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Intracerebral hemorrhage carries high morbidity and mortality, but growing evidence highlights meaningful opportunities for prevention, risk reduction, and long-term recovery. This episode covers key strategies, including blood pressure management, interpretation of neuroimaging markers, and individualized decisions around antithrombotic therapy. It also emphasizes the prolonged recovery timeline and the importance of a holistic, patient-centered approach to improving outcomes. In this episode, Casey S. Albin, MD, FAAN, speaks with Wendy C. Ziai, MD, and Vishank A. Shah, MD, coauthors of the article "Intracerebral Hemorrhage" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Ziai is a professor of neurology and critical care medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland. Dr. Shah is an assistant professor of neurology and critical care medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland. Additional Resources Read the article: Intracerebral Hemorrhage Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Guest: @VishankShah3 Full episode transcript available here Dr Albin: A patient has suffered an intracerebral hemorrhage. They're taken to the neuro ICU, and they fortunately survive. But the journey does not end there. In fact, in some ways, the journey has just begun. Join us today as we unpack holistic care for ICH patients.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Albin: Hello to our audience. This is Dr. Casey Albin. Today, I'm interviewing Dr. Wendy Ziai and Dr. Vishank Shah about their article on intracerebral hemorrhage. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast. I am so delighted that both of you are joining. To begin, let's just do a brief introduction of who you are and, and a little bit of how you got interested in the topic.  Dr Ziai: Hi, I'm Wendy Ziai. Thank you for having me on this podcast. I am a professor of neurology at Johns Hopkins. I am a neurointensivist, and I think I got primarily interested in this topic through clinical trials that I have been a part of since my fellowship days.  Dr Shah: Hi, everyone. I'm, uh, Vishank Shah. I am also, uh, very thankful for being invited to be a part of this podcast. I'm also a neurointensivist at Hopkins and the fellowship program director here for neurocritical care, and I'm interested in recovery after ICH, and that's why I'm a part of this work.  Dr Albin: Welcome to you both. It is such a treat for me to get to interview fellow neurointensivist, particularly those who have such a wealth of experience. So, I am delighted to dive into this. All right. So, to set the stage for our audience, intracerebral hemorrhage has long been approached with pessimism. But your article really highlights that there are meaningful advantages in prevention and risk stratification and long-term recovery for these patients. Though you both are neurointensivist, this article really emphasizes primary prevention and the holistic long-term care for the survivors. And so, to begin, Dr. Shah, can you just lay out a little bit for our listeners the scope of intracerebral hemorrhage and its community impact?  Dr Shah: Yeah. So, you know, ICH is the second most common type of stroke. There are more than three million new cases of ICH globally each year, and it accounts for thirty percent of all stroke types, but it is the one that has the highest mortality, with more than forty to fifty percent of the patients dying in the first thirty days, and then continued long-term impact on both functional as well as outcomes, as well as survivorship after the early period. And it also disproportionately impacts lower socioeconomic, and then minority races like Blacks, Asians, as well as Hispanic ethnicity. And so, there's a lot of work that needs to be done to reduce the burden of this disease.  Dr Albin: Absolutely. I mean, these can really be devastating for families, and I really am appreciative of your highlighting that there's a lot of disparities, and there's a lot of work to be done to really increase equity to these patients. I think a lot of this goes into really the AAN's focus on brain health and trying to improve some of what we're doing to maintain brain health. And I really wanted to kind of drill down on this because for ICH, there's a lot that can be done upfront as we think about how do we counsel patients who may walk into the office about strategies to prevent ever becoming an intracerebral hemorrhage patient. So, Dr. Shah, can you walk us through a little bit about what neurologists in the community need to be doing to make sure that no one ends up with us in the neurointensive care unit?  Dr Shah: Yeah, sure. So, I think, you know, one of the most important risk factors is, of course, hypertension and long-standing uncontrolled hypertension. And so really recognizing the need for early onset screening with regular blood pressure monitoring at a very early age, particularly in the races that I discussed earlier. And then I think another big part, obesity, metabolic syndrome, and type two diabetes. And I think there's a lot of interesting new work that with the GLP-1 agonist, you know, in a large multicenter cohort studies showing that patients receiving these had a significantly lower reduction risk of ICH. And so, this might be a really important part that, you know, clinicians need to start increasingly recognizing and using in their practice. And then, of course, other risk factors that are common include smoking, diet high in sodium, exposure to air pollution, both indoor as well as outdoor. And so, mitigating all of these risk factors can also reduce the burden of ICH.  Dr Albin: Absolutely. And I really want to highlight that hypertension plays such an important role and that we as neurointensivist, as community neurologists, really need to be creative about ways that we can help people meet those blood pressure target and meeting people in the community where they are, making sure that they're not suffering from side effects from their medication that would prevent them from sticking with it long term. Dr. Ziai, anything else to add about what we can do in the community?  Dr Ziai: So, we really want to emphasize, even in the acute phase, that patients moving forward need to have targeted interventions to reduce blood pressure, smoking, enhance their physical activity, have a diet that is high in fruits and vegetables and low in alcohol and salt, and then promoting weight loss, of course.  Dr Albin: And Dr. Ziai, I'm gonna ask you a little bit about one of the things that maybe not all of our listeners have heard about is this APOE2, APOE4 genetic risk for intracerebral hemorrhage. What's going on there and, and should clinicians be testing for that? Dr Ziai: That's a great question, and it is not one that we currently test people for at least acute ICH presentation. APOE2 and A4- E4 alleles, these give patients a two to three times higher risk of ICH by increasing cerebral amyloid deposition. And if you happen to have APOE2 carrier ship status, then along with other risk factors like white matter disease and vascular risk factors, these predict the onset of new microbleeds even during very short follow-up periods of about two years. And as we know, having cerebral microbleeds are associated with an increased risk of all strokes, ischemic and ICH, but they are one of many MRI markers of small vessel disease, which along with cortical superficial siderosis, does significantly increase future ICH risk. And so even in people who've never had an ICH, if they happen to have an MRI, it may be reasonable to look at the MRI and incorporate this burden of small vessel disease, and especially these hemorrhagic markers into, uh, decision-making about interventions.  Dr Albin: That's a really excellent point. And so, I think that your article did a really beautiful job of thinking holistically about the patient, incorporating clinical markers of their risk for having ICH, but also those radiographic markers. I'm just gonna ask you to summarize those again one more time because not everyone will be familiar with these. So, when you're looking at an MRI, what are the things that you're particularly clued in on that would increase the patient's risk of future ICH?  Dr Ziai: In the past, what we're looking for really is markers of cerebral amyloid angiopathy, which significantly increase a person's risk for lobar hemorrhage in particular. And so, we have a set of criteria called the Boston Criteria, and there's a new version of these, version 2.0. And these, um, incorporate a number of imaging markers that provide a very high sensitivity and specificity to diagnose CAA after an ICH. But even if someone's never had an ICH, and they evaluate that risk-benefit ratio for different cardiovascular prevention strategies. And so, the markers that we're specifically interested in are, of course, microbleeds. But not just having microbleeds, but are they lobar or are they deep? Lobar having a higher risk for lobar ICH. How many microbleeds are there? Is it greater than five, or is it just one or two? Also, cortical superficial siderosis is a marker, a hemorrhagic marker, that does portend a significant increased risk of recurrent ICH, along with having a lobar ICH. And now we have these new markers, which are the white matter hyperintensity multi spot pattern, which requires these hyperintensities on flare imaging in the subcortical area, having greater than at least ten of these multi spots, and also having enlarged perivascular spaces in the centrum semiovale, and having at least twenty of those. And finally, white matter hyperintensities, which can be measured with the physica score or just by visualizing them. We can look at white matter hyperintensities as well as being a measure of small vessel disease.  Dr Albin: Got it. And so just to summarize, we're looking for small vessel disease markers because that puts our patients at higher risk of ongoing future bleeds. And then we're also looking for markers of particularly small vessel disease that's caused by cerebral amyloid angiopathy, which again, because it's having that protein deposition, that puts the patient at risk of those leptomeningeal very small vessels, putting the patient at risk of lobar ICH. Just confirming I've summarized this all correctly.  Dr Ziai: Yes. That was perfect.  Dr Albin: Amazing. Dr. Shah, I'm gonna go back to you. Let's say we have a patient. Let's say this is a sixty-five-year-old man who comes in and they want follow-up and they're... And you're trying to think about they've had an ICH in the past, and they are also at risk for ischemic disease. Let's say they, they have hypertension, they've had a smoking history. They have some risk for ischemic events. And you're trying to think about how do you balance those. Let's say the patient needs to be on aspirin but does have some of those high-risk features on their MRI. Is there any guidance on how we think through preventing them from having a recurrent bleed if they're a high-risk patient, also preventing them from having an ischemic event, which they might be at high risk for as well?  Dr Shah: Yes. So, I think, you know, the first step is of course trying to understand what was the type of bleed. I think that has a very important role, like you mentioned. If it's a lobar hemorrhage versus a deep hemorrhage, the risk of recurrent ICH and ischemic events is very variable. So lobar hemorrhages, there's obviously a higher risk of recurrent hemorrhage events, whereas deep hemorrhage is actually at or behaves sort of like small vessel ischemic strokes and have a higher risk of recurrent arterial ischemic events. So that distinction in itself can help you gauge which patients would be safe and would benefit from these therapies. To begin, and of course, looking for some of these markers on MRI that were mentioned by Dr. Ziai for recurrence of hemorrhage risk. In terms of antiplatelet, the, there is a lot more data now to guide treatment, and we have the RESTART as well as the ESTART trial that showed that starting an, a single antiplatelet after intracerebral hemorrhage did not increase the risk of hemorrhage recurrence. They were very variable in the timing when aspirin was started, and so that remains still a question about what is the safest time point to start aspirin. For example, in the ESTART trial, they started them very early, within the first three days, whereas in  the RESTART it was all the way up to two months after the hemorrhage. And so... But in general, the risk of recurrent ICH was very low with a single antiplatelet agent. And so, if it's needed for ischemic prevention, it's relatively safe broadly across all types of hemorrhages.  Dr Ziai: Yeah. I would just mention that there was also a subgroup analysis of the RESTART trial using MRI. And so, this more than likely included patients with CAA, since 40% of the hemorrhages were lobar in that study, and therefore seeing that there was no increased risk of recurrent ICH in RESTART, it is thought that putting patients back on their antiplatelet therapy is safe.  Dr Albin: That's a really huge takeaway pearl for our listeners, that regardless of whether it's a lobar bleed or a deep bleed, if there is a strong indication, you know, this is not just, oh, because someone gave them aspirin 81, but truly that there is a reason that they need to be on a single antiplatelet agent, it probably benefits them to be on that agent, and there's good data that there's not a huge increase in risk. Summarizing all of that?  Dr Ziai: Great.  Dr Albin: Now, things are gonna get a little bit tricky here, because what if the patient, what if they need to be on dual antiplatelet therapy? Or what if they need to be on anticoagulation? Dr. Ziai, I'll, I'll throw that to you. How do you tackle that patient population?  Dr Ziai: Yeah, the safety of dual antiplatelet therapy hasn't really been studied in patients who've had a prior ICH. Although, in people who've had previous strokes, putting them on dual antiplatelets doesn't seem to increase the risk of ICH, but it does increase extracranial hemorrhage. And so there may be other reasons not to put patients on dual antiplatelet agents. Patients who have cancer and also cardiovascular or cerebrovascular disease, putting them on dual antiplatelet therapy does seem to increase the risk for intracranial hemorrhage. So, I think there is enough of a bias against DAPT therapy in patients who have had an ICH that we would not recommend DAPT for patients with a prior ICH.  Dr Albin: Absolutely. And, and then what about, let's say they have atrial fibrillation, and you know that they have a high CHA2DS2-VASc score, and they are at very high risk of ischemic events, but they've also had a prior intracerebral hemorrhage. Walk us through a little bit, how should we approach that patient? Dr. Ziai, I'm gonna start with you again.  Dr Ziai: Sure. So again, looking at the MRI, which all patients with ICH should have nowadays. If patients do have these hemorrhagic findings, a lobar ICH, evidence of CSS, cortical superficial siderosis, especially if it's disseminated, and also lobar microbleeds, especially if there are greater than five, if they're multiple, then anticoagulation should really be avoided in those patients.  Dr Albin: Absolutely. So, I'm really hearing that when we have a patient with ICH, it is just critically important that we understand is this a hypertensive bleed or is this a lobar bleed that is probably related to cerebral amyloid angiopathy? And getting to that distinction is going to play a major role in our deciding whether or not the patient can be on DAPT or can be on anticoagulation. And then what are some of the strategies for patients that you're referring them to if they really cannot tolerate being on anticoagulation, but they have atrial fibrillation, and they do need some sort of ischemic stroke prevention?  Dr Shah: There's still a lot of controversy, even in non-lobar hemorrhages, about resuming anticoagulation and when that would be safe. HAF trial, there was a reduction in ischemic stroke recurrence, uh, but a significantly higher increase in hemorrhage recurrences. I think that trial included both deep and lobar hemorrhages. So, we still need more data, and I think the ASPIRE trial and maybe a meta-analysis would answer that eventually. But in the meantime, if a, specifically for lobar hemorrhages, which are, uh, thought to be CAA related, if they, uh, and the patient has AFib, you know, where anticoagulation would be contraindicated, a watchman device or, you know, AFib ablation may be some of the other strategies that can be looked into for those patients specifically.  Dr Albin: Right. I think that's a really important point to emphasize, that we don't just don't give up and say, "Oh, you're not a candidate for anticoagulation," but we really reach out to our cardiovascular friends and say, "Hey, what other procedures can you offer that will minimize the risk of recurrence?" You know, we don't want them to have an ischemic event, but we also know long-term that there would be a real risk of anticoagulation. Just reminder to our listeners that there are new procedures, and our cardiology colleagues are always doing new trials and new devices, and so we should really leverage their expertise here. I am in the final minutes gonna just switch gears a little bit from talking about sort of the nitty-gritty of secondary ischemic prevention and secondary hemorrhagic stroke prevention and thinking about there has been this degree of pessimism around ICH patients, and that, you know, they have a much more severe outcome than our patients with ischemic strokes. I think that that is probably a myth that we need to do some debunking around, and I think maybe we need to reframe in terms of thinking about just the trajectory. So, Dr. Shah, walk us through a little bit about what we can expect about the recovery trajectory in ICH compared to those patients who have an ischemic stroke. Dr Shah: Yes. From some newer data and studies, it is becoming clear that recovery after ICH is much slower than we expect. In general, for ischemic stroke, recovery is measured within the first few weeks to up to 90 days. But in ICH, we now know that patients can keep recovering all the way up to six months and even beyond. In general, from just a, a study of heart recovery that occurs after ischemic stroke, there's a steep recovery in the first seven days, and then sort of after that, patients still continue to recover, but it, it starts plateauing where up to 90 days. Whereas with ICH, there is not much recovery in the first 7 to 30 days, but after that, there is a recovery that occurs significantly between day 30 and day 180, and then some patients continue to recover all the way up to one year. The more severe the hemorrhage, the slower the recovery, but there's still some evidence to suggest that even severe hemorrhage patients can recover all the way up to one year out and beyond. This is, of course, in terms of functional recovery.  Dr Albin: I think that's a really important point for our audience. Many of the listeners are residents, they're fellows, they're seeing these patients in the hospital, and they may not see a whole lot of improvement over even 30 days. But to keep in mind that just because the patient has not had a dramatic recovery within that first month that they may be in the ICU and then on the floor does not mean that that patient will never have recovery, and that we reset our expectations that recovery is possible, it's just gonna be slower. And I think that that's not only important for the healthcare team to take in mind, but also for patients and their families to know there is hope here. It's just gonna be slower. Dr. Ziai, looking ahead, what developments in this are you most excited about that you think will move the needle for care for the long-term outcomes and the prevention for these patients? What's ahead in, in ICH?  Dr Ziai: Yeah, I think the research that's going on is very exciting at the moment. We just saw the presentation at the World Stroke Organization conference in the fall of the TRIDENT trial, Triple therapy prevention of Recurrent intracerebral Disease events, meaning strokes. And these investigators found that a single pill, a fixed dose of three blood pressure-lowering agents actually was successful in significantly reducing the risk of recurrent stroke in patients who have had a history of ICH and have just normal or low-grade hypertension. So rather than having patients on multiple antihypertensive agents, it may be possible to have them on a single pill, and may dramatically reduce their stroke risk. So that's exciting. There is also a trial ongoing, ASPIRING, testing whether antiplatelet monotherapy after 24 hours only can reduce the risk of all serious vascular events in ICH survivors. So very early antiplatelets. The SATURN trial, we didn't talk about statins yet, but it is comparing continuation versus discontinuation of statin therapy in ICH patients. And then we have ongoing epidemiological studies that are really needed to understand this interaction between the cardiovascular prevention strategies, the antithrombotic use, the blood pressure targets, and these high-risk neuroimaging markers for ICH. And I think that's gonna be key, personalizing the interventions for these patients.  Dr Albin: So, I love that. And what I'm hearing is that it's really important to think about the personalized approach as well as how do we simplify things. We know that blood pressure control is critically important to the primary and secondary prevention of ICH, but we have to make it easy for patients to do so. Dr. Shah, I want to end with kind of understanding, you know, this was an unusual topic for neurointensivists to talk about. This was really about prevention. It was about long-term survivorship. It was about not what's happening in the neuro ICU. How did you guys get interested in sort of that aspect of care?  Dr Shah: Yeah, so that's a great question. Dr. Ziai has been my mentor since I was in fellowship, so now about eight years that I've been working with her, and this was a project that I started in fellowship with under her mentorship, looking at long-term recovery in ICH patients, and specifically severe patients. Happy that work has received a lot of recognition. It was published in JAMA Neurology. We looked at patients with severe intracerebral and intraventricular hemorrhage, those that survived with an mRS of four and five at day 30, and what happened to them over the course of the year. There was really not much data on recovery after ICH. And we were very surprised to see that up to 40% of patients that were an mRS of four and five, so really, really severely disabled at day 30, recovered to an mRS of zero to three by one year. About one-third of that group that recovered actually achieved functional independence with an mRS of zero to two, which was very surprising, really breaking the myths around the pessimism with ICH. We found that a lot of the baseline comorbidities like diabetes, white matter disease, as well as what happens to them during the acute hospitalization, were adding all of that information to the severity of the hemorrhage significantly improved our ability to predict long-term recovery after ICH. And so that's kind of how we got interested in this work, looking at how factors in the care that we provide in the ICU, as well as what the patients come in with, how all of that could be modified to promote recovery in these patients that are often been forgotten.  Dr Albin: I think that there's one takeaway to our listeners is that this is really a place where there's a lot of hope for recovery, and that the nihilism that has really surrounded ICH is a thing of the past, and we have to move forward with thinking about how do we proactively impact the recovery and counsel the patients and give them hope. Because just as your research shows, there really is the ability that they can attain that functional independence, which is absolutely astounding. It's really amazing. Again, today I've been interviewing Dr. Wendy Ziai and Dr. Vishank Shah about their article on intracerebral hemorrhage. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Please be sure to check out Continuum Audio episodes from this and other issues. Please go and check out. They have a wonderful article with lots of tables and figures, so much data. And again, thank you to our listeners for joining us today. Thank you, Dr. Ziai and Dr. Shah.  Dr Ziai: Thanks very much.  Dr Shah: Thank you.   Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

High-performing lawyers are drowning in billable hours, perfectionism, and constant interruptions—but it doesn't have to be that way. In this episode, you'll learn practical strategies to delegate better, protect your time, and manage stress so you can build a sustainable practice without burning out.   In this episode, Steve Fretzin and Ellen Cohen discuss: Transition from in-house entertainment lawyer to leadership coach Biggest stressors and billable-hour pressure in modern law practice Delegation myths and the real cost of “it's easier if I do it myself” Time management, prioritization, and managing interruptions Perfectionism, neuroscience of stress, and practical self-care habits   Key Takeaways: Treating every task as equally urgent and important is a fast track to burnout; you must distinguish between high-value, urgent work and tasks that can be delegated or delayed. The mindset of “it's easier if I do it myself” hides a massive hidden cost in lost billable hours, lost growth, and lost personal time. Truly effective delegation requires training others, tolerating imperfection in the short term, and focusing your time on work that matches your highest value and rate. Perfectionism may look professional on the surface, but it often comes from self-limiting beliefs and dramatically slows productivity while increasing stress and risk of burnout. Chronic stress pushes you into fight-or-flight, which makes clear thinking neurologically harder and raises the risk of malpractice—regular breaks, movement, and joy-producing activities are therefore performance tools, not luxuries.   "When you're stressed out, when you're in fight or flight, when you're in your sympathetic nervous system, you actually cannot neurologically think clearly, and it elevates your risk of malpractice, making mistakes, errors, reactivity, emotional responses that are not in line. You cannot work as efficiently." —  Ellen Cohen   Check out my new show, Be That Lawyer Coaches Corner, and get the strategies I use with my clients to win more business and love your career again.   Join the Be That Lawyer Community and connect with ambitious lawyers who are serious about growing their book of business, strengthening their brand, and becoming confident, consistent rainmakers.   Ready to go from good to GOAT in your legal marketing game? Don't miss PIMCON—where the brightest minds in professional services gather to share what really works. Lock in your spot now: https://www.pimcon.org/   Thank you to our Sponsor! LEX Reception: https://www.lexreception.com/partners/bethatlawyer Rankings.io: https://rankings.io/ Lawyer.com: https://www.lawyer.com/   Ready to grow your law practice without selling or chasing? Book your free 30-minute strategy session now—let's make this your breakout year: https://fretzin.com/   About Ellen Cohen: Ellen B. Cohen is a seasoned executive coach, organizational consultant, and former attorney who brings over 25 years of senior executive experience at major media and tech companies like Disney, Sony, Fox, Microsoft, and Viacom to her leadership development practice. Leveraging over 2,500 hours of coaching experience, she partners with C-suite executives and high-achieving professionals to help them expand their influence, manage stress through neuroscience, and transition from reactive execution to strategic leadership. Ellen holds a J.D. from Emory University School of Law, a Master's in Organization Development and Leadership from Fielding Graduate University, is admitted to the state bars of CA, NY, FL, and GA, and holds multiple elite coaching credentials (PCC, CPCC, CPQC). As a Core Guide for the executive women's network Chief, she combines her deep corporate background with mental fitness practices to help leaders break through mental glass ceilings and build sustainable, high-impact careers.   Connect with Ellen Cohen:   Website: https://ebccoaching.com/ LinkedIn: https://www.linkedin.com/in/ebccoaching/   Connect with Steve Fretzin: LinkedIn: Steve Fretzin Twitter: @stevefretzin Instagram: @fretzinsteve Facebook: Fretzin, Inc. Website: Fretzin.com Email: Steve@Fretzin.com Book: Legal Business Development Isn't Rocket Science and more! YouTube: Steve Fretzin Call Steve directly at 847-602-6911   Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

Join endocrine expert and Endocrine Practice Associate Editor, Dr. Cecilia M. Lansang, as she interviews Dr. Guillermo E. Umpierrez, professor of medicine at Emory University School of Medicine, clinician educator and researcher, for a candid conversation about his journey in medicine, endocrinology, and inpatient diabetes care. Dr. Umpierrez reflects on his early work studying diabetic ketoacidosis and ketosis-prone diabetes, the mentors and teams who shaped his academic career, and the importance of finding the right environment, enjoying the work and celebrating small successes along the way. To learn more, read Dr. Umpierrez's review article in Endocrine Practice: Ketosis-Prone Type 2 Diabetes Mellitus: 3 Decades of Clinical, Pathophysiologic, and Therapeutic Insights.

Rapid advances in acute ischemic stroke care have expanded treatment windows and improved patient outcomes through thrombolysis, mechanical thrombectomy, and optimized antithrombotic strategies. This episode highlights evolving approaches to patient selection, the growing role of tenecteplase, and the importance of team-based systems of care in delivering timely, effective treatment. In this episode, Casey S. Albin, MD, FAAN, speaks with Christopher R. Leon Guerrero, MD, author of the article "Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Leon Guerrero is an associate professor of neurology and the adult neurology residency program director at Atrium Health Carolinas Medical Center in Charlotte, North Carolina, where he also serves as outpatient stroke director. Additional Resources Read the article: Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Full episode transcript available here Dr Albin: In stroke care, every minute kills nearly two million neurons. But today, we're going to unpack all the details about the latest treatments that can give those neurons back.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Albin: Hello and welcome. This is Dr. Casey Albin. Today, I'm interviewing Dr. Christopher Leon-Guerrero about his article on Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast. I always like to start by just having you introduce yourself so our listeners know a little bit about you.  Dr Leon-Guerrero: Thanks for the introduction, Dr. Albin. Really glad to be here today. My name is Chris Leon-Guerrero. I'm a vascular neurologist at Atrium Health in Charlotte, North Carolina, at Carolinas Medical Center. I'm an associate professor in the Department of Neurology. I serve as our Neurology Residency Program Director, and I also wear the hat of an outpatient stroke director in our clinics.  Dr Albin: So, you are wearing a lot of hats and balancing a lot of things, and it's a really exciting time to be talking about this. For our listeners, we are recording this right after the launch of the American Heart Association, American Stroke Association just released their new guidelines on acute ischemic care. So, no better time to kind of dive into some of this. And really, when I think about acute ischemic stroke care, it's dramatically transformed in the last two to three decades. I mean, from lengthening time windows for IV thrombolysis to expanded thrombectomy eligibility, this is really, I think, some of the most exciting stuff in neurology. And your article did a fantastic job of distilling those rapid advancements and clarifying some of the evidence behind some of these new evolving treatment selections and imaging modalities, and it's exciting. So, let's just start with thrombolysis. Where are we now with IV thrombolytics and the time windows there?  Dr Leon-Guerrero: So, a lot has changed in the last decade, since that initial trial with NINDS, nearly thirty years ago. We're still giving intravenous thrombolysis in the traditional time window up to 4.5 hours, and really emphasizing we should be selecting patients for treatment early and quickly as possible. In most of those cases, a non-con head CT is sufficient to rule out bleeding and initiate treatment as quickly as possible. Where things have gotten really exciting is using advanced neuroimaging to help select patients beyond that traditional 4.5 hour window, and we're able to treat patients even up to twenty-four hours from symptom onset.  Dr Albin: Which is really exciting. It has really totally shifted the paradigm here. You know, I think most listeners are going to be pretty familiar with three to four and a half hours. Like, that's sort of our standard. What can you tell us about some of the advanced imaging we're using for that later selection period?  Dr Leon-Guerrero: It's around the principle of you want to be able to, uh, rescue significant salvageable tissue without a lot of core. So, this large profusion deficit and small core is really how you're trying to select out these patients. And two types of modalities are used. One is going to be MRI, and a lot of those imaging protocols, you know, are outlined in the WAKE UP trial and basically are looking for patients with DWI hyperintense lesions and FLAIR negative lesions to suggest that patients in an early time window that's treatable for thrombolysis. And then in the other category, we'll be using profusion imaging, whether that's CT profusion or MR profusion, to look for patients with large salvageable tissue.  Dr Albin: Yeah. And I think that this has been one of the things that, to me, has been really impactful is I think when WAKE UP came out, it was exciting. It was fun to sort of think about, "Hey, we're going to be able to use MRI." But MRI can be very challenging to get acutely, especially in community centers where they don't have the capabilities to get someone from the emergency department into an MRI rapidly enough to make thrombolysis decisions. So, to see some of that expand to CT profusion has been really exciting. How are you going about sort of counseling patients or thinking about their risk when you're using some of those, like, advanced imaging techniques?  Dr Leon-Guerrero: Yeah. I think it's similar to the conversations we've had with patients even within the traditional 4.5 hour window. The risk for intravenous thrombolysis is hemorrhage, and counseling patients on the, you know, the risk and benefits of hemorrhage and the potential clinical benefit of receiving thrombolytics is important. And then providing patients with that information to make an informed decision, so that they can make the best decision for their own care.  Dr Albin: Totally. And it's, again, time sensitive, but trying to give families enough information and enough time to sort of process those, especially when it's a little bit beyond the standard that we're so used to consenting for. The other big area that's really changed is that tenecteplase has become the star of the show. It's really gained momentum, so what should clinicians understand about this?  Dr Leon-Guerrero: Yeah. There's been an explosion of data over the last decade on tenecteplase supporting its use for clinical practice. You know, there was recent updates even from the neurology journal with a large meta-analysis with all of the data showing good clinical outcomes and perhaps even lower risk of bleeding. And so, I think you're seeing a lot of centers across the country switching from alteplase to tenecteplase. There's some practical advantages. So tenecteplase is a one-time bolus dose. And then biologically, it seems to have better fibrin specificity, longer half-life, which may ultimately make it a more attractive drug and may make it even more effective. But I think the practical aspects of tenecteplase are not to be understated. I think there's a lot of advantages for speed and efficiency and for centers to make that switch.  Dr Albin: Yeah. I remember when our health system made the pivot from alteplase to tenecteplase. Like any changes, that obviously created some adjustments with the new workflow. But, the fact that this could be given just as a one-time dose and not with the "we got to calculate the bolus, and now we got to get the infusion on board," like really simplified workflow. So, I think that's been pragmatically one of the nicest things we've done in stroke care. Really exciting.  Dr Leon-Guerrero: Yeah. And, you know, it's a doable thing. I think you have to be, very deliberate about it at whatever center you're at to make sure that all stakeholders are aware of that change. I think that's helpful to get everybody involved and have a lot of planning to avoid wrong dosing errors or inadvertently dosing as alteplase versus tenecteplase. But it's certainly doable, and I think in the long term, centers that have switched have been pretty satisfied with tenecteplase.  Dr Albin: And you know, initially when this came out, there really was sort of a debate about, is it gonna be 0.25? Was it gonna be 0.4? Where have we landed with that debate?  Dr Leon-Guerrero: So, I think we found the correct dose is 0.25 milligrams per kilogram is the recommended dose with a max out of 25 milligrams. There's some within the American Heart Association guidelines that were just published. They mentioned even tier dosing based on 10 kilograms, so intervals. So, that may be an easier way for centers to do it. But that cap out dose of 25 milligrams at 0.25 milligrams per kilogram, I think, is the sweet spot.  Dr Albin: Yeah. That's great, and I think that that has helped, you know, say, "This is what we're doing. There's not a debate that's happening anymore." And that really just got codified in the new ASA guidelines, so really exciting there. So, there is a lot of guidance for these patients, but I think one of the things that your article really tackled is the fact that there are some special populations, where we really still don't have a lot of guidance. And so, I think just to kind of distill those for the listeners, thinking about our pregnant patients, thinking about children, how are we approaching thrombolysis decisions in these special populations?  Dr Leon-Guerrero: These are always tough cases. For example, for pregnant women, they've often been excluded in the thrombolytic trials. But there's still evidence. You know, there's some inference based on the evidence we do have, and there's a lot of registry and case reports suggesting potential safe treatment for pregnant women. And I think when you're approaching those cases, again, it's gonna be patient-centered and really should be multidisciplinary. These are the types of cases you really need to lean on your maternal fetal medicine colleagues, your high-risk OBGYNs, your obstetricians to help with that decision-making. And I think, a multidisciplinary approach is the way to go for these cases. It's the same thing with the pediatric population. We had some data. There was one trial, randomized control trial, called TIPS trial that looked at using intravenous alteplase for acute ischemic stroke in patients under the age of 18. It had difficulty with enrollment. But I think most experts would argue that patients with pediatric stroke should be considered for intravenous thrombolysis if appropriate. Again, same thing. You want to make it a multidisciplinary approach, really getting your pediatric neurologists, your pediatricians involved early to make the best decision for the patient.  Dr Albin: Yeah. That's just really an important takeaway, just thinking about this as a multidisciplinary decision, because there are going to be other stakeholders to the patient's care who may have some different information than what we as neurologists are bringing to the approach. And obviously, our perspective really matters. But trying to work in everyone's unique vantage point of the patient really helps to make the most effective decision. When we talk about acute ischemic stroke care, I really don't think that you could do justice to the topic without pivoting to mechanical thrombectomy, which, you know, as we think about how the medical field as a whole, not just neurology, how the medical field has evolved. I mean, there's probably no bigger impact than mechanical thrombectomy has made in terms of reducing not just morbidity, but mortality from stroke. I mean both. So, thrombectomy has been around for a while, but just walk our listeners through what's the core that we for sure know that these are the patients that this works for?  Dr Leon-Guerrero: The types of patients we should be selecting for intervention are patients with large vessel occlusions. And those initial trials that were published in 2015 really demonstrated that this is a quite an effective treatment for patients with large vessel occlusion ischemic strokes in the anterior circulation. When that smattering of publications occurred in 2015, the general consensus, we should be treating all patients up to six hours from symptom onset if they do have a large vessel occlusion. And then, Dr. Albin, as you know, the, the windows continue to expand. So, we were using advanced neuroimaging with MR selection and perfusion selection based on DAWN and DEFUSE 3 trial protocols to select patients all the way out to the 24 window, and it's even expanded beyond that over the last few years.  Dr Albin: I think that when we think about trials that really, totally, changed the game, when we think about DAWN and DEFUSE 3, and we switched from that time-based window to more of that, like we talked about for thrombolysis, that tissue-based clock and, like, looking at what is salvageable and where can we make an impact on salvageable tissue, truly moved the needle in terms of just bringing this therapy for people who, you know, it's hard to get in within six hours. When we moved the needle to 24, it made a huge difference. But people were still coming in with a lot of ischemic damage already done, and they would have traditionally been excluded from being enrolled in thrombectomy trials. But that's changing too. So where are we there?  Dr Leon-Guerrero: Yeah. I think there were lessons learned from DEFUSE and DAWN that we were probably over-selecting. Perhaps too stringent. You know, we had number needed to treat in the range of two to three for good outcome based on those trials. And so, I think those were lessons learned to move forward, and we, and, and people started looking at large core infarctions. And in the last few years, we've seen a multitude of randomized control trials examining large core infarctions. These are patients with ASPECT scores all the way down to zeros. A lot of the trials relied on three to six as their score, but there was at least one large core study that looked at ASPECT scores down to zero to two, and all of these studies showing benefit.  Dr Albin: Yeah. And we've really moved into if there's some tissue to spare there, probably getting clot out really makes a big difference in impact. You know, it was really surprising to me as a neurointensivist looking at these trials, that the trials had such low rates of hemorrhage, and pretty low rates of dramatic cerebral edema after thrombectomy. I don't know that we've seen all of that in sort of real world applications, but again, we are still seeing some of these patients come in, that really would've been devastated having some amount of functional recovery regained, which is incredible. In terms of another patient population that I think gives a lot of people pause or stickiness, is those basilar artery occlusions, right? Another large vessel, but one that we've had a little bit harder of a time enrolling in trials and having well-selected trials. Where are we now on whether or not basilar artery occlusion should go to mechanical thrombectomy?  Dr Leon-Guerrero: So, a lot of excitement in this area, too. There's at least two studies that were published in the last five years that were showing benefit in doing thrombectomy for patients with basilar artery occlusion up to 24 hours, and these were patients with moderate to severe deficits with NIH Stroke Scale scores greater than 10. And then making sure that they don't have large core, so using a newer scoring algorithm on the CAT scan called PC ASPECT, so basically a posterior circulation ASPECT score, to kind of make sure that patients don't have large core infarctions that are being considered for thrombectomy. All of those things collectively in those two recent studies, the ATTENTION trial and the BAOCHI trial, I think is what ended up making those studies positive, is that we were selecting the right types of patients, uh, without large core, early core, and patients with moderate to severe deficits that made the difference from previous trials.  Dr Albin: Yeah. I think that that's so important. Those trials to me, and like how long it took to get those enrolled, really emphasized to me that there really was a selection bias. Like, we believed this worked, which made it hard to then do a trial. But I'm so glad to hear that we have the data now to support moving forward in a more rigorous way.  Dr Leon-Guerrero: You're absolutely right. I think that was some of the challenges with the initial trials. In fact, the authors had commented on that. There's a lot of difficulties with lack of clinical equipoise, or experts wanting to take these patients anyways out of clinical trial and treat them, and so that's always been an issue. And then, you know, we all remember basilar artery occlusion cases. They can be severe, devastating cases in our career, but the reality is they're not that common. So, if you look at large vessel occlusions, they only account for about 10%, and if you look at all stroke patients presenting to most centers, they represent about 1% of cases. So really hard clinical trials to do just because there's thankfully not a lot of patients walking around with basilar artery occlusions, but certainly makes for challenges when you're trying to conduct randomized controlled trials on this subset of patients.  Dr Albin: Absolutely. But we did it, and I think that, like, really if, if the listeners take nothing else, it's that the field of vascular neurology is really moving forward with evidence-based, doing very rigorously controlled clinical trials, which is, I think, is what makes this field so exciting. Finally, closing out, cause we could talk all day, but we don't have all day. You know, it seems to me that more and more we are just using dual antiplatelet therapy all the time. And maybe that is, uh, a little bit of a hyperbole, cause I don't think it's all the time, but let's walk through— when is there good evidence for dual antiplatelet therapy?  Dr Leon-Guerrero: Yeah. So, there's strong evidence for early initiation of dual antiplatelet therapy or DAPT in patients with minor stroke or high-risk TIAs, and it's been studied using both clopidogrel as an add-on to aspirin and ticagrelor. Both seem like they're viable options in patients. I think one of the key things is the duration of therapy. So, in these cases with minor stroke and high-risk TIAs, we really should be confining the treatment of early DAPT for 21 days. The risk profile changes, so the risk of recurrent stroke starts to decline with time, and that risk of hemorrhage complications increases with time. And so that sweet spot of 21 days, or even some centers will do 30 days for just practical purposes, you know, really is what we should be doing in most of those cases. Other instances where DAPT can be considered, is in patients with intracranial atherosclerosis that's symptomatic, extrapolating from the SAMMPRIS trial that in the, in the medical management arm alone, used dual antiplatelet therapy with aspirin and clopidogrel for up to 90 days. So, you'll see that as well in clinical practice. Some people will opt for a 90-day duration for those patients with symptomatic intracranial atherosclerosis and stroke.  Dr Albin: Just so I emphasize, this is not set it and forget it. You can stay on DAPT forever. It is you're going to have a definitive time course, 21 days, 90 days. We have directed instructions where we're doing more benefit than harm because of that risk of hemorrhage.  Dr Leon-Guerrero: That's correct. In most cases, we really should be confining the duration of DAPT either to 21 days or 90 days. This is a challenging clinical practice. Centers really have been making an emphasis on stroke follow-up, so making sure these patients get appropriate and timely stroke follow-up to address these issues and to make sure that DAPT is discontinued if appropriate.  Dr Albin: Yeah. I love that, and I want to pull on that a little bit because you as someone who is helping direct a stroke center– A lot of this really does rely on systems of care. When we think about early lysis decisions or mechanical thrombectomy, it's how do we get the patient to one of those capable centers as quickly as possible? And then on the back end, when you're discharging a patient, how do you make sure that they are getting follow-up, making sure that they're getting their Holter monitor if they need it? You know, all the stuff that goes into kind of figuring out, why did the stroke happen? What are some of the things that you, in your role, are really excited about, that will move the needle over the next five or 10 years?  Dr Leon-Guerrero: Yeah. I think a lot of centers are doing it just like we're doing it. It really has to be a team-based approach, and you really want to reach the patient where they are in terms of the continuum of care. And so making sure if it's the in the field that you've reached out to your EMS and first responders to make sure they understand triage protocols to get patients where they need to be, to get the acute treatments that they need for the type of stroke that they're presenting with, to the actual centers that you work at, making sure your whole team, nurses, emergency physicians, APPs that are involved in care are all aware of the stroke protocols and how we're selecting these patients, making sure that your imaging protocols are up to date, and so that it's seamless when patients come in, that we're not adding on perfusion if we should have gotten that up front– We already know, have made decisions before that patient gets there. And then thinking about the patient after that hospital stay, I think, is critical. We really want to reduce their risk of recurrence, making sure that we're leveraging transitions of care, getting those patients seen in our stroke clinics for follow-up, and then make sure we're passing that baton to the long term. All of their long-term comorbidities that may be increasing their risk of stroke are managed and reduced as best as possible.  Dr Albin: From the Continuum journal to the continuum of stroke care.  Dr Leon-Guerrero: That's right.  Dr Albin: I mean, we have it all. I think that that really is so important. I'll just close with what's one thing that is your favorite part about being a vascular neurologist?  Dr Leon-Guerrero: I think it's what attracted to me to this field. As a medical student at that time, all we had was intravenous thrombolysis, and there was so much promise. There was so much promise that there was going to be widespread advancements in acute stroke, and here we are. There's been a tremendous amount of advancements and improvements for patients. I'm really excited to see what unfolds in the next few years, and I'm really excited that we've been able to increase the number of patients we're able to treat with acute ischemic stroke. I hope that we continue to expand the time window, the inclusion criteria, all of those things that we can treat more stroke patients effectively.  Dr Albin: It is really a very exciting time to be a vascular neurologist. Again, today, I've been interviewing Dr. Christopher Leon-Guerrero about his article on Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke. This article appears in the April 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues, and thank you again, Dr. Leon Guerrero and our listeners for joining today.  Dr Leon-Guerrero: Thanks for having me.  Dr Monteith: This is Dr. Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.In this Mind Moments episode, Grace Gombolay, MD, associate professor of pediatrics at Emory University School of Medicine and director of the Pediatric Neuroimmunology and Multiple Sclerosis Program at Children's Healthcare of Atlanta, joins Varun Kannan, MD, assistant professor of pediatrics in the Department of Neurology at Emory University School of Medicine and Children's Healthcare of Atlanta, for a discussion on acute disseminated encephalomyelitis (ADEM), a rare inflammatory demyelinating syndrome that remains an important diagnostic consideration in pediatric neuroimmunology. The conversation provides a practical overview of how clinicians should recognize ADEM, distinguish it from conditions such as multiple sclerosis, MOG antibody-associated disease (MOGAD), and neuromyelitis optica spectrum disorder (NMOSD), and approach treatment in the absence of FDA-approved therapies. Gombolay and Kannan review the clinical and radiographic hallmarks of ADEM, the role of MRI and antibody testing in the diagnostic workup, and current treatment strategies involving corticosteroids, IVIG, and plasma exchange. They also discuss long-term outcomes, the evolving relationship between ADEM and MOGAD, emerging biomarkers such as neurofilament light chain and cytokine profiling, and common misconceptions that can complicate diagnosis and management in clinical practice. Looking for more Multiple sclerosis & demyelinating disorders discussion? Check out the NeurologyLive® Multiple sclerosis & demyelinating disorders clinical focus page.Episode Breakdown: 1:15 – Recognizing the clinical and imaging features of ADEM 3:30 – Distinguishing ADEM from MS, MOGAD, and NMOSD 7:20 – Current treatment approaches and management strategies 10:10 – Neurology News Network  12:40 – Long-term outcomes and monitoring after recovery 15:55 – Emerging biomarkers and improving diagnostic precision 19:10 – Preventing future attacks and reducing relapse risk 21:10 – Remaining research gaps and unanswered questions in ADEM The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here: FDA Allows AMT-130 Huntington Disease Data to Support Planned BLA Submission Under Accelerated Approval Pathway Teva Submits NDA for Ecopipam, Potential First New Tourette Syndrome Treatment in Over a Decade FDA and EMA Accepts Regulatory Applications for Cemdisiran in Generalized Myasthenia Gravis Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.

This CEO Wants To Help Your Nerves Heal Faster. Meet Adam Rogers CEO NervGen – NGEN GuestAdam Rogers, MD, Chair, President & Chief Executive Officer at NervGenAdam's BIO: Adam H. Rogers, MD, is the President and Chief Executive Officer of NervGen Pharma and has served as Chairman of the Company's Board of Directors since July 2025. Dr. Rogers has more than fifteen years of experience advancing novel therapies for diseases with significant unmet medical need. He is the Principal of Boston-based PFP Biosciences Holdings and previously co-founded Hemera Biosciences in 2010, a clinical-stage biotechnology company developing a one-time investigational gene therapy administered via outpatient intravitreal injection to preserve vision in patients with geographic atrophy, a late-stage and severe form of age-related macular degeneration. He served as Hemera's Chief Executive Officer from 2017 until December 2020, when the rights to its lead program were acquired by Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson. Earlier in his career, Dr. Rogers served as an Assistant Professor of Ophthalmology at the New England Eye Center at Tufts Medical Center and has authored numerous peer-reviewed publications. Dr. Rogers is a board-certified ophthalmologist specializing in diseases and surgery of the retina and vitreous and holds an MD from Emory University School of Medicine.Company Bio NervGen Pharma (NASDAQ: NGEN) is a clinical-stage biopharmaceutical company developing first-in-class neuroreparative therapeutics for spinal cord injury (SCI) and other neurotraumatic and neurologic conditions. The Company's mission is to transform the lives of individuals living with SCI by enabling the nervous system to repair itself. NervGen's lead therapeutic candidate, NVG-291, is a subcutaneously administered, neuroreparative peptide designed to target the inhibitory CSPG-PTPσ pathway. NVG-291 is the first pharmacologic candidate to improve function, independence, and quality of life in chronic tetraplegia, as demonstrated in the Phase 1b/2a CONNECT SCI study. NVG-291 has received Fast Track designation from the FDA and Orphan Drug designation from the European Medicines Agency for the treatment of SCI. Through NVG-291 and the Company's next-generation candidate, NVG-300, NervGen is pursuing a pharmacologic approach to transform the treatment paradigm for neurotraumatic and neurologic conditions with significant unmet medical need. For more information, visit www.nervgen.com and follow NervGen on X and LinkedIn.

Host: Steve Jackson, PharmD Guest: Nisha Joseph, MD This is a non-certified educational series produced and controlled by ReachMD. As BCMA-directed therapies move into earlier lines of care, more patients with relapsed and refractory (R/R) multiple myeloma are entering a treatment space with limited consensus on optimal sequencing strategies. In this conversation with Dr. Steve Jackson, Dr. Nisha Joseph explores how disease biology, immune exhaustion, prior treatment response, and patient-specific factors can guide therapy selection in this population. She's an Associate Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine in Atlanta.

In episode 79 of Going anti-Viral, we represent a panel discussion from June 9, 2026, as part of the IAS–USA Dialogue series Emerging Infections and Health Threats. This Dialogue is a must listen as our distinguished panel of infectious disease experts dives deep into some of the most pressing public health challenges facing the world today. Moderated by Carlos del Rio, MD, a Distinguished Professor of Medicine in the Division of Infectious Diseases at Emory University School of Medicine, this Dialogue brings together world-class experts Yvonne Maldonado, MD of Stanford University, and Peter Chin-Hong, MD, of the University of California San Francisco. The panel discusses the impact of the World Cup on public health as well as providing updates on current health threats including hantavirus, Ebola, measles, alpha-gal syndrome, and influenza. The panel also provides an update on alpha-gal syndrome and tick-borne diseases, as well as a discussion about an effort by Google to control diseases spread by mosquitoes. Finally, the panelists discuss the risk of the New World screwworm fly to livestock and humans, an outbreak of Campylobacter from the consumption of raw milk, and the impact of the World Cup on influenza in the US.0:00 – Introduction 1:32 – Impact of the World Cup travel on public health7:10 – Lessons learned from the hantavirus outbreak 13:42 – Status of Ebola outbreak, treatment options, and vaccine development25:18 – Update on measles in the US and public health response37:22 – Overview of alpha-gal syndrome and tick-borne diseases42:20 – Update on the Google Debug project45:31 – Risk of the New World screwworm fly to livestock and humans 47:42 – Outbreak of Campylobacter from the consumption of raw milk52:59 – Overview of influenza season in southern hemisphere and risk to the US57:46 – Closing remarks __________________________________________________Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections.Going anti-Viral's host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences. Email podcast@iasusa.org to send feedback, show suggestions, or questions to be answered on a later episode.Follow Going anti-Viral on: Apple Podcasts YouTubeXFacebookInstagram...

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Orforglipron for maintenance of body weight reduction  - Nature Medicine2026. Discussion by:Guest:Joe Gonella, MD Resident - Abington Family Medicine Residency Program Jefferson Health2. Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN) Lancet 2026.  Discussion by: Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington3. Survival and Recurrence with GLP-1 Receptor Agonists in Breast Cancer" – JAMA Network Open Discussion by:Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington4. In Vivo Base Editing of PCSK9 with VERVE-102 for Hypercholesterolemia.   NEJM 2026 Discussion by:Guest:Alex Sauer, MD Resident - Abington Family Medicine Residency ProgramJefferson HealthMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit  http://naceonline.com to engage in more live and on demand CME/CE content.

Welcome to Fertility & Sterility Roundtable, hosted by Dr. Emily Barnard and Dr. Ben Peipert! Each week, we will host a discussion with the authors of "Views and Reviews" and "Fertile Battle" articles published in a recent issue of Fertility & Sterility.  Today, we will be discussing the Fertile Battle episode from the April 2026 edition of Fertility and Sterility entitled "Is Concurrent Gestational Surrogacy an Ethical Practice?" Concurrent surrogacy involves two gestational carriers being engaged simultaneously—or whose pregnancies overlap—to allow a single intended parent or couple to have children born without the usual spacing between births  Dr. Michelle Bayefsky is a second year Reproductive Endocrinology and Infertility fellow at the Icahn School of Medicine at Mount Sinai. She has written a book and more than 30 peer-reviewed papers on issues related to reproductive ethics and fertility preservation. She is currently a member of the ASRM Ethics Committee. For the purposes of this discussion, Dr. Bayefsky authored the Pro side of the argument that concurrent gestational surrogacy is an ethical practice.  Dr. Caroline Violette is a second year Reproductive Endocrinology & Infertility Fellow at Brown University. Prior to fellowship, Dr. Violette obtained her medical degree from Emory University School of Medicine and completed her residency in Obstetrics and Gynecology at the University of Southern California. Her research interests include oncofertility and addressing healthcare disparities related to access to fertility treatment in the United States. For the purposes of this discussion, Dr. Violette authored the "con" side of the argument that these concurrent surrogacy arrangements are unethical.  Dr. Arthur Caplan is a Professor and founding head of the Division of Medical Ethics at NYU School of Medicine in New York City. Dr. Caplan has served on a number of national and international committees, including chair of the Advisory Committee to the United Nations on Human Cloning, a member of the advisory committee to the International Olympic Committee on genetics and gene therapy, and co-director of the Joint Council of Europe/United Nations Study on Trafficking in Organs and Body Parts. He is the author or editor of thirty-five books and over 890 papers in peer reviewed journals. Dr. Caplan authored the pro side of the argument.  Read the Fertile Battle from Volume 125, Issue 4 p598-604 in the April 2026 issue View Fertility and Sterility at https://www.fertstert.org/  

Kate Mihevc Edwards, PT, DPT, OCS, physical therapist and board-certified orthopedic specialist who practices running medicine.  She has over 16+ years of experience working with high performers, CEOs, runners and endurance athletes of all levels, from recreational athletes to Olympians. She is the founder of Precision Performance Running Medicine Clinic in Atlanta, GA, RUNsource app.And co-host of the Interdisciplinary Case MIlesPodcast. She is an integral part of the multidisciplinary team supporting Atlanta Track ClubElite. Dr. Edwards has served as adjunct faculty at Emory University School of Medicine and is a published author and speaker, contributing extensively to education, research and the advancement of sports medicine for runners.  #drdanamzallag, #drdanpodcast, #Happinessjourneywithdrdan,#ddanmotivation, #inspiringinterviews, #drdancbt, #drdantherapy,#drdancoaching, #drdanhappiness,  

In this special EMS One-Stop update, Rob Lawrence is joined by returning guest Dr. Alex Isakov to break down the rapidly developing Andes Hantavirus outbreak linked to the expedition cruise ship MV Hondius. What began as a handful of unexplained respiratory illnesses aboard a South Atlantic voyage has evolved into an internationally monitored infectious disease event involving multiple countries, quarantine operations, public health investigations and the repatriation of exposed passengers to specialized containment facilities in the United States. | MORE: Hantavirus outbreak aboard cruise ship sends Americans to biocontainment quarantine units Dr. Isakov is professor of emergency medicine at Emory University School of Medicine and executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR). He also serves as EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC), where he helps lead national preparedness efforts for high-consequence infectious diseases. In the episode, he explains how Andes Hantavirus differs from other hantaviruses already present in North America because it is capable of person-to-person transmission in limited circumstances. The discussion covers transmission dynamics, incubation periods, PPE recommendations, public health monitoring and why experts continue to assess the overall public risk as low. Listeners are also directed toward the excellent educational resource hub on preparedness and response available through NETEC Hantavirus Resources. Episode timeline 00:00 – Introduction to the Special Edition. Rob Lawrence introduces the emergency update format and welcomes Dr. Alex Isakov to discuss the emerging Andes Hantavirus outbreak. 00:50 – Understanding hantaviruses. Dr. Isakov explains the difference between common North American hantaviruses and Andes Virus, emphasizing the rare person-to-person transmission capability. 03:13 – The cruise ship incident. Discussion of the outbreak aboard the MV Hondius, including onboard transmission concerns, severe illness development and international evacuation efforts. 05:16 – U.S. monitoring and quarantine. Review of quarantine operations in Nebraska and ongoing public health monitoring of exposed American passengers. 07:21 – Incubation and EMS risk assessment. Dr. Isakov outlines the prolonged incubation period and explains why frontline EMS encounters remain unlikely. 11:17 – PPE guidance for EMS personnel. Specific PPE recommendations are reviewed, including standard, contact and airborne precautions with eye protection. 13:17 – Looking ahead to World Cup 2026. The discussion turns to international travel, mass gatherings and why clinicians must maintain awareness of rare infectious diseases tied to travel history. 14:32 – EMS and public health resources. Dr. Isakov directs listeners to CDC, WHO and NETEC resources for ongoing guidance and EMS-specific updates.

In this North America episode of the World PICU Awareness Week 2026 podcast, leading experts explore how leadership directly influences caregiver wellbeing and burnout in pediatric intensive care. Through practical examples and evidence-based insights, the discussion highlights the importance of listening to teams, addressing system-level challenges, and fostering a culture where wellbeing is embedded into everyday practice. From leadership behaviors to institutional support, this episode emphasizes a clear message: sustainable PICU care starts with how we lead. HOST Leah Harris Professor and Chair, Department of Pediatrics Dell Medical School at the University of Texas at Austin - Dell Children's Hospital GUEST Asha N Shenoi Professor, Associate Dean University of Kentucky Will Border Chief Physician Wellness Officer, Director of Noninvasive Cardiac Imaging Children's Healthcare of Atlanta and Emory University School of Medicine Wendy Quiroz Nasser Pediatric Nurse Practitioner Baylor College of Medicine (BCM) | Texas Children's Hospital DATE Initial publication date: May 7, 2026 TRANSCRIPTS English - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript Spanish - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=7 French - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=3 Portuguese - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=6 Italian - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=5 German - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=4 Arabic - https://cdn.bfldr.com/D6LGWP8S/as/jcbg3x5x35f4sb3wct2kx89w/North_America_26_transcript?position=2 Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes Results From the VESALIUS-CV Trial. JAMA 2026. Discussion by:Guest:Jessica Stieritz, MDResident - Abington Family Medicine Residency Program Jefferson Health2. A treat-to-target strategy versus symptom-driven management of gout in the Netherlands (GO TEST Overture): a multicentre, open-label, pragmatic, superiority, randomized controlled trial. Lancet Rheumatology 2026. Discussion by:Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington3. Oral Nirmatrelvir–Ritonavir for Covid-19 in Higher-Risk Outpatients. NEJM 2026 Discussion by: Guest:Steven Leonard, MD Resident - Abington Family Medicine Residency Program Jefferson HealthMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit  http://naceonline.com to engage in more live and on demand CME/CE content.

Breast Cancer Briefing, hosted by Sara Nunnery, MD, MSCI, a breast medical oncologist and the director of Breast Cancer Research at Tennessee Oncology in Nashville, is a podcast series that breaks down the latest news in breast cancer research, one conversation at a time.In part 2 of this conversation, filmed live onsite at the 43rd Annual Miami Breast Cancer Conference, Dr Nunnery sat down with Neil M. Iyengar, MD, an associate professor and co-director of Breast Medical Oncology in the Department of Hematology and Medical Oncology at the Emory University School of Medicine, as well as the director of Survivorship Services at the Winship Cancer Institute of Emory University in Atlanta, Georgia.Their conversation highlighted the evolving integration of GLP-1 agonists into the breast cancer treatment armamentarium.

This mini-series on Behind the Knife delves into the technical aspects of the Operative Standards for Cancer Surgery, developed through the American College of Surgeons Cancer Research Program and Cancer Surgery Standards Program. This episode highlights sentinel lymph node biopsy for breast cancer.Hosts:- Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncology fellow at MD Anderson Cancer Center.- Lauren Postlewait, MD, FACS, is an Associate Professor of Surgery at Emory University School of Medicine and is the Medical Director of the Breast Center at Grady Memorial Hospital in Atlanta, GA.- Chantal Reyna, MD, FACS (@kprgrl3) is a Breast surgical oncologist at Loyola University Medical Center in Chicago, IL and serves as the oncology clinical lead for the breast service line.Guest:- Susan E. Pories, MD, FACS (@SusanPoriesMD) is a professor of surgery, vice chair for quality and safety, and director of the Rutger's Breast Center at the University hospital. Learning Objectives: -       Understand the definition and identification of axillary sentinel lymph node. -       Understand the technique for injecting tracer or dye to perform sentinel lymph node biopsy. -       Understand the importance of preincision drainage evaluation and transcutaneous localization.-       Understand techniques to minimize seroma formation.Links to Papers Referenced in this EpisodeOperative Standards for Cancer Surgery, Volume 1: Breast, Lung, Pancreas, Colonhttps://www.facs.org/quality-programs/cancer-programs/cancer-surgery-standards-program/operative-standards-for-cancer-surgery/purchase/Kindle edition:https://www.amazon.com/Operative-Standards-Cancer-Surgery-Section-ebook/dp/B07MWSNFSBSentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial Lancet Oncol. 2010 Oct;11(10):927-33.https://pubmed.ncbi.nlm.nih.gov/20863759/Improved Axillary Evaluation Following Neoadjuvant Therapy for Patients With Node-Positive Breast Cancer Using Selective Evaluation of Clipped Nodes: Implementation of Targeted Axillary Dissection J Clin Oncol. 2016 Apr 1;34(10):1072-8.https://pubmed.ncbi.nlm.nih.gov/26811528/The false-negative rate of sentinel node biopsy in patients with breast cancer: a meta-analysis World J Surg. 2012 Sep;36(9):2239-51. https://pubmed.ncbi.nlm.nih.gov/22569745/Effect of lymphoscintigraphy drainage patterns on sentinel lymph node biopsy in patients with breast cancer Am J Surg. 2005 Oct;190(4):557-62.https://pubmed.ncbi.nlm.nih.gov/16164919/Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial JAMA Oncol. 2023 Nov 1;9(11):1557-1564.https://pubmed.ncbi.nlm.nih.gov/37733364/Choosing Wisely GuidelinesSociety of Surgical Oncology. Released 2016 July 12; last updated 2020 November 13. Choosing Wisely: Five Things Physicians and Patients Should Question.https://surgonc.org/wp-content/uploads/2020/11/SSO-5things-List_2020-Updates-11-2020.pdfPlease visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewOral Board Simulator: https://app.behindtheknife.org/oral-board-simulatorTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Forty million people use ChatGPT for health-related questions every day, making it one of the most widely used tools for health information in the world. So what is their team doing to maximize impact and minimize harm? For one, they've brought in hundreds of physicians globally to continuously review outputs and shape how the models respond across different scenarios, literacy levels, and edge cases. Second, they've hired my Rock Health co-founder, Nate Gross, MD, as their VP of Health.In this full-circle episode, I sit down with Nate, who also co-founded Doximity (DOCS) and knows a thing or two about building in digital health. We discuss the astonishing speed of AI progress, how models are trained for safety and accuracy, and what this technological evolution means for every part of the healthcare system.Key topics:How ChatGPT is becoming a 24/7 front door for health questions, and whether it is replacing Dr. Google or starting to compete with the healthcare system itselfHow OpenAI is trying to reduce hallucinations, avoid sycophantic behavior, and build guardrails for sensitive use cases like mental healthOpenAI's goals to “raise the floor, sweep the floor, and raise the ceiling” with new product launches like ChatGPT for Clinicians and GPT-RosalindHow Nate thinks about the AI race and what winning in healthcare actually requiresWhere startups should focus their efforts now that specialized products are launching for clinicians and life sciencesThe single hardest problem in healthcare that AI, according to Nate, probably won't fix anytime soon— About our guest:Dr. Nate Gross is the VP of Health at OpenAI. He previously co-founded Doximity and Rock Health. He graduated from the Emory University School of Medicine with an MD, Harvard Business School with an MBA, and Claremont McKenna College with a BA in Government. He serves as affiliated faculty for the Clinical Informatics Fellowship at Stanford.— Show notes:ChatGPT for CliniciansChatGPT for Health (for patients)OpenAI for HealthcareGPT-Rosalind—

The "Community Meets Clinic" podcast series introduces clinicians and healthcare personnel specializing in rare neuroimmune disorders. In this episode hosted by Krissy Dilger of SRNA, we met Dr. Grace Gombolay and Dr. Varun Kannan, both from Emory University and Children's Healthcare of Atlanta, designated Centers of Excellence in Rare Neuroimmune Disorders. Dr. Kannan discussed learning alongside families as conditions like MOG antibody disease emerged clinically and his focus on tailoring treatment and supporting clinical trials in a field with few approved therapies [03:37]. Dr. Gombolay outlined her research on biomarker development, a Children's biobank, advanced MRI collaborations, and participation in the Network of Pediatric MS Centers covering disorders such as MOGAD, NMOSD, optic neuritis, ADEM, and TM [06:36]. They described their multidisciplinary clinic team, highlighted home infusions and telemedicine to reduce burden, and shared personal self-care strategies [10:22]. Dr. Gombolay and Dr. Kannan expressed hope for more trials, remyelination, prevention, and earlier diagnosis aided by AI prompts [20:43].You can view Dr. Grace Gombolay's medical profile here:https://www.choa.org/doctors/grace-gombolayYou can view Dr. Varun Kannan's medical profile here:https://www.choa.org/doctors/varun-kannanGrace Gombolay, MD, MSc, FAAN is an Associate Professor at Emory University and Director of the Pediatric Neuroimmunology and Multiple Sclerosis Clinic at Children's Healthcare of Atlanta. Her research interest involves biomarker development in pediatric neuroinflammatory diseases including autoimmune encephalitis, multiple sclerosis, MOGAD, and NMOSD.Varun Kannan, MD graduated from Emory University School of Medicine in 2017. He then completed child neurology residency in 2022, followed by pediatric neuroimmunology and multiple sclerosis fellowship at Baylor College of Medicine and Texas Children's Hospital in 2023. He returned to Emory and Children's Healthcare of Atlanta in 2023, where he has worked closely with Dr. Grace Gombolay in the neuroimmunology program. He is interested in clinical research regarding severe/relapsing forms of rare neuroimmune disorders including autoimmune encephalitis and MOGAD. He is currently involved in multiple upcoming phase 3 clinical trials exploring new disease modifying treatments for pediatric rare neuroimmune disorders. He is also passionate about medical education and is currently one of the Associate Program Directors for the Emory child neurology residency.00:00 Welcome01:56 Dr. Grace Gombolay's Journey03:37 Dr. Varun Kannan's Path05:06 Kannan's Research Focus06:36 Biomarkers and Biobank10:22 Clinic Team and Care13:44 Self Care and Balance16:15 Children's Healthcare of Atlanta20:43 Hopeful Future Ahead24:49 Closing

Many pediatricians care for underserved populations, and have long recognized the inextricable links between the well-being of families and the outcomes for their children.  Dr. Terri McFadden, professor of pediatrics at Emory University School of Medicine, medical director for Reach Out and Read Georgia, and president-elect for the American Academy of Pediatrics, joins us to talk about a new book which serves as a valuable 'how-to' on applying a two-generation approach to serving children and their families in an integrated manner — and offers primary care strategies for promoting optimal health and better developmental outcomes for children living in low-resourced environments.

Dr Matthew Milowsky from the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina, comments on real patient cases of metastatic urothelial bladder cancer presented by Dr Jacqueline T Brown from the Emory University School of Medicine in Atlanta, Georgia, and Dr Nazli Dizman from The University of Texas MD Anderson Cancer Center in Houston.CME information and select publications here.

In this episode we discuss with Rabbi Dr. Michael J. Broyde the evolution, especially in the past half century, of communal standards for tzniut in dress, particularly among women; whether laws of tzniut over the millennia have been objective and fixed, or subject within bounds to changing societal norms; possible U.S. societal changes that might affect tzniut in the Orthodox community; the positive benefits of increasing diversity in the Orthodox community, especially in the U.S.; Haredi shifting values relating to learning and working, Rabbi Broyde is a professor of law at Emory University School of Law and a leading scholar at the intersection of law, religion, and Jewish ethics. He is also Berman Projects Director and senior fellow at Emory's Center for the Study of Law and Religion, and teached Jewish Law at Columbia University. His most recent book, "Splitting Hairs," which we discuss in some detail, is a rigorously argued and refreshingly candid halakhic study of women's hair covering and tzniut more broadly. It is available at Amazon … click HERE. Ordained at Yeshiva University, he served for many years as a dayan on the Beth Din of America and was the founding rabbi of Young Israel of Toco Hills in Atlanta. He holds a JD from New York University School of Law and has authored hundreds of articles and numerous books on Jewish law, family law, bioethics, religious freedom, and comparative religious law. In recent years, he has written on such topics as religious arbitration, kidney transplants and vouchers, Jewish law and modesty, and a modern explication of the Book of Genesis. Rabbi Broyde can be reached at mbroyde@emory.edu, and he welcomes emails. A Times of Israel interview about his new book is available at this LINK.

With the launch of a new journal, the American Diabetes Association (ADA) is also launching a brand new podcast: The Points of CARE, the official podcast of Diabetes, Obesity, and CardioMetabolic CARE. Join hosts Richard Beaser, MD and Jane Reusch, MD, as they highlight key research findings, clinical implications, and emerging themes across diabetes, obesity, and cardiometabolic health through interviews with journal authors and subject-matter experts. 2:30 After introducing his co-host, Jane Reusch, Beaser speaks with James Gavin, MD, PhD, of the Emory University School of Medicine and Naunihal Virdi, MD, MBA, FACP, of Abbott Diabetes Care. They are the authors of "Advancing Type 2 Diabetes Care: The Role of Continuous Glucose Monitoring in Noninsulin-Treated Patients," available for free at doi.org/10.2337/doc25-0058. 13:00 Our hosts are joined by Ivy Shi, MD and Dhruv Kazi, MD, MSc, MS, both of Beth Israel Deaconess Medical Center. They are the authors of "GLP-1 RA Eligibility in Reproductive-Age U.S. Women," available in the March/April issue of Diabetes, Obesity, and CardioMetabolic CARE. 19:40 Next, Eva Tseng, MD, MPH, associate professor of medicine at Johns Hopkins School of Medicine joins the podcast. Her article, "START Diabetes Prevention: A Multilevel Strategy for Primary Care Clinics," is available in the March/April issue of Diabetes, Obesity, and CardioMetabolic CARE. To learn more about Diabetes, Obesity, and CardioMetabolic CARE please visit diabetesjournals.org/docm-care. Thank you for listening, and don't forget to subscribe.

Novel MRI biomarkers, including cortical lesions, the central vein sign, and paramagnetic rim lesions, are highly specific for MS and can aid diagnosis in select clinical scenarios, particularly early in the disease course or in atypical presentations. When used with appropriate MRI sequences, these markers can improve diagnostic sensitivity while helping prevent misdiagnosis. In this episode, Casey Albin, MD, speaks with Jiwon Oh, MD, PhD, FRCPC, FAAN, author of the article "Diagnostic Neuroimaging Biomarkers for Multiple Sclerosis" in the Continuum® April 2026 Multiple Sclerosis and Related Disorders issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Oh is the medical director of the Barlo Multiple Sclerosis Program at St. Michael's Hospital and an associate professor at the University of Toronto in Toronto, Ontario, Canada. Additional Resources Read the article: Diagnostic Neuroimaging Biomarkers for Multiple Sclerosis Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Full episode transcript available here Dr Albin: Spend any time in a neurology conference, and you are certain to hear about the new central vein sign, which, as I learn, is not actually all that new. But have you heard about cortical lesions or these paramagnetic rim lesions? Because today I have the privilege of talking to Dr Jiwon Oh about her article, and we're going to unpack all these new biomarkers in MS. Dr Jones: This is Dr Lyell Jones, editor in chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Albin: Hello, this is Dr Casey Albin. Today I'm interviewing Dr Jiwon Oh about her article on diagnostic neuroimaging biomarkers for Multiple Sclerosis, which appears in the April 2026 Continuum issue on multiple sclerosis. Welcome to the podcast. Thank you so much for being here. I'd love to start by having you introduce yourself to our listeners.  Dr Oh: Thanks, Casey. Hi, everybody. My name is Jiwon Oh and I'm a neurologist, mainly an MS specialist at Saint Michael's Hospital at the University of Toronto, and I'm the medical director of our MS program. Dr Albin: And you have written a really fantastic article that dives deep into some of the nitty gritty about these new diagnostic biomarkers that we find on the MRI that we're getting for our patients with multiple sclerosis. And I think we are going to get into a lot of that nitty gritty. How do we look for them? How do they improve our diagnostic specificity? This is really come a long way in shaping the advances for multiple sclerosis. And I'd kind of like to just start with the big picture. Like why do we need these more specific biomarkers?  Dr Oh: This set of diagnostic criteria in MS, it's actually a huge change in the field, and particularly for people like me who are really interested in developing new MRI measures, we're really, really excited because it's actually the first time since MRI was officially incorporated into the MS Diagnostic criteria, which was way back in 2001. It's the first time that we've actually been able to get newer, more advanced imaging measures beyond just simply detecting, new T2 lesions in the MS diagnostic criteria. So, it's a big moment in the field, and many of us are really excited about it in terms of why we need some of these newer, more specific imaging measures. Well, you know, diagnostic criteria always evolve over time for any disease state, and MS is one that we've recognized over the years. By the time someone actually presents with typical clinical symptoms and has diagnosed, whatever has been happening from a patho-biological standpoint has been happening probably for almost 5 to 10 years before that individual actually presents. And so, because of this recognition in the field and the fact that we're recognizing how important it is to first diagnose MS and then treat MS earlier and earlier, because we know that early treatment helps prevent more clinical outcomes. Diagnostic criteria over time have become much more permissive, meaning that we're doing everything that we can to try to facilitate a diagnosis of MS when we know that someone biologically has MS. But the problem with making diagnostic criteria more permissive, and it's obviously a good thing because you want to capture as many people with MS as early on as possible. The problem with making it permissive is there is this terrible risk of misdiagnosis. As clinicians, we all think we never make mistakes. But it turns out when you actually do studies, you do. And even at MS specialty centers, when studies have been done, 10% to 20% of people with MS are misdiagnosed. So, this is exactly why we need in diagnostic criteria that really help to facilitate a diagnosis. We need things that help us prevent misdiagnosis as well. And these are these specific imaging measures that have now been incorporated into the diagnostic criteria in many settings that will help to facilitate a diagnosis. But the really big perk is if you use them, you can help to prevent misdiagnosis as well.  Dr Albin: Yeah, that really shone through in your article that this was such a big step in towards being more specific about who were diagnosing. Also capturing more people, right? Trying to get those people that we, we don't want to miss because of all the things you say, you know, that allows them to accumulate more disability, have worse outcomes. Early diagnosis is so important. But I really did take away from your article just how critical these are and sharping our diagnostic acumen. And so just to jump right in, and you describe these three new biomarkers, these cortical lesions the central vein sign and paramagnetic rim lesions. And so just to kick things off let's start with cortical lesions I sort of conceptualize multiple sclerosis a disease of white matter. So, what's going on here?  Dr Oh: Yes. MS classically has always been described as a white matter disease. But it turns out when you look at brain and spinal cord tissue, as well as when you use kind of better sequences to actually look for lesions in the gray matter, it actually turns out there's a ton of lesions in the gray matter as well. And in fact, what's interesting is that regardless of whether it's the cortex or the deep gray matter, it's lesions within these areas that seem to have the highest relevance for clinical disability in MS. So, all this to say, of course, MS is a lesion that does affect white matter, but it also affects gray matter a lot. And maybe pathology within the gray matter is even more relevant to clinical disability. So, this is why we're really interested in being able to develop methods using MRI to more accurately visualize the gray matter, particularly the cortex, as well as deep gray matter structures like the thalamus. I should add the caveat that cortical lesions were actually included in the 2017 diagnostic criteria revisions, but they were included together with juxtacortical lesions, which are a typical area that MS lesions form. And so, this imaging measure, despite the fact that it is relatively novel and we consider it advanced, it hasn't been used that much only because it's not that easy to detect lesions within the cortex. And reasons for this include that you usually need higher field magnet platforms. And so, the typical clinical MRI scanners that are available kind of widely, regardless of whether you're at an academic center or a community center, are 1.5 Tesla magnets. And cortical lesions are actually really difficult to detect on those typical scanners. But when you get to like, say, three Tesla or seven Tesla, they're a lot easier to detect. But obviously that's a big hindrance to widespread use. And then you actually need very specialized sequences to adequately visualize cortical lesions. And these are not sequences that are usually collected for clinical purposes. So, it kind of requires convincing your radiologists that you need this additional sequence. And then it actually takes a lot of time and training to be able to adequately, accurately detect cortical lesions. So, despite the fact that it's actually very useful when you do have the appropriate MRI sequences and scanners to detect cortical lesions, even though they were incorporated into the 2017 criteria outside of specialty centers, they're not actually widely used. But when you do have the appropriate sequences, cortical lesions are actually pretty specific for MS. So, very helpful for a diagnosis in certain settings. But there's all these practical limitations that have really limited its widespread use. Dr Albin: That is a beautiful summary. So, it sounds like once we kind of get up to speed in terms of like the protocols for this, having the magnet strength for this, this will be really a game changer in terms of increasing the specificity and also maybe finding things that impact patient's clinical presentation and therefore quite meaningful. But it sounds like for most of us, this is probably not something that they're going to be adopting right away. Is that a fair assessment?  Dr Oh: Yes. And you know, they were included in the last diagnostic criteria revisions. And it really hasn't changed things very much, only because of these difficulties with, you know, requiring higher field magnet strengths and these specialized sequences and then needing training to kind of figure out how you can adequately detect cortical lesions. Dr Albin: Totally. So, the other thing we've heard a lot about, and I have to say, I was in the AAN fall conference not too long ago, and this came up quite a bit, was the central vein sign and the fascination with that, because it tells us a lot about the MS pathophysiology and again, increasing that specificity. And it seems like maybe this is one that we can more easily adopt in clinical practice. So, tell our listeners about what that is, how they detect it. How many do you need to find?  Dr Oh: Sure. And so, this is one of the imaging measures I'm really excited about. So, the central vein sign heard about it recently. And probably in the last ten years particularly in the MS field we're talking about it all the time. But just wanted to emphasize that the central vein sign is not something that is new. Even back in the 1800s, when Charcot described MS lesions in these ancient textbooks, he actually very clearly described that MS lesions form around the central vein. And that makes sense, because we know that these waves of peripherally mediated inflammation somehow get through the blood-brain barrier and cause this cascade of events leading to inflammation in the brain and spinal cord, which is what MS is. But we know that B cells in T cells require veins to get into the central nervous system. And so, it's no surprise, really, that MS lesions form around veins. And so, this is something that's been known pathologically. But the reason we're so excited about it now is because we actually have good enough iron-sensitive MRI sequences that allow us to see a central vein when it is present within a white matter lesion. As a neurologist, we know that there's probably hundreds and hundreds of different things that can cause white matter lesions in the brain. But when you use an appropriate iron-sensitive sequence and you see that many of them, if not most of them, actually have visible central veins, that tells you that this person very likely has MS. And so that's why we're so excited about it, because there have been many studies done in the last ten years. In fact, so much evidence generated in the last ten years that there have been I think it's now four systematic reviews and meta analyzes. Looking at the diagnostic properties of the central vein sign. And, you know, it turns out that when you look at people with MS, most of them have a pretty high proportion of white matter lesions that have visible central veins. And there's a lot of questions about, you know, how to best use the central vein sign. But when 40% or more of the white matter lesions that you see have visible central veins, then the likelihood of a diagnosis of MS is very high. So, this is why we're so excited about it in the MS field because it's a really useful diagnostic tool. You know, again when you have appropriate ion sensitive sequences, if you see someone with white matter lesions and you see that 40% or more of them have visible central veins, this tells you that this person very likely has MS.  Dr Albin: So, Dr Oh, I hear you say, you know, 40% of the lesions. Does that mean the neuro radiologist needs to look at every single lesion and then count how many have the central veins, or is there an easier way to do this? Dr Oh: Great question. Casey, there is definitely an easier way because our neuro radiologists would not be our friends anymore if we made them look at every white matter lesion and make sure that 40% of them had the central vein sign. So, because it's so time-consuming to use that 40% threshold, there's an easier criterion that has actually made it into the diagnostic criteria. And it's called Select Six. And what this means is when you have more than ten lesions, as long as you show that six of them have a visible central vein, you just have to count six with the central vein. Then you're done. So that means you're Select Six positive or central veins nine positive. However, if you have ten or fewer lesions, as long as you show that more than 50% of them show a visible central vein, then you are select six positive, and then you're done. So, as you can see, it's a much simpler criterion to apply, and it seems to perform almost as well as that 40% threshold, which is why that is the criterion that's made it into the new diagnostic criteria.  Dr Albin: Perfect. I love that we definitely do not want to make enemies with our neuro radiology colleagues, but yet they do so much for us. So perfect. I'm glad that we can, make their jobs a little easier without losing any specificity there, or just losing a touch of specificity there. All right. If I am working with a, you know, in a center that maybe doesn't do this all the time, am I just getting a run of the mill SWI sequence? Do I need to ask my radiologist for a special sequence? Or is this just, you know, you can get it from the typical array of what our patients are getting.  Dr Oh: You know, SWI is a widely available commercial sequence that's iron-sensitive, the ones that are typically commercially available, they can detect central veins, but there actually are little tweaks that you can do to make it a little more optimal. With the recent diagnostic criteria publication, which was, led by Xavier Montalban and recently published in Lancet Neurology. There's actually a companion MRI paper that was led by Frederick Barkov and Danny Wright. And the reason I'm specifically citing those papers is in that companion MRI paper, there's a table that has kind of optimal sequence parameters that you can use even with a conventional SWI sequence, to try to best detect the central vein sign. And then there's a wide range of different iron-sensitive sequences, and SWI is one of them, but the one that seems to have emerged as most sensitive to detect the central vein sign is something called the 3D T2*-EPI sequence. But the bottom line is there's a whole bunch of different iron-sensitive sequences that you can use, little tweaks that you can do to make them optimal, to be able to visualize central veins when they're present within white matter lesions. Dr Albin: Incredible. So like partner with your neuro radiologist, there is a great sounds like a field guide almost to this. So, it makes it easy to pick up in your standard of care so that you can make sure that you are detecting them at the optimal level to see that more specific diagnostic biomarker.  Dr Oh: Yes. And you know, in contrast to what we were talking about with cortical lesions, you can actually detect central veins when you use these iron-sensitive sequences at any field magnet. So even at 1.5 Tesla, particularly when you use contrast, which is often given with the diagnostic scan anyway, you can very easily detect a central vein. So that's a huge benefit because it allows for widespread use. As long as you work with your radiologist to get the right iron-sensitive sequences in.  Dr Albin: Yeah, that's incredible. I mean, I think that it really will be practice-changing. And then the last one that I think was honestly new to me, I feel like I had heard a lot about the central vein sign, but the whole new to me term was this paramagnetic rim lesion. So, what does that tell us about the underlying biology of MS? And are there any other things that might also have this finding that we should sort of be aware of? And how specific is it?  Dr Oh: You know, the central vein sign is kind of the main, really new imaging measure that's made it into every part of the MS diagnostic criteria. And then together with that paramagnetic rim lesions or we call them PRL or pearls for short, they've made it as well, but in a much more limited way only because there's not as much evidence that has accumulated over time to support the diagnostic utility of pearls. But first of all, what are pearls? So, people in the MS field are really excited about pearls, because we know that they capture a subset of what we call chronic active lesions. So, MS lesions will form acutely and over time, some of them will become inactive. And then some of them are chronic active lesions, meaning that they have this rim of activated microglia around them. Over time, they continue to slowly expand. And it's almost like this slow burn. And the reason why we focus a lot on chronic active lesions is because we know that they're a driver of progressive disease biology and MS, meaning that in people who have progressive MS or who have pretty severe disability, global disability or cognitive disability, we know that they have a high burden of pearls. And so that's why there's so much excitement in MS about being able to image chronic active lesions. It's because we're always looking for an imaging measure that allows us to accurately predict progression or to, measure progression over time. So that's why there's so much excitement in MS about pearls. But as kind of an added bonus, it turns out pearls are also really specific for MS. And so, when you use the same iron-sensitive sequences, by the way, that's used to detect the central vein sign when you use appropriate iron‑sensitive sequence. And if you see that someone has a pearl, the likelihood of a diagnosis of MS is very high. The one exception to that is Susac syndrome, where pearls have been observed. But other than that, with many other white matter diseases like neuro rheumatology disease, NMOSD, MOGAD, you really don't see pearls. And so, this is why it's made it into the new diagnostic criteria. In contrast to the central vein sign, though, not everybody with MS has a pearl, so the sensitivity isn't as high. However, it's really, really specific in the range of, you know, 90 to 95%. So, this is why it's been added as, an imaging measure in certain settings. It can help facilitate a diagnosis. But the real utility, again, is when you use it, it helps you to prevent misdiagnosis.  Dr Albin: It's fantastic. And hearing you talk about that, this one stands out to me as a biomarker that not only helps increase our diagnostic specificity, but also may really inform if the patient has having progression despite the treatment they're on, that this could play a role in helping you say, look, there probably is something that we need to switch because we can still see this ongoing progression. Dr Oh: Yes. And especially in this new era of treatment in MS. I think, you know, MS as a field, we've been so fortunate to have so many treatments emerge over the years that mainly target relapsing disease. But we hopefully, in the next little while, in short order, I hope we'll have treatments that target these progressive disease biologies. And so, not only is it helpful as a diagnostic marker, but there's a lot of evidence accumulating, showing that it may have a lot of prognostic value and will also help guide treatment decisions, exactly as you said.  Dr Albin: It truly does sound like it's a great time to be an MS doctor there. So, so many new advances in the field. There is so much more that we can do for these patients in our limited time left. I'd love to ask you, what is it that you're most excited about now with the change in the biomarkers, the change in the treatment, what makes you really excited to be a doctor specializing in MS right now? Dr Oh: I feel like we're on the brink of a new era of treatment. I think, you know, in the last two decades, MS care has changed so dramatically. I remember, you know, way back when, as a medical student, when I did my first neurology elective, this was when the first treatments for MS were emerging. And the prognosis that we were talking to patients about at that time is like night and day compared to what we talk to them about now. But we're going to do even better in the next couple of years. And so, there's a number of new treatments that hopefully will be approved soon that, for the first time, have shown an effect in clinical trials where it seems to be decreasing progression that is independent of relapsing activity. And that's really the greatest unmet treatment need that we have. And it seems like we might have some therapies on the horizon that can actually target that aspect of progression. It's really exciting, and even more that we're going to be able to do for our patients to completely change the way, we look at and the way we treat MS in the years to come.  Dr Albin: Dr Oh, this has just been fantastic. To all of our listeners, I really want to point you to the article because obviously, as an imaging biomarker article, there are so many beautiful images. There are great examples. There are some fantastic cases that show how applying these new biomarkers can help get you to the right diagnosis. This is truly a tour de force of how imaging has really shifted the care that we provide patients with MS, and so please go and check it out. It is one that you do not want to miss. And again, today I've been interviewing Dr Jiwon Oh about her article on diagnostic neuroimaging biomarkers for multiple sclerosis, which appears in the April 2026 Continuum issue on multiple sclerosis. Thank you again, Dr Oh, this has just been such a delight.  Dr Oh: Thank you for having me on the show, Casey, and look forward to people reading the article. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Being on the caregiver side of complex, rare disease care reveals critical gaps in our healthcare system, even for two physician parents with strong connections. In this powerful follow-up episode of Succeed In Medicine, host Dr. Bradley Block welcomes back Dr. Heather Gatcombe, as she recounts her family's journey: her son's initial metabolic stroke-like episodes at age 7, the five-year path to a definitive mitochondrial disease diagnosis (including a muscle biopsy and eventual identification of a pathogenic variant), sudden heart failure at age 11 during the COVID-19 pandemic, ECMO, LVAD placement, and successful heart transplant. She openly discusses the immense challenges of hospital discharge with an LVAD when no pediatric rehab would accept him, managing tube feeds and alarms at home without adequate home health support, and the frustration of subtle symptoms like throat clearing being overlooked as a sign of heart failure. Dr. Gatcombe also reflects on moments where she felt her family wasn't fully heard, and the lasting impact of those experiences. Throughout the conversation, she shares how this journey has made her a more empathetic and effective clinician, particularly in communicating uncertainty, avoiding premature reassurance, listening to parental intuition, ensuring robust discharge planning with support services, and staying curious even when a diagnosis remains elusive. This episode offers practical lessons for all physicians on improving communication, supporting families through diagnostic uncertainty, preparing patients for safe transitions home, and the power of transparency and advocacy in rare disease care. Three Actionable Takeaways: Communicate uncertainty honestly and compassionately: When the diagnosis isn't clear yet, be transparent about what you know and don't know. Offer guidance on next steps, second opinions, and support resources rather than premature reassurance that may later need to be walked back. Prioritize discharge planning and support services: The transition from hospital to home is one of the most vulnerable periods. Ensure patients and families have home health, equipment (wheelchair, shower chair, etc.), dietician and nurse navigator follow-up, and clear instructions before discharge, especially for medically complex cases. Listen to patients and families as the experts on their own bodies: Parental intuition and lived experience matter. When a child or family member expresses concern, even if it seems outside the norm,  take it seriously, investigate, and avoid dismissing it. Follow up after adverse events when possible to maintain trust. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Heather Gatcombe is a board-certified radiation oncologist at Winship Cancer Institute of Emory University and an Assistant Professor at Emory University School of Medicine. She specializes in breast radiation oncology and serves as Vice Chair for Community and Belonging. As the mother of a child with mitochondrial disease who experienced metabolic strokes starting at age 7, progressing to heart failure and transplant, she is deeply committed to raising clinician awareness, reducing diagnostic delays, and advocating for patients and families. She serves on the Board of Trustees and the Scientific and Medical Advisory Board Clinical Training and Education Committee of the United Mitochondrial Disease Foundation (UMDF). Website: https://winshipcancer.emory.edu/profiles/gatcombe-heather.php LinkedIn: https://www.linkedin.com/in/heather-gatcombe-md-3891875 Instagram: https://www.instagram.com/heathergatcombe UMDF: https://umdf.org/about/board-trustees About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this special edition on Continuous Ketone Monitoring our host, Dr. Neil Skolnik will discuss this new technology – its promise and its application. This special episode is supported by an independent educational grant from Abbott. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Guillermo Umpierrez, M.D.,  Professor of Medicine, Division of Endocrinology, Clinical Director of the Diabetes and Metabolism Center at Emory University School of Medicine, Director of the Diabetes and Endocrinology Section and Clinical Research Unit at Grady Memorial Hospital, Atlanta, Georgia. Member of the ADA Professional Practice Recommendation Committee, and Chair of the ADA Consensus Report on Hyperglycemic Crises in Adults with Diabetes.   Reference: Hyperglycemic Crises in Adults With Diabetes: A Consensus Report. Diabetes Care 2024;47:1257–1275 | https://doi.org/10.2337/dci24-0032

Breast Cancer Briefing, hosted by Sara Nunnery, MD, MSCI, a breast medical oncologist and the director of Breast Cancer Research at Tennessee Oncology in Nashville, is a podcast series that breaks down the latest news in breast cancer research, one conversation at a time.In today's episode, filmed live onsite at the 43rd Annual Miami Breast Cancer Conference, Dr Nunnery sat down with Neil M. Iyengar, MD, an associate professor and co-director of Breast Medical Oncology in the Department of Hematology and Medical Oncology at the Emory University School of Medicine, as well as the director of Survivorship Services at the Winship Cancer Institute of Emory University in Atlanta, Georgia.Their conversation centered around lifestyle and medical interventions pertinent to breast cancer survivorship. Dr Iyengar explained that although endocrine therapies can be life-saving, they disrupt estrogen signaling, which can lead to cardiometabolic dysfunction, including increased risks for diabetes, heart disease, and bone health issues. He noted that weight gain associated with these treatments is often tied to the induction of a post-menopausal state, which disrupts energy homeostasis and promotes inflammation.A key theme of the conversation was Dr Iyengar's explanation of a "drug development paradigm" for lifestyle changes. Rather than offering generic advice, his research focuses on precision lifestyle interventions, treating diet and exercise as prescribed medical therapies with specific "doses". He highlighted that body mass index (BMI) is an insufficient tool for risk stratification, as high body fat despite a normal BMI is a significant risk factor for cancer recurrence.The discussion also covered the rising use of GLP-1 receptor agonists to manage metabolic health. These drugs replicate natural hormones to maintain glycemic balance and reduce hunger. Dr Iyengar addressed the black box warning for thyroid cancer associated with this class of drugs, noting that although the data are mixed, the protective benefits against obesity-related cancers appear to outweigh the risks. Finally, he emphasized that exercise is a critical tool for managing treatment adverse effects like fatigue, noting that although starting is difficult, the "return on investment" for patient health is immense.

In episode 73 of Going anti-Viral, we represent a panel discussion from March 26, 2026, as part of the IAS–USA Dialogue series Emerging Infections and Health Threats. This Dialogue is a must listen as our distinguished panel of infectious disease experts dives deep into some of the most pressing public health challenges facing the world today. Moderated by Carlos del Rio, MD, a Distinguished Professor of Medicine in the Division of Infectious Diseases at Emory University School of Medicine, this Dialogue brings together world-class experts Yvonne Maldonado, MD, and Peter Chin-Hong, MD. The panel discusses a recent federal court ruling regarding the Advisory Committee on Immunization Practices (ACIP) and addresses the latest news on rates of vaccination and an update on emerging viral outbreaks, including measles, influenza, COVID-19, meningitis, tuberculosis, mpox, and RSV. The panel also reflects on the implications of the lack of leadership at the CDC on public health.0:00 – Introduction 2:33 – March 2026 federal court ruling pausing the work of the ACIP7:08 – Review of the reduction in immunization rates in the US12:51 – Measles cases in the US and efforts to address misinformation20:28 – Breaking down recent influenza rates 25:42 – Update on COVID-19 – variants and vaccination33:42 – Leadership gap at the CDC and implications for public health 41:35 – Meningitis outbreak in England and status of vaccination in the US49:46 – Increase in cases of tuberculosis in the US56:45 – Update on mpox cases and vaccination59:12 – Brief review of RSV cases and vaccination and closing remarks __________________________________________________Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections.Going anti-Viral's host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences. Email podcast@iasusa.org to send feedback, show suggestions, or questions to be answered on a later episode.Follow Going anti-Viral on: Apple Podcasts YouTubeXFacebookInstagram...

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study. BMJ 2026. Discussion by:Guest:Susan Kucher, MDProgram Director - Abington Family Medicine Residency Program Jefferson Health2. Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes Results From the VESALIUS-CV Trial. JAMA. Discussion by:Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington3. Prevalence of Youth Overweight, Obesity, and Severe Obesity. JAMA Network Open. Discussion by:  Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington4. A Placebo-Controlled Trial of the Oral PCSK9 Inhibitor Enlicitide. New England Journal of Medicine 2026. Discussion by:Guest:Griffin Johnson, MDResident - Abington Family Medicine Residency Program Jefferson HealthMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit  http://naceonline.com to engage in more live and on demand CME/CE content.

In today's episode, we spoke with Ticiana Leal, MD, about variability in community practice and evolving treatment strategies for patients with small cell lung cancer (SCLC). Dr Leal is a professor and director of the Thoracic Medical Oncology Program in the Department of Hematology and Medical Oncology at Emory University School of Medicine, as well as the medical director of the Clinical Trials Office at Winship Cancer Institute in Atlanta, Georgia.In our exclusive interview, Dr Leal began by discussing how SCLC management can differ widely across community settings according to how patients present. Leal emphasized the importance of quickly confirming a patient's diagnosis and initiating treatment to avoid missing the critical window where chemotherapy could provide meaningful clinical benefit. However, Leal noted that the field still lacks predictive biomarkers to guide treatment selection. Accordingly, current strategies, including chemoimmunotherapy, maintenance approaches, and second-line options like tarlatamab-dlle (Imdelltra) and lurbinectedin (Zepzelca) are largely chosen based on clinical factors such as disease burden, comorbidities, and patient preferences.The conversation then shifted to the challenge of treating patients who may not meet traditional clinical trial eligibility criteria due to poor performance status, comorbidities, or social vulnerabilities. Leal stated that a multidisciplinary approach, including collaboration with supportive care teams, is essential to optimize outcomes for these patients. She noted that potential solutions to restrictive trial eligibility criteria may include decentralizing trials, improving collaboration between academic and community centers, and providing additional patient support such as transportation and care navigation services.Looking ahead, Leal emphasized the need for community practices to prepare for emerging therapies, including antibody-drug conjugates and novel immunotherapy approaches. Successfully integrating these treatments into everyday practice will require education, infrastructure development, and multidisciplinary collaboration, Leal imparted.

In this episode of The ICHE Podcast, host Dr. David Calfee speaks with Jose Navarrete, MD. of Emory University School of Medicine and Marin Schweizer, PhD. of the University of Wisconsin about infection risks among patients receiving hemodialysis, including common pathogens and factors that increase vulnerability. They discuss their recent research and share key findings, along with practical insights on how to improve infection prevention in hemodialysis settings. https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/trends-of-bloodstream-infection-incidence-rates-among-patients-on-outpatient-hemodialysis-national-healthcare-safety-network-20122021/3DC9CCED04161F16F274F12919DC3F7C https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/abs/survey-of-hemodialysis-patients-knowledge-of-their-infection-risk-and-acceptability-of-an-intranasal-decolonization-intervention/EA68F7DAB1D54174D633E1DE5EE38136

Dr Matthew Milowsky from the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina, comments on real patient cases of metastatic urothelial bladder cancer presented by Dr Jacqueline T Brown from the Emory University School of Medicine in Atlanta, Georgia and Dr Nazli Dizman from The University of Texas MD Anderson Cancer Center in Houston. CME information and select publications here.

In this episode of The Visible Voices Podcast, Dr. Sharon Bergquist — physician, author of the Plantology cookbook, host of The Whole Health Cure podcast, and lifestyle medicine expert at Emory University School of Medicine — joins for an episode on food as medicine and chronobiology. Dr. Bergquist unpacks the science of when we eat, not just what we eat, explaining how meal timing shapes our circadian biology, metabolic health, and disease risk; she makes the case for front-loading calories earlier in the day, and rethinking "healthy" foods like farmed salmon, avocado, and eggs with more nuance. The conversation covers soil quality and dietary diversity, the gut microbiome, protein needs across the lifespan, the community and mindfulness dimensions of eating, and practical take-homes for anyone looking to leverage food as one of our most powerful tools for prevention and longevity. Follow Dr. Bergquist on Instagram at @drsharonbergquist and drsharonbergquist.com Wish to help the show? Leave ⭐⭐⭐⭐⭐ on Apple. Subscribe here and send it to a friend.

What if a patient's multisystem symptoms, unexplained strokes, or exercise intolerance point to mitochondrial disease, but it takes 5–10 years and multiple specialists to confirm? In this eye-opening episode, Dr. Bradley Block speaks with Dr. Heather Gatcombe. As both a physician and the mother of a son with mitochondrial disease, leading to metabolic strokes, heart failure, and transplant,  Dr. Gatcombe shares her family's journey, from a terrifying stroke-like episode at age 7, through years of uncertainty, negative initial genetic testing, muscle biopsy confirmation, and eventual identification of a novel nuclear DNA mutation. They explore the heterogeneity of primary mitochondrial diseases, why presentation ranges from infancy lethality to adult-onset fatigue, and key red flags: multisystem involvement, symptom worsening with metabolic stressors, and misdiagnoses like chronic fatigue syndrome, fibromyalgia, or psychiatric conditions. The discussion covers workup, multidisciplinary care, perioperative risks, and treatment.  They stress the power of early diagnosis: better empathy, treatment changes, support groups, and hope with new therapies in the pipeline. Clinicians in every specialty need awareness, especially anesthesiologists, surgeons, and hospitalists, to prevent crises. Three Actionable Takeaways: Spot the Warning Signs Early: Look for patients with symptoms in 3 or more organ systems, unexplained strokes or seizures, diabetes and hearing loss, brain lesions in basal ganglia, or symptoms that worsen with stress like fever, fasting, or surgery. Send them quickly to a geneticist or mitochondrial specialist for testing. Free options exist at umdf.org Protect Patients During Surgery or Procedures: For anyone known to have mitochondrial disease, talk to their mitochondrial specialist first. Avoid long fasting, dehydration, or extreme temperatures. Some need IV glucose before procedures and special care with anesthesia or certain drugs to prevent a dangerous metabolic crisis. Learn More and Speed Up Diagnosis: Visit umdf.org for free doctor education (CME courses), patient support groups, and the latest on new treatments. Raising awareness helps cut the long wait for diagnosis, gives patients validation, better care, and access to emerging FDA-approved therapies.  About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Heather Gatcombe is a board-certified radiation oncologist at Winship Cancer Institute of Emory University and an Assistant Professor at Emory University School of Medicine. She specializes in breast radiation oncology and serves as Vice Chair for Community and Belonging. As the mother of a child with mitochondrial disease who experienced metabolic strokes starting at age 7, progressing to heart failure and transplant, she is deeply committed to raising clinician awareness, reducing diagnostic delays, and advocating for patients and families. She serves on the Board of Trustees and the Scientific and Medical Advisory Board Clinical Training and Education Committee of the United Mitochondrial Disease Foundation (UMDF). Website: https://winshipcancer.emory.edu/profiles/gatcombe-heather.php LinkedIn: https://www.linkedin.com/in/heather-gatcombe-md-3891875 Instagram: https://www.instagram.com/heathergatcombe UMDF: https://umdf.org/about/board-trustees About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter   This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In today's episode, we spoke with Colin Vale, MD. Dr Vale is an assistant professor in the Department of Hematology and Medical Oncology at the Emory University School of Medicine in Atlanta, Georgia.In our exclusive interview, Dr Vale discussed data from a phase 2 trial (NCT03263572) evaluating blinatumomab (Blincyto) plus ponatinib (Iclusig) in patients with Philadelphia chromosome–positive B-cell acute lymphoblastic leukemia. In addition to underscoring the findings and their clinical significance, Vale expanded on how the combination can improve patient quality of life by helping patients avoid procedures like allogeneic stem cell transplant.

In this episode, Dr. Andy Cutler talks with Dr. Robert Cotes about optimizing outcomes in early psychosis and why the first episode is a critical window for intervention. They discuss the impact of duration of untreated psychosis, recovery trajectories after a first episode, and what to measure beyond symptom reduction—including functional outcomes, cognition, and relapse risk. The conversation also highlights strategies for engaging young adults and families in coordinated specialty care, early identification of clinical high risk for psychosis, and innovations aimed at improving long-term recovery.  Robert O. Cotes, MD, is Professor of Psychiatry and Behavioral Sciences at Emory University School of Medicine and Chief of Psychiatry at Grady Health System in Atlanta. He directs the Clinical and Research Program for Psychosis at Grady, which includes Project ARROW, a coordinated specialty care program for young people with early psychosis, and a specialized clozapine clinic for treatment-resistant schizophrenia.    Andrew J. Cutler, MD, is a distinguished psychiatrist and researcher with extensive experience in clinical trials and psychopharmacology. He currently serves as the Chief Medical Officer of Neuroscience Education Institute and EMA Wellness. He is a Clinical Associate Professor of Psychiatry at SUNY Upstate Medical University in Syracuse, New York.  Save $100 on registration for 2026 NEI Spring Congress with code NEIPOD26  Register today at nei.global/spring  Never miss an episode!

Welcome to Transmission Interrupted! In this episode, host Jill Morgan sits down with the principal investigators of NETEC—Dr. Aneesh Mehta, Dr. Vikramjit Mukherjee, and Dr. John Lowe—to reflect on a decade of advancing special pathogen preparedness across the U.S. healthcare system. Together, they revisit the origins of NETEC, tracing back to the transformative events of the 2014 Ebola outbreak, and share their unique journeys as infectious disease experts, critical care clinicians, and scientists on the front lines. The conversation dives into the challenges and lessons learned while building a national network equipped for high-consequence infectious diseases, the evolution from isolated specialty units to a system-wide approach, and the critical importance of healthcare worker safety. You'll hear insights on what it takes to maintain readiness in a landscape of ever-changing threats, the value of interdisciplinary collaboration, and a call to expand this “tight-knit club” of preparedness champions. Whether you're a healthcare professional, public health advocate, or just curious about how the U.S. prepares for medical crises, this episode delivers an inspiring look at the past, present, and future of special pathogen response—and why it matters to us all. Guests John-Martin Lowe, PhD John-Martin Lowe, PhD, is the director of the Global Center for Health Security, assistant vice chancellor for health security training and education, and professor of Environmental, Agricultural and Occupational Health at the University of Nebraska Medical Center. At the University of Nebraska Medical Center, he leads research and training initiatives to advance environmental risk assessment and infection control for high consequence pathogens. As a virologist and environmental exposure scientist, Dr. Lowe has worked extensively throughout the U.S., Africa, Asia and Europe as an educator, researcher, and in health emergency risk management related to infectious disease, infection control and emergency response. As a professor of environmental and occupational health, his expertise focuses on infectious disease risk assessment and management of risk for clinical, community and industrial environments. Dr. Lowe also has extensive experience in emerging pathogens and health security. He is co-PI for the U.S. National Emerging Special Pathogens Training and Education Center, established an international network for emerging infectious diseases, and served lead investigator for a multi-country bio-surveillance network in Africa. He has experience in a broad range of health security topics from surveillance, public health response and clinical response to health emergencies. Dr. Lowe led successful COVID-19 efforts in 2020 at the National Quarantine Unit and Nebraska Biocontainment Unit to provide monitoring and care for repatriated U.S. citizens exposed to and infected with SARS Coronavirus 2. He also led early and continued efforts to characterize the transmission dynamics of SARS Coronavirus 2 which were presented to in a joint meeting hosted by the Academy of Medicine and American Public Health Association on April 15, 2020. Dr. Aneesh Mehta, MD, FIDSA, FAST Aneesh Mehta is a Professor of Medicine and of Surgery at Emory University School of Medicine, and also serves as the Chief of Infectious Diseases Services and Assistant Director of Transplant Infectious Diseases at Emory University Hospital. He is a board-certified infectious diseases physician, who received an MD from the University of Oklahoma and completed Internal Medicine and Infectious Diseases training at Emory University. Aneesh has been one of the core physicians of the Emory Serious Communicable Diseases Unit (SCDU) since 2009. He was admitted physician for Emory's first patient with Ebola Virus Disease and was highly involved in care of the four patients with EVD, one patient with Lassa Fever, and several PUIs cared for by the Emory SCDU. During the Ebola activation, Aneesh was involved in all aspects of unit management, patient care, laboratory handling, and research. Aneesh is a co-Principal Investigator at NETEC. He also has been involved in development of the Special Pathogens Research Network Biorepository and evaluation of Medical Countermeasures. Vikramjit Mukherjee, MD, FRCP (Edin) Vikramjit Mukherjee is an intensive care physician who serves as the Chief of Critical Care at NYC Health+Hospitals/Bellevue. He also is the Chief of Bellevue's Special Pathogens Program. Dr. Mukherjee is an Associate Professor of Medicine in the Division of Pulmonary, Critical Care and Sleep Medicine at the NYU Grossman School of Medicine. Dr. Mukherjee serves as co-Principal Investigator for NETEC, as a steering committee member for the National Special Pathogens System of Care, and as an executive member of the Task Force for Mass Critical Care. His research interests include special pathogen preparedness and mass critical care. Vikramjit Mukherjee completed his medical training at Armed Forces Medical College, India, before arriving in the United States. Here, he completed his residency and chief residency at Georgetown University/Washington Hospital Center and fellowship and chief fellowship in Pulmonary and Critical Care Medicine at New York University Medical Center. Following completion of training in 2015, he joined faculty in the Division of Pulmonary, Critical Care and Sleep Medicine at New York University Grossman School of Medicine. Host Jill Morgan, RN Emory Healthcare, Atlanta, GA Jill Morgan is a registered nurse and a subject matter expert in personal protective equipment (PPE) for NETEC. For 35 years, Jill has been an emergency department and critical care nurse, and now splits her time between education for NETEC and clinical research, most of it centering around infection prevention and personal protective equipment. She is a member of the Association for Professionals in Infection Control and Epidemiology (APIC), ASTM International, and the Association for the Advancement of Medical Instrumentation (AAMI). Resources About NETECNETEC LeadershipTransmission Interrupted PodcastNational Special Pathogen System (NSPS)NETEC Resource Library About NETEC A Partnership for Preparedness The National Emerging Special Pathogens Training and Education Center's mission is to set the gold standard for special pathogen preparedness and response across health systems in the U.S. with the goals of driving best practices, closing knowledge gaps, and developing innovative resources. Our vision is a sustainable infrastructure and culture of readiness for managing suspected and confirmed special pathogen incidents across the United States public health and health care delivery systems. For more information visit NETEC on the web at www.netec.org. NETEC Consultation Services Assess and Advance Your Readiness for Special Pathogens with Free, Expert Consulting. NETEC offers free virtual and onsite readiness consulting to help health care facilities and EMS agencies prepare for special pathogen events. Our targeted support services are delivered by experts selected and assigned to each inquiry based on the unique needs of your organization. Have a question? Ask a NETEC expert. For more information visit: netec.org/consulting-services.

In episode 248 of America Adapts, host Doug Parsons is joined by Professor Mark Nevitt of Emory University School of Law to unpack the repeal of the Clean Air Act's Endangerment Finding and what it means for climate governance in the United States. Long considered the legal backbone of federal climate regulation, its rescission raises fundamental questions about agency authority, the role of the courts, and the durability of federal climate policy. Mark explains the legal theory behind the repeal, how it intersects with Supreme Court precedent, and what likely comes next in federal court. The conversation also explores the practical implications of regulatory instability — from increased climate litigation to the shifting balance between federal, state, and local responsibility. For listeners working in adaptation, public policy, infrastructure, law, or risk management, this episode offers a clear look at how legal shifts at the federal level can reshape the broader climate landscape — and why adaptation efforts must continue regardless of political volatility. Transcript for this episode here.  Key Themes Covered in This Episode What the Endangerment Finding actually did under the Clean Air Act Why Massachusetts v. EPA mattered The legal basis for the repeal How the repeal affects federal climate regulation The role of the Supreme Court and administrative law What happens next in federal court More emissions and rising adaptation costs States and cities filling the federal vacuum The growing role of climate litigation Adaptation continuing — but in a more fragmented system Previous appearances by Mark Nevitt on America Adapts Destroy, Rebuild, Repeat: How to Break the Climate Disaster Cycle with Mark Nevitt Climate Change and the Legal System: Why the U.S. Constitution Needs to Adapt with Law Professor Mark Nevitt Climate Adaptation Predictions for 2025: What the Experts Say For Educators & Students The structure and limits of federal agency authority The interaction between executive action and judicial review How Supreme Court doctrine reshapes environmental governance Federalism and the division of climate authority between states and Washington Legal uncertainty and its impact on infrastructure and long-term planning Climate governance in periods of institutional instability The evolving role of courts in climate policy disputes Risk management when regulatory frameworks shift abruptly Professors are welcome to assign this episode or excerpts in syllabi. Who Should Listen to This Episode Climate adaptation and resilience professionals navigating shifting federal policy State and local government officials responsible for long-term planning Urban and regional planners integrating climate risk into infrastructure decisions Insurance, reinsurance, and financial sector professionals assessing regulatory volatility Corporate risk, legal, and strategy teams tracking climate governance shifts Environmental law and public policy scholars following administrative law developments Funders and foundations evaluating the durability of climate investments Climate communicators explaining governance instability to broader audiences   ClimateTech Connect Conference Mentioned in the Episode! ClimateTech Connect Registration Use code: AAVIP for 25% discount off ticket prices   Support for America Adapts helps make episodes like this possible, including more international conversations on how adaptation is unfolding globally. All donations are now tax deductible! Check out the America Adapts Media Kit here! Subscribe to the America Adapts newsletter here. Listen to America Adapts on your favorite app here!   Facebook, Linkedin and Bluesky: https://www.facebook.com/americaadapts/ https://bsky.app/profile/americaadapts.bsky.social https://www.linkedin.com/in/doug-parsons-america-adapts/ Doug Parsons and Speaking Opportunities: If you are interested in having Doug speak at corporate and conference events, sharing his unique, expert perspective on adaptation in an entertaining and informative way, Now on Spotify! List of Previous Guests on America Adapts Follow/listen to podcast on Apple Podcasts. The 10 Best Sustainability Podcasts for Environmental Business Leadershttps://us.anteagroup.com/news-events/blog/10-best-sustainability-podcasts-environmental-business-leaders For more information on this podcast, visit the website at http://www.americaadapts.org and don't forget to subscribe to this podcast on Apple Podcasts.   Podcast Music produce by Richard Haitz Productions Write a review on Apple Podcasts ! America Adapts on Facebook!   Join the America Adapts Facebook Community Group. Check us out, we're also on YouTube! Subscribe to America Adapts on Apple Podcasts Doug can be contacted at americaadapts @ g mail . com

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Impact of a Smartwatch Hypertension Notification Feature for Population Screening.JAMA 2026. Discussion by: Guest:Erin Russell, MD Resident - Abington Family Medicine Residency Program Jefferson Health - Abington2. A guide to consumer-grade wearables in cardiovascular clinical care and population health for non-experts. Discussion by: Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington3. Enhanced Detection and Prompt Diagnosis of Atrial Fibrillation Using Apple Watch: A Randomized Controlled Trial. Journal of the American College of Cardiology 2026 Discussion by: Guest:Jessica Stieritz, MD Resident - Abington Family Medicine Residency Program Jefferson Health - AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

Dr. Patel is the Chief of Cardiology at Vitruvian Health and a board-certified interventional and structural cardiologist. He attended medical school at the Emory University School of Medicine in Atlanta, Georgia, and completed his residency training in internal medicine at the University of California San Francisco in San Francisco, California. He earned his Master in Business Administration degree at Northwestern University-Kellogg School of Management in Evanston, Illinois.He also completed his fellowships in cardiology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois, and then further trained in structural and interventional cardiology at the Emory University School of Medicine in Atlanta, Georgia.https://vitruvianhealth.com/services/heart-vascular

Dr. Patel is the Chief of Cardiology at Vitruvian Health and a board-certified interventional and structural cardiologist. He attended medical school at the Emory University School of Medicine in Atlanta, Georgia, and completed his residency training in internal medicine at the University of California San Francisco in San Francisco, California. He earned his Master in Business Administration degree at Northwestern University-Kellogg School of Management in Evanston, Illinois.He also completed his fellowships in cardiology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois, and then further trained in structural and interventional cardiology at the Emory University School of Medicine in Atlanta, Georgia.https://vitruvianhealth.com/services/heart-vascular

Dr. Patel is the Chief of Cardiology at Vitruvian Health and a board-certified interventional and structural cardiologist. He attended medical school at the Emory University School of Medicine in Atlanta, Georgia, and completed his residency training in internal medicine at the University of California San Francisco in San Francisco, California. He earned his Master in Business Administration degree at Northwestern University-Kellogg School of Management in Evanston, Illinois.He also completed his fellowships in cardiology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois, and then further trained in structural and interventional cardiology at the Emory University School of Medicine in Atlanta, Georgia.https://vitruvianhealth.com/services/heart-vascular

In this throwback episode honoring National Women Physicians Day, host Shikha Jain, MD, with Physicianary's Hansa Bhargava, MD, and Mend the Gap's Dagny Zhu, MD, discuss the evolution of empowering yourself and others and advocacy with a panel of guests. ·       Intro 0:32 ·       What does it mean to empower women in medicine, and what are the ways that we can really empower others to achieve the things that they may not see for themselves?  1:37 ·       What are some ways in which you have empowered or hope to empower women in medicine? Are there tips or skills that have worked well?  4:41 ·       How have you been empowered by others, or have helped others find their voices?  7:37 ·       Do you agree that the conversation is changing toward a cultural shift in empowerment for women in health care? 12:23 ·       What are some challenges facing advocacy and empowerment? […] What do you do when your advocacy work is not being received or it is a struggle to speak up for someone?  17:10 ·       Emphasizing the importance of communication in advocacy work. 22:23 ·       Intro to Physicianary's part 3 on physician burnout and work-life balance. 22:51 ·       Thanks for listening 23:31 Be sure to listen to Part 1 and Part 3 of Healio's Women In Medicine roundtable discussion, streaming everywhere now! Vineet Arora, MD, MAPP (NAM), is a Herbert T. Abelson professor of medicine, vice dean of education in the biological sciences division and dean for medical education at the University of Chicago Pritzker School of Medicine. She is also an elected member of the National Academy of Medicine. She is a founding member of the 501c3 Women of Impact and advisor to the Women in Medicine Summit. Jennifer Bepple, MD, MMCi, is a double board-certified physician in urology and informatics. She is a member of the American Telemedicine Association, American Urologic Association and American Medical Informatics Association and holds a certification from the American Board of Telehealth and the American Board of AI in Medicine. Hansa Bhargava, MD, is Healio's chief clinical strategy and innovation officer. Listen to her Healio podcast, Physicianary. Shikha Jain, MD, FACP, is a board-certified hematology and oncology physician. She is a tenured associate professor of medicine in the division of hematology and oncology, the director of communication strategies in medicine and the associate director of oncology communication & digital innovation at the University of Illinois Cancer Center in Chicago. Mara Schenker, MD, FACS, FAOA, is an orthopedic trauma surgeon at Grady Memorial Hospital. She is double board certified in orthopedic surgery and clinical informatics. She serves as the chief of orthopedics and associate chief medical information officer.  She is an associate professor of orthopedics at Emory University School of Medicine. She serves on multiple boards for medical and digital technology advisory and sits on major national committees for the American Academy of Orthopaedic Surgeons, AAMC, American College of Surgeons and the Orthopaedic Trauma Association. Dagny Zhu, MD, is a cornea, cataract and refractive surgeon and medical director and partner at NVISION Eye Centers in Rowland Heights, CA. She can be reached on X @DZEyeMD. Listen to her on Healio's Mend The Gap: Equity In Medicine podcast. We'd love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Follow Healio on X and LinkedIn: @HemOncToday and https://www.linkedin.com/company/hemonctoday/. Follow Dr. Jain on X: @ShikhaJainMD. Disclosures: The hosts and guests report no relevant financial disclosures.

Many serious medical illnesses are associated with some degree of serum electrolyte abnormality, renal impairment, or both. The neurologist must determine if the patient's neurologic symptoms are related to the renal and electrolyte disturbances or whether a concurrent primary neurologic process is at play. In this episode, Casey Albin, MD, speaks with Eelco F. M. Wijdicks, MD, PhD, FAAN, FACP, FNCS, author of the article "Neurologic Manifestations of Renal and Electrolyte Disorders" in the Continuum® February 2026 Neurology of Systemic Disease issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Wijdicks is a professor of neurology and attending neurointensivist for the Neurosciences Intensive Care Unit at Mayo Clinic in Rochester, Minnesota. Additional Resources Read the article: Neurologic Manifestations of Renal and Electrolyte Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Guest: @EWijdicks Full episode transcript available here

The sale is complete for a Walton County, Ga. industrial warehouse that will become a new detention center for U.S. Immigration and Customs Enforcement. Local officials confirmed the purchase of the rural warehouse, located approximately 40 miles east of Atlanta. But Social Circle city officials say they’re against it, and Gareth Fenley, a local organizer with Indivisible Boldly Blue, shares on “Closer Look” how she plans to fight it. Plus, Atlanta area hospitals say their staff and resources are ready to respond to the 300,000 FIFA World Cup visitors expected here this summer. Preparations have been ongoing for months in advance, including a training simulation involving two patients who entered the U.S. with an infectious disease. Doctors from Grady Hospital, Piedmont Hospital and the Emory University School of Medicine join the program to discuss their plan to keep residents and visitors healthy during the games. Then, a new ProPublica report is linking a conservative researcher to the seizure of Fulton County’s election records. The author tells us about Kevin Moncla, who has long accused Fulton County of election fraud.See omnystudio.com/listener for privacy information.

Nicole Moorman, a top criminal defense attorney based in Atlanta, walks through what it's really like working inside the justice system — from defending people in serious felony and federal cases to the pressure of high-stakes trials and courtroom strategy. Born in Chicago and trained in criminal justice and law at Southern Illinois University, Troy University, and Emory University School of Law, Nicole brings a unique perspective shaped by years of legal experience and time spent as a probation officer and task force agent before becoming a lawyer. She explains how she approaches complex defenses, the ethical challenges defenders face, and why protecting the rights of the accused matters so deeply, with insights drawn from real cases and her career as one of Georgia's most respected advocates. _____________________________________________ #CriminalDefenseAttorney #TrueCrime #JusticeSystem #LegalReality #DefenseAttorney #RealStories #YouTubePodcast #lawandcrime _____________________________________________ Thank you to FACTOR for sponsoring this episode: Head to https://factormeals.com/lockedin50off and use code lockedin50off to get 50% off your first Factor box PLUS free breakfast for 1 year. Offer only valid for new Factor customers with code and qualifying auto-renewing subscription purchase. Make healthier eating easy with Factor. _____________________________________________ Connect with Nicole Moorman: Instagram: https://www.instagram.com/_kingcole_/?hl=en Website: https://moorman-law.com/ _____________________________________________ Hosted, Executive Produced & Edited By Ian Bick: https://www.instagram.com/ian_bick/?hl=en https://ianbick.com/ Shop Locked In Merch: http://www.ianbick.com/shop _____________________________________________ Timestamps: 00:00 Intro: Cooperation, Ethics & the Reality of the Justice System 00:27 Nicole Mormon's Childhood, Family & Early Influences 01:33 Education Path That Led to Criminal Justice 05:44 Why Nicole Chose Criminal Justice 07:01 From Chicago to Atlanta: Becoming a Probation Officer 11:10 First Cases as a Probation Officer & Reality Shock 13:37 Probation, Pretrial Supervision & System Flaws 14:40 Leaving Probation to Attend Law School 16:16 Law School Life & Interning at the DA's Office 17:55 Inside the DA's Office: What Prosecutors Really See 19:58 Starting Her Legal Career & Going Solo 20:35 First Trials, Stress & Emotional Pressure 22:00 Attorney-Client Relationships & Ethical Boundaries 23:38 Choosing Clients & Managing Expectations 24:43 Judges, Prosecutors & Fairness in the Courtroom 26:22 Prosecutor vs Defense Relationships Explained 27:16 State vs Federal Cases: Key Differences 28:53 Target Letters, Indictments & Bond Hearings 31:00 Trial Strategy: When to Push Forward or Slow Down 32:54 Preparing for Trial Mentally & Physically 35:23 Balancing Personal Life During High-Stress Trials 37:32 Trial Tactics, Verdicts & Jury Psychology 40:31 Jury Behavior in High-Profile Cases 42:27 Jury Selection & the Role of Consultants 43:32 Critical Trial Moments & Penalties for Going to Trial 44:53 Sentencing, Judges & the Appeals Process 47:17 Custody Status, Bond & House Arrest Explained 50:48 Biggest Client Misconceptions & Money in the System 53:00 Political Influence on Prosecutors & Charging Decisions 55:46 Diversion Programs, Plea Options & Fairness 57:00 Cooperation, Plea Deals & Informants 59:02 Plea Agreements, Testifying & Subpoenas 01:01:31 Trial Delays & Frustrations with the System 01:02:20 What Nicole Would Change About the Justice System 01:03:10 Advice to Her Younger Self 01:04:28 Life Lessons from a Legal Career 01:05:56 Final Thoughts & Closing Message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Nicole Moorman, a top criminal defense attorney based in Atlanta, walks through what it's really like working inside the justice system — from defending people in serious felony and federal cases to the pressure of high-stakes trials and courtroom strategy. Born in Chicago and trained in criminal justice and law at Southern Illinois University, Troy University, and Emory University School of Law, Nicole brings a unique perspective shaped by years of legal experience and time spent as a probation officer and task force agent before becoming a lawyer. She explains how she approaches complex defenses, the ethical challenges defenders face, and why protecting the rights of the accused matters so deeply, with insights drawn from real cases and her career as one of Georgia's most respected advocates. _____________________________________________ #CriminalDefenseAttorney #TrueCrime #JusticeSystem #LegalReality #DefenseAttorney #RealStories #YouTubePodcast #lawandcrime _____________________________________________ Thank you to FACTOR for sponsoring this episode: Head to https://factormeals.com/lockedin50off and use code lockedin50off to get 50% off your first Factor box PLUS free breakfast for 1 year. Offer only valid for new Factor customers with code and qualifying auto-renewing subscription purchase. Make healthier eating easy with Factor. _____________________________________________ Connect with Nicole Moorman: Instagram: https://www.instagram.com/_kingcole_/?hl=en Website: https://moorman-law.com/ _____________________________________________ Hosted, Executive Produced & Edited By Ian Bick: https://www.instagram.com/ian_bick/?hl=en https://ianbick.com/ Shop Locked In Merch: http://www.ianbick.com/shop _____________________________________________ Timestamps: 00:00 Intro: Cooperation, Ethics & the Reality of the Justice System 00:27 Nicole Mormon's Childhood, Family & Early Influences 01:33 Education Path That Led to Criminal Justice 05:44 Why Nicole Chose Criminal Justice 07:01 From Chicago to Atlanta: Becoming a Probation Officer 11:10 First Cases as a Probation Officer & Reality Shock 13:37 Probation, Pretrial Supervision & System Flaws 14:40 Leaving Probation to Attend Law School 16:16 Law School Life & Interning at the DA's Office 17:55 Inside the DA's Office: What Prosecutors Really See 19:58 Starting Her Legal Career & Going Solo 20:35 First Trials, Stress & Emotional Pressure 22:00 Attorney-Client Relationships & Ethical Boundaries 23:38 Choosing Clients & Managing Expectations 24:43 Judges, Prosecutors & Fairness in the Courtroom 26:22 Prosecutor vs Defense Relationships Explained 27:16 State vs Federal Cases: Key Differences 28:53 Target Letters, Indictments & Bond Hearings 31:00 Trial Strategy: When to Push Forward or Slow Down 32:54 Preparing for Trial Mentally & Physically 35:23 Balancing Personal Life During High-Stress Trials 37:32 Trial Tactics, Verdicts & Jury Psychology 40:31 Jury Behavior in High-Profile Cases 42:27 Jury Selection & the Role of Consultants 43:32 Critical Trial Moments & Penalties for Going to Trial 44:53 Sentencing, Judges & the Appeals Process 47:17 Custody Status, Bond & House Arrest Explained 50:48 Biggest Client Misconceptions & Money in the System 53:00 Political Influence on Prosecutors & Charging Decisions 55:46 Diversion Programs, Plea Options & Fairness 57:00 Cooperation, Plea Deals & Informants 59:02 Plea Agreements, Testifying & Subpoenas 01:01:31 Trial Delays & Frustrations with the System 01:02:20 What Nicole Would Change About the Justice System 01:03:10 Advice to Her Younger Self 01:04:28 Life Lessons from a Legal Career 01:05:56 Final Thoughts & Closing Message Learn more about your ad choices. Visit megaphone.fm/adchoices

When addressing obesity in the clinic, it's common to ask patients to focus on food and exercise. But what if we think upstream of the clinical problem and consider the environments, habits and systems that shape health from the very beginning? In this episode, we sit down with an expert whose research has focused on building resilience against obesity starting early in life. From family dynamics to school and community initiatives, the picture of prevention is complex.  Shari Barkin, MD, is the Pediatrician in Chief at Children's Healthcare of Atlanta. She is also the Chair of the Department of Pediatrics, Executive Director of the Pediatric Institute, and the George W. Brumley Jr. Endowed Professor of Pediatrics at Emory University School of Medicine.  Some highlights from this episode include: How to influence eating behaviors in the first six months of life  The role of community involvement and partnerships in preventing childhood obesity  Translating research into practical strategies  Strong communication methods to engage families successfully  This episode is underwritten by Ovintiv, a proud philanthropic supporter of Charting Pediatrics and the Children's Hospital Colorado Foundation. Ovintiv recognizes that their responsibility begins in the communities where they live and work. They are committed to giving back and building safer and more resilient communities. Ovintiv's generous support has made a monumental difference for our patients and families, from enhancing health outcomes to reducing health disparities.  For more information on Children's Colorado, visit: childrenscolorado.org. 

In this inspiring episode of the Emory University series on Nurse Converse, host Dr. Everett Moss II, CRNA, sits down with three powerful voices from the Emory University School of Nursing—Dr. Beth Ann Swan, Dr. Shawana Moore, and recent graduate Sofi Igyan—to unpack one of the most misunderstood words in nursing: power.Together, they challenge the idea that power is something loud, aggressive, or purely positional. Instead, they explore power as the ability to influence change, whether you're an academic leader, an advanced practice nurse, or a new graduate stepping into the profession for the first time.Listeners will hear:Why power is deeply personal and often situational—shifting with the room you're in, the role you hold, and how others perceive you.How humility and silence can be profound sources of strength, including the concept of the “silent storm” and the impact of knowing when not to speak.The student and new-graduate perspective on power—how embracing agency, mentorship, and opportunities can transform the nursing school and early-career experience.The role of mentorship in cultivating influence and the responsibility to lift others as you rise.How storytelling and social media can serve as powerful platforms when nurses share lived experiences and credible information.Practical advice for nurses at every stage—from flowing like water through challenges, to embracing new opportunities, to navigating imposter syndrome.From redefining influence to owning your voice at any stage of a career, this conversation highlights the many forms of power nurses hold—and how harnessing that power can shape both individual careers and the future of the profession.>>8 Keys to Cultivating Power in Your Nursing CareerJump Ahead to Listen: [00:02:19] Understanding power and influence in nursing [00:04:43] Navigating personal power and professional presence [00:10:15] Influence within nursing's power structures [00:14:32] Elevating student confidence and empowerment [00:20:17] How nursing students shape conversations online [00:21:24] Examining influencers and credibility in nursing [00:26:01] Storytelling as a catalyst for impact [00:30:09] Mentorship as a foundation for future leaders [00:37:01] Staying open to unexpected opportunities [00:40:05] Adapting and “flowing like water” in your career [00:42:15] Growth through professional and personal challenges [00:47:00] Books and ideas that inspire empowered nursing practice For more information, full transcript and videos visit Nurse.org/podcastJoin our newsletter at nurse.org/joinInstagram: @nurse_orgTikTok: @nurse.orgFacebook: @nurse.orgYouTube: Nurse.org

  Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Sarah presents a case to Sebastian and Vijay.  Sarah Blaine (@sarahkblaine) Sarah Blaine is an MD/MSc student at Emory University School of Medicine applying into neurology residency. She isfrom SouthernCalifornia and went to UC Berkeley for her undergraduate… Read More »Episode 435: Neurology VMR – Weakness and numbness

From November 6, 2024: For today's special episode, Lawfare General Counsel and Senior Editor Scott R. Anderson held a series of conversations with contributors to a special series of articles on “The Dangers of Deploying the Military on U.S. Soil” that Lawfare recently published on its website, in coordination with our friends at Protect Democracy.Participants include: Alex Tausanovitch, Policy Advocate at Protect Democracy; Laura Dickinson, a Professor at George Washington University Law School; Joseph Nunn, Counsel in the Liberty and National Security Program at the Brennan Center; Chris Mirasola, an Assistant Professor at the University of Houston Law Center; Mark Nevitt, a Professor at Emory University School of Law; Elaine McCusker, a Senior Fellow at the American Enterprise Institute; and Lindsay P. Cohn, a Professor of National Security Affairs at the U.S. Naval War College. Together, they discussed how and why domestic deployments are being used, the complex set of legal authorities allowing presidents and governors to do so, and what the consequences might be, both for U.S. national security and for U.S. civil-military relations more generally.To receive ad-free podcasts, become a Lawfare Material Supporter at www.patreon.com/lawfare. You can also support Lawfare by making a one-time donation at https://givebutter.com/lawfare-institute.Support this show http://supporter.acast.com/lawfare. Hosted on Acast. See acast.com/privacy for more information.