Podcasts about duke medical center

In honor of Women's History Month, we wanted to present you with information on breast health. Meet my next guest, Dr. Hillary Smith.Dr. Hillary Smith, D. C., CCT III is the only Level III Advanced Certified Clinical Thermographer (American Academy of Clinical Thermology) in California. In continuous practice in the Los Angeles area since 1985.Go to https://thebreastthermographycenter.com/scheduling/BIODr. Hillary Smith began her integrative chiropractic and nutrition practice in the San Fernando Valley area of Los Angeles in 1985, after graduating Magna Cum Laude from the Southern California University of Health Sciences. There she earned a Bachelor of Science in Biology and a Doctor of Chiropractic degree in 1984. Her studies have continued in Functional Nutrition, Kinesiology, Mind Body Therapies, Herbal Medicine and Homeopathy. She was a class valedictorian when she received a Doctorate of Homeopathic Medicine from the Hahnemann College of Homeopathy in 1994. In 2005, Dr. Hillary Smith received certification in First Line Therapy, a lifestyle change program that addresses many chronic health issues and was certified in one the first Health Coach programs in 2000.While researching options for her own pro-active health, Dr. Smith became interested in Digital Infrared Thermal Imaging (DITI) or Thermography. In 2006, she opened Advanced Medical Thermography, The Breast Thermography Center within her existing Sherman Oaks location. Dr. Smith realized that utilizing thermal imaging at the center of wellness and offering a superior service was where all the roads she had traveled led to. She went to North Carolina to receive her training on the campus of Duke Medical Center through the auspices of the American College of Clinical Thermography.Because of her dedication and excellence in the field, Dr. Smith was hand selected to train as a Level III Clinical Thermographer, the highest certification available through the ACCT. She was personally trained by Dr. Peter Leando, an international leader in thermal imaging. In 2019, she was awarded the Certificate of Outstanding Achievement at the ACCT International conference. In 2013, her practice focus became centered on Breast and Full Body Thermography, and how the information from the images could be translated into a proactive health action plan.Hillary is a native of Los Angeles and received her education locally. In addition to staying current in functional nutrition and natural medicine, she enjoys traveling, live music, yoga practice and spending time with fun and interesting people. Other interests include her participation on the Advisory Board of The She Angels Foundation. Her greatest accomplishment is raising a remarkable son.Connect with Rev. Wendy SilversConnect with Rev WendyIg: https://instagram.com/revwendysilvers X: https://x.com/wendysilversFb: https://facebook.com /mamawendysilversTikTok: https://tiktok.comm/wendysilvers

Meet my next guest, Dr. Hillary SmithDr. Hillary Smith, D. C., CCT III is the only Level III Advanced Certified Clinical Thermographer (American Academy of Clinical Thermology) in California. In continuous practice in the Los Angeles area since 1985.Go to https://thebreastthermographycenter.com/scheduling/BIODr. Hillary Smith began her integrative chiropractic and nutrition practice in the San Fernando Valley area of Los Angeles in 1985, after graduating Magna Cum Laude from the Southern California University of Health Sciences. There she earned a Bachelor of Science in Biology and a Doctor of Chiropractic degree in 1984. Her studies have continued in Functional Nutrition, Kinesiology, Mind Body Therapies, Herbal Medicine and Homeopathy. She was a class valedictorian when she received a Doctorate of Homeopathic Medicine from the Hahnemann College of Homeopathy in 1994. In 2005, Dr. Hillary Smith received certification in First Line Therapy, a lifestyle change program that addresses many chronic health issues and was certified in one the first Health Coach programs in 2000.While researching options for her own pro-active health, Dr. Smith became interested in Digital Infrared Thermal Imaging (DITI) or Thermography. In 2006, she opened Advanced Medical Thermography, The Breast Thermography Center within her existing Sherman Oaks location. Dr. Smith realized that utilizing thermal imaging at the center of wellness and offering a superior service was where all the roads she had traveled led to. She went to North Carolina to receive her training on the campus of Duke Medical Center through the auspices of the American College of Clinical Thermography.Because of her dedication and excellence in the field, Dr. Smith was hand selected to train as a Level III Clinical Thermographer, the highest certification available through the ACCT. She was personally trained by Dr. Peter Leando, an international leader in thermal imaging. In 2019, she was awarded the Certificate of Outstanding Achievement at the ACCT International conference. In 2013, her practice focus became centered on Breast and Full Body Thermography, and how the information from the images could be translated into a proactive health action plan.Hillary is a native of Los Angeles and received her education locally. In addition to staying current in functional nutrition and natural medicine, she enjoys traveling, live music, yoga practice and spending time with fun and interesting people. Other interests include her participation on the Advisory Board of The She Angels Foundation. Her greatest accomplishment is raising a remarkable son.

Our 101st episode features Dr. Ilyas who gives us a wonderful overview of Distal Biceps Tendon Injuries. Click here for show notes. Dr. Ilyas is a board certified Orthopaedic Surgeon with a certificate of added qualification in Hand Surgery. He specializes in hand, wrist, elbow and orthopaedic trauma surgery. Dr. Ilyas has a particular interest in fracture surgery, nerve injury, opioids and pain management in orthopaedic surgery, and is considered an expert in "wide awake hand surgery." Dr. Ilyas also serves as the Consulting Hand Surgeon to both the Philadelphia 76'ers and the Philadelphia Eagles. Dr. Ilyas is an Alpha Omega Alpha graduate of MCP-Hahnemann College of Medicine of Drexel University. After medical school he completed his Orthopaedic Surgery training at Temple University Hospital. He subsequently completed his fellowship as a Harvard Fellow at the prestigious Massachusetts General Hospital in Boston prior to returning to the Philadelphia area. Dr. Ilyas is annually recognized as a “Top Doc” in Philadelphia and Main Line Today magazines. Most recently, he was privileged to be the top ranked Orthopaedic Hand Surgeon among his peers in Main Line Today. Learn more about Dr. Ilyas here. Goal of episode: To develop a baseline knowledge of distal biceps tendon injuries. In this episode, we discuss: Epidemiology  Anatomy  Mechanism  Fixation options  Chronic tears  + more This episode is sponsored by Arthrex: Arthrex has been helping surgeons treat their patients better for more than 40 years. Differentiate your practice by offering the Nano Experience, which combines patient comfort with leading-edge, extremely minimally invasive technology. Deeply committed to surgeon support and patient education, Arthrex has also introduced  TheNanoExperience.com, a patient resource illustrating the science and benefits of Nano arthroscopy, detailing the wide variety of applications, and directing patients to surgeons in their area. Visit Nano.Arthrex.com to learn more about enhancing your practice and providing optimal patient outcomes with this game-changing technology. Also, check out JOMI The Journal of Medical Insight (https://jomi.com) is a peer-reviewed surgical video journal / virtual operating theatre. JOMI films and publishes surgical procedures performed by top teaching physicians in an effort to make it possible for residents, attendings, medical students, clinical staff, and patients to have a rich high-quality didactic experience in being walked through procedures from incision to closure by the operating surgeons. JOMI has filmed at Massachusetts General Hospital, Brigham and Women's Hospital, Charite Hospital (in Berlin), Duke Medical Center, Rothman Institute, and many others and currently focuses on general surgery, orthopaedics, neurosurgery, and head & neck surgery. Find out more at https://jomi.com. Use code - NailedIt - for 20% off on all subscriptions.  

Prashanthan Sanders, MBBS, PhD, FHRS of the University of Adelaide discusses a worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study. This study recently appeared in the European Heart Journal. He is joined by guests Jonathan P. Piccini, Sr., MD, MHS, FHRS of Duke Medical Center and Han S. Lim, MBBS, PhD, FHRS of the University of Melbourne. https://www.hrsonline.org/education/TheLead Host Disclosure(s): P. Sanders: Research (Contracted Grants for PIs Named Investigators Only): Boston Scientific, Abbott, Medtronic, PaceMate, Becton Dickinson, CathRx; Advisory Committee Membership: Medtronic, Boston Scientific, PaceMate, CathRx   Contributor Disclosure(s): J. Piccini: Honoraria/Speaking/Consulting Fee: Biotronik, AbbVie, LivaNova, Boston Scientific, Phillips, Medtronic, Electrophysiology, Frontiers, Abbott, UpToDate, Inc., Sanofi, Milestone Pharmaceuticals, Bayer Healthcare Pharmaceuticals; Research (Contracted Grants for PIs Named Investigators Only): Boston Scientific, Bayer Healthcare Pharmaceuticals, AMA, Abbott, Phillips, Element Science, Inc., iRhythm Technologies, NIH H. Lim: No relevant financial relationships with ineligible companies to disclose. 

JCO PO authors Dr. Michael J. Kelley and Dr. Katherine I. Zhou share insights into their JCO PO article, “Real-world Experience With Neurotrophic Tyrosine Receptor Kinase Fusion–positive Tumors and Tropomyosin Receptor Kinase Inhibitors in Veterans.” Host Dr. Rafeh Naqash, Dr. Kelley, and Dr. Zhou discuss the robust Veterans Affairs (VA) National Precision Oncology Program (NPOP), accurate identification of gene fusions, and toxicities landscape of TRK inhibitors. Click here to read the article! TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, Social Media Editor for JCO Precision Oncology, and assistant professor at the OU Stephenson Cancer Center in the Division of Medical Oncology.   Today, I'm thrilled to be joined by Dr. Michael J. Kelley. Dr. Kelley is the executive director of Oncology for the Department of Veterans Affairs. He's also the chief of Hematology-Oncology at the Durham VA Medical Center, and also a Professor of Medicine at the Duke University School of Medicine. And he's also a member of the Duke Cancer Institute. We are also joined by Dr. Katherine I. Zhou who is a Hematology-Oncology fellow at the Duke University. Dr. Zhou also spent time at the Duke Medical Center as part of her fellowship training, which I believe is how this project that was led by her came to fruition.  So thank you both for joining today. This is going to be, hopefully, of very high interest to our listeners and I look forward to chatting with you both. Dr. Michael Kelley: Great, thanks for having us. Dr. Katherine Zhou: Thank you for having us. Dr. Rafeh Naqash: Thank you so much for joining. So I was very intrigued with this paper, and this paper follows a recent podcast that we had with Dr. Alexander Drilon, who's led some of the NTRK tropomyosin receptor kinase inhibitor studies that have been published in the last several years. And we had a very interesting discussion a couple of weeks back and I felt this was going to be a very interesting subsequent discussion into what was also an interesting discussion with Dr. Drilon. So what caught my attention is obviously the fact that you guys in this report, which is a real-world report, did not exactly see what we generally expect from clinical trials as far as response to target therapies in NTRK fusions.  So before I ask you questions related to this project, one of the very interesting things at least I found was the fact is that the Veterans Health Administration is the largest integrated health system. Studies, whether conducted in the UK, for that matter European countries, or in Canada, they have integrated health systems which we do not. But we do have this advantage of the VA trying to do things in a very unique, centralized manner. So I wanted to ask Dr. Kelley first, how is it that you have implemented this National Precision Oncology Program, the NPOP as you call it, into the VA precision medicine workflow and how does it help in conducting research studies like the one that you published in the JCO Precision Oncology? Dr. Michael Kelley: Yeah, thanks for that question, Dr. Naqash. The NPOP started in 2016 as a national program and right from the beginning it grew out of an effort that was a joint collaboration between both clinical operations in the VA and the Research Office or the Office of Research and Development. It was designed from the very beginning to support discovery, new knowledge generation, and identifying patients for clinical trials in addition to bringing them best-in-class molecular testing and a consultation service.  So it was initially funded out of the Cancer Moonshot 1 in 2016 when President Biden was then Vice President. The VA endorsed the model going forward in 2019 and now it's continued on and grown even bigger, it's expanded both in terms of scope and the complexity of the testing that's been done. So it was offered as services to facilities. They didn't have to do this, but I think they all saw the value of using NPOP to provide this group of services and that's what led to the generation of the robust underlying dataset that Dr. Zhou has used for this paper. Dr. Rafeh Naqash: Definitely. Thank you so much for that explanation. I did not know, and was not well aware, of how robust this program is. So I think it's a great learning opportunity for our listeners to know that a program like this exists. As we all know, there are different platforms, sequencing platforms, that each institution uses, whether it's commercial or whether it's in-house based. But the fact is, until and unless we have big pool datasets like the ones that you have generated or have access to, it's not easy to answer real-world questions.  So first of all, I'd like to congratulate you and the rest of the VA administration to set up a program like this that hopefully is helping in matching the right patients to the right therapies and in clinical trial approvals. Now, before we take a deeper dive into the study that Dr. Zhou led, I did want to ask you, you have access to this amazing centralized platform, what are the kind of sequencing strategies or platforms that you use as part of this program? And is there an incorporation of molecular tumor boards to help understand some of these sequencing results that sometimes can be a little complicated to understand even for oncologists who look at these reports on a daily basis? So could you tell us a little bit more about that, Dr. Kelley? Dr. Michael Kelley: Yeah, certainly. So the VA contracts for the sequencing service, currently we're contracting with Foundation Medicine and Tempus for the comprehensive genomic profiling. There are some other services, and before we started using Foundation, there were two other companies that we used. There is a molecular tumor board. Our molecular oncology tumor board is designed primarily for case-based education. But there's also an asynchronous on-demand consultation service that occurs electronically because we have a unified electronic health record system. So any oncology provider in the country can enter a request through what's called an interfacility consult. It comes to a team, that team vets that, discusses it with the appropriate experts; that includes molecular oncologists, molecular pathologists. A lot of oncology pharmacists have been trained at a course that's at the University of Kentucky.  And we have a lot of experience in doing this since that service was set up in 2016 as well, right from the beginning, because we understood the complexity of the data and the need for every oncologist across our enterprise to have access to the very best interpretation of that.  We also have educational sessions that are integrated into the molecular tumor board time slot we call primers in terms of the underlying science of why you do the interpretations the way you do. And then there's also some additional education that we'll be endeavoring to offer to our staff and our oncologists coming up this year. Dr. Rafeh Naqash: Excellent. It sounds like you definitely have taken this into a very multidisciplinary approach where you're incorporating oncologists, pharmacists, and perhaps even genetic counselors and then, obviously, keeping the patient at the center and trying to find the best possible therapies that are most relevant for that individual.   Now, going to Dr. Zhou's study here. Dr. Zhou, first of all, it's great to see a fellow lead a study and then especially, I think you're our first fellow on the podcast. We've had a lot of different individuals, but we have not had a fellow before. So thanks for coming.  Could you tell us, for our listeners, what drove your interest into NTRK fusions? As we know, they are rare, something that is not commonly seen, and we do have clinical trial data in this space. So what was the idea behind looking at a real-world data set? Did you start out with a hypothesis or were you just interested to see how targeting these fusions in the real-world setting, actually, what kind of results does it lead to? Dr. Katherine Zhou: Yeah, well, first of all, thanks for the question. And I do just want to mention that although I did sort of bring this project to the finish line, it was started by another fellow, Vishal Vashistha. So just wanted to mention that. And I think the interest was really just that NTRK is such a rare fusion and just a difficult one to be able to study, like you said, in the real-world setting. And we have the advantage of having so much data through the VA and through NPOP, specifically. And so having seen such great results with the TRK inhibitors and clinical trials, I think there's this big question of how that translates into the real-world setting. We have the ability to do that with our large patient population. Dr. Rafeh Naqash: Excellent. And again, it's nice to acknowledge the support that you had from the other individual who co-led this study. Now, since you would have, I'm guessing, done most of the analysis here and looked into the whole idea of the kind of results that you saw—and from my understanding, you looked at the entire VA data set and tried to understand first the incidence or frequency of NTRK fusions and also responses to treatment, which I think is the main message—but could you tell us a little bit more about the data set? How did you acquire the data set, and what it took to analyze? Because obviously every project has a very unique story, and I'm guessing there's one very unique story here, since as a fellow you have limited time to do all this interesting work. So how did you navigate that and analyze and work with some of the things that you had to look at to get to the results? Dr. Katherine Zhou: Yeah, so again, this was work that was done with multiple people involved, of course. And we used what we had, the resources we had available, some tools we had available through the VA. So first, looking at NPOP and looking at patients who are sequenced through NPOP, we could just find all the ones who had an NTRK rearrangement of some kind. The second way we went about finding patients was through the CDW or the Corporate Data Warehouse where we could see which patients were prescribed larotrectinib or entrectinib and kind of go backwards from there and see which of those patients had NTRK alterations or specifically NTRK rearrangements. And so we combined the patients from both of those different methods to come up with our cohort at the end of 33 patients with NTRK rearrangements and 12 patients who are treated with TRK inhibitors. Dr. Rafeh Naqash: Excellent. Could you walk us through what was the subsequent analysis as far as how many NTRK fusions? I know you mentioned in the paper about DNA versus RNA-based testing. So how many were DNA-based, how many were RNA-based? I think there's some element of ctDNA-based testing also, or what tumor types those people had so that we get an understanding of what's the landscape of the findings that you had. Dr. Katherine Zhou: Sure. Since this is a real-world setting, as you may expect, the vast majority of the sequencing was done through tissue DNA sequencing, and that was the case. So for the 25 patients who were sequenced through NPOP that we found who had NTRK rearrangements, 23 of them had tissue DNA sequencing. And then one was tissue DNA RNA, and one was cell-free DNA sequencing. And so using that and being able to go back and look at how many patients have been sequenced in NPOP in total, we could kind of come up with a yield, although the numbers are very small. But we do see that there does seem to be probably a lower yield, for example, with cell-free DNA sequencing, as one might expect.  And then looking at our total group of 33 patients, if we look at what types of cancers they had, we did have quite a few patients just based on prevalent tumors at the VA, I think, and in the population, prostate cancer was common, lung cancer, and then we had smaller numbers of colon and bladder, and I think there's a pancreatic cancer patient. We did have some of these rarer tumor types that more commonly have NTRK fusions as well, so like papillary thyroid carcinoma, and salivary gland cancers as well as soft tissue sarcomas. Dr. Rafeh Naqash: Question for you, Dr. Kelley, related to this data set: do you think that given that the denominator that you have is a unique population, the VA population, that's often males, they're usually above the age of 18, could the frequency have been influenced by that denominator where you may not have been able to capture, let's say, some of the rarer tumors that happen in the younger patient population, for that matter? Could that be a little bit of a bias here?  Dr. Michael Kelley: Definitely. The population of veterans that have cancer that is treated in the Veterans Health Administration do represent generally adult males in the United States, but there is some skewing in certain regards. One of them is towards a higher frequency of smoking status. So not current smoking, which is actually about the same as the national average of about 11%, but the former smoking rate is about twice as high as it is in the rest of the United States. So we may have a lower frequency of some actionable variants in cancers in general because there's a higher etiological role for tobacco smoke in our population. But overall, looking at adult men if we look at like EGFR mutations, our incidence of EGFR mutations in adenocarcinoma is similar to what is reported in other real-world evidence bases from the United States, which is significantly lower than that which is found in academic medical centers. Dr. Rafeh Naqash: Thank you. I'm a big fan personally of real-world data sets. I do a lot of this with some other collaborators and generally, I do phase I trials, which is why I'm interested in precision medicine. And two weeks back, actually, I had a patient with prostate cancer, who ended up having NTRK fusion on a liquid biopsy. Now, you do talk about some of this related to in-frame or out-of-frame fusions and how that can have interesting aspects related to the kinase domain functionality and RNA expression. Dr. Zhou, for the sake of our listeners, could you briefly describe why understanding some of that is important and what implications it has? Dr. Katherine Zhou: Yeah, so I think the oncogenic NTRK fusion that we think of and that's being targeted by the TRK inhibitors is a fusion 5-prime of a protein that forms a dimer and on the 3-prime end is the kinase domain of the tropomyosin receptor kinase. And so you have to have some kind of a gene fusion that results in not only the transcription of that RNA fusion, RNA transcript, but then the translation of that fusion protein. So that needs to be, like you mentioned, that has to be in frame so that the entire protein is translated and expressed and it needs to include the kinase domain. It can't be the other end of the NTRK gene. And both of the genes need to be in the same orientation, of course. And then also the partner gene probably matters in that the ones that we know that actually cause activation of this oncogene are the ones that sort of spontaneously dimerize. And so that's a lot of requirements that we don't necessarily see when we just get, for example, a DNA sequencing result that says there's an NTRK rearrangement. Dr. Rafeh Naqash: Excellent way to describe the importance of understanding the functionality of the activated oncogenic fusion. Now, I know here in most of the patients that you have is DNA sequencing and I'm sure you'll talk about some of the results. And when you connect the results to the kind of data that you have, do you think not having the RNA assessment played a role in not knowing perhaps whether those fusions were functionally active?  Dr. Katherine Zhou: Yes, I think we can't know for sure without having the RNA sequencing data. But certainly, that is a pattern in our small number of patients that we saw and something that makes sense just in terms of the mechanism of this oncogenic fusion protein. So I think that is a question of when should we be doing RNA sequencing to confirm that a fusion that we see on DNA sequencing is actually transcribed into RNA and how do we use RNA sequencing in a cost-effective and useful way to be able to detect more of these NTRK fusions that are actually clinically relevant. Dr. Rafeh Naqash: I absolutely agree with you and this is an ongoing debate. I know some platforms, commercial platforms that is, have incorporated RNA sequencing both bulk or whole transcriptome as part of their platform assessments, but it's still not made inroads into some other sequencing platforms that are commercially used. So it's an ongoing debate, but at the same time helping people understand that certain fusions need some level of RNA assessments to understand whether they're functionally active or not. Which again has implications, as you pointed out in terms of therapies are extremely relevant.   Now, going to the results, which again was very interesting, could you tell us about the findings from the therapeutic standpoint that you observed and what your thoughts are about why you saw those results which were very different from what one would have expected?  Dr. Katherine Zhou: Right. So in the clinical trials of larotrectinib and entrectinib, there were quite high objective response rates on the order of 60%, 70%, even almost 80%. In our very small real-world group of 12 patients who were treated with TRK inhibitors, nobody had an objective response and five patients had stable disease and everybody else, the other seven patients, progressed.  And so the question is why did we see such a big difference compared to the trials? I sort of think of this as two big buckets. One is the population that we were looking at. So this is a real-world population. For example, in the clinical trials, there were almost no Black or African American patients, whereas here we had about 30%-40% Black or African American patients.  Because it's a VA population, it was very heavily male, of course, the age groups are also different in that we didn't have children in the VA population whereas children were included in the trials. And the tumor types also differed because I think in the trials, which makes sense, there's a bias towards tumor types that have more NTRK fusions, and some of the tumor types we were looking at are just common tumor types like prostate and lung cancer where NTRK fusions are not common. But just because there are so many patients with these cancers, we did see them. And so certain of these groups, particularly certain racial and ethnic groups as well as certain tumor types, were not really represented in the trial to the extent that we can make conclusions about whether TRK inhibitors are effective in this population. So that's one.  The second part, I think we've already talked about some, is just the method of detecting these NTRK fusions and how many of these NTRK fusions were actually truly producing oncogenic fusion proteins. And I tried to sort of categorize some of these fusions as being canonical in that they've been more studied. We know the partner gene, they are known to produce an oncogenic protein and to respond to TRK inhibitors. But actually of the four patients who had what we called canonical fusions, all four of them had stable disease at least, whereas the ones that were noncanonical mostly did not have a response or have even stable disease and mostly just progressed. And so then you wonder whether they even had the actual target protein we thought we were targeting. So this is where the real-world setting we're not doing the RNA sequencing or this additional testing to confirm that it's an oncogenic fusion protein. Dr. Rafeh Naqash: And I do see in your results there's a patient especially—you pointed out canonical and noncanonical fusions—you have a patient with a papillary thyroid cancer that I believe had a stable disease for close to two years plus. Is there anything interesting apart from an NTRK fusion in that specific patient where certain co-mutation could have played a role or certain other factors that do you think played into the fact that this patient had stable disease but didn't respond on the TRK inhibitor? Dr. Katherine Zhou: I don't have a great answer for that. I think this is one of the cancers that was well represented in the trials and that commonly has NTRK, or more likely has NTRK fusions. And this was a well-studied canonical NTRK fusion. So I think those are all reasons. The question of co-mutations I think is really interesting. We didn't have the data for every single patient, but for the ones we looked at a lot of the time, NTRK fusions are mutually exclusive with other driver mutations. So we didn't see a whole lot of commutations that we could sort of differentiate between responders or stable disease and progression.  Dr. Rafeh Naqash: Thank you. Going to the toxicities, as a phase I trialist myself toxicity is the bane of my existence where we have to label toxicities, attribute toxicities, understand toxicities. The trial, obviously, as you very well know, that in the trials, they didn't have a lot of toxicities that caused patients to come off or required significant dose reductions, which is not the case compared to what you saw. Could you tell us a little bit about the landscape of toxicities for TRK inhibitors and what you saw in your cohort? That, again, I feel was interesting.  Dr. Katherine Zhou: Of the 12 patients, I think two-thirds of them had either dose reduction or interruption or discontinuation, or some combination of the above. The toxicities we saw were more common than, or at least led to discontinuation and interruption and dose reduction more commonly than in the trials. But the toxicities we saw were also seen in the clinical trials. So LFT elevations, creatinine elevations, neurotoxicity, some cytopenias. We didn't actually see a whole lot of that, but those were present as well, and then some sort of nonspecific things like fatigue. And so, as much as we could tell from retrospective trial review, at least these were severe enough to lead to holding the drug. Dr. Rafeh Naqash: Thank you so much, Dr. Zhou. Question for you, Dr. Kelley. Putting this into perspective, the analysis that you did, how would you connect it to other real-world questions that one could answer using these kinds of data sets? So basically, what are the lessons learned from this amazing program that you guys have run successfully and are, I'm guessing, expanding in different directions? And how can you use a program like this to look at some of these unique questions using real-world data sets? Dr. Michael Kelley: There are a couple of, I guess, next steps for us that are based off this study and other information that we've gotten in other analyses from our NPOP data set. So, first of all, access to an RNA-Seq test. So that has been resolved to some extent, in that we now have two options for comprehensive genomic profiling, one of which does have RNA-Seq.  And then the other approach that we're doing is to do more robust data generation. So we're going to be launching a study to collect prospective data on patients who are treated with off-label drugs. And as part of that, we will also have an on-label cohort for rare populations or any investigator in the VA who's interested in a particular drug or a particular genetic variant. They'll be able to tie into this protocol, and we will then collect data from across the system prospectively, which we think will improve the quality to some degree.  And then thirdly, I think there's an opportunity to merge the initial generation of data in rare genetic types or other populations, which are highly selected by doing a distributed type of clinical trial where patients can be enrolled in prospective treatment trials. So we're not just generating data based on their real-world exposure to FDA-approved drugs, but we're generating data as we're developing the new drugs, we can have a much more heterogeneous and representative population of patients enrolled in clinical trials. So this is called the decentralized clinical trial model. We're starting to launch some trials with industry partners in this area to test out the model. If it works, I think we'll be able to help contribute to the knowledge that we all can use in terms of the patient types, the patient characteristics, but also some of the different tumor characteristics, and also to bring clinical trial opportunities to a more representative group. A lot of the initial clinical trials are done in urban areas, rural populations in VA are about a third of our patients live in rural areas, compared to only 14% of the country. So we think this is a very important diversity issue that should be addressed. Those are some of the ways that we're taking a lesson from this trial and other data that we have to sort of bring it forward. Dr. Rafeh Naqash: Those are excellent next steps and I think the kind of work that the VA is doing and this specific program, Precision Oncology Program, the NPOP program is doing, it's definitely setting up a unique standard in the United States where we have been limited by not having a centralized database. So setting something up of this sort hopefully will help answer a lot of these unique, interesting questions as you have access to data. And then the fact that you mentioned decentralized clinical trials and trying to cater to this access issue for patients in the VA system, I think that would be huge.  And again, I congratulate you and your team on these efforts, and once again, thank you for joining us today and making JCO Precision Oncology a destination for your interesting work. We hope to see more of this work subsequently and hopefully, I get a chance to talk to you more about all the exciting stuff that you guys are leading within the VA health system.  Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast.  The purpose of this podcast is to educate and 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. Bios: Michael J. Kelley, MD, is Executive Director of Oncology for the Department of Veterans Affairs, Chief of Hematology-Oncology, Durham VA Medical Center, Professor of Medicine at Duke University School of Medicine and Member of the Duke Cancer Institute. Katherine I. Zhou, MD, PhD is a hematology-oncology fellow at Duke University. She also spends time at the Durham VA Medical Center as part of her fellowship training. COIs: Michael J. Kelley, MD Research Funding: Novartis (Inst), Bristol-Myers Squibb (Inst), Regeneron (Inst), Genentech (Inst), EQRx (Inst) Katherine I. Zhou, MD, PhD: No disclosures  

First data from CODEBREAKSotorasib in G12C mutant Pancreatic Cancer Presented Feb 15, 2022 by Dr. John Strickler of Duke Medical Center

Sim Sitkin is a Founding Partner of Delta Leadership Inc. Delta is a leadership development organization that offers educational programs and materials, including those based on the Six Domains of Leadership™ Model.   Sim also serves as Michael W. Krzyzewski University Professor of Leadership, Professor of Management and Public Policy, and founding Faculty Director of the Fuqua/Coach K Center on Leadership and Ethics (COLE) at the Fuqua School of Business, and Director of the Behavioral Science and Policy Center at Duke University. Sim's research focuses on the effects of leadership and organizational control on trust, risk-taking, experimentation, learning, and innovation. His most recent books are Organizational Control (2010), The Six Domains of Leadership (2016), and Routledge Companion to Trust (2017). He has won numerous awards for his research and teaching. He is a Fellow of the Academy of Management and the Society for Organizational Behavior. He is Co-Founder and Co-President of the Behavioral Science and Policy Association.   He has extensive consulting, coaching, and executive education experience with organizations around the world, including American Airlines, Cisco Systems, Compaq Computer, Corning, Credit Suisse First Boston, Deutschebank, Duke Medical Center, Ericsson, Glaxo, General Electric, IBM, Lenovo, PricewaterhouseCoopers, Red Hat Software, Siemens, State Farm Insurance, U.S. Dept of Justice, Xerox Corporation.   Connect with us! WEBSITES: Speaking: https://www.cbbowman.com/ Coaching Association: https://www.acec-association.org/ Workplace Equity & Equality: https://www.wee-consulting.org/ Institute/ Certification: https://www.meeco-institute.org/ SOCIAL MEDIA: LinkedIn: https://www.linkedin.com/in/cbbowman/ Twitter: https://twitter.com/execcoaches Facebook: https://www.facebook.com/CB.BowmanMBA/ YouTube - https://bit.ly/3iQP5Z3 Apple Podcast - https://apple.co/3skrfIi

The May issue of the journal ONCOLOGY featured a review article titled “Primary Focal Therapy for Localized Prostate Cancer: A Review of the Literature.” Sudhir Isharwal, MD, an assistant professor in the Department of Urology at Oregon Health & Science University in Portland, Oregon, discussed the emergence of focal therapies in the last few years for the treatment of patients with localized prostate cancer. This literature review investigated some of the advantages and drawbacks of various therapeutic models in this space. The perspective for this article was written by Thomas Polascik, MD, a professor of Surgery/Urology and director of Focal Therapy at the Duke Cancer Center, Duke Medical Center in Durham, North Carolina. Polascik discussed the response he wrote to this article, titled “Prostate Cancer Focal Therapy Has Made Great Strides and the Future Remains Bright.” He touched on all aspects of focal therapy, including history, potential hurdles, and patient selection and surveillance, among other things.   Don't forget to subscribe to the "Oncology Peer Review On-The-Go" podcast on Apple Podcasts, Spotify or anywhere podcasts are available.

While there is a diversity of laboratory information systems available, there is no one system used by bio-banks. Furthermore, there is an increased utilization of digital whole-slide scanning technology in converting slides made from biobanking into digital whole slide images. In this CAPcast, Duke Medical Center pathology resident Dr. Richard Davis interviews leading pathology informatics expert Dr. Raj Dash about biobanking and its integration with various LIS technologies. Dr. Dash is also at Duke Medical Center. For more information about biobanking, please visit the Biorepository Accreditation Program section on CAP.org: https://capatholo.gy/3rzSPkg.

In this episode, Mimi talks with NC locals and sisters, Anna Lutz, RD, and Louise Metz, MD about weight inclusive care in nutrition / dietetics and medical care. Anna Lutz is in private practice in Raleigh, NC and specializes in eating disorders and pediatric/family nutrition. Anna received her Bachelor of Science degree in Psychology from Duke University and Master of Public Health in Nutrition from The University of North Carolina at Chapel Hill. She is a Certified Eating Disorders Registered Dietitian (CEDRD) and an Approved Supervisor, both through the International Association of Eating Disorder Professionals (iaedp).  Anna previously worked at Children's National Medical Center in Washington, DC and Duke Student Health, treating individuals with eating disorders. Anna has done extensive training through the Embodied Recovery Institute and strives to provide her clients trauma and somatically informed care. Anna is a national speaker and delivers workshops and presentations on eating disorders, weight-inclusive healthcare, and childhood feeding. She also writes and talks about nutrition and family feeding, free of diet culture, on her blog, Sunny Side Up Nutrition, and the Sunny Side Up Nutrition Podcast. Dr. Louise Metz is an Internal Medicine physician with expertise in the medical care of eating disorders. She is the owner of Mosaic Comprehensive Care, a medical practice in Chapel Hill, North Carolina offering weight-inclusive primary care for adults and adolescents of all genders. After receiving an undergraduate degree in Biology and Women's Studies at Duke University, she attended medical school at the University of North Carolina and completed her residency in Internal Medicine at the University of California at San Francisco. She has published research on heart disease in women, and has previously held academic positions at NYU's Bellevue Hospital and Duke Medical Center. Dr. Metz leads workshops and presentations on weight-inclusive medical care and eating disorders. She is committed to increasing access to inclusive and affirming medical care for all individuals.

The CardioNerds discuss Lipid Management with Dr. Ann Marie Navar and Dr. Nishant Shah from Duke Medical Center, Division of Cardiology. Amit, Carine and Dan take a deep dive into the greasy world of lipids and cholesterol, covering lipid metabolism, therapeutic targets, approach across the entire spectrum of predicted risk, and key common management scenarios (statin intolerance, hypertriglyceridemia, elevated LP(a)), and more. Episode 42. Lipids and Cholesterol with Drs. Drs. Ann Marie Navar and Nishant Shah Take me to the Cardionerds Cardiovascular Prevention PageTake me to episode topics page The Cardionerds CV prevention series will include in-depth deep dives on so many topics related to prevention starting with this case discussion. Stay tuned for upcoming episodes on the ABCs of prevention, obesity, hypertension, diabetes mellitus and anti-diabetes agents, personalized risk and genetic risk assessments, hyperlipidemia, women’s cardiovascular prevention, coronary calcium scoring and so much more! Key references: Toth, P. P. (2020). Familial Hypercholesterolemia and Lipoprotein(a): Unraveling the Knot That Binds Them. Journal of the American College of Cardiology, 75(21), 2694–2697.Michos, E. D., McEvoy, J. W., & Blumenthal, R. S. (2019). Lipid management for the prevention of atherosclerotic cardiovascular disease. New England Journal of Medicine, 381(16), 1557–1567. AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 73(24), e285–e350.Lloyd-Jones, D. M., Braun, L. T., Ndumele, C. E., Smith, S. C., Sperling, L. S., Virani, S. S., & Blumenthal, R. S. (2019). Use of Risk Assessment Tools to Guide Decision-Making in the Primary Prevention of Atherosclerotic Cardiovascular Disease: A Special Report from the American Heart Association and American College of Cardiology. Circulation, 139(25), E1162–E1177.Laufs, U., Parhofer, K. G., Ginsberg, H. N., & Hegele, R. A. (2020). Clinical review on triglycerides. European Heart Journal, 41(1), 99–109.ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 74(10), 1376–1414. We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Cardionerds Cardiovascular Prevention Series Dr. Ann Marie Navar is a cardiologist and epidemiologist at the Duke Clinical Research Institute focusing on cardiovascular disease prevention. She received an MD from Duke University and a PhD in Global Disease Epidemiology and Control from the Johns Hopkins School of Public Health in 2009 before completing residency in internal medicine and pediatrics and fellowship in cardiology at Duke. Dr. Navar’s research focuses on improving cardiovascular disease prevention through better identification of at-risk populations, targeted interventions to improve quality of care and patient engagement through the electronic health record, and better treatment of hypertension and cholesterol to lower CV risk. She also studies the impact of payer-imposed barriers to novel therapies. Her areas of expertise include risk prediction, patient risk communication, real world data analyses using EHR- and claims-based datasets, and registries. She is an associate editor at JAMA-Cardiology and a board membe...

According to Dr. Rhonda Merwin, individuals with anorexia and low weight are, “doing exactly what society has told them makes sense to be a good person.” At the same time, having anorexia and being over-controlled with food narrows your life, increases preoccupation with weight, and has negative health consequences. ACT offers a novel approach to treating eating disorders. By stepping back from eating disorder thoughts, identifying values and increasing acceptance and willingness, men and women can gain headway in recovery from one of the most difficult mental health issues. In this episode, Diana talks with Dr. Rhonda Merwin, Associate Professor at Duke University Medical Center and lead author of ACT for Anorexia Nervosa: A Guide for Clinicians about ways to apply ACT to find freedom from anorexia and restrictive eating.   In honor of National Eating Disorder Awareness Week, this episode is dedicated to all who are seeking recovery in their relationship with food and weight. May you find peace. #NEDAwareness #ComeAsYouAre Listen and Learn The power of appreciating the benefits of an eating disorderWhy some people at higher risk for anorexia or restrictive eatingWhy ACT is especially effective for anorexia and disordered eatingWhat functional analysis is and how to use it to assess and treat disordered eatingWhat it means to be “emotion phobic” and how it relates to restrictive eatingWhy over-working, people-pleasing, and being compliant are often linked to anorexiaHow to create a more flexible sense of self that is not coupled with the eating disorderThe role that self-parenting plays in recovery from an eating disorderWhat is it really like to have ACT co-founder Kelly Wilson as your mentor? About Dr. Rhonda Merwin Rhonda Merwin, Ph.D. is a licensed psychologist and Associate Professor in the Department of Psychiatry and Behavioral Sciences at Duke Medical Center. She conducts research on the mechanisms and treatment of eating disorders, specifically restrictive eating disorders and eating disorders in the context of Type 1 Diabetes. Dr. Merwin is also a Peer-Reviewed ACT Trainer, the Director of the ACT at Duke University Clinical and Training Program, and lead author of ACT for Anorexia Nervosa: A Guide for Clinicians. Resources ACT for Anorexia Nervosa: A Guide for Clinicians, by Rhonda Merwin, Ph.D., Nancy Zucker, Ph.D., and Kelley Wilson, PhDACT at Duke.org for further information about Dr. Merwin’s research and educational and clinical activitiesAppetite Awareness Training with Dr. Linda Craighead, Psychologists Off the Clock Episode #18Self Care, Kindness and Living Well with Dr. Kelly Wilson, Psychologists Off the Clock Episode #65 Diana with Dr. Rhonda Merwin

I’m thrilled to have made friends with Dr. Amy Laura Hall. Not only is she back on the podcast to talk about Stanley Hauerwas’ influence on her work and theology, she’ll be our special guest in June at our annual live podcast at Annual Conference in Roanoke, Va. Amy Laura Hall was named a Henry Luce III Fellow in Theology for 2004-2005 and has received funding from the Lilly Foundation, the Josiah Trent Memorial Foundation, the American Theological Library Association, the Child in Religion and Ethics Project, the Pew Foundation and the Project on Lived Theology.At Duke University, Professor Hall has served on the steering committee of the Genome Ethics, Law, and Policy Center and as a faculty member for the FOCUS program of the Institute on Genome Sciences and Policy. She has served on the Duke Medical Center’s Institutional Review Board and as an ethics consultant to the V.A. Center in Durham. She served as a faculty adviser with the Duke Center for Civic Engagement (under Leela Prasad), on the Academic Council, and as a faculty advisor for the NCCU-Duke Program in African, African American & Diaspora Studies. She currently teaches with and serves on the faculty advisory board for Graduate Liberal Studies and serves as a core faculty member of the Focus Program in Global Health.Professor Hall was the 2017 Scholar in Residence at Foundry United Methodist Church in Washington D.C., served on the Bioethics Task Force of the United Methodist Church, and has spoken to academic and ecclesial groups across the U.S. and Europe. An ordained elder in the United Methodist Church, Hall is a member of the Rio Texas Annual Conference. She has served both urban and suburban parishes. Her service with the community includes an initiative called Labor Sabbath, an effort with the AFL-CIO of North Carolina to encourage congregations of faith to talk about the usefulness of labor unions, and, from August 2013 to June 2017, a monthly column for the Durham Herald-Sun. Professor Hall organized a conference against torture in 2011, entitled “Toward a Moral Consensus Against Torture,” and a “Conference Against the Use of Drones in Warfare” October 20-21, 2017. In collaboration with the North Carolina Council of Churches and the United Methodist Church, she organized a workshop with legal scholar Richard Rothstein held October, 2018.Amy Laura Hall is the author of four books: Kierkegaard and the Treachery of Love, Conceiving Parenthood: The Protestant Spirit of Biotechnological Reproduction, Writing Home with Love: Politics for Neighbors and Naysayers, and Laughing at the Devil: Seeing the World with Julian of Norwich. She has written numerous scholarly articles in theological and biomedical ethics. Recent articles include "The Single Individual in Ordinary Time: Theological Engagements in Sociobiology," which was a keynote lecture given with Kara Slade at the Society for the Study of Christian Ethics in 2012, and "Torture and American Television," which appeared in the April 2013 issue of Muslim World, a volume that Hall guest-edited with Daniel Arnold. Her essay “Love in Everything: A Brief Primer to Julian of Norwich" appeared in volume 32 of The Princeton Seminary Bulletin. Word and World published her essay on heroism in the Winter 2016 edition, and her essay "His Eye Is on the Sparrow: Collectivism and Human Significance" appeared in a volume entitled Why People Matter with Baker Publishing. Her forthcoming essays include a new piece on Kierkegaard and love for The T&T Clark Companion to the Theology of Kierkegaard, to be published by Bloomsbury T&T Clark.Laughing at the Devil was the focus of her 2018 Simpson Lecture at Simpson College in Iowa and has been chosen for the 2019 Virginia Festival of the Book. She continues work on a longer research project on masculinity and gender anxiety in mainstream, white evangelicalism.

I’m thrilled to have made friends with Dr. Amy Laura Hall. Not only is she back on the podcast to talk about Stanley Hauerwas’ influence on her work and theology, she’ll be our special guest in June at our annual live podcast at Annual Conference in Roanoke, Va. Amy Laura Hall was named a Henry Luce III Fellow in Theology for 2004-2005 and has received funding from the Lilly Foundation, the Josiah Trent Memorial Foundation, the American Theological Library Association, the Child in Religion and Ethics Project, the Pew Foundation and the Project on Lived Theology.At Duke University, Professor Hall has served on the steering committee of the Genome Ethics, Law, and Policy Center and as a faculty member for the FOCUS program of the Institute on Genome Sciences and Policy. She has served on the Duke Medical Center’s Institutional Review Board and as an ethics consultant to the V.A. Center in Durham. She served as a faculty adviser with the Duke Center for Civic Engagement (under Leela Prasad), on the Academic Council, and as a faculty advisor for the NCCU-Duke Program in African, African American & Diaspora Studies. She currently teaches with and serves on the faculty advisory board for Graduate Liberal Studies and serves as a core faculty member of the Focus Program in Global Health.Professor Hall was the 2017 Scholar in Residence at Foundry United Methodist Church in Washington D.C., served on the Bioethics Task Force of the United Methodist Church, and has spoken to academic and ecclesial groups across the U.S. and Europe. An ordained elder in the United Methodist Church, Hall is a member of the Rio Texas Annual Conference. She has served both urban and suburban parishes. Her service with the community includes an initiative called Labor Sabbath, an effort with the AFL-CIO of North Carolina to encourage congregations of faith to talk about the usefulness of labor unions, and, from August 2013 to June 2017, a monthly column for the Durham Herald-Sun. Professor Hall organized a conference against torture in 2011, entitled “Toward a Moral Consensus Against Torture,” and a “Conference Against the Use of Drones in Warfare” October 20-21, 2017. In collaboration with the North Carolina Council of Churches and the United Methodist Church, she organized a workshop with legal scholar Richard Rothstein held October, 2018.Amy Laura Hall is the author of four books: Kierkegaard and the Treachery of Love, Conceiving Parenthood: The Protestant Spirit of Biotechnological Reproduction, Writing Home with Love: Politics for Neighbors and Naysayers, and Laughing at the Devil: Seeing the World with Julian of Norwich. She has written numerous scholarly articles in theological and biomedical ethics. Recent articles include "The Single Individual in Ordinary Time: Theological Engagements in Sociobiology," which was a keynote lecture given with Kara Slade at the Society for the Study of Christian Ethics in 2012, and "Torture and American Television," which appeared in the April 2013 issue of Muslim World, a volume that Hall guest-edited with Daniel Arnold. Her essay “Love in Everything: A Brief Primer to Julian of Norwich" appeared in volume 32 of The Princeton Seminary Bulletin. Word and World published her essay on heroism in the Winter 2016 edition, and her essay "His Eye Is on the Sparrow: Collectivism and Human Significance" appeared in a volume entitled Why People Matter with Baker Publishing. Her forthcoming essays include a new piece on Kierkegaard and love for The T&T Clark Companion to the Theology of Kierkegaard, to be published by Bloomsbury T&T Clark.Laughing at the Devil was the focus of her 2018 Simpson Lecture at Simpson College in Iowa and has been chosen for the 2019 Virginia Festival of the Book. She continues work on a longer research project on masculinity and gender anxiety in mainstream, white evangelicalism.

Live Right Now - Episode 023 – The Pineal Gland We Never Knew What we don’t know is more liberating than what we think we know. The holy temple is a living miracle and every part has a designated purpose. To assume God created us to have a gland or organ that does nothing lacks knowledge. We were told the appendix is useless and must be removed, yet Duke Medical Center immunologists’ et. al. researchers reveal it actually produces good probiotic bacteria, harbors and protects good microbes for the gut by "rebooting" the digestive, microbiome system.  I don’t recall being advised that keeping A healthy gut microbiome serves mind and body affecting the temple throughout life by controlling digestion, immune system, central nervous system and other bodily processes. Useless? I also don’t remember being extensively educated about the pineal gland. The pea size pineal is situated right in the center of the brain. Often referred to as the third eye, this small, pinecone-shaped endocrine organ secretes melatonin that regulates your daily sleep-wake patterns, hormone levels, stress levels, boosts moods, enhances sex, physical performance, and even increasing longevity by as much as 10-25% according to Stanford University.  Pineal Gland Essentials Of the endocrine organs, the function of the pineal gland was the last discovered. Located deep in the center of the brain, the pineal gland was once known as the “third eye.” The pineal gland produces melatonin, which helps maintain circadian rhythm and regulate reproductive hormones. It is an endocrine gland sitting alone in the brain, level with our eyes. The pineal gland produces melatonin and regulates our daily and seasonal circadian rhythms. Melatonin is the chemical in charge of our sleep cycles and the quality of our sleep, and it also regulates the onset of puberty. Melatonin is responsible for fighting against free radicals. A decline in melatonin triggers the ageing process in the body. Serotonin, the neurotransmitter or happy chemical responsible for our mood, is transformed into melatonin only in the pineal gland. Scientific evidence supports the possibility that our third eye, or pineal, was once our first eye. Under the microscope, the pineal is made up of cells that have the same features as the rod-shaped light sensitive cells found in our retinas. The pineal gland receives signals that travel down the optic nerves. It seems the primitive third eye functioned as a sight organ before our current set of eyes. The pineal gland gives a perception of the world around us through our senses. It controls the action of light upon our body and is located beneath the cerebral cortex where the two hemispheres of the brain join. This is the place where the brain regulates consciousness and interprets the body’s sensory and motor functions. Hinduism, Buddhism and Taoism believe there’s a divine side of the pineal gland. Our third eye connects soul energy to your body. Once your pineal gland is activated to the world of spirituality, it may seem as if you’re more conscious; connected to the universal flow of heavenly energy. This can be achieved through meditation, yoga or shamanistic plant medicine. This may be a stretch for some of you, but the pineal gland, “all seeing eye”, third eye symbol, can be seen on the back of the American dollar bill and statues of the pineal exist at the Vatican. Be mindful it’s been known for decades that fluoride in our water and toothpaste is kryptonite to the pineal. To reactivate your pineal gland, you first need to eliminate sources of fluoride and cut out junk foods, especially soda. If you don’t change this part of your diet, you won’t gain any ground. Plant-foods like cilantro, garlic, lemon juice, and coconut oil may help detox, but It also may be worth considering a full body detox. Foods that definitely support the pineal gland are turmeric, cacao beans, green plants and vegetables, spring water, reishi mushroom tea, wheatgrass juices, raw beets, apple cider vinegar, iodine supplementation, and others. Now you’re awakened to what you weren’t taught in school. Go for it!   For more from Chef Wendell including the “Eat Right Now” books and info on how to book Chef Wendell to speak to your group go to http://www.chefwendell.com. To connect with the Live Right Now Podcast “like” our Facebook page or email us at LiveRightNowRadio@gmail.com.   The Live Right Now theme music is “future soundtrack II” by Adam Henry Garcia from the Free Music Archive licensed under CC BY-NC-SA 4.0  

Gina Rapacz is a 48 year old mother of 2 teenage daughters living in the Chicago suburbs.  She recently had a liver transplant after hers failed and she lingered on the transplant list in Chicago for over a year.  Her transplant was completed at Duke Medical Center in Durham, NC. She is now on her way to a healthier life with a new liver. See Transcript of this show below. Transcript  Lita: [00:00:16] Hello and welcome to podcast DX. This show that brings you interviews with people just like you whose lives were forever changed by a diagnosis. [00:00:24][8.7] Lita: [00:00:26] I'm Lita. [00:00:26][0.2] Ron: [00:00:27] I'm Ron. [00:00:28][0.2] Jean: [00:00:28] And I'm Jean Marie. [00:00:28][0.6] Lita: [00:00:29] Collectively we are the hosts of podcast d x. This podcast is not intended to be a substitute for professional medical advice diagnosis or treatment. Always ask the advice of your physician or other qualified health care provider for any questions you may have regarding a medical condition or treatment and before undertaking any new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast. [00:01:03][33.5] Ron: [00:01:05] On today's show we will be interviewing Gina a liver transplant recipient. [00:01:09][3.8] Jean: [00:01:10] Gina is a 48 year old from a Chicago suburb, where she lives with her husband two teenage daughters Nikki Sarah and their adorable puppy. Coco. [00:01:18][8.1] Lita: [00:01:19] Hi Gina thank you for joining us today. [00:01:21][2.0] Gina: [00:01:22] Hello. Thank you for having me. [00:01:24][1.2] Ron: [00:01:25] I understand it's been almost six months since you had a liver transplant. Yes I was transplanted September 30th 2017. [00:01:32][6.7] Gina: [00:01:33] In North Carolina at Duke University Hospital. [00:01:35][1.6] Lita: [00:01:36] Well you look great. [00:01:37][0.6] Gina: [00:01:38] Thanks. I actually I feel great. This is the best I've ever felt actually. For. A long long time. [00:01:43][5.4] Lita: [00:01:43] . Gina, what symptoms first led you to the doctor. [00:01:48][4.8] Gina: [00:01:49] Well. As far back as I can remember 2016 I had a really bad swollen. Ankles from water retention. Very tired. I was always cold. The doctors were. Thinking I had cancer. Which. Led my disease to. Worsen. As they were testing me for cancer. But it was not. [00:02:11][21.6] Jean: [00:02:13] How long did it actually take before you got. A correct diagnosis? [00:02:15][2.1] Gina: [00:02:17] My symptoms were bothering me for at least five months before they diagnosed my liver problem. [00:02:21][4.4] Ron: [00:02:24] Gina, Can you recall any specific symptoms that really stood out. [00:02:27][3.2] Gina: [00:02:28] Yes of course. My stomach. I look like I was nine months pregnant. And the build up of ascites is a toxic fluid. That forms in your stomach. Making it. Enlarged. My eyes were no longer clear they were. Foggy. and my skin was chapped & itchy. Always thirsty. Almost like you want to stick your head in the swimming pool. I lost my appetite. I had dry heaves almost throwing up but not quite. Always had leg cramps. My calves were so painful they'd wake me up at night. I would try standing up. They were. Very. Painfully twitching. And the muscles would cramp up. You. It's like a charlie horse times 10. Very painful. Terrible terrible. [00:03:13][45.0] Lita: [00:03:14] Were there any embarrassing symptoms that you had? [00:03:17][2.5] Gina: [00:03:18] Yes I actually would. I, I had. A bad case of diarrhea all day I would go maybe eight to 10 times a day never knowing when it was an attack. But usually when I was at Target or Wal-Mart shopping. And I would have to use a public bathroom for no reason at all my nose would start bleeding. And. It was on a daily basis. [00:03:43][24.7] Jean: [00:03:44] Did anything help relieve any symptoms. [00:03:46][1.3] Gina: [00:03:47] Well for the chills I would layer up. I would layer clothes use the electric blanket at night. wear socks, which, I am not a socks person. I also spend time in the sun which helped. I never used air conditioning or a fan never wanted to cause a breeze my way because the chills. You can never. you, that feeling was intense. [00:04:07][20.3] Ron: [00:04:10] You mentioned that you're always thirsty. How do you deal with the thirst. Even though you're thirsty all the time. [00:04:17][6.7] Gina: [00:04:18] The doctor puts you on a water intake a day. So I was on a two liter a day intake. Of liquid. After. My water intake. I would move over to a frozen. freezy pop. Like a Popsicle. Yeah because a popsicle had flavor to it and it would break up the monotonous taste of the water. Also. They give you a little sponge like. Device at the doctor's office where you dip it in water. And you kind of stuff the water on this little sponge. And that helped. [00:04:48][30.6] Lita: [00:04:51] Did anything help with the swelling that you had? [00:04:54][3.0] Lita: [00:04:55] Your stomach was swollen. [00:04:56][0.6] Gina: [00:04:57] Yes actually. There's a procedure they call Paracentesis. [00:04:59][2.6] Lita: [00:05:00] Wait a minute, Paracent- whatis? [00:05:01][0.3] Gina: [00:05:02] Paracentesis. you're in the hospital outpatient. Procedure where they go in. To your stomach with a needle like, device. And they hook up the hose, to a JAR, glass jar liters and the fluid is flushed out of your stomach. Out of your abdomen. Very painful. But. When you leave. After that. Procedure. You're about five to six liters. Of fluid. Down. Where the relief is amazing. [00:05:35][32.5] Lita: [00:05:36] So besides the Paracentesis. Was there anything else that you. Could do that would help the swelling. [00:05:41][5.4] Gina: [00:05:43] Yes, you could watch what you eat. Restricted salt diet and limiting my fluid intake helped the swelling. At night we tried to get comfortable by putting a wedge under my legs. To help with the cramping. When the cramping got real bad. I tried to walk it off. As early as I could. Sometimes when you check the sodium levels of the food that you're eating you'd be shocked that a lot of things have sodium. So. You do have to read labels and watch your sodium intake because that will cause fluid to accumulate in your stomach. Also I was a member at a health club that I had access to a Hot water Jacuzzi. Which helped. My legs in the cramping and feel less tense. I suggest that for anybody. And also. I self meditate. Myself out of pain. And that helped me get through a lot of my symptoms. [00:06:37][54.2] Lita: [00:06:40] Well that's really great. That's probably a good suggestion for anybody. Did you know what to expect when your doctors. Actually inform you that you have cirrhosis and now end stage liver disease? [00:06:53][13.2] Gina: [00:06:54] I didn't even know really a part of cirrhosis of the liver but I never really knew what. It. Was or what it untailed. I assumed it was kind of like if somebody had a heart attack. You go into the emergency room. You get back to a goal you undergo surgery. And. That's the end of it. I do not know. What end stage liver meant. But. It was. They gave me weeks to live. And that was scary because you're you don't know what to expect. Day to day. Now 48 years old and this, all the time this, and the rest of you. Yes very much very and very sudden. [00:07:37][43.1] Ron: [00:07:39] I understand that the hospital provided a number of classes to help prepare you for life with a new liver? [00:07:44][4.8] Gina: [00:07:44] Yes. You explained. Hospitals they go over everything that you need to do to prepare yourself before transplant and what you need to do. It was so it was terrible. At the time you're so sick that you can't even concentrate on what they're telling you. My caregiver was with me thank God because she took notes for me. During these meetings it's like a three day process where you meet different actors and different people on the team. Transplant team. It's very consuming. The information is very hard to understand because you're so sickly at the time. The toxins built up in my. In my brain. That. The liver. Isn't processing. And I became very confused and even I became combative. [00:08:33][48.9] Jean: [00:08:35] Did you realize that you were confused or combative?. [00:08:36][1.5] Gina: [00:08:37] No really. Well. When the nurse came in to check on me she asked me a couple of questions like What was my name and who was the president. What state do I live in. I answered. "Gina" To all the answers to all the questions. Yes. And. She knew from being a liver nurse she knew that was a symptom of toxins build up. In the brain. So immediately they put me to the emergency room and took care of me and they had to flush the toxins from my abdomen. [00:09:10][32.7] Lita: [00:09:12] Dangerous dangerous. You're from Chicago. But your transplant was in North Carolina. Why is that? [00:09:20][7.8] Gina: [00:09:20] Yes. Well I heard. They had some regions have faster results and you could register in more than one region. My caregiver told me about North Carolina because I was. Actually listed in Illinois where I live. For over a year. I only university. When she told me. About North Carolina and the turnaround in the. Past transplants. Turn around that they have their high. Low down and got on their list. And. High on their list. Actually in August of 2017 and I was transplanted. September 30th twenty seventeen. [00:09:55][34.6] Ron: [00:09:57] Definitely a lot there. What would you say was the worst part of this process. [00:10:02][5.1] Gina: [00:10:04] The worst part was waiting. Waiting. To. You know you don't know when you're going to get the phone call for the transplant. Getting sicker by the day. Ascities... The fluid retention in my stomach. Hurting. Constant swelling bloating. My legs were starting to give out because they were so swollen felt like my skin was going to rip open. There was nothing that they were prescribing me at that point that was helping me to get any kind of comfort. My sleep was lost. It was painful. Actually to even take a deep breath. Because the fluid was so. There was so much fluid in my stomach it was pushing the rest of my organs up. Through. My chest. And. Cause it Hard to breathe. [00:10:48][44.4] Jean: [00:10:49] It's sounds Awful. Did anything at all help with the swelling? [00:10:52][2.6] Gina: [00:10:52] . Well doctors told me to wear compression socks. Trying to stay positive thinking and moving about. Staying busy with my everyday life. The swelling in my stomach like I said before was released. Through. Paracentesis. That was the draining of the fluid. At the hospital. [00:11:12][20.0] Lita: [00:11:13] Sure. How did you feel when you first got that call saying. You know. We have a liver waiting for you. Was that was a surprise? Especially, you say it was only a month after you signed up over North Carolina! How did you how did that make you feel? [00:11:29][15.8] Gina: [00:11:30] Well I was shocked when I got the call I was actually at the store picking up. A prescription. And they told me to go home pack a bag and go to the hospital right away that they had a perfect liver. Well. I was excited. I was sad. I got very emotional I think every emotion went through me. When I got to the hospital. Yes I was excited but I had to wait for about. 10 hours before they actually operated on me. So I had time. For this information to sink in. Yeah. But it was at first it was a shock and I was. Like I went through every emotion. [00:12:05][35.4] Ron: [00:12:07] I understand you were released from the hospital sooner than some people, what do you think, what do you think about that? What aided you in your recovery? [00:12:16][9.4] Gina: [00:12:18] Well. I listened to my doctors I did everything they told me. Walking. Well actually let me back up. I'm sorry. I did. Exercise a lot before my transplant even though I was very sick. I had to try to build up muscle. They told me that after her transplant you would lose a lot of muscle. And I'm happy that I listened in that way because they after transplant you have to lock. And build up strength. But I'm glad that I was physically fit free for transplant. That makes sense. Also. I'm sorry but also eating healthy. As much as you can. You have to. Know a lot of protein low sodium a chicken and peanut butter nut protein bars protein shakes anything with high protein. That would build up muscle mass. [00:13:11][52.9] Jean: [00:13:12] Did you to take a lot of medication. [00:13:13][1.3] Gina: [00:13:15] After transplant? Yes I was on 40 pills a day, and it was four times a day. So yes when they, when the pharmacy rep brought in the pill box, the day before I got discharged, I said it looked like a fishing tackle box! (laughter from co-hosts) I thought to myself there's no way I would ever understand this! I'm not a pill person. And I just, I didn't think I could do it. But as time went on I, now fill up my pillbox blindfolded. (more laughter from co-hosts) Actually, I'm down to 16 pills a day so there is a big difference. [00:13:53][38.2] Ron: [00:13:54] Yeah. That's a lot to swallow. (co-hosts and guest laugh) Has anything changed since your procedure? [00:14:04][9.5] Gina: [00:14:05] Yes I mean I learned that I have to stay very active, walking is important. I wasn't able to lift anything five pounds or heavier. But now that I am six months out I am able to lift 25 pounds and more. I mean. I have to watch what I do because. They don't want me to get a hernia where the incision is. Absolutely there's no smoking no alcohol even sun exposure is considered high risk because of the medicine that I'm on can cause skin cancer. [00:14:37][32.4] Jean: [00:14:38] And just to keep an eye on your vitals. [00:14:41][2.1] Gina: [00:14:41] Yes every day I have to check my blood sugar because of the medicine intake could raise my blood sugar. I have to check my temperature. Make sure there's no type of fever. Virus going on I maintain a healthy diet. And again I do high protein and low sodium. [00:14:58][17.1] Jean: [00:14:59] Were there any rules, things that you cannot eat? Or is there anything that interferes with your medication? [00:15:05][5.5] Gina: [00:15:06] Yeah. The grapefruit you're not allowed to have any grapefruit or any product that has grapefruit in it. I was shocked to see that I I do. I used to use minced garlic in a jar and I found out that there's grapefruit juice in there some kind of preservative. And. Yeah. I was shocked. So you have to read every label. You have to make sure. The product is dated and if you can't read the day don't buy it don't chance it. If you. Touch something at the grocery store it is supposed to be cold and it's not. Don't buy it. Also. I would always use after transplant right after transplant when I was going to the stores or restaurants or out in the public I would wear face masks and I would bring wipes and wipe down everything handles of the grocery cart. Even menus at the restaurant. [00:15:53][47.0] Jean: [00:15:55] That's probably a good tip for everybody. Did anything make a recovery. Recovery period easier? [00:16:01][5.5] Gina: [00:16:01] While I was recovering at my house. I get it. Very great caregivers taking care of me. But also when I was by myself like taking a shower. I did use a grab bar in the shower. I did use the handlebars on the toilet seat. To get up and down because you are still sore. Compression sox would help my legs from getting to swollen. Squatty-Potty would help, so you don't have to, I'm sorry but, push while you go to the bathroom. You don't want anything. You don't want any tension around that. Incision. I also, like I said, the antibacterial wipes are very good. Use them Lysol spray. Wipe down everything. Just be cautious be careful. And you don't want to touch any germs. If you can't if you can rent a lift chair. [00:16:51][49.6] Lita: [00:16:53] Right. All of those products that you recommended like the squatty- potty and the handlebars for the toilet area. And the grab bars for the shower will be listed. On our Web site. For purchase. For anyone that's interested. And. The lady. Ready. Them back. Yes we'll be getting these products. From the Amazon Web site directly for you to show that you don't have to search too hard for these helpful aspects. You know there was good information. What would you. Like our audience to know about the importance of being an organ donor. [00:17:30][36.5] Gina: [00:17:31] Well I personally was never an organ donor myself but now I am. On Through. totally unknown it. I think everybody should be a donor if anything of ours can help. Two three. More people. I don't. Being a donor. I say. Definitely do it. [00:17:51][19.7] Ron: [00:17:52] That is an amazing story. Any other advice for the listeners out there. [00:17:57][5.1] Gina: [00:17:58] Oh yes I do actually. When you go to the doctor's office. Make sure that you. Tell them. Exactly. Your symptoms like if you. If you're feeling like you have a headache every other day or a sore throat once in a while just tell them everything that you feel or tell them. You are a drinker or tell them that you do diet pills or. Just. Be honest with them you're there for a reason you they're not going to judge you. And. Possibly they'll. Test you. And they'll before a disease. Occurs. They can help you. And treat you. [00:18:31][33.1] Jean: [00:18:31] That's great Gina, Thank you so much. Oh I want to thank you, on behalf of the podcast staff, and our listeners. And we really appreciate you taking the time today to speak with us. [00:18:41][9.9] Lita: [00:18:42] If you have any questions or comments related to today's show you can contact us at podcast D X at Yahoo dot com through our Web site where you can link to our Facebook page and also see more information as we build our site. Please go to podcast D X dot com. [00:19:01][19.3] Ron: [00:19:02] And if You have a moment. Please give us a five star review on the ITunes Podcast App.. [00:19:02][0.0] [1042.8]

The post Episode 40: Dr. David Casarett, Palliative Care Physician at Duke Medical Center appeared first on Death By Design, End Of Life Planning, Pallative, Hospice. See acast.com/privacy for privacy and opt-out information.

Be sure to visit www.prolongedfieldcare.org for the associated quiz and show notes! Dr. David Van Wyck an Intensivist and Neurointensivist Fellow at Duke Medical Center in North Carolina explains the evolving management of TBI in the field for medics in austere environments. Go to www.prolongedfieldcare.org for the accompanying blog post, shownotes and quiz.

TODAY'S GUEST: Dr. Hillary Smith has maintained an Integrative Wellness and Chiropractic practice in the  Los Angeles area since 1985. In 2006, she incorporated Advanced Medical Thermography-The Breast Thermography Center into her office.  Because of her dedication and excellence in the field, Dr. Smith was chosen to train for and  receive the  highest Clinical Thermographer certification. She personally trained with Dr. Peter Leando, an international leader in thermal imaging. While researching options for her own pro-active health, Dr. Smith became interested in Digital Infrared Thermal Imaging (DITI) or Thermography. Further study lead her to the realization that DITI is an amazing and underutilized screening tool that could help people detect very early changes in their physiology and be used to track the efficacy of their treatment choices. In 2006, Dr. Smith decided that educating the public about Thermography and offering a superior service was where all the roads she had traveled led to. She went to North Carolina to receive her training on the campus of Duke Medical Center through the auspices of the American College of Clinical Thermography.  Dr. Smith graduated Cum Laude from the Southern California University of Health Sciences where she earned a B.S. in Biology and a Doctorate of Chiropractic degree in 1984. She received a Doctorate of Homeopathic Medicine from The Hahnemann College of Homeopathy in 1992. In 2005, Dr. Hillary Smith received certification in First Line Therapy, a lifestyle change program that addresses many chronic health issues and is a Certified Health Coach. With a focus on Clinical Nutrition, she has attended numerous hours of post graduate education, including the 100 hour course of Applied Kinesiology. Continuing the study of homeopathy, Dr. Smith has attended many seminars with internationally renowned Homeopaths, including a yearlong Master Clinician Course with world class Homeopath Louis Klein. Dr. Smith became interested in mind/body therapies during the early years of her practice, doing advanced training in several techniques, and incorporating them her practice. In 2013, she changed the focus of the integrative chiropractic  practice to specialize in Thermography and Wellness coaching. Hillary was born in Los Angeles and received her education locally. She continues to study the applications of Thermal Imaging and Breast Health, and enjoys speaking engagements to educate the public about the power of early detection and proactive health. Her mission is to empower women with knowledge, truth, self acceptance and peace of mind. Connect With Today's guest: Dr. Hillary Smith Website: http://thebreastthermographycenter.com/staff/ Main Office: Dr. Hillary Smith DC DHM CCT 12840 Riverside Dr. Suite #202 Sherman Oaks, CA 91607 818-769-4045 Special offer: Mention vidalSPEAKS podcast and receive 10% off till the end of 2016. goes here) IN THIS EPISODE: What have you heard about breast thermography? Probably not enough. It's one of the things I'm most excited about when it comes to the prevention of the terrible disease of breast cancer simply because it enables you to diagnose a potential problem years before other methods will ven be able to detect an issue, and by then it could already be too late. Breast thermography is a non-invasive technique that does NOT bombard your body with any kind of harmful radiation or chemical to do its work. It is a high resolution camera that detects the heat signature of your body's parts and organs and highly trained technicians are able to read the picture to determine if you have any foreign masses growing in your body. With the existence of breast thermography I don't see any reason women should continue having mammograms done. Not only are they unneeded, they are also being show more and more to actually cause harm to women while they are doing the work of diagnosing. What kind of sense is that? I can't see any which is why I am suggesting thermography to all my clients. Or maybe you didn't realize that. Mammograms are the process of running radiation through the breast in order to take a “picture” what what exists in the breast in terms of masses, cysts, etc. But the saddest part of the mammogram scheme is that the only thing proven to cause breast cancer is radiation. It's silly. Women are encouraged to have regular mammograms which are very likely the very cause of the cancer they are trying to detect. It's ridiculous. I hope you take the time to listen to this conversation with Dr. Hillary Smith, my friend and licensed Thermologist. She's got a load of great insights to share with you about how the practice of thermography could help you detect breast health problems long before they become problems. This one screening could do more to put you in charge of your health than any other medical procedure I know of. Outline Of This Great Episode [1:58] My introduction to this episode about thermography. [5:10] The risks of getting breast cancer from your mammograms. [9:07] My dedication of this episode to Ellen and Eileen. [10:34] Who is Dr. Hillary Smith? [12:50] How Hillary got into the realm of using thermography to detect breast cancer. [18:44] What is breast thermography? [21:50] The kinds of things to look for when doing thermography. [23:30] How does a thermography session work? [27:30] Why a number of thermography appointments are needed. [29:10] How can breast thermography be used when you already have a lump? [31:05] Why there's nobody who can't have a thermography. [39:22] What you should do if thermography reveals something could be wrong? [45:04] The margins of error in using thermography. [48:10] How thermography can detect possible issues so much earlier than other methods. [52:30] The pressure from the medical community to have mammograms. [57:40] The growing number of medical docs who are supporting thermography. [1:03:05] Other body parts that can be examined using thermography. [1:05:00] How you can connect with Dr. Smith. [1:05:23] Did you know the pink ribbon breast cancer campaign is funded by a controversial pharmaceutical company? Resources Mentioned On This Episode BOOK: Radical Remission (affiliate link) www.PictureInside.com - Dr. Smith's website

US Congresswoman Renee Ellmers talks about her platform in Election 2014. A wounded soldier reunites with the Duke medical team who saved him. A special memorial honors military service dogs killed in the line of duty. And it's opening day of the NC State Fair.

We continue our series profiling the UNC campuses with NCSU. Doctors at Duke Medical Center use new technology to treat stroke patients. And professor Walt Wolfram talks about NC's rich language & dialect heritage.

In today’s episode, Ryan talks with Dr. Sujay Kansagra, an attending pediatric neurologist at Duke Medical Center. He is the author of the top reviewed Everything I Learned in Medical School: Besides All the Book Stuff, a memoir about his medical school experiences at Duke as well as the author of Why Medicine?: And 500 Other Questions for the Medical School and Residency Interviews. His third book is in the works which will be a comprehensive medical school advice manual for anyone in high school, college, or even in medical school. Sujay has mastered the use of Twitter under his Twitter handle @medschooladvice. Links and Other Resources: Full Episode Blog Post Dr. Sujay Kansagra’s Books: Everything I Learned in Medical School: Besides All the Book Stuff Why Medicine?: And 500 Other Questions for the Medical School and Residency Interviews Save $225 on the Princeton Review’s MCAT Ultimate or MCAT Self-Paced Prep Course through March 30th 2016 by going to www.princetonreview.com/podcast If you need any help with the medical school interview, go to medschoolinterviewbook.com. Sign up and you will receive parts of the book so you can help shape the future of the book. This book will include over 500 questions that may be asked during interview day as well as real-life questions, answers, and feedback from all of the mock interviews Ryan has been doing with students. Are you a nontraditional student? Go check out oldpremeds.org. For more great content, check out www.mededmedia.com for more of the shows produced by the Medical School Headquarters including the OldPremeds Podcast and watch out for more shows in the future! Free MCAT Gift: Free 30+ page guide with tips to help you maximize your MCAT score and which includes discount codes for MCAT prep as well. Hang out with us over at medicalschoolhq.net/group. Click join and we’ll add you up to our private Facebook group. Share your successes and miseries with the rest of us. Check out our partner magazine, www.premedlife.com to learn more about awesome premed information. Next Step Test Prep: Get one-on-one tutoring for the MCAT and maximize your score. Get $50 off their tutoring program when you mention that you heard about this on the podcast or through the MSHQ website. Listen to our podcast for free at iTunes: medicalschoolhq.net/itunes and leave us a review there! Email Ryan at ryan@medicalschoolhq.net or connect with him on Twitter @medicalschoolhq

This episode is primarily relevant to consumers. In this episode R. Trent Codd, III, Ed.S., LPC interviews Jeffrey Brantley, MD, DFAPA about mindfulness meditation. Some of the items they discuss include: What mindfulness meditation is  Why consumers of mental health services should be interested in mindfulness  The types of difficulties mindfulness has been applied to  A brief discussion of the research base in the area of mindfulness  Current directions in mindfulness research and application  Dr. Brantley also takes listeners through a brief mindfulness exercise  JEFFREY BRANTLEY, MD, DFAPA BIOGRAPHY Jeffrey Brantley, MD, DFAPA, trained in and practiced psychiatry, in both community mental health settings and in private practice for approximately 18 years. He became Board Certified in psychiatry in 1984, and was elected as a "Distinguished Fellow of the American Psychiatric Association" in 2008. He is a Consulting Associate in the Department of Psychiatry and Behavioral Sciences at Duke Medical Center. Dr. Brantley was trained in mindfulness as a resident in psychiatry at the University of California at Irvine Medical Center, and has been practicing mindfulness for 30 years. He began teaching mindfulness meditation to health professionals and others in 1990. Dr. Brantley is one of the founding faculty members of Duke Integrative Medicine, where he started the Mindfulness-Based Stress Reduction program in 1998. He has participated in many intensive meditation retreats, practicing with a variety of teachers, including Joan Halifax, Thich Nhat Hanh, Larry Rosenberg, Christina Feldman, and members of the Amaravati Buddhist monastic community. He has also completed the professional training for Mindfulness-Based Stress Reduction offered by Jon Kabat-Zinn and Saki Santorelli. Dr. Brantley is the author of Calming Your Anxious Mind: how mindfulness and compassion can free you from anxiety, fear, and panic and is the co-author, with Wendy Millstine, of the Five Good Minutes series (www.fivegoodminutes.com) His most recent books, with Wendy Millstine, are Daily Meditations for Calming Your Anxious Mind and Five good minutes in your body: 100 mindful practices to help you accept yourself & feel at home in your body.