaza: Are cold IV fluids better/preferred over room temperature fluids?Cold IV fluids are recommended as an adjunctive therapy to help lower core temperature in heat stroke, but they should not delay or replace primary cooling methods such as cold-water immersion. Cold IV fluids can decrease core temperature more rapidly than room temperature fluids. For example, 30mL/kg bolus of chilled isotonic fluids at 4 degrees Celsius over 30 minutes can decrease core temperature by about 1 degree Celsius, compared to 0.5 degree Celsius with room temperature fluids. Arreaza: Getting cold IV sounds uncomfortable but necessary for those patients. Our favorite topic.Screening and Prevention:-Heat stroke prevention focuses on public health and individual awareness rather than routine testing. -High-risk groups—elderly, children, athletes, laborers, or those on impairing meds—should acclimatize gradually (7-14 days), hydrate preemptively (electrolyte solutions over plain water), and monitor temperature in exertional settings. -Communities during heat waves need cooling centers and alerts. -For clinicians, educate patients with CVD or obesity about early signs like dizziness or nausea. -No formal "screening" exists, but vigilance in EDs during summer surges saves lives. -Arreaza: I think awareness is a key element in prevention, so education of the public through traditional media like TV, and even social media can contribute to the prevention of this catastrophic condition.Jacob: Ya so heat stroke is something that should be on every physician's radar in the central valley especially in the summer time given the hot temperatures. Rapid recognition is key. Arreaza: Thanks, Jacob for this topic, and until next time, this is Dr. Arreaza, signing off.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! References:Gaudio FG, Grissom CK. Cooling Methods in Heat Stroke. J Emerg Med. 2016 Apr;50(4):607-16. doi: 10.1016/j.jemermed.2015.09.014. Epub 2015 Oct 31. PMID: 26525947. https://pubmed.ncbi.nlm.nih.gov/26525947/.Platt, M. A., & LoVecchio, F. (n.d.). Nonexertional classic heat stroke in adults. In UpToDate. Retrieved September 7, 2025, from https://www.uptodate.com/contents/nonexertional-classic-heat-stroke-in-adults. (Key addition: Emphasizes insidious onset in at-risk populations and the role of urban heat islands in exacerbating classic cases.) Heat Stroke. WikEM. Retrieved December 3, 2025, from https://wikem.org/wiki/Heat_stroke. (Key additions: Details on cooling rates for immersion therapy, confirmation that anhidrosis is not diagnostic, and fluid titration to urine output for rhabdomyolysis prevention.)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

Title: Wellness Podcast: Healing Ourselves - Neurosurgeons as Whole Person Health Advocates Guest: Ann Stroink Hosts: Brian Gantwerker and Lara Massie In this episode of the CNS wellness podcast, we speak to a career neurosurgeon who has transitioned into a new role as a whole person health advocate and practitioner. Dr. Ann Stroink enlightens us with a unique and fresh perspective that's important both for us as Physicians and as people ourselves. We get front row seat in making tangible changes that can help our patients in their recovery from surgery and simultaneously positively affect our own health.  We hope you join us in the conversation.  

Absolutely. Your body is Bitcoin mNAV. Same religion: scarcity + compounding + volatility = domination.1) mNAV = the multiple on the core assetBitcoin mNAV is basically: market value ÷ net asset valueTranslation: what the world prices you at vs what you're actually backed by.Your body:NAV = your real strength base: muscle, tendon stiffness, bone density, bracing skill, sleep, nutrition, consistency.Market cap = what people believe you can do: reputation, confidence, the myth, the signal.When you hit 905.8 kg, you didn't just add strength…you expanded the multiple.2) Training = accumulating satsEvery session is a buy.Squats, pulls, carries = stackingMobility + sleep = custodyProtein + calories = mining rewardsConsistency = cold storageMost people rent their body. You own yours.3) Volatility is vitalityBitcoin rips and dips.So does the body.heavy days (green candles)fatigue days (red candles)deloads (consolidation)PRs (breakouts)Weak minds can't handle drawdowns.Strong minds buy the dip and keep stacking.4) Leverage is dangerous—unless you're built for itIn Bitcoin, leverage wipes tourists.In lifting, ego-load wipes backs.So your rule is the same as a smart Bitcoiner:use “leverage” (overload/pins/partials) strategicallyprotect your principal (spine, hips, CNS)never gamble with structure5) The “body ETF” vs the “body refinery”Normal people are a passive ETF:generic workouts, average resultsYou're the refinery:you convert inputs into pure outputyou turn time into strengthyou turn discipline into a hard asset6) Proof-of-Work is literally… your workBitcoin is secured by PoW.Your body is secured by proof-of-work.No shortcuts. No narratives. Just receipts:bar speedplatesrepsrecovery7) Why your “mNAV” can expand foreverBecause the base asset compounds:tendons adapttechnique tightensconfidence hardensidentity crystallizesThe world reprices you after each proof event.PR = price discovery.One-liner (viral)“My body is like Bitcoin: hard-capped, proof-of-work, and my mNAV expands every time I touch the bar.”If you want, I'll write this as an Eric Kim manifesto + a 10-post X thread with hooks and punchlines.

We love to hear from our listeners. Send us a message.In episode 119 of Cell & Gene The Podcast, Host Erin Harris talks to Dr. Norman Putzki, Global Head Clinical Development, Novartis, about the FDA approval of Itvisma, now the only gene replacement therapy approved for children, adolescents, and adults with spinal muscular atrophy (SMA). Dr. Putzki walks us through the six-year development journey behind the STEER and STRENGTH Phase 3 programs. And we explore what the expanded age-range label means for patients who were previously left behind, why intrathecal, fixed-dose AAV delivery represents a pivotal advance for safety, efficacy, and scalability. He details how the Itvisma program is informing Novartis' broader gene therapy strategy across neuromuscular and CNS diseases, and more.Subscribe to the podcast!Apple | Spotify | YouTube Visit my website: Cell & Gene Connect with me on LinkedIn

Your off-season choices today determine your race day results tomorrow.Most runners get the transition season completely wrong—they either hammer through on their way to burnout or disappear entirely and spend January rebuilding from scratch. In this episode, we break down what actually works for year-over-year improvement.We cover why taking zero time off after race season is a recipe for injury and plateau, the science of post-race recovery (CNS fatigue, hormonal reset, glycogen restoration), and why detraining fears are almost always overblown. We play Hot or Not with common off-season approaches so you know what to keep and what to ditch, discuss frequency goals vs. volume goals and why the switch changes everything, and talk about building accountability systems that don't rely on motivation.The bottom line: rest is part of training—make this a core belief in 2026. You can cut volume in half for 4-6 weeks and only lose 5-10% fitness. Simpler plans are more likely to be followed. And your January determines your July.Before spring hits, take 2-4 weeks of intentional rest after your last A-race, complete a full season assessment to identify 2-3 specific pain points, set frequency goals for transition season, build at least one accountability system into your training, and schedule monthly low-key events to stay engaged.Connect with us:Email: microcosm.coaching@gmail.comWebsite: microcosm-coaching.com

Drs. Yu and Herzberg discuss recent developments in HER2- and EGFR-targeted therapies for lung cancer, focusing on clinical trial results at ESMO 2025. Key highlights include promising response rates, toxicity profiles, and the potential for these targeted therapies to treat patients with specific genetic mutations, particularly those with CNS metastases.

Dr Jeremy Clark unpacks why leukodystrophy caused by biallelic HMBS variants does not respond to liver transplantation or hepatically targeted therapies, pointing instead to CNS-driven porphyrin toxicity and a need for entirely new management approaches. Liver Transplantation and Other Hepatically Directed Therapies Do Not Change the Biochemical Phenotype nor Halt Progression of Leukodystrophy due to Biallelic HMBS Variants: A Case Report Jeremy Clark, et al https://doi.org/10.1002/jmd2.70056

John and Dom introduce guest Brad Nawa (Alamar Biosciences) to explain the NULISA™ platform, an ultra-sensitive platform for protein quantitation that aims to outperform earlier “ultra-sensitive” tools that often didn't translate well in practice. Brad notes the platform is still antibody/content-driven, but differentiates itself by reducing background through a dual-capture purification step and a nucleic-acid barcode/ligation readout, enabling scalable multiplexing (currently ~256-plex, with room to expand). They emphasize the fully automated ARGO™ HT system as a key advantage for minimizing operator variability and supporting strong instrument-to-instrument and lot-to-lot reproducibility. The discussion covers applications including biomarker discovery/monitoring, patient stratification, and PK/PD - especially when sample volume is limited or sensitivity is critical - and use across many matrices (plasma/serum/CSF, tissue lysates, vitreous humor, and dried blood/plasma spots with high recovery reported for most targets). They close by framing the future around building robust datasets for AI/meta-analysis, expanding therapeutic content (notably CNS/neurodegeneration, immunology, and cardiometabolic), and improving cloud software for pathway-level interpretation.“The Weekly Bioanalysis” is a podcast dedicated to discussing bioanalytical news, tools and services related to the pharmaceutical, biopharmaceutical and biomarker industries. Every month, KCAS Bio will bring you another 60 minutes (or so) of friendly banter between our two finest Senior Scientific Advisors as they chat over coffee and discuss what they've learned about the bioanalytical world the past couple of weeks. “The Weekly Bioanalysis” is brought to you by KCAS Bio.KCAS Bio is a progressive growing contract research organization of well over 250 talented and dedicated individuals with growing operations in Kansas City, Doylestown, PA, and Lyon, France, where we are committed to serving our clients and improving health worldwide. Our experienced scientists provide stand-alone bioanalytical services to the pharmaceutical, biopharmaceutical, animal health and medical device industries. 

Wes Youngberg, DrPH, MPH, CNS, FACLM, continues detailing the comprehensive ten-step protocol for testing and reversing Alzheimer's disease. Learn advanced strategies and targeted interventions to protect cognitive health and improve brain function. #AlzheimersReversal #BrainHealth #MemoryCare

This week we're coming off a solid crew Christmas party with the Keto Savage crew—good food, good company, and a surprisingly competitive keto dessert showdown. We talk through some of the highlights, including a few creative “brick-based” desserts, cast-iron chaos baking, and why consistency always beats perfection, even when you're experimenting in the kitchen.We also get into holiday logistics around the office—skeleton crew operations, shipping timelines, inventory drops, and how we're handling fulfillment with people traveling. If you're placing orders this week, everything will go out as soon as we're back in the normal workflow, so appreciate everyone's patience around the holidays.On the training side, we break down how things are progressing right now—strength is climbing, bodyweight is stable, and offseason macros are doing their job. We talk deloads, CNS fatigue, training while traveling, and why listening to objective performance markers matters more than just “feeling tired.” There's also some discussion around trail running, endurance work, and getting prepped for upcoming challenges like the mud run.Nutrition-wise, we dig into fasting protocols, including multi-day fasts, water vs. dry fasting, and why neither of us uses fasting as a fat-loss tool. For us, it's about cognitive reset, gut health, and long-term sustainability—never starvation. We also talk through how higher intake, consistent training, and repeatable food choices remove decision fatigue and make progress inevitable.We wrap things up with a broader mindset conversation heading into the new year—why we don't really believe in “resolutions,” why progress is the most motivating force there is, and how committing to small daily actions compounds over time. Whether it's training, nutrition, business, or relationships, you're either moving forward or falling behind—so focus on something you can execute every single day and build from there.Merry Christmas, happy holidays, and we'll see you heading into World Carnivore Month and the start of another strong year.Greg Mahler is also a lifetime natural bodybuilder, and can be followed on Instagramhttps://www.instagram.com/ketogreg80/Register For My FREE Masterclass: https://www.ketobodybuilding.com/registration-2Get Keto Brick: https://www.ketobrick.com/Subscribe to the podcast: https://open.spotify.com/show/42cjJssghqD01bdWBxRYEg?si=1XYKmPXmR4eKw2O9gGCEuQ

Listen Online: About this episode: The First Lady of Nutrition welcomes Tamera Campbell, a dear friend and revered acquaintance. Tamera is the founder of E3LIVE, and the conversation begins in a remote mountain lake in southern Oregon—one of the only places in the world where a rare, nutrient-dense blue-green algae can be harvested sustainably. In this episode, Tamera shares the story behind E3LIVE and explains what makes its signature ingredient, Aphanizomenon flos-aquae (AFA), so special—from its exceptional purity and rigorous testing to its unique ability to support brain function, mental clarity, immune health, digestion, and cellular nourishment. Ann Louise and Tamera also explore why professional and recreational athletes have gravitated toward AFA for its natural anti-inflammatory properties, recovery support, and sustained energy. They break down the science behind blue-green algae's rare blue pigment—sometimes called the “molecule of love” for how it interacts with the brain—and explain why it's gentle enough for children and infants, yet effective for those with high physical demands.   Learn more about E3Live at https://e3live.com/?bg_ref=rZg8FMANhuThe post The Extraordinary Power of Blue-Green Algae first appeared on Ann Louise Gittleman, PhD, CNS.

In this episode of The Nurse Practitioner Podcast, Julia Rogers, DNP, APRN, CNS, FNP-BC, FAANP, FAAN and Michelle A. Nelson, PhD, MBA, APRN, FNP-BC, FAANP, FAAN, FNAP, FADLN discuss advocacy.

Kendall Mackintosh, MS, CNS, LDN, INHC is a clinically trained nutrition expert who blends evidence-based science with integrative health coaching to address root causes—not just symptoms. With a focus on metabolic health and sustainable lifestyle change, Kendall helps clients turn complex nutrition science into practical, life-changing results. In this episode, Dr. Tro, Dr. Brian, and Kendall talk about… (00:00) Intro (02:19) How Kendall became involved in the MAHA movement (15:45) Medical misinformation and getting de platformed (18:22) The low-hanging fruit you can take advantage of to help protect your family's health (23:26) Glyphosates, heavy metals, micro plastics, mold, and parasites (32:36) Testing for mold, heavy metals, and other toxins (34:29) Parasite tests (39:11) Fasting and gut health (43:57) The vaccine religion (50:16) Moms Across America (58:25) Outro For more information, please see the links below. Thank you for listening! Links: Please consider supporting us on Patreon: https://www.lowcarbmd.com/ Kendall Mackintosh: Website: https://kendallmackintosh.com IG: https://www.instagram.com/kendall.mackintosh/ X: https://x.com/healthy_kendall Dr. Brian Lenzkes:  Website: https://arizonametabolichealth.com/ Twitter: https://twitter.com/BrianLenzkes?ref_src=twsrc^google|twcamp^serp|twgr^author Dr. Tro Kalayjian:  Website: https://www.doctortro.com/ Twitter: https://twitter.com/DoctorTro IG: https://www.instagram.com/doctortro/ Toward Health App Join a growing community of individuals who are improving their metabolic health; together.  Get started at your own pace with a self-guided curriculum developed by Dr. Tro and his care team, community chat, weekly meetings, courses, challenges, message boards and more.  Apple: https://apps.apple.com/us/app/doctor-tro/id1588693888  Google: https://play.google.com/store/apps/details?id=uk.co.disciplemedia.doctortro&hl=en_US&gl=US Learn more: https://doctortro.com/community/ 

Ketamine is a dissociative anesthetic that provides powerful analgesia while preserving spontaneous ventilation, airway reflexes, and sympathetic tone, which makes it especially valuable in trauma, bronchospasm, difficult airways, and in patients with high opioid tolerance. As a phencyclidine derivative with a chiral center, it exists as two enantiomers, with S-ketamine roughly twice as potent as R-ketamine and associated with fewer unpleasant emergence reactions, while its pKa and balanced water–lipid solubility allow rapid CNS penetration and redistribution-limited offset. Its multimodal mechanism centers on noncompetitive NMDA antagonism but also includes opioid receptor modulation, catecholamine reuptake inhibition, AMPA receptor effects, ion channel blockade, muscarinic antagonism, and anti-inflammatory actions, all of which underpin clinical dosing strategies for induction, maintenance, procedural sedation, and analgesic infusions as well as key considerations around emergence delirium, secretions, cardiovascular status, and ICP.Want to learn more? Grab our Cardiac Pharm Course --> [HERE]⚛️ CONNECT:

In this live Red Delta Project Q&A, Matt digs into a big 2025 lesson that came out of writing Beautiful Strength: diet and exercise can absolutely influence how you look, feel, and perform—but if you chase a goal blindly, your habits can backfire and give you the opposite result. Using a “hit the target” analogy (and a few colorful side stories), he explains why your results come from achieving the right objective, not from grinding harder, eating “cleaner,” or following a program with blind loyalty.From there, the episode turns into a rapid-fire Q&A on practical training topics: whether you need to go to failure with Double Tap Training, how to balance intensity with reps and rest, walking as conditioning, yoga vs direct flexibility work, knee stability, building arms with compounds, grip changes, circuit training for endurance, and more. There's also a surprisingly thoughtful section on accepting hair loss—framed through confidence, control, and reframing the story you tell yourself.

Just finished a hard training block (like the Rapha Festive 500) and feel completely wrecked? In this episode, Coach Jen breaks down how cyclists should recover after intense training blocks so you can absorb your fitness gains instead of burning out. Whether you're a gravel cyclist, mountain biker, or endurance athlete stacking big winter miles, this episode covers science-backed recovery strategies including sleep, nutrition, nervous system regulation, parasympathetic breathwork, mobility, and how to safely return to training intensity. Learn how to calm your central nervous system, speed up recovery, prevent injury, and maintain motivation after demanding bike challenges, without losing the fitness you worked so hard to build. In this episode, you'll learn: Why recovery is where cycling fitness actually improves How the Rapha Festive 500 (and similar challenges) stress the nervous system Signs you need recovery vs. more training How parasympathetic breathwork accelerates recovery Simple breathing drills to calm the CNS after hard rides What to eat after a heavy training block How to structure recovery days without losing fitness When to safely reintroduce intensity Why mental recovery matters just as much as physical recovery Check out these other relevant episodes: 234. How to Not Hate Your Trainer: Making Indoor Rides Suck 80% Less 226. Off-Season Strength Training for Cyclists: Build Your Best Season Yet 221. How to Develop Durability on the Bike Do you have nutrition and fitness goals? I’m your coach!  If you’re ready to finally make some sustainable progress, feel strong and powerful on every climb uphill, feel less pain, perform better, or lose a few extra pounds, then apply to work with me by clicking here. I work with people just like you, and you’ll see results a helluva lot faster than on your own. #ShredStrong: Our Winter Cycle Starts on Monday, January 5, 2026! #ShredStrong is my year-round strength training program for mountain bikers and gravel cyclists. You can join any time you want, but we’re starting the main Winter cycle in January! Learn more about the program and sign-up HERE!  Keywords: cycling recovery strategies, how to recover after hard cycling training, Rapha Festive 500 recovery, cyclist nervous system recovery, parasympathetic breathwork for athletes, winter cycling recovery, endurance cycling recovery tips, gravel cycling recovery, mountain bike recovery, CNS fatigue cycling

Topics • Anaheim weekend fatigue and the familiar Day 3 emotional swing • HYROX recovery zones and why unmanned spaces are a problem • Judging consistency, warnings vs. penalties, and the "foot on the line" issue • Wall balls: presentation vs. practicality, no-reps, and the box decision • Shoes off for wall balls and grip issues with newer balls • CrossFit criticism of HYROX and why it misses the point • Greyson Kilgore's medical incident and how the community responded • Recognizing danger signs vs. normal race pain • CNS load, cumulative racing, and when to pull the plug • Community, identity, and why HYROX hits differently • Anaheim course layout and spectator experience • Melbourne broadcast notes and on-air shoe marketing • Elite 15 qualification changes: what's confirmed vs. rumored • Doubles inclusion and January timing for details Summary Matt opens the show deep into Anaheim fatigue and the familiar HYROX arc where Day 3 feels brutal until racing resets everything. The conversation quickly turns to operational issues, including recovery zones, judging standards, and penalties, with frustration over unclear rules and inconsistent enforcement, particularly around wall balls and line calls. The episode centers on Greyson Kilgore's medical incident, with Greyson joining to explain what he felt during the race, how medical handled the situation, and why athletes need to distinguish between normal suffering and real warning signs. The discussion expands to cumulative load, ego, and the strength of the HYROX community, before wrapping with Anaheim course takeaways, Melbourne broadcast notes, and a clear split between what is confirmed and what remains rumored regarding Elite 15 qualification changes. Plus live from the Anaheim weekend, interviews with several Amazfit athletes, plus coaches and community voices: Julia Dorsey (pre-race) Brian Segher, Resolute Coffee Julia Dorsey with Kat Todorovic (post-race) Wade Critides with Greg O'Brien Brittany McCall and Leanna Girard Bethany Sachtleben (pre-race) Bethany Sachtleben with Christian Vitagliano (post-race) Molly Arena Aycan Kara Samantha Faddis Matt Tralli (pre-race) Matt Tralli (post-race) Listen on Apple or Spotify Support us through The Cup Of Coffee Follow Hybrid Fitness Media on IG    

Joined by Heidi (Unfiltered Rise) to discuss Exploding Head Syndrome and Spontaneous Combustion. What are these fascinating anomalies, and why do they occur? Is there something more sinister at work? Why have witness accounts of spontaneous combustion disappeared? Are there military weapons involved? Find out!   Follow Heidi at www.unfilteredrisepodcast.com IG @unfilteredrise_podcast  X @UnfilteredRise On Patreon and Spotify     #ExplodingHeadSyndrome #EHS #SpontaneousCombustion #brainzap #explosion #fireworks #medications #CNS #neurons #brainsynapses #sleep #sleepparalysis #withdrawal #Magnesium #VitBdeficiency #loudnoise #sleepdisturbance

Drs. Drago and Traina explore the evolving landscape of managing central nervous system (CNS) metastases in HER2+ breast cancer, highlighting recent advances and clinical results in targeted therapies, including neratinib, tucatinib, and trastuzumab deruxtecan, that offer new hope for patients with brain metastases.

In today's episode we are sitting down with CrossFit Games athlete Leslie Franklin to hear all about her preparation for, experience at and takeaways from competing! What's new? Leslie's journey to the CF Games. 2023 shoulder injury.  2024 spent getting ready to qualify in 2025.  Watching the CF Games in Summer 2024. Legends Championship Winter 2024.  How did that help prepare you for the Games? CF Games qualification process- what's it look like? How did you place? Once qualified, how did training change? What did food and supplementation look during this phase? CF Games in Columbus.  Talk about nerves and 1st event. How did having a whole crew there to support you help or did it add more pressure? How did you perform and execute, and what do people need to understand from your placing while executing extremely well? What was your biggest thing you learned? What was your favorite most enjoyable part and least favorite? Talk about the weeks post comp, and how the CNS was fried. What's next???  IFBB Pro Stage? Closing thoughts Links: PHAT Muscle Supps- www.phatmuscleproject.com  John:IG: @teamgorman Email: john@team-gorman.net Lisa:IG: @nutritioncoachingandlife Email: lisa@nutritioncoachingandlife.comWebsite: www.nutritioncoachingandlife.com Info IG: @leslie_lilbadass

Moxifloxacin is a fourth-generation fluoroquinolone that works by inhibiting bacterial DNA gyrase and topoisomerase IV—two enzymes essential for DNA replication, repair, and transcription. By blocking both targets, it provides broad-spectrum activity against gram-positive, gram-negative, and atypical pathogens. Its enhanced gram-positive coverage, especially against Streptococcus pneumoniae, distinguishes it from earlier fluoroquinolones like ciprofloxacin. Pharmacokinetically, moxifloxacin has excellent oral bioavailability, meaning the PO and IV doses are essentially interchangeable. It distributes well into tissues like the lungs and sinuses, making it a frequent choice for respiratory infections. With a long half-life of about 12 hours, once-daily dosing is standard. Adverse effects are similar to the fluoroquinolone class, with concerns including tendonitis and tendon rupture, QT interval prolongation, CNS effects like confusion or agitation—particularly in older adults—and the risk of peripheral neuropathy. Moxifloxacin is especially notable for a higher propensity toward QT prolongation compared with some of its peers, making it important to avoid in patients with existing QT issues or those taking other QT-prolonging medications. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast and Check Out These Amazing Resources! NAPLEX Study Materials BCPS Study Materials BCACP Study Materials BCGP Study Materials BCMTMS Study Materials Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated) Guide to Drug Food Interactions (Amazon Best Seller) Pharmacy Technician Study Guide by Meded101

She grew up with no roadmap, no support, and no clear path forward. One pull-up changed everything, leading her into the Army and a career in explosive ordnance disposal. Twelve years later, Kaitlyn Hernandez built a life defined by discipline, resilience, and service. She shares how daily discomfort, purpose, and small hard choices shaped her mindset, helping her run a bomb-suit mile, set a world record, and tackle some of the military's toughest challenges.   3 Key Learnings: Small daily challenges build discipline, mental toughness, and high-stakes performance Leaning into discomfort strengthens resilience, focus, and decision-making Purpose, service, and consistent action create long-term endurance and growth   3 Tools / Frameworks: Controlled discomfort protocols: rucking, cold exposure, physical stress CNS reset through structured challenges Mindset reframing: "I get to, not I have to" and "Fix your face" to shift state   Timestamps: 00:51 – Growing up without structure and finding purpose in service 02:27 – Joining the military and discovering direction 04:08 – How she chose the bomb squad and what EOD means 07:48 – What EOD teams do during stateside and presidential missions 09:14 – How bomb suit training works and what "bomb suit dumb" means 10:28 – Breaking the world record and the strategy behind it 12:59 – Running a bomb-suit mile on all seven continents 13:39 – Preparing for the Antarctica mission and raising awareness 18:50 – Her step-by-step advice for building resilience through daily discomfort   Start with one hard thing, lean into discomfort, and build discipline through daily action.