Podcasts about Georgetown University Medical Center

In this episode of Health Matters, we discuss what causes dizziness with Dr. Louise Klebanoff, a neurologist with NewYork-Presbyterian and Weill Cornell Medicine. Dr. Klebanoff explains the different types of dizziness, such as lightheadedness, vertigo, and gait instability. We also cover how to differentiate between these types, the potential causes, and  when to seek medical attention.___Dr. Louise Klebanoff, MD has been named the Chief of General Neurology and the Vice Chair of Operations for the Department of Neurology at Weill Cornell Medical College. She is also an Assistant Attending Neurologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.  Dr. Klebanoff received her medical degree from Georgetown University Medical Center, graduating first in her class, and went on to complete a residency in Neurology and a fellowship in Critical Care Neurology at NewYork-Presbyterian Hospital/Columbia University Medical Center.Prior to joining the Weill Cornell faculty, Dr. Klebanoff served as Attending Neurologist at Beth Israel Medical Center, where she also held leadership roles on various committees and served as the first female president of the Medical Board.Dr. Klebanoff is board certified in Psychiatry and Neurology. She is a member of the Alpha Omega Alpha honor society, the American Medical Association and the American Academy of Neurology.___Health Matters is your weekly dose of health and wellness information, from the leading experts. Join host Courtney Allison to get news you can use in your own life. New episodes drop each Wednesday.If you are looking for practical health tips and trustworthy information from world-class doctors and medical experts you will enjoy listening to Health Matters. Health Matters was created to share stories of science, care, and wellness that are happening every day at NewYork-Presbyterian, one of the nation's most comprehensive, integrated academic healthcare systems. In keeping with NewYork-Presbyterian's long legacy of medical breakthroughs and innovation, Health Matters features the latest news, insights, and health tips from our trusted experts; inspiring first-hand accounts from patients and caregivers; and updates on the latest research and innovations in patient care, all in collaboration with our renowned medical schools, Columbia and Weill Cornell Medicine. To learn more visit: https://healthmatters.nyp.org

In this #episode of the Longevity & Aging Series, Dr. Shubhankar Suman from the Department of Oncology at Georgetown University Medical Center joins host Dr. Evgeniy Galimov to discuss a #research paper he co-authored in Volume 17, Issue 1 of Aging (Aging-US), titled: “Senolytic agent ABT-263 mitigates low- and high-LET radiation-induced gastrointestinal cancer development in Apc1638N/+ mice.” DOI - https://doi.org/10.18632/aging.206183 Corresponding author - Shubhankar Suman - ss2286@georgetown.edu Author interview - https://www.youtube.com/watch?v=ClLO0ERwC0M Video short - https://www.youtube.com/watch?v=M_WEht4vy4w Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.206183 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, senescence-associated secretory phenotype, senolytic agent, carcinogenesis, inflammation, β-catenin To learn more about Aging (Aging-US), please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Bluesky - https://bsky.app/profile/aging-us.bsky.social Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM

In this Leveling Up episode of the PRS Global Open Deep Cuts podcast, Dr. Christopher Attinger discusses how to build a successful wound center, the benefits of including psychiatry in a wound care service, the importance of removing all indurated tissues during a debridement, why placing a skin graft on granulation tissue is actually a bad idea, the benefits of bypass surgery over angioplasty, how to know when Integra has good take, his go-to local flaps for the foot and ankle and why he doesn't like reverse sural flaps. He also discusses the nuances of performing a TMA and a BKA, why he never uses deep sutures in any wound closure, how TMR has been a game changer in his practice, the rating system for medial arterial calcinosis that predicts the risk of complications, and how he has structured the service to maximize resident education. Read a classic PRS Global Open article by Dr. Attinger and his colleagues, “The Effect of Positive Postdebridement Cultures on Local Muscle Flap Reconstruction of the Lower Extremity”: https://bit.ly/DebridementFXLE  Dr. Christopher Attinger is a Professor in the Plastic and Reconstructive Surgery Department at Georgetown University Medical Center, and the Director of the Center for Wound Healing at MedStar Georgetown University Hospital. He served two tours of duty in Vietnam, as a lieutenant in the 82nd Airborne and the 101st Airborne divisions, and was honorably discharged with a Purple Heart and Bronze Star. He received his medical degree from Yale University, and then completed a residency in general surgery and fellowship in vascular surgery at Brigham and Women's Hospital in Boston, and a plastic surgery residency and hand surgery fellowship at New York University. After completing his training, he joined the faculty at Georgetown, and has been there ever since. In 2007, Dr. Attinger started an annual limb salvage conference to bring together all the members of the limb salvage community to exchange ideas and innovations.  Your host, Dr. Puru Nagarkar, is a board-certified plastic and hand surgeon, and Associate Professor of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas. The views expressed by hosts and guests are their own and do not necessarily reflect the official policies or positions of ASPS. #PRSGlobalOpen #DeepCutsPodcast #PlasticSurgery #LevelingUp

Episode 10 highlights examples of how patient advocacy groups influenced pharmaceutical decisions at the US Food and Drug Administration (FDA). In a conversation with health policy researcher, author and activist, Sharon Batt PhD, we explore regulatory decisions on Relyvrio (AMX0035), Avastin (bevacizumab), and Addyi (flibanserin) within the context of our latest report “What Needs to Change at the FDA?Protecting and Advancing Public Health.”Pharmanipulation is produced by PharmedOut, a project at Georgetown University Medical Center that advances evidence-based prescribing. Additional Resources Full Report “What Needs to Change at the FDA? Protecting and Advancing Public Health”: https://georgetown.box.com/s/n87us836fpmdhtcvdaqopyobfwx7bymx  Webinar on “What Needs to Change at the FDA?”: https://www.youtube.com/watch?v=4g9br3wZW-k&t=11s  Article on “How some drug companies manipulate patient advocates” by Judith Garber: https://lowninstitute.org/how-some-drug-companies-manipulate-patient-advocates/  

Dean's Chat hosts, Drs. Jensen and Richey, welcome Dr. Douglas Pacaccio, director of the Northwest Illinois Foot and Ankle Surgical Fellowship program. Dr. Pacaccio graduated from the University of Illinois at Urbana/Champaign with a dual degree in biology and philosophy-focused on ethics.  In interview you will hear how this has helped shape his perspective and viewpoint.  He went on to complete his podiatric medical degree with Rosalyn Franklin University and did his 3-year surgical residency with the prestigious Inova Fairfax program.  He continued his education with a plastic surgery fellowship at Georgetown University Medical Center and then moved back to Illinois to start his practice with his wife who is also a podiatrist. Tune in as we discussed all things podiatric medicine and surgery, including how Fellowship impacted his own career and now what his thoughts are regarding fellowship training with special insights from a current fellowship director. Listen as we discuss academics and how to acquire life long learning skills.  Join us as we discuss complex hindfoot reconstructive surgery and how simple beginnings sparked his interest in the field along with the impact of watching the ingenuity and craftsmanship of his father. Join us as we dive into the importance of community and giving back. Dr. Pacaccio also has multiple patents for medical devices and shares his experiences and how curiosity and necessity began to spark innovation.  He also dives into important concepts including what brings joy, satisfaction and happiness into our lives.  Stay tuned for upcoming episodes where we dive deeper into this with a new session coined "Deep thoughts with Doug". https://www.orthoillinois.com/find-a-provider/douglas-pacaccio-dpm-facfas/ https://www.acfas.org/ https://bakodx.com/ https://bmef.org/ www.explorepodmed.org www.apma.org https://podiatrist2be.com/  

BUFFALO, NY—February 18, 2025 — A new #research paper was #published by Aging (Aging-US) on January 8, 2025, in Volume 17, Issue 1, titled “Senolytic agent ABT-263 mitigates low- and high-LET radiation-induced gastrointestinal cancer development in Apc1638N/+ mice.” Researchers Kamendra Kumar, Bo-Hyun Moon, Santosh Kumar, Jerry Angdisen, Bhaskar V.S. Kallakury, Albert J. Fornace Jr., and Shubhankar Suman from Georgetown University Medical Center explored whether a drug called ABT-263 could help reduce the risk of gastrointestinal (GI) cancer caused by radiation exposure. Their findings suggest that ABT-263, a senolytic agent, helps eliminate harmful aging cells in the gut, reducing inflammation and lowering cancer risk in mice. These results could lead to potential treatments for people exposed to radiation, including cancer patients and astronauts. Radiation exposure, whether from medical treatments, environmental sources, or space travel, can damage cells and increase the risk of GI cancer. One key factor in this process is cellular senescence, where damaged cells stop dividing but continue to release harmful molecules that promotes tumor growth. This study tested whether ABT-263, a drug designed to remove these aged cells, could lower cancer risk in a mouse model of GI cancer. In this study, researchers exposed mice to radiation and found that it increased the number of damaged cells in their intestines, leading to more tumors. However, when the mice were given ABT-263, the number of harmful cells decreased, and they developed fewer tumors. The drug also reduced inflammation and blocked signals that promote cancer growth. “Oral administration of ABT-263 in Apc1638N/+ mice resulted in a significant reduction in low-LET IR-induced intestinal tumor burden at 5 months post-exposure." These findings highlight the potential of senolytic drugs like ABT-263 as a preventive treatment for radiation-induced cancers. This approach could be especially beneficial for cancer patients undergoing radiation therapy, astronauts exposed to cosmic radiation, and individuals at risk from environmental sources such as radon gas. However, while ABT-263 showed promise, it also has known side effects, including reduced platelet counts, which can impact blood clotting. Future research will focus on optimizing senolytic treatments to ensure they are both safe and effective for human use. Scientists are also exploring alternative drugs and combination therapies that might offer the same benefits with fewer risks. This study provides strong evidence that removing senescent cells could help prevent radiation-related GI cancer. With further research, senolytic drugs may become an important tool in protecting at-risk populations from the long-term effects of radiation exposure. DOI - https://doi.org/10.18632/aging.206183 Corresponding author - Shubhankar Suman - ss2286@georgetown.edu Video short - https://www.youtube.com/watch?v=M_WEht4vy4w Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts About Aging-US The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population. The journal aims to promote 1) treatment of age-related diseases by slowing down aging, 2) validation of anti-aging drugs by treating age-related diseases, and 3) prevention of cancer by inhibiting aging. (Cancer and COVID-19 are age-related diseases.) Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM

Today on America in the Morning   Gaetz Report Released The House Ethics Committee released a long anticipated report into allegations of illegal sexual relations with an underage girl and drug use by former Trump Attorney General nominee and Republican Congressman Matt Gaetz. John Stolnis has more from Washington.    Mangione's Day In Court The man accused of fatally shooting the CEO of United Healthcare went before a judge in New York City. Correspondent Julie Walker reports as Luigi Mangione pleaded not guilty to state murder and other charges inside the courtroom, outside there were protests demanding he be released.     North Carolina Police Officer Killed A Greensboro, North Carolina police officer was killed after he responded to a 9-1-1 call about a man with a gun inside of a supermarket. Correspondent Lisa Dwyer reports.    Texas Sues NCAA Just 24 hours after President-elect Donald Trump told a crowd in Arizona that he will end what he called the “transgender lunacy,” Texas announced it is filing a lawsuit against the NCAA, as transgender athletes are about to face another challenge in court. Correspondent Gethin Coolbaugh reports.     Biden Commutes Death Sentences In his last month in office, President Joe Biden is commuting the sentences of most every prisoner on federal death row. Correspondent Donna Warder has the details.    Bill Clinton Hospitalized Bill Clinton has been hospitalized after developing a fever. The 78-year-old former president was in Washington, DC at the time, and was taken to Georgetown University Medical Center as a precaution for treatment and observation.      Busy Travel Day Today will be a busy travel day as a part of a tough travel week, with millions of Americans also facing weather issues including rain and snow in the Pacific Northwest and the Northeast, and some rain in the Midwest. Correspondent Julie Walker reports holiday travel did get off to a good start for some leaving early.    Trump On Panama & Greenland President-elect Donald Trump is doubling down on statements that he wants control of the Panama Canal returned to the United States, and that America should purchase Greenland from Denmark.     Migrant Arrested For NYC Subway Murder Critics are blasting New York City after surveillance video showed some people running away while others were standing around and watching after a woman was set on fire on a subway train. Pamela Furr reports fast action by police caught the primary suspect in the horrific killing, an illegal migrant from Guatemala who had been previously deported.    Dangerous California Surf A major storm is pounding California's central coast creating damaging surf conditions, and at least one person has died.  Correspondent Ben Thomas reports.    Arrest In Chemical Leak The head of a chemical company is facing charges in Michigan, related to the 2022 oil and chemical discharge into the Flint River.  Correspondent Haya Panjwani reports.    FAA Investigating Florida Drone Incident As Florida authorities are trying to determine why some drones fell from the sky in Orlando, Florida during a Christmas light show, the FAA is now getting involved after a young boy was hit by a falling drone and required life-saving surgery.  Correspondent Mike Hempen reports.     Nordstrom Sold A major department store chain is being sold and one of those buying Nordstrom is a Mexican retail group. Correspondent Rita Foley reports.     Tech News Quantum communications promises near instant transfer of massive amounts of data. But, until now, it was not able to traverse the existing Internet. Here's Chuck Palm with today's tech news.    Finally   This one most likely was not on your holiday gift list. Correspondent Norman Hall reports there's been an uptick in the sales of nuclear bomb shelters.    As we begin to close the door on Hollywood and music in 2024, Kevin Carr takes a look ahead for what we need to know about some of the top entertainment events in 2025. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Joshua E. Reuss, MD The phase 2 ICARUS-Lung01 study evaluated not only the efficacy and safety of datopotomab deruxtecan (Dato-DXd) in patients with previously treated advanced non-small cell lung cancer (NSCLC), but also potential biomarkers associated with response and/or resistance. Here to discuss the findings with Dr. Charles Turck is Dr. Joshua Reuss, Assistant Professor in the Department of Medicine at Georgetown University Medical Center.

Welcome to another insightful episode of the NeuroNoodle Neurofeedback and Neuropsychology Podcast! This episode features tech legend Jay Gunkelman and special guest Dr. Robert Hedaya, a pioneer in Functional Medicine and laser therapy.

In this episode, Cassandra interviews Cathleen Beerkens about her new book, “Your Creator Matrix: How to Use Optimal Wellness and Quantum Healing to Master Your Story and Create Your Reality”. Cathleen Beerkens is an author, speaker and a dedicated health professional with a diverse background in nursing and a passion for holistic wellness and healing. She has recently published her first book, Your Creator Matrix. Holding a BS degree in Health Education from University of Maryland and a BSN from Georgetown University, Cathleen embarked on her nursing career at Georgetown University Medical Center in Washington, DC.  Driven by a desire to share her insights with the world, Cathleen founded A Wellness Revolution in 2018 (awellnessrevolution.com). This organization is dedicated to training and certifying Health and Wellness Coaches globally. Through A Wellness Revolution, Cathleen Beerkens continues to be a catalyst for positive change in the global landscape of health and wellness. Grab your copy of Your Creator Matrix here:https://amzn.to/3XKrVsk Follow and stay up to date with Cathleen here:https://www.instagram.com/awellnessrevolution?igsh=em1uamxqNWI1ejQ%3D&utm_source=qr https://www.awellnessrevolution.com/ https://www.youtube.com/channel/UCIrkiWzJZvMxwAh28MDZTmA Grab the DDYL 101 workshop for FREE at -https://www.divinelydesignyourlife.com/DDYL101 SIGN UP TO GET ACCESS TO THE *FREE* REALIGNMENT BUNDLE + CONSCIOUS LIFESTYLE DESIGN ASSESSMENT + BUNDLE  —https://cassandrabodzak.activehosted.com/f/33 Work with Cassandra One on One:https://cassandrabodzak.com/one-on-one-with-cassandra Grab the “Amplify your Magnetism” 40 day guided manifesting through meditation journey here:https://www.divinelydesignyourlife.com/offers/9W5F4G7C/checkout Ready to get accountable and have Cassandra's coaching towards writing that book or launching that course, business or website! This group is for you!Join Cassandra's Creative hours:https://cassandrabodzak.com/cassandras-creative-hours Grab my FREE Divinely Design Your Life Guided Meditation Bundle here: https://www.divinelydesignyourlife.com/meditation-bundle Join us in THE REALIGNMENT, the 8 week course will have you upgrading your life both physically and energetically in lightning speed. https://cassandrabodzak.com/the-realignment Join Divinely Design Your Life: The Process here: https://bit.ly/3m1cR2Y Grab your copy of “Manifesting Through Meditation” the book here: https://amzn.to/2TZkX49 Grab your copy of “The Spiritual Awakening Journal” here: https://amzn.to/3IJe8Jd Love audiobooks like me? Join audible: https://amzn.to/2W4RcO3 Say Hi to Cassandra on social media!http://facebook.com/cassandrabodzakhttp://twitter.com/cassandrabodzakhttp://instagram.com/cassandrabodzakhttp://youtube.com/cassandrabodzakTV

In this video, Dr. Catherine M. Broome, Professor of Medicine at Georgetown University Medical Center, answers questions asked by the audience during her CME/NCPD–approved activity with i3 Health, Putting the Freeze on Cold Agglutinin Disease (CAD). Dr. Broome shares insights into resources she recommends for patients with CAD, the role of thromboprophylaxis, treatment advances to expect within the next year, the most important things for primary care providers and non-hematologists to know about CAD, and more! Interested in completing this activity and earning FREE CME/NCPD credit? Click here: https://bit.ly/3RlJJ8X

Who gets to decide on what it means to have a disease? I posed this question a while back in reference to Alzheimer's disease. I'll save you from reading the article, but the main headline is that corporations are very much the “who” in who gets to define the nature of disease. They do this either through the invention of disease states or, more often, by redrawing the boundaries of what is considered a disease (think pre-diabetes). On today's podcast, we invite Adriane Fugh-Berman to discuss the influence of industry, whether it be pharma or device manufacturers, on healthcare. Adriane founded PharmedOut, a Georgetown University Medical Center project that “advances evidence-based prescribing and educates health care professionals and students about pharmaceutical and medical device marketing practices.” I've listened to a lot of Adriane's talks. It is clear to me that she is not anti-medicine or even anti-pharma but is very much against both the visible and hidden influences that pharma and device manufacturers use to sell their products.  This could be through overt marketing like advertisements or drug rep visits, or more covert measures like unrestricted grants to advocacy organizations, funding of CME, paying “key opinion leaders,” or the development of “disease awareness campaigns.” So take a listen and dont worry, while GeriPal podcasts offer CME, we never take money from industry. By: Eric Widera      

The World's #1 Personal Development Book Podcast!  Join the world's largest non-fiction Book community! https://www.instagram.com/bookthinkers/ Today's episode is sponsored by Ken Rusk, if you're ready to get UNSTUCK check out the links below: https://courses.kenrusk.com/ https://www.kenrusk.com/ In today's episode we have the pleasure to interview Cathleen Beerkens author of “Your Creator Matrix: How to Use Optimal Wellness and Quantum Healing to Master Your Story and Create Your Reality”  In this episode, you'll learn about:   - Her book - What good health actually looks like - How health is about the whole - mind, body, and spirit - What science has to do with spirituality and energy - Insights into quantum healing - How you can begin to create your reality and step into who you are really meant to be. To learn more about Cathleen and buy her book “Your Creator Matrix: How to Use Optimal Wellness and Quantum Healing to Master Your Story and Create Your Reality”  follow the links below: Website: https://www.awellnessrevolution.com/ Book: https://a.co/d/coAiIZz Instagram: https://www.instagram.com/awellnessrevolution/ YouTube: https://www.youtube.com/@AWellnessRevolution Facebook: https://www.facebook.com/AWellnessRevolution/ LinkedIn: https://www.linkedin.com/company/wellnessrevolution/ Cathleen, is a dedicated health professional, holds degrees from the University of Maryland and Georgetown University, with over 12 years of diverse experience at Georgetown University Medical Center. In Washington, DC, she contributed to various medical settings, including the emergency room, medical/surgical ward, and high-risk labor and delivery units. Fast forward and Cathleen's journey led her to Amsterdam, where she delved into integrative medicine, earning certifications in practices such as Polarity Healing, Reflexology, and Reconnective Healing. Graduating as a certified Health Coach in 2017, she founded A Wellness Revolution in 2018. The organization globally trains Health and Wellness Coaches, emphasizing holistic coaching rooted in cellular well-being.  Cathleen went from being involved in western medicine to finding a better approach to our health and I'm so glad she did! What we have done as a society isn't working and it's time to bring in the new health care system, one of wellness, not sickness.  We hope you enjoy this incredible conversation with Cathleen Beerkens! The purpose of this podcast is to connect you, the listener, with new books, new mentors, and new resources that will help you achieve more and live better. Each and every episode will feature one of the world's top authors so that you know each and every time you tune-in, there is something valuable to learn. If you have any recommendations for guests, please DM them to us on Instagram. (www.instagram.com/bookthinkers) If you enjoyed this show, please consider leaving a review. It takes less than 60-seconds of your time, and really makes a difference when I am trying to land new guests. For more BookThinkers content, check out our Instagram or our website. Thank you for your time!

Dr. Matthew Biel, Professor of Psychiatry and Pediatrics at Georgetown University Medical Center, worries about the impact of social media on young people; Carolyn Mullen, ASTHO Senior Vice President for Government Affairs and Public Relations, says the federal budget continues to be the focus of work on Capitol Hill; ASTHO has new policy statements on Adverse Childhood Experiences and Public Health Infrastructure; and harm reduction laws are mapped in a webpage developed by ASTHO's Public Health Legal Mapping Center. ASTHO Webpage: Policy Statements ASTHO Webpage: ASTHO's Public Health Legal Mapping Center  

Dr. Matthew Biel, Professor of Psychiatry and Pediatrics at Georgetown University Medical Center, tells us social media is not necessarily a good part of childhood; Lexa Giragosian, ASTHO Senior Analyst for the Maternal and Newborn Health Team, says one concern linked to social media use is eating disorders among young people; and Dr. Anne Zink, ASTHO Past President and Chief Medical Officer for the Alaska Department of Health's Division of Public Health, headlines a series of four events aimed at learning the basics of disease forecasting. New York Times News Article: Today's Teenagers – Anxious About Their Futures and Disillusioned by Politicians ASTHO Blog Article: Reducing the Impact of Eating Disorders on Adolescent Girls ASTHO Webinar: Disease Forecasting Learning Series ASTHO Webpage: Stay Informed

Episode 8 features an interview with Shahram Ahari MD, an emergency medicine physician and former drug rep, that explores the world of pharmaceutical samples. We chat about why samples are the most important marketing tactic drug companies have, how samples are used to manipulate prescribing choices, and discuss whether or not drug samples should be banned. Pharmanipulation is produced by PharmedOut, a project at Georgetown University Medical Center that advances evidence-based prescribing. Additional Resources PharmedOut fact sheet on drug samples: ⁠https://georgetown.app.box.com/s/y51hkdvu2dju9sv26fjcc976ivlvwtkj Summaries of key articles on the topic of drug samples: ⁠https://georgetown.app.box.com/s/3052cjlgv9thfw0qf3k9fkuyio978mbr PharmedOut's paper “Pharmaceutical marketing: the example of drug samples.” Link: https://joppp.biomedcentral.com/articles/10.1186/s40545-022-00479-z PharmedOut's paper “Following the Script: How Drug Reps Make Friends and Influence Doctors.” Link: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0040150 PharmedOut's paper “Why lunch matters: Assessing physicians' perceptions about industry relationships.” Link: https://onlinelibrary.wiley.com/doi/abs/10.1002/chp.20081 Dr. Ahari's op-ed in The Washington Post “I was a drug rep. I know how pharma companies pushed opioids.” Link: https://www.washingtonpost.com/outlook/i-was-a-drug-rep-i-know-how-pharma-companies-pushed-opioids/2019/11/25/82b1da88-beb9-11e9-9b73-fd3c65ef8f9c_story.html

Artificial Intelligence enhances deterrence capabilities in various ways, contributing to the overall effectiveness of military strategies and national security. Deterrence aims to dissuade adversaries from taking certain actions by convincing them that the costs or risks outweigh the potential benefits. So, how does AI, particularly machine learning, serve as a force multiplier in the development and application of deterrence? Considering the role of AI in intelligence and military deterrence operations, how do algorithms enhance real-time human-machine interfacing and contribute to the overall deterrent effect against potential threats? And finally, what are some thoughts on the ethical considerations surrounding the use of AI in deterrence, especially in non-kinetic operations. Dr. James Giordano is Pellegrino Center Professor of Neurology and Biochemistry, Chief of the Neuroethics Studies Program, and Chair of the Sub-Program in Military Medical Ethics at Georgetown University Medical Center. He is a Senior Bioethicist of the Department of Defense Medical Ethics Center; Science Advisory Fellow of the Strategic Multilayer Assessment Branch, of the Joint Staff of the Pentagon; a Senior Fellow of the Simon Center for the Professional Military Ethic, United States Military Academy, West Point, and Distinguished Fellow at the Stockdale Center for Ethical Leadership. He was a designated Naval Aerospace Physiologist, and served with the US Navy and Marine Corps.

What does it really mean to “be healthy”? In this episode, join Dr. Kara Wada as she welcomes Dr. Kenneth Zweig, a specialist in sleep disorders, hypertension, and behavior change. They talked about the intricacies of primary care, the crucial role of sleep in overall health, practical tips for enhancing sleep quality, and the art of making lasting behavior changes. Plus, get insights into the unique aspects of concierge medicine. Listen to this latest episode for insights on how small changes in sleep and behavior can have a profound impact on your health and lifestyle! EPISODE IN A GLANCE-A Physician's Guide to Mastering Sleep & Behavior Change-Dr. Kenneth Zweig's Journey into Medicine-The Intricacies and Challenges of Primary Care-The Role of Sleep in Overall Health-Tips for Improving Sleep Quality-The Art of Behavior Change for Better Health-Concierge Medicine ABOUT KENNETH ZWEIG, MDKenneth Zweig, MD, is an experienced internist at Northern Virginia Family Practice Associates, specializing in personalized preventative care with a focus on sleep disorders, hypertension, and promoting behavioral changes for better health. With 18 years in the medical field, he values the patient-oriented approach of concierge internal medicine. Dr. Zweig emphasizes the importance of preventing medical issues by addressing poor behavioral habits and advocates for a holistic treatment approach that includes nutrition, exercise, and stress management.In addition to his clinical work, Dr. Zweig is an educator, serving as a clinical instructor at The George Washington University Hospital and an assistant professor at Georgetown University Medical Center. His past experiences include a 15-year tenure at General Medicine Internal Group, P.C. and involvement with the HealthConnect Accountable Care Organization. He has also volunteered in Honduras and received numerous accolades including Washingtonian's Top Doctor and the Patients' Choice Award. Dr. Zweig earned his doctorate from The Ohio State University College of Medicine. He lives in Arlington with his family and enjoys outdoor activities like hiking, biking, and skiing CONNECT WITH KENNETH ZWEIG, MDWebsite → https://nvafamilypractice.com/ LinkedIn → https://www.linkedin.com/in/louiskennethzweig/ Twitter → https://twitter.com/KenZweigMD ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@crunchyallergist SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health. JOIN THE BECOMING IMMUNE CONFIDENT JUMPSTART! If you are looking for support and realize that 2024 is 2024 the year that you gain a deep understanding of your body, learn to trust your ability to navigate the uncertainties that come along with living with chronic inflammation and build a lifestyle that supports and nourishes your immune system...APPLY HERE→ https://www.immuneconfident.com

​​This week's Wealthy Wellthy Podcast could actually save your life. I mean it.  Today's guests have a transformative approach to proactive healthcare. That's right, proactive healthcare. For too long, our healthcare industry has only responded to illness and disease after it's already present.  Well, Steven Marler and Dr. Anthony Sparks of Advanced Longevity are committed to changing that model in order to save your life, and they're both here to talk about this revolutionary new healthcare technology. Steve and Dr. Sparks, are not only experts in their fields but also passionate advocates for a transformative approach to healthcare. As you know, our healthcare system often gets caught in the trap of treating illness rather than preventing it. This episode sheds light on the critical yet often overlooked aspect of early disease detection and preventative health.  Steve shares the moving account of his mother's battle with late-stage cancer as a powerful reminder of the importance of early detection and the personal motivation that led him to champion comprehensive scans as a tool for saving lives. Dr. Anthony Sparks, with his time at Baylor College of Medicine and Georgetown University Medical Center, shares his invaluable perspective and experience throughout this conversation, highlighting how early detection of diseases like cancer - often when they are asymptomatic - can be life-saving for patients.  

Show SummaryOn this episode, we feature a conversation with Dr. Sumitra Muralidhar, Program Director for the Department of Veteran's Affairs Million Veteran Program. Since launching in 2011, 1 million Veterans have joined MVP. It's the largest research effort at VA to improve health care for Veterans and one of the largest research programs in the world studying genes and health.About Today's GuestDr. Sumitra Muralidhar is the Program Director for VA's Million Veteran Program (MVP) in the Office of Research and Development (ORD). She oversees the policy and infrastructure development for the collection and use of samples and genetic, clinical, lifestyle and military exposure data from one million Veterans. She served as ORD's liaison to the White House Precision Medicine Initiative under President Obama, and continues to represent ORD/MVP in the federal interagency group on precision medicine. She also serves as the designated federal officer for VA's Genomic Medicine Program Advisory Committee, which advises the VA Secretary on the development and implementation of research and clinical arms within the Veterans Health Administration. She previously served as Health and Science Advisor to the Senate Veterans Affairs Committee (SVAC), and Associate Professor at Georgetown University Medical Center. She received her Ph.D. in Molecular Biology from the University of Maryland.Links Mentioned In This EpisodeThe Million Veteran Program WebsitePsychArmor Resource of the WeekThis week's PsychArmor resource of the week is the PsychArmor course Demystifying Genomic Testing: Biomarker Tests for Better Prostate Cancer Outcomes. This course reviews some of the biomarker tests identified in this episode. This can improve the cancer diagnostic process as well as reduce unnecessary procedures, office visits, and costs. You can see find the course here:  https://learn.psycharmor.org/courses/Demystifying-Genomic-Testing This Episode Sponsored By: This episode is sponsored by PsychArmor. PsychArmor is the premier education and learning ecosystems specializing in military culture content PsychArmor offers an. Online e-learning laboratory that is free to individual learners as well as custom training options for organizations. Contact Us and Join Us on Social Media Email PsychArmorPsychArmor on TwitterPsychArmor on FacebookPsychArmor on YouTubePsychArmor on LinkedInPsychArmor on InstagramTheme MusicOur theme music Don't Kill the Messenger was written and performed by Navy Veteran Jerry Maniscalco, in cooperation with Operation Encore, a non profit committed to supporting singer/songwriter and musicians across the military and Veteran communities.Producer and Host Duane France is a retired Army Noncommissioned Officer, combat veteran, and clinical mental health counselor for service members, veterans, and their families.  You can find more about the work that he is doing at www.veteranmentalhealth.com  

Robin West, MD, Associate Professor of Orthopaedic Surgery at Georgetown University Medical Center, Professor of Medical Education at the University of Virginia School of Medicine, Inova Campus, Adjunct Associate Professor at Uniformed Services University of Health Sciences, and Head Team Physician for the Washington Nationals Baseball team shares the harrowing experience of her most difficult case, the differences in caring for football and baseball athletes, how her own experience as a patient has informed her professional practice, and more.

Join Christopher Habig in an enlightening conversation with Dr. Mark Dybul, CEO of Renovaro Biosciences and professor of medicine at Georgetown University Medical Center. The episode explores the challenges of healthcare innovation, advocating for a departure from bureaucratic hospital systems. Dr. Dybul shares Renovaro Biosciences' groundbreaking approach to cancer treatment, emphasizing immune system retraining and genetic modifications to minimize reliance on traditional chemotherapy. The discussion highlights the vision of democratizing access to innovative healthcare solutions, empowering providers in real-time decision-making, and fostering a culture of experimentation. As the episode concludes, Dr. Dybul offers invaluable advice for aspiring medical professionals: think big, push boundaries, and embrace technology to overcome challenges and drive innovation.More on Freedom Healthworks & FreedomDocSubscribe at https://healthcareamericana.com/episodes/More on Dr. Mark Dybul & Renovaro BiosciencesFollow Healthcare Americana:Instagram & LinkedIN

In this episode of The Root Cause Medicine Podcast, we discuss neuropsychiatric symptoms, brain health, brain inflammation, head trauma, and neurodegenerative conditions. They dive into: 1. Inflammation Root Causes 2. Traumatic Brain Injury and Psychological Processes 3. HYLANE Technology Dr. Robert Hedaya is a Clinical Professor of Psychiatry at Georgetown University Medical Center. He is a neuropsychiatrist that teaches functional medicine, psychiatry, brain health, brain inflammation, head trauma, and neurodegenerative conditions, and the founder of The Whole Psychiatry & Brain Recovery Center. Dr. Hedaya also wrote several books, including Understanding Biological Psychiatry, The Anti-depressant Survival Program, and Depression: Advancing the Treatment Paradigm. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

Today on Specifically for Seniors, we're going to do something just a bit different. We have three guests who are here to tell you three completely different stories about parts of their lives. You've met two of them on previous podcasts, but they didn't have the time to tell you the rest of their stories. The third is new to Specifically for Seniors, but it's the story of a part of American history that our generation cannot forget. So make yourself a cup of coffee, sit back, relax, and let these three men tell you about a part of each of their lives. Those of you who are regular listeners to specifically for seniors will recall Alistair Henry from our May, 2023 podcast. Alistair retired at 57, shed his possessions and went to live with the First Nations band in the Northwest Territory, then left Canada's North to volunteer, working with local NGOs. Those are nonprofit organizations in Bangladesh. He and his wife enjoyed budget pack packing for four months at a time in Central America and Southeast Asia in their sixties. In 2020, Alistair endured a double lung transplant. Alistair is back today to talk about the transplant and the work he is now doing as a Trillium Gift of Life advocate. On November 22nd, 1963, a 26 year old junior duty officer was on duty at Bethesda Naval Hospital when the casket containing the body of Jack Fitzgerald Kennedy arrived from Dallas. You met that naval officer on this podcast on May 3rd, 2023. Sorel Schwartz today is a professor emeritus of pharmacology at Georgetown University Medical Center, and Senior Pharmacology advisor at the FDA Sorel is with us today as we near the 60th anniversary of JFK's assassination. My third and final guest on today's podcast is Robert Norris. Robert's story is one that many of us who were draft aged during the Vietnam War era will have faced in one way or another. Robert is a Pacific Northwest, native Vietnam war, conscientious objector who served sometime in a military prison, an expat resident of Japan since 1983. He's the author of The Good Lord Willing, and The Creek Don't Rise. But, but let me let Robert tell you his story. We're talking to Robert from his home in Fukuoka, Fukuoka, Japan. Book Availability: The Good Lord willing and The Creek Don't Rise https://www.amazon.com/Good-Lord-Willing-Creek-Dont/dp/180100000X

Bilingual speakers effortlessly mix multiple languages into conversation – but something much more complex and fascinating is happening in their minds. Washington Post columnist Theresa Vargas and Sarah Phillips, a postdoctoral scholar in the neurology department at Georgetown University Medical Center, join host Krys Boyd to discuss bilingualism in our culture and the neurological pathways that allow language switching to flow so freely.

Episode 6 invites Ragen Chastain, activist and author, and Joel Lexchin MD of York University, to discuss myths about weight and health, the hype around Ozempic and Wegovy, and the unclear connection between weight loss and health.  Pharmanipulation is produced by PharmedOut, a project at Georgetown University Medical Center that advances evidence-based prescribing. To learn more about Ragen Chastain and her work, please visit her website: https://weightandhealthcare.substack.com/ Additional Resources Dances With Fat Monthly Workshop – September: Navigating Weight Stigma at the Doctor's Office date changed from September 27 to October 11 to avoid overlap with ASDAH's annual meeting. Link: https://danceswithfat.org/monthly-online-workshops/  Books “Fearing the Black Body: The Racial Origins of Fat Phobia” by Sabrina Strings. Link: https://nyupress.org/9781479886753/fearing-the-black-body/ “Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness” by Da'Shaun L. Harrison. Link: https://www.penguinrandomhouse.com/books/670607/belly-of-the-beast-by-dashaun-harrison/ Articles "Semaglutide: a new drug for the treatment of obesity" by Joel Lexchin and Barbara Mintzes. Drug Ther Bull. 2023 Oct 25:dtb-2023-000007. doi: 10.1136/dtb.2023.000007. Link: https://pubmed.ncbi.nlm.nih.gov/37879878/ “How the ‘It's Bigger Than Me' Campaign Is Harming Fat People for Profit" by Ragen Chastain. Link: https://themighty.com/topic/eating-disorders/its-bigger-than-me-campaign-harms-fat-people-for-profit/  “Weighing the Consequences of Weight-Loss Drugs” by Judy Butler and Dr. Adriane Fugh-Berman. Link: https://www.medpagetoday.com/opinion/second-opinions/104482 Igho J. Onakpoya, Carl J. Heneghan and Jeffrey K. Aronson. Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review. BMC Medicine 2016;14:191. Link: https://pubmed.ncbi.nlm.nih.gov/27894343/ Prescrire's "Semaglutide (Wegovy°) for excess body weight" Prescrire International 2023; 32 (245): 36-38. Link: https://english.prescrire.org/en/81/168/66102/0/NewsDetails.aspx Please note: the full article is available for subscribers only. PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Dr. Robert Hedaya has been practising functional medicine psychiatry for many years, and is a clinical professor of psychiatry at Georgetown University Medical Center. He is the author of Understanding Biological Psychiatry, The Antidepressant Survival Guide and Depression: Advancing the Treatment Paradigm, and the founder of the Whole Psychiatry and Brain Recovery Center, as well as a faculty member at The Institute for Functional Medicine (IFM). In this captivating interview for The MindHealth360 Show, Dr. Hedaya talks about how he uses Functional Medicine, focusing on nutrition, digestion, inflammation, toxicity, and hormone levels, and combines it with novel brain therapies which he bundles in his pioneering HYLANE protocol, for a truly personalised treatment for mental health and neurological disorders. HYLANE combines hyperbaric oxygen therapy (HBOT), qEEG guided transcranial laser therapy, and neural exercises to treat dysfunction in the brain. He has had great successes with treatment-resistant depression, anxiety, neurodegenerative and other brain disorders using this technology, sometimes even when not combined with functional medicine.  He also discusses how our brains can be deeply affected by socio-cultural, environmental factors and trauma, leading to dysregulation of the hypothalamic pituitary and adrenal (HPA) axis and epigenetic mutations which can affect vital functions such as methylation.

Rebecca McLaughlin is joined by Max Riesenhuber to have a conversation about the ethics and morality of artificial intelligence.Questions Covered in This Episode:What first interested you about neuroscience?Can you talk about recent advancement in AI and where we might go?Do we have a moral responsibility to artificial intelligence beings?What do you say to scientists who say that humans are just computers in a flesh case?What is moral truth?Do you think we need to be concerned about the ethical direction that AI's are taking us?What is the good side of artificial intelligence?How did you become a Christian?Guest Bio:Max Riesenhuber is a Professor in the Department of Neuroscience at Georgetown University Medical Center and Co-Director of the CNE. His research uses computational modeling, brain imaging and EEG to understand how the brain makes sense of the world, and how these insights can be translated to neuromorphic AI and augmented cognition applications. Max obtained his Master's degree in physics from the University of Frankfurt, Germany, and his PhD in computational neuroscience from MIT. He has received several awards, including Technology Review's “TR100”, one of the “100 innovators 35 or younger whose technologies are poised to make a dramatic impact on our world” and an NSF CAREER award.Resources Mentioned:“Klara and the Sun” by Kazuo Ishiguro“The Scandal of the Evangelical Mind” by Mark A. NollSponsors:To learn more about our sponsors please visit our website.Follow Us:Instagram | TwitterOur Sister Shows:Knowing Faith | The Family Discipleship Podcast | Starting Place | Tiny TheologiansConfronting Christianity is a podcast of Training the Church. For ad-free episodes and more content check out our Patreon.

A new editorial paper was published in Oncotarget's Volume 14 on August 30, 2023, entitled, “Subpopulations of AIB1 isoform-expressing breast cancer cells enable invasion and metastasis.” In their new editorial, researchers Amber J. Kiliti, Ghada M. Sharif, Anton Wellstein, and Anna T. Riegel from Georgetown University Medical Center discuss potential mechanisms of breast cancer invasion and metastasis. Genetic and epigenetic events drive individual tumor cells to proliferate and expand into a heterogeneous mixture of cells that evade immune surveillance, acquire the ability to invade the vasculature and spread as metastatic seeds to distant sites. Organ metastasis contributes to more than 90% of all cancer-related deaths. “The model of Darwinian evolution explains the stepwise selection of cancer cells capable of invasion and metastatic spread and an extensive body of work supports that cancer cell-autonomous features match the selected cancer cell ‘seed' with the appropriate ‘soil' of the target organ.” However, this concept was challenged in a recent paper in Cancer Research. Sharif et al. observed that a subclonal population of cells in a heterogeneous tumor can significantly alter the growth characteristics, invasiveness and metastasis of an entire tumor through cell-cell crosstalk. These functionally relevant cell subpopulations are difficult to detect through bulk analysis though their presence may influence disease outcome and efficacy of treatments. “In their paper, Sharif et al. detailed how expression of a splice isoform of the transcriptional coregulator and oncogene Amplified In Breast Cancer 1 (AIB1) in a small subpopulation of cells can lead to increased tumor growth and invasion of surrounding tissues by ductal carcinoma in situ (DCIS) cells.” DOI - https://doi.org/10.18632/oncotarget.28452 Correspondence to - Anna T. Riegel - ariege01@georgetown.edu Video short - https://www.youtube.com/watch?v=_yZnwzitBek Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28452 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, AIB1, AIB1Δ4, breast cancer, invasion, metastasis About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: SoundCloud - https://soundcloud.com/oncotarget Facebook - https://www.facebook.com/Oncotarget/ Twitter - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

This episode was originally released November 2021. Susan Hingle is a leader among leaders. She is an Internal Medicine specialist and a Professor of Medicine, who serves as Associate Dean for Human and Organizational Potential, and Director of Faculty Development at Southern Illinois University School of Medicine. She earned a bachelor's degree from Miami University and a medical degree from Rush University Medical College. She completed an Internal Medicine residency at Georgetown University Medical Center, where she served as Chief Resident of Internal Medicine. Dr. Hingle completed the Executive Leadership in Academic Medicine (ELAM) Program. She has been active nationally in numerous organizations, including the American College of Physicians, the American Medical Women's Association, the Alliance of Academic Internal Medicine, and the American Medical Association. She served as Chair of the ACP Board of Regents and Chair of Board of Governors and is President-elect for AMWA. Pearls of Wisdom from the episode: -Self-care is essential and we, as leaders, should lead by example by practicing it. -Wellness should be “THE Goal” NOT “A goal” in healthcare. -Organizations need to define what a healthy workforce looks like and make it a priority. -Let go of the drive for perfection! The goal should be to become the best version of ourselves. Just enough is good enough. -Understand the power of saying no. Recommended Reading: Just Enough- Laura Nash Untamed- Glennon Doyle The Hundred Years of Lenni and Margo- Marianne Cronin

You can also listen to this episode on Apple Podcasts or Spotify!Manish Agrawal MD and Paul Thambi MD are oncologists who have spent decades caring for patients with cancer. They realized early in their careers that chemotherapy could treat the cancer—but what about the emotional, psychological and spiritual impact of facing mortality? When they learned about the potential for medications like MDMA and psilocybin to help people gain access to parts of their minds they didn't know existed—and to address the human experience of suffering—they quit their day jobs as practicing cancer doctors to found Sunstone Therapies, the sole psychedelic-assisted therapy research and treatment center in the Washington, D.C. area.  The data are increasingly clear: these non-addictive substances hold the power to expand consciousness and improve quality of life.When guided by a trained therapist in the appropriate setting, even one experience with a psychedelic medication can help people unlock closed doors in their minds and to feel safe enough to explore its contents. They can be the catalyst for patients' ability re-route well-worn pathways of negative and maladaptive thoughts, feelings and behaviors.It turns out that science and spirituality aren't mutually exclusive.On this episode of Beyond the Prescription, Drs. McBride, Agrawal and Thambi discuss the inseparability of physical and mental health; the promise of psychedelic therapy to treat the psychological impact of cancer and other diseases such as PTSD, anxiety, and depression; and their shared excitement about the potential for these drugs to fundamentally expand the standard of care in medicine. Bios:Manish Agrawal, MDManish brings an extensive background and experience that spans medicine, engineering, philosophy, and ethics to his role as CEO of Sunstone Therapies. Driven by a deep interest in healing, Manish is particularly passionate about whole person healing and the transformative potential of psychedelic therapies. Manish previously held the position of Co-Director of Clinical Research at Maryland Oncology Hematology, where he dedicated 15 years to the care of cancer patients. He completed a fellowship at the National Cancer Institute, National Institutes of Health, and his residency at Georgetown University Medical Center.Paul Thambi, MDPaul brings deep experience in oncology care and clinical trial design to his role as Chief Medical Officer at Sunstone. He is a proponent of strong organizational culture and strives to create a compassionate, open and accepting workplace to advance whole person healing in medicine. As a medical oncologist, Paul developed important and meaningful relationships with patients, witnessessing their emotional and physical distress upon diagnosis and throughout treatment, leading him to explore psychedelic therapies to improve the emotional and mental health of patients fighting cancer. Paul completed his oncology fellowship at the National Cancer Institute and, prior to pursuing medicine, he began his professional career in engineering and consulting.Join Dr. McBride every Monday for a new episode of Beyond the Prescription.You can subscribe on Apple Podcasts, Spotify, or on her Substack at https://lucymcbride.substack.com/podcast. You can sign up for her free weekly newsletter at lucymcbride.substack.com/welcome.Please be sure to like, rate, and review the show!The transcript of the show is here![00:00:00] Dr. Lucy McBride: Hello, and welcome to my office. I'm Dr. Lucy McBride, and this is Beyond the Prescription, the show where I talk with my guests like I do my patients, pulling the curtain back on what it means to be healthy, health as more than the absence of disease. As a primary care doctor, I've realized that patients are more than their cholesterol and their weight. We are the integrated sum of complex parts. Our stories live in our bodies. I'm here to help people tell their story, and for you to imagine and potentially get healthier from the inside out. You can subscribe to my free weekly newsletter at lucymcbride.substack.com and to the show on Apple Podcasts, Spotify, or wherever you get your podcasts. So let's get into it and go Beyond The Brescription. [00:01:03] Buckle your seatbelt. Today we are going to talk about one of my favorite subjects, the re emerging field of psychedelic medicine. I truly believe it is going to change the landscape of modern mental health care in this country. I cannot wait to introduce you to my guests today, Dr. Manish Agarwal and Dr. Paul Thambi. They are oncologists who have spent decades caring for patients with cancer. They realized early in their careers that chemotherapy could treat the cancer, but what about the whole person? What about the emotional, psychological, and spiritual impact of facing a hard diagnosis and mortality? When they learned about the potential for psychedelic medicines like MDMA and psilocybin to address patients' whole health, to offer some acceptance and insight and access to the patient's interiority in ways that they had never seen before, Paul and Manish left their day jobs as practicing cancer doctors to found Sunstone Therapies. [00:02:13] This is where I am now sending some of my patients, not just to face cancer diagnoses, but also for anxiety, depression, and PTSD. Sunstone Therapies is the sole psychedelic assisted therapy research and treatment center in the Washington, D. C. area. The goal of Sunstone is to better treat the emotional and psychological impact of cancer and other disorders. Paul and Manish are contributing to the fundamental expansion of the standard of care in medicine and it is a wonderful thing to be part of and to watch. Paul and Manish, thank you so much for joining me today on the podcast.[00:02:53] Dr. Paul Thambi: It's a pleasure to be here. Thanks for having us.[00:02:55] Dr. Manish Agarwal: Yeah, it's great having you. Thank you. [00:02:57] LM:  The two of you together have backgrounds in medicine, engineering, philosophy, data science, and research, yet you landed in the field of psychedelics for a reason. Tell me why that is. What is so exciting about this field to you?[00:03:15] MA: Paul and I both have been practicing oncologists for almost 20 years, and over time we got really good at taking care of cancer patients, their physical symptoms, but their quality of life was not always directly proportional to how they physically felt. And over time it really starts eating away at you, that you're not able to take care of the emotional health of cancer patients.[00:03:35] When we saw this emerging field and started looking at the data, We visited and learned about it and then got training and explored to see is this real. And that's what sort of led us down this path is, for me personally I've always been into philosophy, that's why I have my masters in philosophy.[00:03:54] I've been interested in the human side of medicine not just the science side. Both have fascinated me and this really brought both of them together. The reason that Paul and I both went into medicine is to treat people and to make them feel better. And really, for the cancer patient, for any patient, you have to take care of everything, not just the physical symptoms.[00:04:14] PT: Everything that Manish said is echoed in my life and how I was drawn to this. And I think there were a few patients that really suffered emotionally that really hit home for me. And I carried that pain from what they went through with me. And when Manish showed me the data on psychedelic assistive therapy, it wasn't really the data, it was really more these YouTube videos where we saw how there were a couple of patients on the NYU trial and the Hopkins trial, and how they were before they went on that treatment and after. And there was a palpable change that you could feel through the video even, and it was just something that I wanted to be able to see if we can bring to our patients. [00:05:00] LM: Can you give me an example of a patient who has been served by this treatment, maybe a cancer patient? I'd love to hear an anecdote.[00:05:08] MA: There's a young patient with kids and a serious cancer, and had struggled with depression, didn't know anything about psychedelics, but really applied. And to see the change in his life, he's changed the relationship with his mother, who had a hard time with her son having cancer. And he was able to have a conversation with her afterwards, saying, I want my mom back.[00:05:29] And then he was bleeding, when he went home for something else, he got a cut. And his young boy sat up and said, “Dad, are you dying?” And he was able to sit and have a conversation with him. He said, I would never be able to do those things before. And he was able to really sense into that. And then the other group that's really, I've sort of been really blown away by is the military that we've been treating recently.[00:05:51] They have such complex things that they've seen, such complex trauma. And they've tried everything. I mean everything. For a military person to come and seek this care is not easy because the entire institution, it can affect their career if they talk about mental health. So they're desperate and to see the lives that are turned around, I literally wouldn't believe it if I didn't see it.[00:06:15] And it's been powerful to see them going from, thinking about suicide regularly, to really no meaning, to a sense of despair, to not where everything is great and perfect, but they're having a fundamental change, and they want to live, and they want to reconnect, and they're building their lives back together.[00:06:33] LM: I mean, that says everything that you need to know about why this is important. Acceptance, hope, peace, which isn't possible every day of the week, nor is it mutually exclusive with ongoing pain, as humans experience a myriad emotions on a day to day basis. But to think that there's something out there that could give people more agency and acceptance is pretty extraordinary given that we've had pretty poor tools to help people with emotional health and mental health. And so I guess my question to you is then, how do you see the psychedelics changing the way we think about mental health?[00:07:19] PT: One of the things that can help to do is just to shine a light on this is a part of our health that we need to focus on. There is now these tools that are being talked about that can be helpful, perhaps more helpful than the existing tools and that allows people to start talking about their emotional health more to their doctors, to their family.[00:07:44] And in terms of how these medicines can help, I think it's not just the medicine. I just want to talk a little bit more about that because the medicine does some things and would act on some of the same receptors that SSRIs act, but there's more to it than the medicine. You talked about it being an experience and it is that, and it's not always that it finds stories that are hidden, sometimes those stories are there and people feel them all the time, but they turn away from them. And what you need to do, what we're starting to learn with this is that you need to create an environment, a container as it's called in this space, that feels safe, that allows people to trust and be vulnerable in that space.[00:08:32] So that when they experience those fears, and some of those stories may be hidden, some of them may be ones that they've lived with their whole lives, but now they can look at those. They can be with that story that they've felt, and face it. Because they feel a sense of trust, and they're with therapists or people who care about them.[00:08:53] Who created a relationship with them that allow them to go deep into that story and find the pieces of that story that serve them and the, and the pieces of the story that don't and talk about that, integrate that into their lives, integrate that into their conversations with their families. It's that that does the healing more so than the medicine or as much as the medicine.[00:09:17] LM: It's such an important point because I see patients Who I will kind of raise this idea to—people who have complex PTSD or who are facing terminal diagnosis. And sometimes they'll say to me, well, I tried mushrooms in college and [it] didn't do much then. And I just had a bad experience. I remind them that that set and setting matters so much.[00:09:40] And I think it's such a good point that it's not just the medicine.It's the ability to feel vulnerable and safe, which is sort of this mystical aspect of the medications and then to face some things that you already did know you had and that weren't hidden. I think that's a great point.[00:09:57] MA: Yeah, I mean, I think it's actually pretty nuanced in all of that, because one thing I tell people is, I think psychedelics allow you to access psychic material like no other thing that I know of. But they're not a magic bullet. And if MDMA cured PTSD, I tell people that anyone that goes to a rave wouldn't have PTSD anymore.[00:10:22] But lots of people go to raves and still have PTSD. And so it must be more than the medicine. So it's not to take away from it, because I think you have access, but it is again, the context or, or how it's received. And so, it's like any medicine, the wrong dosage in the wrong context can be harmful or beneficial.[00:10:37] And what you talked about, I think, is really nuanced, and I think it's important. We actually call it sometimes therapy assisted by psychedelics. Because a relationship allows you to really trust, and to trust yourself, and to go deep. And if you have that sense of trust, you're able to access material that you may not otherwise be able to.[00:10:56] And a lot of times, sometimes injury or things occurred in a relationship and to have another wiring of your brain in a healthy relationship, to be witnessed when you were in pain or just to be held or to be supported is a different experience now than it might have been the time that it happened. And you're able to almost nurture that younger part of yourself.[00:11:18] And so that's, it's really, it is quite cutting edge and that's one of the things that fascinated us because it's not… people want medicine therapy. It's like, it's really this combination of the two and, and so you can emphasize one, emphasize the other, but without the two and done in concert and the right setting, it just is not as effective.[00:11:37] And so, you know, for us the therapists and the medicine are super important, but so is everything else. So the way the room is set up, the furniture, the music. The person that answers the phone, the way you're received, the way the follow up is. Because if you think about it, we all are sort of on alert, and you get a sense in your gut, can I trust this place? Can I trust this institution? Can I trust this store? We have relationships with people and institutions, and you start… some part of your psyche that's assessing for danger knows, how deep can I go? And so, you really have to build a place that tries to reassure even the unconscious part that it's okay to go deep here.[00:12:18] LM: I think it's such a good point. And because I was going to ask you how much… let's take psilocybin, for example, which is the active ingredient in mushrooms, how much of that feeling of safety and trust is the chemical itself, and how much is the therapist, the experience of, you know, calling the front desk, scheduling, seeing the lighting, seeing the room, because I have patients who are in therapy for 30 years, even, who trust their therapist, who feel safe, they have a comfortable experience, but they aren't actually making the kind of progress that you sometimes see in patients who have three experiences with psychedelics in the right setting.[00:13:08] MA: I don't think it's medicine that causes the trust. I think it's the environment. I think the medicine brings to the surface the issues that are there, and without the trust, you are not able to process them. And so, yeah, if they have a trusting relationship with their therapist, that's probably a really important piece, but then it's also deeper than that.[00:13:29] Can the therapist handle whatever material comes up? Are they able to be with that? Do they know how to navigate that? And so, if there's distress or anxiety or fear, what they don't necessarily need is reassurance or minimizing of it, and it's how to navigate those waters that's a different skill set than traditional therapy. I don't think the medicine in itself causes trust, it just amplifies what's there, but in a therapeutic relationship trust can be built, and trust is an intrinsic part of each one of us, but it's to rediscover that.[00:13:58] LM: Such a great point.[00:14:00] PT: I echo all of that. I think also, what the medicine does is when you feel that trust, the medicine is a catalyst for you to go into those crevices that you talked about within the story. It may be a story that you know about, but now there's going to be chapters of that story that were hidden to you. And if you feel the trust, it allows you to do that in a way that I think is hard to do on your own. So there is that catalyst that you get from the medicine around that.[00:14:30] LM: It's so gratifying to hear you talk about these sort of mystical and, and visible elements of the human experience because, again, I think that's what's missing in modern medicine, at least in the United States. We don't think about the 364 days a year you're not sitting with your doctor as health.[00:14:52] We don't think about the way we feel in our bodies, the way we think, our self perception, the way we approach stress or vulnerabilities as health. When actually there are direct physical impacts of chronic stress on our bodies. There's direct physical impact of what you described as a vigilance.[00:15:16] In fact, so many patients I see have been diagnosed with anxiety. And we'll use the word anxiety kind of casually, because it's so commonly used, people know the word, but, but actually when you dig deeper with a lot of these patients who have “anxiety” it's not necessarily that they worry excessively, or that they feel even anxious, they don't even often identify with that word, but that's the code in their charts: F41.9, but a more nuanced description of the way they feel, I think, is this vigilance, this sort of emotional, behavioral, and then sometimes medical reaction to feeling threatened that stems from an experience or set of experiences in their childhood. And we talk about adverse childhood experiences having physical and emotional mental health manifestations later in life.[00:16:06] But I see patients all the time who have been diagnosed with anxiety, but whose symptoms stem directly from some adverse childhood set of experiences or experience. And then they have hypertension, binge eating, cardiovascular disorder, cardiovascular disease, racing thoughts, sort of like a twitchiness physically and emotionally when they are faced with stress. And I think that those are the people, as far as I understand it, who have had PTSD who are being studied first and foremost with psychedelics. Is that right?[00:16:41] PT: Yeah, that's right. Right now, that's the indication that has shown the most benefit with MDMA.[00:16:45] MA: Yeah, and to piggyback on, I mean, you've made a couple of points, I guess, and we should probably just touch on them. I think just working backwards… the last point, I think that if people do have these feelings of anxiety or depression, and I think when, um, a disservice we've done is pathologize them, that somehow that's the problem.[00:17:05] And it actually is a sign of health because they're having a normal reaction to abnormal situations. And so, what trauma can sometimes be is that when you're very young you have a situation that was very difficult. But you responded normally, you would feel anxious or you'd feel depressed or sad. But then you didn't have support in that situation and so it got stuck.[00:17:27] And then, now you react when things arise, your body, your psyche has a visceral memory of that, of that lack of safety or that issue that occurred. And so, it's not that the person is a problem, it's not a pathology. They had a normal response to an abnormal situation, whether it was an abusive family member or neglect or abandonment, whatever it was.[00:17:50] It's just that, that situation isn't occurring now. And they need support to be able to work out of that. And what they do, what I've seen sometimes, is that actually becomes their superpower. So they get really sensitive. If you had power issues and somebody that powered over you wasn't, you get really sensitive to that.[00:18:07] And you know in your body when something might be happening even before your mind does. And so, it's turning that story to say it's not a problem as much as how you can move on with it. And then the only other comment I was going to make is on the first part you were saying around, medicine, not looking at these other aspects of our emotional health and I think it's a historical time, really. I think for much of history, the shamans were the physicians and there was a connection between the mind, body, and spirit. And then to great progress, we developed a great scientific understanding of the body and develop antibiotics and other things that help us live a lot longer.[00:18:47] And that's helped us, but then because your blood pressure is good and because your coronaries are clean and you don't have cancer, it doesn't mean you're happy. Now I think things are turning again, that the human is not just a biological entity, but it's also a spiritual, emotional, psychological… whatever you want to call it.[00:19:06] And until you have all of that together. You're just not going to feel fully human. And so before there was this science versus religion or science versus woo woo or whatever it is. But I think more and more you'll see really respected neurobiology labs that are starting to, to talk about that. And you're doing MRIs of monks of brains and you're seeing that meditation causes certain changes.[00:19:27] And then when we do MRIs of patients on psychedelics, going back to your point on vigilance, there is something called the default mode network. And that part of the brain is always looking for problems. It's the default mode. It's being vigilant. And that's the part that quiets down, other parts of the brain wake up, and they're able to start connecting.[00:19:49] And so science now is backing up what's happening. And so there's not so much this tension there, and people are wanting to both be physically and emotionally whole.[00:19:58] LM: It makes so much sense. I've heard Roland Griffiths talk about the experience that long term meditators can have as being the closest to the experience or benefits of psychedelic. Is that something you agree with?[00:20:18] PT: Yeah, I think that, that makes sense. I mean, I think deep meditation allows you to see or feel things that you're feeling with a little bit of removal from that. And that allows you to have a different perspective. So, there is a correlation that can be made.[00:20:36] LM: So, when people look at the New York Times and they see an article about psychedelic medicine, I think they automatically, in many cases, go to two thoughts. One, aren't these recreational drugs that are just for people in rock concerts in the 1960s? And two, that doesn't apply to me. This is for people who are really far gone. And so I'd love for you to speak to the sort of stigma around psychedelic medicine, where that comes from.[00:21:08] PT: Yeah, and Michael Pollan talks a lot about this in, in his book How to Change Your Mind and how there was social and maybe political pressure around creating stigma. So I think that's some of what happened and then also you get into the 1980s where, you know, this is your brain on drugs, those commercials that would come out that really heightened my sensitivity as a child growing up in the 80s around that.[00:21:34] And I think those are things that are hard to release. And now that we're starting to understand, and this is coming up again, psychedelics, realizing that these have been around for millennia. And they've been used by cultures as rites of passage for ways to solve the problems of a community. And I think now that those stories are coming back up and also the scientific data which provides people with a level of comfort, especially those people that have this fear of addiction and drugs and all of those things that I had when I was a kid, knowing that this is coming up in the medical institution. Along with the stories from the past are allowing for people to see this in a different way and to accept it more… I think one of the reasons that people feel safe doing this is that, especially like in the environments that we have at Sunstone, where it is in a sort of a medical environment, where our office, where we treat people, is on the campus of a hospital, and they can see the hospital out the window.[00:22:36] And we're clinicians that have treated patients before as doctors, and it's in a research setting. That allows them to overcome that stigma, to feel safe as they embark on this thing they were told never to do in the past.[00:22:51] LM: And so what do you make of this kind of... Emerging industry where people are taking the medicines off label with various healers and going on retreats in Costa Rica, because I worry, I don't know if you worry that if the set and setting are not appropriate, if the person who is supposed to be the guide isn't trained or perhaps worse, if the recipient of the therapeutic isn't aware of the potential risks and isn't guided in an appropriate way, then, then we might end up losing all the ground and getting these medications approved through the appropriate medical channels. Do you have that concern? [00:23:32] MA: For sure, to some degree I do. I mean, I think there are probably great practitioners around some of those settings, but there's just no way to filter through that. And what I worry about, and I get more worried about, is the longer we're doing this, because we're treating complex PTSD patients, they're complicated. And things that come up, if you're not trained and equipped to do that well, it actually... it causes more harm. In fact, I was speaking with a senior psychedelic therapist who's worked for MAPS in Colorado, and she does only things legally, but she does a lot of integration work, and it's integration work for people that did psychedelics underground.[00:24:17] And the biggest thing that she sees... As people got re-traumatized because they would have an experience and it was severe and the therapist wasn't able to be there. So then again, it felt like what I'm feeling is not okay, which is a feeling that they had the first time. And so she's having to rework through that.[00:24:35] So in that way there's legitimate concern. And the other thing that I worry about is, we've seen this, that you talk to people, they seem fine, or you have one assessment of their mental condition, but it gets more complex and even they're not aware of it fully. And so you have to be really prepared for that.[00:24:56] And the other point I was going to make is what you said, what you asked initially about the underground. But then you also said, people said, I'm not as sick, or how about that stigma? So I think there's a real stigma around mental health. There's a stigma around psychedelics and there's a stigma around mental health.[00:25:13] And so this is both. What it still surprises me time and time again is that people just under report their symptoms, but they still seek it out. So there's sort of this dance. They're like kind of… I'm really kind of okay because it's how they dealt with it. It's like we don't have an environment where you're able to be sad or anxious and there's not something wrong with you and so people play it down and… this is totally anecdotal, but I swear it's worse with men. We'll see, they'll come in, and they're like, I'm fine, I'm fine, and then you, well I drink a lot, and then, yeah, I guess I have feelings of sadness, and then you do the scale, and it's like, wow.[00:25:53] I think it's even harder for men to admit their emotional struggles and that's just a generality, but overall I think there's a collusion of denial around our emotional state and somehow you just have to be, present a certain way, and there's something wrong with you if you're struggling.[00:26:07] LM: I mean, I have a couple of thoughts about that. One is thank you for saying out loud that men are more walled off than women to a woman. No, I'm kidding. I think you're generalizing, but yes, let's just acknowledge that we are very self aware species, women, that is. Secondly, I think we all have a level of denial.[00:26:22] I think denial serves us sometimes, right. Denial is a way of partitioning off pain so that we can cope and function. But then when denial takes on a life of its own and the stuff that is in the denial closet is sort of seeping through the edges and like running out of the bottom of the closet and informing our health, that's when denial is no longer serving us. It's when it's actually in the driver's seat. So it strikes me that the experience, in an appropriate setting with a psychedelic, could help people pull that wall down or open that closet and, and take a look inside and maybe rethink how they approach that thing they didn't think they could approach.[00:27:08] And then secondly, yeah, mental health still has a bad rap when, as you both know, we all have mental health. It's not a feature you can kind of opt out of as like the human without the mental health. And as you said earlier as well, we tend to medicalize and pathologize mental health.[00:27:30] So in a way that's good because we are acknowledging that these have medical consequences, that an anxiety disorder is a medical condition, as opposed to just a personality flaw, which was what some people think of it as. But we also tend to label and sort and diagnose conditions that are just normal.[00:27:50] Like, of course, when someone has been raised by an alcoholic parent and they have been conditioned to sort of be a certain way, sort of invisible or good or not a problem, that is going to have an impact on their health such that when they get into a therapist's office or a doctor's office in their forties and their maybe that's not depression.[00:28:13] Maybe you had a response to an experience and sure the symptoms are that of depression, but it's actually something more complex, more nuanced. And so I'm not really asking you a question. I'm just making an observation that we're up against a lot as we market these medicines and therapeutics to people because of the stigma around mental health because of the stigma around drugs But I think if it's done well—which is why Sunstone and other research institutions exist—if it's done well, and we can actually help people understand that their interior lives their past their stories have relevance to their health. And that yes, having clean coronary arteries and nice blood pressure is great, but it's not sufficient for health, then it really, I do think is going to change the way we think about health.[00:29:04] It's already changed it for me. It's just that it's not legal yet in DC. And I haven't tried psychedelic medicine. I want to, it has changed the way I think about emotional health. I mean, I've been thinking about mental health and health in this way, my whole career, but I don't think modern medicine has given doctors really permission to do that.[00:29:20] And so I wonder what you think is in the pipeline. Are these things going to be FDA approved in the next five years, ten years? Are people going to be able to access these therapeutics? Are there going to be enough guides to appropriately shepherd people through the process? What are we looking at in the next year or five years.[00:29:41] MA: I just want to comment a little bit on what you said around the denial piece. I think that denial actually is quite healthy. And on where your neurological system was, when you experienced something, it might've been, it probably was overwhelming and the proper and healthy response would have been denial and to put it into a box.[00:30:00] It's just that now it's not necessary and it's not integrating back into your life. And so I'm very wary of pathologizing any of these things because they're usually healthy. It's just in the context now. And so I just make that one point and the other one around the mental health issue that, it's good that we're talking about it, but I think that we wouldn't want a life without emotions, right?[00:30:23] If you push down your anxiety and your fear, you also push down your joy and happiness and love, the things that we humans live for. And so they sort of go both hand in hand and you can't have both of those.[00:30:38] LM: Yeah, sort of like when we talk about alcohol when we're sort of self medicating, right? It blunts distress, but also blunts joy, libido, life. So you can't selectively numb. You also can't selectively be the human without an emotional life because that wouldn't be good. Then we'd all be like chat GPT or AI, right?[00:31:00] PT: Yeah, yeah, and it just, I'm just going to piggyback on that denial part of things too, because I think one of the things that's important to remember is that people have built up these ways of denial, of sort of pushing things away. Psychedelics, like we mentioned before, can be a catalyst to break through that denial.[00:31:17] That can be, you can lose your balance when that happens. So I just want to highlight again how important it is to have that integration and that container afterwards because you can't feel that way afterwards. You have to be with people that help you find that centeredness again. [00:31:35] And in terms of access and what's happening, we talked about how MDMA has been studied in PTSD for some time now. And there are two phase three trials. They're showing significantly positive results. And that might be the first medication that gets approved as a psychedelic for PTSD outside of esketamine, which has been approved for depression. And that might happen in the next year or two and we will hope for that.[00:32:01] And psilocybin is behind that in terms of how it's being used in various types of depression, and more and more information is coming out around that looks good, and perhaps if it continues to look good, that could be the next medication that gets approved. We'll see. So I think those are the things that are happening in terms of access and how we get this to people if they are approved, if they do show that they are effective, You're right, I don't think our healthcare system is built for this right now and there aren't enough therapists that are trained in this to treat everyone that has PTSD or even a half the people that have PTSD that might qualify for MDMA or for psilocybin in some sort of depression. And that's what we're thinking a lot about.[00:32:48] We have investigated how to do this in a group setting, with group preparation, taking the medicine as a group, and having integration as a group. We find it is not only a way that introduces efficiencies, but we also see therapeutic healing with that approach, too. To be able to be connected with another group of people that have something similar to what you have or what you're going through, whether that be cancer or PTSD or depression, and to develop this bond during the sessions that you have with each other around preparation and integration, we think that's probably going to be therapeutic, too.[00:33:29] That model also allows for more people to be trained on this. So, we're trying to think about how to do that from a group setting. We're trying to think about how digital tools can be used to improve or to give us efficiencies in this setting, but also remembering that there's compassion that's needed with this, so not to overuse digital processes. We're thinking about that as well. How do you do scheduling and other things? So, I think there's a number of problems to be solved around access, but they're solvable.[00:34:00] LM: And so if you're listening to this and you're thinking to yourself, wow, I've been in therapy for 10 years. I'm on Prozac, but I still feel anxious. I'm sure there's some parts of me I haven't really discovered. This sounds really interesting. Or if you're just listening and want to try psychedelics, where would you go?[00:34:18] Would you have to enroll in a clinical trial? Would you call Sunstone? Would you wait until MDMA is approved? What would you do if you were curious and wanted to participate in the research or the therapeutic elements here?[00:34:31] MA: I think the first thing you would do is look for a clinical trial. And so, there are many, many places now that are doing research throughout the country and internationally. And certainly at Sunstone, we have five studies open now, and we will have another three more open this year. We have them in depression and anxiety and PTSD and cancer and family members of cancer patients and so there's other places that have that. So I think that's sort of the most rigorous way to get that. And I do think that some medicines, as Paul said, will be approved next year. I think that, I cannot underemphasize the importance of the context and the safety. What you don't want is to do something and get worse and so you want to make sure that you have safety if you're not good on that road.[00:35:16] And I think we've talked a lot about the upsides of psychedelics and we're talking about that because so much of mental health right now, we don't have great treatments for, but we're still really in early days and we still have a lot to learn. Who's most going to benefit? Which people are completely contraindicated for?[00:35:36] How do you get people ready? And so I understand the hype because people are desperate. And at the same time, I want to be cautious in that I think we're still learning about how to use these powerful medicines.[00:35:50] LM: Yeah, I mean, I think one thing I am concerned about in particular, and I know this is out there in the public, is the potential risk for someone, particularly in their 20s who may be predisposed to schizophrenia. Is there a link between the use of psychedelic drugs and either the awakening or the schizophrenia or mental illness?[00:36:09] Plus, as you've already talked about, this idea of not having the right set and setting not having the appropriately trained guide or the feeling on the patient side of of safety and trust such that people get worse. So what are the absolute contraindications right now in your mind?[00:36:28] PT: Some of them are around people who have a tendency towards manic episodes. Like bipolar disorder with mania because that has been described where people had manic episodes after having a psychedelic experience, so I think that's one firm contraindication right now, at least in research trials. [00:36:49] The others are—there are some cardiac effects that people worry about with some of the psychedelic medicines, so if there's a history of abnormal heart rhythms or a potential tendency to have an abnormal heart rhythm, that's another contraindication. Some of them like MDMA have sympathomimetic effects, which means they can cause the heart rate to go up and the blood pressure to go up. So if someone doesn't have controlled high blood pressure, or if they have underlying heart disease, they may need to get evaluated with a stress test and things like that to show that things would be safe if those conditions happen.[00:37:27] LM: And what about, so many Americans are on SSRIs, so is there a contraindication? For people who are on SSRIs or who are on any other medications at all?[00:37:38] MA: In terms of the SSRIs, right now we taper people off of them, and it's less about safety as much as efficacy, that we think it might blunt the depth of the response of a psychedelic. Although there are ongoing studies that are bringing some of that into question, and so they probably do work maybe at a higher dose, and so it's not an absolute contraindication, it's certainly not a contraindication for safety, it's just a, you might limit its efficacy.[00:38:02] LM: Interesting.[00:38:03] MA: And some of the drugs that can prolong the QTC, there's some concern around that, and so we certainly do EKGs on all the patients.[00:38:11] LM: What is so great about the way you're describing the research is that you have a healthy level of respect for these medications. You have enthusiasm, but it is tempered with appropriate caution. So thank you guys for joining me. It's been so fun learning about Sunstone. I've been grateful to you guys for taking some of my patients into your clinical trials, and I can't wait to see what's next.[00:38:37] PT: Thanks for having us, Lucy.[00:38:39] MA: Yeah, it's just been great getting to know you.[00:39:03] LM: Thank you all for listening to Beyond the Prescription. Please don't forget to subscribe, like, download, and share the show on Apple Podcasts, Spotify, or wherever you catch your podcasts. be thrilled if you liked this episode to rate and review it. And if you have a comment or question, please drop us a line at info@lucymcbride.com. The views expressed on this show are entirely my own and do not constitute medical advice for individuals. That should be obtained from your personal physician. Get full access to Are You Okay? at lucymcbride.substack.com/subscribe

Plastic surgery is a profession that seems to be almost inextricably linked with certain ideas about physical beauty in popular culture. Yet, l have often wondered whether working in the field might not give plastic surgeons a more nuanced understanding of beauty than we tend to give them credit for.In this episode of This is Beauty Podcast, I talk to Plastic Surgeon and Researcher Dr. Michael Reilly, a double-board certified facial plastic and reconstructive surgeon at MedStar Georgetown University Hospital in Washington, DC, about the subject of beauty and the role it plays in his profession and his practices, both as a cosmetic and reconstructive surgeon. How does the concept of beauty inform his work and how has his work influenced, or been influenced by, his personal philosophy of beauty?While I have always had lots of questions on the subject, plastic surgery is a topic that I've always skirted on the show until now — not because it doesn't have a place here, but because I really wanted to avoid the kind of skin-deep only conversations that can erupt when people mention beauty and plastic surgery in the same breath. In Michael, I found not only an expert on the subject of cosmetic and reconstructive surgery, but someone who has clearly given the concept of beauty and its relationship to his work serious thought.In this conversation, we discuss Michael's work with both his cosmetic and reconstructive surgery patients and how beauty takes on different meanings depending upon the objectives of the procedure and more!Enjoy!When perfection matters Social media's influence on the field of plastic surgeryHow mental health and self-esteem influence patient outcomesDr. DeSilva on the Golden Ratio and the most world's most beautiful womenDefinitions of beauty Bell's Palsy and Facial Paralysis Who benefits most from plastic surgeryWhy men seek plastic surgeryStandards of physical beauty: men vs. womenAge as a factor in proceduresWhy people elect plastic surgeryMentioned in this episode:MedStar Georgetown University Hospital The Most Beautiful Women in the World - Dr. Julian DeSilvaBell's Palsy and Mental HealthPsychology Today Blog: Dissecting Plastic SurgerySocial Media Drives Interest in Plastic Surgery ProceduresPlastic Surgery Can Make You More LikeableAbout Today's Guest:Doctor Michael Reilly is a Professor of Otolaryngology--Head & Neck Surgery at Georgetown University Medical Center and a double-board certified facial plastic and reconstructive surgeon at MedStar Georgetown University Hospital in Washington, D.C. His areas of expertise include both facial cosmetic surgery, including the full spectrum of minimally invasive treatments, and facial reconstructive surgery, with particular interests in the areas of nerve paralysis and microvascular reconstructive and melanoma...

The Ethical and Religious Directives have been a popular topic of conversation in health care circles for the past year. But what if we stopped viewing them simply as a list of do's and dont's, but as a living document articulating the mission and identity of Catholic health care?Betsy Taylor, editor of Health Progress, and Fr. Myles Sheehan, director of the Edmund D. Pellegrino Center for Clinical Bioethics and the David Lauler chair of Catholic Health Care Ethics at Georgetown University Medical Center, join the show to discuss the ongoing conversation around the ERDs and how they can fortify the identity of Catholic health care. Fr. Sheehan also speaks directly to several specific parts of the ERDs, giving a comprehensive view of the directives and guiding principles beneath them.

Episode 5 invites Tony Scialli MD, an obstetrician-gynecologist and reproductive toxicologist, to talk about the overuse of gynecologic surgeries – namely hysterectomies and Cesarean sections. Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/1bdbxvaezezlpu0qsm02q3101mmhsi3a To learn more about Dr. Tony Scialli, please visit his website: https://www.scialliconsulting.com/#about Additional Resources The Cultural Warping of Childbirth by Doris Haire. Link: https://www.abebooks.com/9789315600471/Cultural-Warping-Childbirth-Doris-Haire-9315600479/plp Our Bodies, Ourselves by Boston Women's Health Collective. Link: https://www.simonandschuster.com/books/Our-Bodies-Ourselves/Boston-Womens-Health-Book-Collective/9781439190661 Spiritual Midwifery by Ina May Gaskin. Link: https://www.abebooks.com/servlet/BookDetailsPL?bi=31385160493&ref_=ps_ggl_17730880232&cm_mmc=ggl-_-US_Shopp_Trade_10to20-_-product_id=COM9781570671043USED-_-keyword=&gclid=Cj0KCQjw1_SkBhDwARIsANbGpFs4ExX1P9YXQFUuTueJytlUy2VdelLMIBU7neywgGu14aYawh1w7hkaArxfEALw_wcB National Women's Health Network. Link: https://nwhn.org/ PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Episode 4 invites medical anthropologist Sylvia Önder PhD and cultural psychologist Yulia Chentsova Dutton PhD to discuss the differences among disease, sickness and illness and explore the concepts of invented diseases, folk illnesses, and the social value of certain diseases.  Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/ufrrmreu5d26cbfvorbu863uz32qkih9 PharmedOut Conference: https://sites.google.com/georgetown.edu/pharmedout/resources/conferences/2023-conference Bonnie O'Connor. Healing Traditions: Alternative Medicine and the Health Professions. 1995. Link: https://www.jstor.org/stable/j.ctt3fhvd3 Irving Zola. Medicine as an institution of social control. 1976. Link: https://www.jstor.org/stable/43618673 Michel Foucault. The Birth of the Clinic: An Archaeology of Medical Perception. Link: https://www.penguinrandomhouse.com/books/55034/the-birth-of-the-clinic-by-michel-foucault/  PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Karen and Blake talk with Professor James Giordano from the departments of Neurology and Biochemistry at Georgetown University Medical Center about the phenomenon called Deja Vu. Learn more about your ad choices. Visit megaphone.fm/adchoices

Sorell Schwartz, PhD is Professor Emeritus of Pharmacology at Georgetown University Medical Center, Senior Pharmacology Advisor at the U.S. Food and Drug Administration and has had advisory appointments at the National Library of Medicine, the FDA, the EPA, the National Institute on Drug Abuse, the FTC, the U.S. House of Representatives, OSHA, the Department of Defense, the FBI and WHO. Dr. Schwartz explains the confusion between the FDA and CDC and their roles, the importance in taking our medications as directed, the interaction among our mutiple medications, the difference between side effects and adverse effects, the efforts toward deprescribing, the proper way to stop a medication and the current thinking about Mifepristone and Misoprostol. This is a podcast you cannot miss. Your life could literally depend on it.

In this episode, we talk to Dr. Yesmean Wahdan, Vice President for U.S. Medical Affairs in the Bayer Women's HealthCare division. In this episode, we discuss the prevalence, causes and treatments for heavy menstrual bleeding. This is a great opportunity to learn more about Bayer's new women's health strategy which emphasizes partnerships with startups, and which companies they're interested in working with.Remember to like, rate and subscribe and enjoy the episode!Guest bioDr. Yesmean Wahdan, MD is the Vice President for U.S. Medical Affairs in the Bayer Women's HealthCare division. She is the eldest of 6 children and was born and raised in the Northern Virginia area not far from the Nation's Capital – Washington, DC. She received her bachelor's degree in Cellular and Molecular Biology from Marymount University in Arlington, Virginia, and her Medical Degree from Georgetown University School of Medicine in Washington, DC. She completed her OB/GYN residency at a combined program at Georgetown University Medical Center and Washington Hospital Center in Washington, DC. She has also published several abstracts and articles in the field of Women's Health. In her time at Bayer, Dr. Wahdan has served as Medical Science Liaison, a Medical Director, and most recently as head of the U.S. Medical Affairs group for Women's HealthCare.  Dr. Wahdan is passionate about the care and health of women and is proud to work with an organization dedicated to advancing the health of women through science, research, and creating accessibility to options that impact the lives of women throughout their life journey. She believes that when women are healthy, informed, and can realize their full potential, their families, communities, and ultimately the world can have better tomorrows.Dr. Wahdan is based in the US Bayer Headquarters office in Whippany, New Jersey, and lives in Northern New Jersey with her family.FemTech Focus Podcast bioThe FemTech Focus Podcast is brought to you by FemHealth Insights, the leader in Women's Health market research and consulting. In this show, Dr. Brittany Barreto hosts meaningfully provocative conversations that bring FemTech experts - including doctors, scientists, inventors, and founders - on air to talk about the innovative technology, services, and products (collectively known as FemTech) that are improving women's health and wellness. Though many leaders in FemTech are women, this podcast is not specifically about female founders, nor is it geared toward a specifically female audience. The podcast gives our host, Dr. Brittany Barreto, and guests an engaging, friendly environment to learn about the past, present, and future of women's health and wellness.FemHealth Insights bioLed by a team of analysts and advisors who specialize in female health, FemHealth Insights is a female health-specific market research and analysis firm, offering businesses in diverse industries unparalleled access to the comprehensive data and insights needed to illuminate areas of untapped potential in the nuanced women's health market.Time Stamps[04:10] Dr. Wahdan's background[06:49] What is Bayer?[09:10] Why is Bayer deprioritizing women's health Research & Development?[12:45] What is Heavy Menstrual Bleeding?[15:14] Indicators of Heavy Menstrual Bleeding[16:06] Causes of Heavy Menstrual Bleeding[16:55] Prevalence of Heavy Menstrual Bleeding[19:27] Disproportion based on race, ethnicity, age and location[20:10] Are you born with Heavy Menstrual Bleeding or does it develop?[20:32] Treatment options[23:30] Hormonal contraceptive impact on bleeding[24:43] Non-hormonal options[25:34] Bayer's clinical trials for endometriosis treatments[28:03] What kind of partnership is Bayer looking for?[28:35] What's an area of Women's Health that still needs innovation?[30:42] What does the femtech industry as a whole need the most in order to be successful? ResourcesBayer's commitment to Women's Healthcare - Episode 141 Episode ContributorsDr. Yesmean WahdanLinkedIn: @Yesmean H. Wahdan, MD Dr. Brittany BarretoLinkedIn: @Brittany Barreto, Ph.D.Twitter: @DrBrittBInstagram: @drbrittanybarreto BayerWebsite: https://www.bayer.com/en/us/bayer-united-states-of-americaLinkedIn: @BayerTwitter: @BayerInstagram: @bayerofficial   FemTech Focus PodcastWebsite: https://femtechfocus.org/LinkedIn: https://www.linkedin.com/company/femtechfocusTwitter: @FemTech_FocusInstagram: @femtechfocus FemHealth InsightsWebsite: https://www.femhealthinsights.com/LinkedIn: @FemHealth Insights

Episode 3 of Pharmanipulation invites Gretchen LeFever Watson PhD and Robert Whitaker to question diagnoses of attention deficit hyperactivity disorder and to critique drug treatment of behaviors associated with ADHD. Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/jjei0u9zhtezfqg2i5p83h9per8nzugc For a list of resources and studies mentioned in this episode, please visit: ⁠https://bit.ly/Ep3Resources To learn more about Dr. LeFever Watson, please visit her website: https://drgretchenwatson.com/ To learn more about Robert Whitaker, please visit his website: https://www.madinamerica.com/robert-whitaker-new/  PharmedOut is supported primarily by individual donations. To donate, please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

In this episode of Causes or Cures, Dr. Eeks chats with Dr. James Giordano about narrowing in on the cause of Havana Syndrome, a mysterious illness targeting the intelligence community. Havana Syndrome was first identified in 2016, when diplomats and intel officers working in Havana, Cuba began experiencing a mysterious set of symptoms. Dr. Giordano was one of the experts tasked to investigate the cause of Havana Syndrome, and while other reports of Havana Syndrome have occurred in other locations, this podcast will focus on what happened in Havana in 2016. "Dr James Giordano is Pellegrino Center Professor in the Departments of Neurology and Biochemistry, and Chief of the Neuroethics Program at Georgetown University Medical Center, Washington DC. He is Senior Bioethicist of the Defense Medical Ethics Center, and Adjunct Professor of Psychiatry at the Uniformed Services University of Health Sciences/Walter Reed National Military Medical Center, Bethesda, MD, and is Distinguished Visiting Professor of Brain Science, Health Promotions, and Ethics at the Coburg University of Applied Sciences, Coburg, Germany. He is the author of over 350 peer-reviewed publications, 9 books, and 40 government reports on brain science, ethics, and biosecurity. Dr. Giordano was elected to the European Academy of Science and Arts; is an International Fellow of the Royal Society of Medicine (UK); was a Senior Fellow and Task Leader of the EU Human Brain Project; and was an appointed member of the US Department of Health and Human Services Secretary's Advisory Committee on Human Research Protections."You can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Or Facebook here.Or Twitter.Subcribe to her newsletter here.Support the show

Dr. Shannon Westin and her guests, Dr. Michael Atkins, Dr. Adil Daud, and Dr. Gary Schwartz, discuss a definitive work: The DREAMseq Trial. TRANSCRIPT The guests on this podcast episode have no disclosures to declare.     Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast that gets in-depth on articles that have been published in the Journal of Clinical Oncology. And it is my great pleasure to be your host. I'm Shannon Westin, GYN oncology, and I serve as the social media editor for the Journal of Clinical Oncology.   Today, we're going to be discussing a very exciting article describing “The DREAMseq Trial—ECOG-ACRIN EA6134, Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma.” This article was published in the JCO on January 10th, 2023.   And I am joined today by the lead author, Dr. Michael Atkins, who is Deputy Director, Georgetown Lombardi University Hospital, and Scholl Professor and Vice Chair of Oncology at Georgetown University Medical Center. Welcome.   Dr. Michael Atkins: Thank you. Nice to be here.   Dr. Shannon Westin: In addition, we are also accompanied by two experts in the field, Dr. Adil Daud, Professor in the Department of Medicine at the University of California San Francisco, and Director of Melanoma Clinical Research at UCSF Helen Diller Family Comprehensive Cancer Center. Welcome, Dr. Daud.   Dr. Adil Daud: Hi, great to be here.   Dr. Shannon Westin: And with Dr. Daud is Dr. Gary Schwartz, the Division Chief of Hematology Oncology and Deputy Director of the Herbert Irving Comprehensive Cancer Center in Columbia, New York. Thank you for being here.   Dr. Gary Schwartz: Delighted to be here.   Dr. Shannon Westin: So I'm surrounded by experts, and I'm very excited as a GYN oncologist to hear all of what you all have learned in melanoma because we're always excited to take that back into our field. So I think first, though, for those of us that aren't melanoma experts, Dr. Atkins, can you just level set for us and tell us what was the standard of care for melanoma when you began this study?   Dr. Michael Atkins: Sure. Well, first of all, this was a study for patients with BRAF V600 driver mutations in their melanoma, which represents about 50% of the patients with metastatic melanoma. And at the time the study was launched in 2015, two BRAF/MEK inhibitor combinations were FDA approved and shown to produce significant progression-free survival and overall survival benefits relative to BRAF inhibitor monotherapy. In addition, combination checkpoint inhibitor therapy with nivolumab and ipilimumab was shown to be superior to ipilimumab and, in particular in patients with BRAF-mutant melanoma, also to nivolumab monotherapy based on the results of the CheckMate 067 study, leading to its FDA approval. So we had these two regimens there that were approved. Of note, despite the many debates and attempts to garner real-world evidence at the time—the study actually reported out in 2021—marketing data showed that half of all patients in the US with metastatic BRAF-mutant melanoma were receiving BRAF/MEK inhibitors, and only one-quarter received nivo-ipi as initial therapy. So there remained a confusion throughout the course of the study as to which regimen was best in the US and around the world.   Dr. Shannon Westin: Tell me, what led to the current study? Was it really trying to drive at that very question?   Dr. Michael Atkins: These were the best treatment available at the time. And they really had changed melanoma patient outcomes in ways that we could have only dreamed about just five to 10 years prior, when median survival for patients with metastatic melanoma was six to nine months. Hence, the DREAMseq trial, this doublet, randomized evaluation of advanced melanoma sequencing, was really an apt acronym for the trial. But we had these two regimens of BRAF/MEK inhibitors tending to display the overall survival curve, while immunotherapy tended to raise the tail. And at the time the study was launched, it was really unclear which treatment was preferred in general or for particular subsets of patients. And given that patients would likely have the option to receive both approaches, was there a preferred sequence? So the DREAMseq trial was a launch to address these questions.   Dr. Gary Schwartz: I can echo Michael's statement about that. There was also—having been at the beginning of immunotherapy and targeted drug therapy, the transformation of cancer medicine in melanoma was extraordinary. Over a very short amount of time, we transformed a disease that's incurable to curable. And I don't think anybody, at least not in my lifetime, that ever think we'd ever see—or I'd see that type of transformation. But the debate in the community was what should be the first therapy. Should it be a targeted drug combination targeting RAF and MEK for BRAF-mutant melanoma, or should it be immunotherapy? And actually, there was a trend favoring immunotherapy, I think, at the time of the start of the study. It was actually an unresolved issue that many of us were continuing to debate up to the publication of this data, which certainly has now solidified the role of immunotherapy as a starting point for patients with BRAF-mutant melanoma.   Dr. Michael Atkins: Thanks, Gary.   Dr. Shannon Westin: I would love for you—because it is a complex design, and I feel like a lot of times, as drug developers, we're often discouraged to do too many lines in a row. And I was just so intrigued at how well this was laid out to really understand those very questions of superiority as well as sequence, which we don't often assess. Dr. Atkins, will you just summarize the design so that all of the very smart researchers on the line can utilize that for their own cancer types?   Dr. Michael Atkins: Yeah, it was complicated to execute, but the design was pretty simple. Patients with treatment-naive BRAF-mutant metastatic melanoma were stratified according to ECOG performance status and LDH normal and high and randomized in step 1 to receive either combination nivo-ipi induction for 12 weeks, followed by nivo monotherapy maintenance for up to 72 weeks—that was arm A, and that was standard of care for that regimen—or dabrafenib-trametinib continuously, and that was arm B. And if patients experienced disease progression and met the step 2 eligibility criteria, they were able to cross over to the alternative sequence: arm C, dabrafenib-trametinib, or arm D, nivo-ipi. And we followed the patients and chose two-year overall survival as the primary endpoint.   Dr. Shannon Westin: And we kind of got a little hint. So what was the primary finding?   Dr. Michael Atkins: Yes, because of the anticipated distinct shapes of the overall survival curves, with the BRAF/MEK inhibitors tending to have their benefit early and the immunotherapies tending to raise the tail of the curve, we thought there'd be non-proportional hazards and that the overall survival curves might cross. And therefore, we chose as a primary endpoint two-year landmark overall survival, with an estimate that the nivo-ipi first sequence would have a 70% overall survival rate compared to 50% for the dab-tram first sequence. And with 300 patients enrolled and 270 evaluable, there was about a 90% power to show this difference in two-year overall survival rate, with a two-sided type one error rate of 0.05.   Dr. Shannon Westin: And it met its primary endpoint?   Dr. Shannon Westin: Yes, the study was opened in July of 2015, and it was set up that there would be Data Safety Monitoring Committee meetings after the first 100 patients were accrued every six months and that the data cutoff used for the fourth interim Data Safety Monitoring Committee meeting, which was a median follow-up of a little over two years, 265 patients had enrolled in step 1—those were evenly split between the two arms—and 73 had enrolled in step 2, with nearly two-thirds of those being on arm D, second-line nivo/ipi. And the two initial arms were balanced for most of the characteristics and was randomized for the important characteristics.   And from an efficacy standpoint, once again, we chose landmark two-year overall survival as a primary endpoint. And the overall survival curves for the combined sequences showed the anticipated biphasic pattern; they actually crossed around 10 months, and 100 patients had died, with 62 of them on the sequence beginning with dab-tram. And the two-year overall survival rate was 72% for patients who started on nivo/ipi and 52% for those who started on dab-tram. And that was a pretty significant difference; P equals about 0.01 by log-rank test. And so this 95% repeated confidence intervals, along with the 20% difference in overall survival, ranged from 3% to 38%, and the O'Brien-Fleming boundary had been crossed based on this estimate. Interesting, as we published, the three-year overall survival difference was even greater, approaching 24%. So that was the main study endpoint. And because the Data Safety Monitoring Committee felt that that difference was clinically significant even though we had only had about 59% information, they recommended at that point that the study be closed early and that patients who were on arm B, dabrafenib-trametinib, be given the option to cross over to immunotherapy before disease progression.   So that was the primary endpoint. I'm going to pause there. There were some secondary endpoints that I think were interesting, but maybe Gary or Adil have comments about this.   Dr. Shannon Westin: I hope they do, yeah. I'm going to give over my podcast hosting to you.   Dr. Adil Daud: Mike, congratulations on that study. I mean, that's transformative. I mean, I think there was a feeling, like Gary was saying, that immunotherapy might be better in the long term. But I remember a lot of discussions, and I think you answered them in 2015 or 2014 and 2013 because you've been working on this design for a while, that the people who were treated with BRAF inhibitor therapy were just different. And a lot of people would say that when somebody walks into the clinic, the folks who are BRAF-mutant, they just have rapidly progressive disease, like something really bad is going on. And that's why the results on BRAF/MEK inhibitor therapy just looked different than immunotherapy. Immunotherapy was for slower-growing tumors, and I think your study kind of puts maybe a different spin on that, basically suggesting differently. Would you comment on that?   Dr. Michael Atkins: Yeah. So, Adil, I think early on, people thought that the BRAF/MEK inhibitor was for patients who had rapidly progressive disease, and you needed to get a response to get the disease under control. But over time, as those studies were followed out, it appeared that the BRAF/MEK inhibitors tended to work best in patients who had less aggressive disease—performance status 0, M1a or b disease, and normal LDH. And so it was still confusing as to who should get which therapies. And when you compared the results using retrospective data between those who got immunotherapy and those who got targeted therapy, it was really difficult to be sure that these were the same patient population. So the only way you could really know whether immunotherapy was truly better was to do prospectively randomized studies where the two arms were balanced, which is what we set out to do in DREAMseq.   Dr. Adil Daud: Yeah, I think there's a lot of areas in oncology where people think whether you should give somebody a CAR T-cell or whether you should give somebody myeloma therapy or—people think, well, these are just totally different. Or in melanoma, I think, the TIL therapy, there's this question about, can you really compare that to anything else? And I think your study, which perhaps wouldn't be done by a pharmaceutical company and perhaps wouldn't be— outside of the cooperative groups, I feel that it's hard to really do a study of that type.   Dr. Michael Atkins: I agree.   Dr. Gary Schwartz: Yeah. First, I want to say congratulations on really an extraordinary study, Michael. I think it really answers some critical clinical and biological questions that have been subject to debate in the melanoma and the medical oncology community for the last five or more years.   There were a couple of things that surprised me. One was the fact that patients that started on dab-trame, when crossed over to immunotherapy, the outcomes were pretty poor. And that was a biological outcome, I guess, we kind of thought about. But this study certainly suggests that there's something about prior targeted drug therapy that may affect outcome and immunotherapy. And also, the other thing that was surprising was the number of dropouts that developed and couldn't cross over because of the rapid progression on the first-line study. Do you want to comment on both of those points and maybe share some thoughts about what that means for the medical care of patients who get this type of treatment?   Dr. Michael Atkins: Sure. First of all, response rates were similar between the step 1 regimen and for dab-tram, whether used in step 1 or step 2. In contrast, as you said, nivo-ipi appeared to be less effective after progression on dab-tram than in the first line. It was like a 46% response rate in the first line, and about 30% in the second line. The median PFS in the first line was about 11+ months, and in the second line, was only about three months. And I think there was some feeling in the community—probably wishful thinking and also based on what I think are some flawed preclinical and translational studies—that BRAF/MEK inhibitors might cause some immunogenic cell death and cause new antigens to be expressed and activate the immune system, be synergistic with immunotherapy given afterwards, while I think other data suggested that the resistance mechanism to the dabrafenib-trametinib was immunosuppressive, leading to upregulation of VEGF and things like that.   So this result suggested that immunotherapy didn't work as well in the second line. There are probably several reasons for that. It could be biologic changes, which I think we don't pay enough attention to when we think about what we're doing in the first and the second line. But also the type of patients who progressed on BRAF/MEK inhibitors. when you stop those drugs, the disease tends to accelerate. Many of them probably had subclinical CNS disease, and it was just not a good time for them to be going on immunotherapy, while in the front line, you didn't have to deal with those type of issues. And with regard to crossover, one of the things that we looked at as a secondary endpoint in this study was feasibility of doing the crossover. Because in clinical practice, we found that if you waited until disease progression on BRAF/MEK inhibitors and then tried to cross them over, oftentimes, patients progressed really rapidly, and you weren't able to get the immunotherapy in to large degree, while in patients who got immunotherapy, they had a lot of toxicity often, which caused them to stop therapy. And if they had toxicity at the time they were progressing, it might be complicated to add new drugs in.   And so I think the community was a bit surprised that only about half the patients were able to successfully cross over. But I think that's reality, that if you use these drugs to progression and then have eligibility criteria, which you have to have in a clinical trial for patients to go on the second-line treatment, you're going to have a lot of dropouts. One of the major reasons for dropouts on dab-tram was progression in the CNS, and dabrafenib-trametinib doesn't work as well in the CNS as it does systemically, while immune therapy actually appears to work as well for patients with asymptomatic or undetected CNS metastases as it does systemically. And I think that was an important reason why immunotherapy was better.   Dr. Gary Schwartz: I've looked at your paper now multiple times, Michael, and I can't think of any reason why anybody would want to start a targeted therapy for BRAF-mutant melanoma. I mean, I think this really becomes a definitive study declaring that immunotherapy is where all medical oncology should begin in the treatment of BRAF metastatic melanoma. Is that too much of a statement to make, or would you agree with that as well? I've been trying to think of all the reasons why not to give immunotherapy first. I can't think of one now, after your paper, that would suggest otherwise.   Dr. Michael Atkins: Well, I've been chastened by a lot of reviewers, as you know, to say that these results only definitively apply to the patients who were eligible for this study. And patients who had poor performance status or active brain mets or who required steroids and needed to be in the hospital or had to have a response were not eligible for this study. And so I think there are some patients where the disease is just on fire, where you may need to give BRAF/MEK inhibitors to try to cool it off before you start immunotherapy, particularly if patients need to be on immunosuppressive drugs to control edema in their brain, or because of bone mets pressing on the spinal cord or things like that, I think that it's important to have that other option. But as soon as you can, as soon as you've created enough window to get patients off immunosuppressive drugs or improve their performance status enough so that they can be an outpatient, you probably should switch to immunotherapy and give them the chance for a long-term benefit.   Dr. Adil Daud: I have doctors call me outside of academia and say, “Hey, I've got a patient walking in. I'm trying to decide, should I do the triple therapy, or should I do…”—which triple therapy in melanoma refers to dabrafenib plus trametinib plus a PD-1 drug like pembrolizumab or, in some cases, like a PDL-1 inhibitor—and they're questioning whether that's an appropriate place to start. Or sometimes people say, “Well, what about doing a sandwich regimen where we start off with dabrafenib-trametinib and then switch over to something else without waiting for progression just to give people…” And I give a long-winded answer to that, but I'm curious to hear what you think, what you both think.   Dr. Michael Atkins: So my view is—I've always thought, based on some of our early translational studies, which were presented at ASCO and hopefully we'll be able to publish soon, that the BRAF/MEK inhibitor data that showed that there was an influx of immune cells and potential synergy was actually an artifact, that it was not increasing immune cells in the tumor microenvironment, but actually loss of tumor cell in the tumor microenvironment that was causing the impression that the tumors were more inflamed. And I felt that when it came to immunotherapy, BRAF/MEK inhibitors were not ipilimumab and were not going to add to the benefit that we see with immunotherapy of durable responses the way you can see with nivo/ipi.   So I've stayed away from those triplet regimens, and I think we've seen with the studies that have been published so far that they tend to have sub-additive benefit when you add an anti-PD-1 to BRAF/MEK inhibitors. You see some prolongation of PFS, but you don't see the same tail of the survival curve. And even at two years, the tail of the survival curve for those triple regimens is below where it is for nivo/ipi in the BRAF-mutant population all the way out at five years. And the nivo/ipi population—I'm talking about the progression-free survival curve—and that nivo/ipi population can still get BRAF/MEK inhibitors if they progress. So I think that triple regimen, I can't think of a patient where I would use that. But the sandwich regimen, as I was just describing, may be useful in some patients who just aren't in appropriate shape to start with immunotherapy.   Dr. Gary Schwartz: Now, I would agree with Michael. I think the clinical trial data would really discourage the use of triplet therapy. They really lean—again, the benefit of triplet therapy for all the published papers we've seen so far in that area. But I guess you're right. The idea, if you have one of those patients that comes in and who's really on fire with rapidly progressive disease, on steroids, and needs a very quick benefit, perhaps initiating targeted therapy first for a short time would be reasonable in the treatment of those patients. But beyond that, I really think there probably are not going to be many exceptions to starting immunotherapy first because your data, to me, strongly would suggest that starting targeted therapy is going to diminish the benefits of immunotherapy to follow. And that, to me, is an important take-home point of the study and sort of validates some of the preclinical data. I mean, depends what you look at. But there is preclinical data suggesting that MEK inhibition will diminish T-cell responsiveness, and I think this supports that biological effect. So I think we have to be cautious about upfront targeted drug therapy now and have to find what are those opportunities where it may be appropriate. But I think they're really diminishingly few.   Dr. Michael Atkins: And I would just emphasize the flip side of that, which is that targeted therapy is equally effective in the second line for patients who don't respond to immunotherapy. And I think that was also a critical component of why the immunotherapy first sequence was better than the targeted therapy first sequences. You had better salvage.   Dr. Gary Schwartz: That's a very good point.   Dr. Shannon Westin: Well, I personally just want to thank the three of you. I learned a ton today, and I fully intend to take that back to the work that we're doing in gynecologic malignancies, combining immune therapies and targeted therapies, and I hope our listeners will do the same.   Further, I agree with you, Dr. Schwartz. I think this is a practice-changing study. I appreciate you, Dr. Atkins, in being a little cautious. I appreciate the editors that reviewed it as well. But this is as clear a definitive trial as we can get and a testament to your hard work through the cooperative groups, which we all know can be a struggle in itself to get this type of trial through. So congratulations again.   Dr. Gary Schwartz: And I think the lessons learned in melanoma are going to be applicable to all solid tumors. So melanoma is about so far ahead of many other tumors, but what we learned here isn't just impacting melanoma, but will impact all cancer medicine. And I think that what's so important about this trial is that lessons learned here really are broadly based and have clinical applications to many patients getting immunotherapy, targeted drug therapies today. So congratulations, Dr. Atkins. I think you hit a home run on this one. The medical oncology community is indebted to you and to your group to making this possible. And thank you for bringing it to JCO as well. I think that itself speaks to the success of the journal and the impact these types of studies have on reaching a large segment of the medical oncology community.   Dr. Michael Atkins: Well, thank you very much, Gary. I do want to emphasize the point you made, that I think this result does impact how we think about the use of targeted therapies or chemotherapies or antiangiogenic therapies in other tumors in coordination with immunotherapy. And I'm sort of on a mission to make the point that if you want to get the most benefit out of immunotherapy, you should give it first, and you should give it unencumbered by other things that might interfere with its activity.   Dr. Gary Schwartz: I think that's the last word, Shannon.   Dr. Shannon Westin: I believe it is. I believe it is. Thank you all so much for being here. And thank you to our listeners for being here for another episode of JCO After Hours. Again, we were discussing “Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma: The DREAMseq Trial—ECOG-ACRIN EA6134,” published in January 10th, 2023, in the JCO.   Please do check out our other podcast offerings. You can check them out on the JCO website or anywhere you get your podcasts. Until next time, be well.     The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

This is our second installment of happiness week on the Plain English podcast. On Tuesday, I spoke with the directors of the Harvard Study of Adult Development about what makes a good life, based on their 80-year longitudinal study. Today's episode is about the phenomenon of rising teenage unhappiness. What's actually happening? Why is it happening? What theories make sense, and what theories don't? How can we fix this problem? Today's guest is Matthew Biel, the chief of child and adolescent psychiatry at Georgetown University Medical Center, and chief medical officer at Fort Health. Host: Derek Thompson Guest: Matthew Biel Producer: Devon Manze Learn more about your ad choices. Visit podcastchoices.com/adchoices

Episode 2 of Pharmanipulation invites Adewole S. Adamson MD, MPP, to discuss the relationship of sun exposure to melanoma, whether sunscreen actually prevents skin cancer, and the overdiagnosis of melanoma. Dr. Adamson is a board-certified dermatologist and an assistant professor in the department of Internal Medicine at Dell Medical School at the University of Texas at Austin where he studies skin cancer, evidence-based medicine, and health policy. He is also the Director of the Pigmented Lesion Clinic at the University of Texas at Austin, and he serves as an assistant editor at JAMA Dermatology. Pharmanipulation is produced by PharmedOut, a Georgetown University Medical Center rational prescribing project. For a transcript of this episode, please visit: https://georgetown.box.com/s/3bte8vynpulj33kv3qdtwdabamm2n9xx To learn more about Dr. Adamson, please visit his website: https://adeadamson.com/ Dr. Adamson's paper on Estimating Overdiagnosis of Melanoma Using Trends Among Black and White Patients in the U.S. is available here: https://jamanetwork.com/journals/jamadermatology/fullarticle/2789995 Dr. Adamson's paper on The Rapid Rise in Cutaneous Melanoma Diagnoses is available here: https://www.nejm.org/doi/10.1056/NEJMsb2019760?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed PharmedOut is supported primarily by individual donations. To make a donation please visit: https://sites.google/com/georgetown.edu/pharmedout/donate

Pharmanipulation is a new show created by PharmedOut, dedicated to the topics of evidence-based medicine and industry influence on medical information and public health. PharmedOut is a Georgetown University Medical Center rational prescribing project. Episode 1 covers pharmaceutical marketing tactics, industry influence on medical knowledge, and invented diseases. Join hosts Caroline Renko and Patricia Bencivenga as they interview Adriane Fugh-Berman MD, the Director of PharmedOut. Links PharmedOut website: https://www.pharmedout.org/ PharmedOut is supported primarily by individual donations. To make a donation please visit: https://sites.google.com/georgetown.edu/pharmedout/donate Pharma Marketing Hub (factsheets and summaries of important topics): https://sites.google.com/georgetown.edu/pharmedout/resources/pharma-marketing-hub?authuser=0 Patient Grooming Webinar: https://youtu.be/PD_tBqHDouY Transcript to this episode: https://georgetown.box.com/s/qsf6875gd5qgelemtx9urltgaxyl77lx

A new research paper was published in Oncotarget's Volume 13 on December 20, 2022, entitled, “Resistance of MMTV-NeuT/ATTAC mice to anti-PD-1 immune checkpoint therapy is associated with macrophage infiltration and Wnt pathway expression.” One of the central challenges for cancer therapy is the identification of factors in the tumor microenvironment that increase tumor progression and immune tolerance. In breast cancer, fibrosis is a histopathologic criterion for invasive cancer and poor survival that results from inflammatory factors and remodeling of the extracellular matrix to produce an immune-tolerant microenvironment. In this new study, researchers Hongyan Yuan, Lu Jin, Handan Xiang, Anannya Bhattacharya, Philip E. Brandish, Gretchen Baltus, Alexander Tong, Changyan Zhou, and Robert I. Glazer from Georgetown University Medical Center, Merck Research Institute and Bicycle Therapeutics aimed to determine whether tolerance is associated with the immune checkpoint, Programmed Cell Death 1 (PD-1). A conditional model of mammary fibrosis recently developed by this team, NeuT/ATTAC mice, were administered a murine-specific anti-PD-1 mAb related to pembrolizumab. The researchers monitored drug response by tumor development, imaging mass cytometry, immunohistochemistry, and tumor gene expression by RNAseq. “Utilizing this more stringent tumor model to test its susceptibility to anti-PD-1 immunotherapy, we report the signaling processes associated with its lack of responsiveness.” Tumor progression in NeuT/ATTAC mice was unaffected by weekly injection of anti-PD-1 over four months. Insensitivity to anti-PD-1 was associated with several processes, including increased tumor-associated macrophages (TAM), epithelial to mesenchymal transition (EMT), fibroblast proliferation, an enhanced extracellular matrix and the Wnt signaling pathway, including increased expression of Fzd5, Wnt5a, Vimentin, Mmp3, Col2a1, and Tgfβ1. These results suggest potential therapeutic avenues that may enhance PD-1 immune checkpoint sensitivity, including the use of tumor microenvironment targeted agents and Wnt pathway inhibitors. “Overall, the immune tolerant TME in NeuT/ATTAC mice was associated with tumor-infiltrating macrophages, Foxp3+/PD-1- Treg cells as well as upregulation of the Wnt signaling pathway, which may provide further insights into the therapeutic options that may enhance immune checkpoint therapy.” DOI: https://doi.org/10.18632/oncotarget.28330 Correspondence to: Robert I. Glazer - glazerr@georgetown.edu Keywords: PD-1, NeuT, Wnt, macrophages, mammary tumorigenesis About Oncotarget: Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, visit Oncotarget.com and connect with us on social media: Twitter - https://twitter.com/Oncotarget Facebook - https://www.facebook.com/Oncotarget YouTube – www.youtube.com/c/OncotargetYouTube Instagram - https://www.instagram.com/oncotargetjrnl/ LinkedIn - https://www.linkedin.com/company/oncotarget/ Pinterest - https://www.pinterest.com/oncotarget/ LabTube - https://www.labtube.tv/channel/MTY5OA SoundCloud - https://soundcloud.com/oncotarget For media inquiries, please contact: media@impactjournals.com.

Study links nutrients in blood to better brain connectivity, cognition in older adults University of Illinois, December 20, 2022 A new study links higher levels of several key nutrients in the blood with more efficient brain connectivity and performance on cognitive tests in older adults. The study, reported in the journal NeuroImage, looked at 32 key nutrients in the Mediterranean diet, which previous research has shown is associated with better brain function in aging. It included 116 healthy adults 65-75 years of age. "We wanted to investigate whether diet and nutrition predict cognitive performance in healthy older adults," said University of Illinois postdoctoral researcher Christopher Zwilling, who led the study with U. of I. psychology professor Aron Barbey in the Beckman Institute for Advanced Science and Technology. The analysis linked specific patterns of a handful of nutrient biomarkers in the blood to better brain health and cognition. The nutrient patterns included omega-3 fatty acids, which are abundant in fish, walnuts and Brussels sprouts; omega-6 fatty acids, found in flaxseed, pumpkin seeds, pine nuts and pistachios; lycopene, a vivid red pigment in tomatoes, watermelon and a few other fruits and vegetables; alpha- and beta-carotenoids, which give sweet potatoes and carrots their characteristic orange color; and vitamins B and D. The researchers relied on some of the most rigorous methods available for examining nutrient intake and brain health, Barbey said. Rather than asking participants to answer food-intake surveys, which require the accurate recall of what and how much participants ate, the team looked for patterns of nutrient "biomarkers" in the blood. The team also used functional magnetic resonance imaging to carefully evaluate the efficiency with which various brain networks performed. The analysis found a robust link between higher levels of several nutrient biomarkers in the blood and enhanced performance on specific cognitive tests. These nutrients, which appeared to work synergistically, included omega-3 and omega-6 fatty acids, carotenoids, lycopene, riboflavin, folate, vitamin B12 and vitamin D. The analysis also revealed that a pattern of omega-3s, omega-6s and carotene was linked to better functional brain network efficiency. Different nutrient patterns appeared to moderate the efficiency in different brain networks. For example, higher levels of omega-3 fatty acids paralleled the positive relationship between a healthy frontoparietal network and general intelligence. The frontoparietal network supports the ability to focus attention and engage in goal-directed behavior. "Our study suggests that diet and nutrition moderate the association between network efficiency and cognitive performance," Barbey said. "This means that the strength of the association between functional brain network efficiency and cognitive performance is associated with the level of the nutrients." (NEXT) Sunlight offers surprise benefit -- it energizes infection fighting T cells Georgetown University Medical Center, December 20, 2022 Sunlight allows us to make vitamin D, credited with healthier living, but a surprise research finding could reveal another powerful benefit of getting some sun. Georgetown University Medical Center researchers have found that sunlight, through a mechanism separate than vitamin D production, energizes T cells that play a central role in human immunity. Their findings, published in Scientific Reports, suggest how the skin, the body's largest organ, stays alert to the many microbes that can nest there. "We all know sunlight provides vitamin D, which is suggested to have an impact on immunity, among other things. But what we found is a completely separate role of sunlight on immunity," says the study's senior investigator, Gerard Ahern, PhD, associate professor in the Georgetown's Department of Pharmacology and Physiology. "Some of the roles attributed to vitamin D on immunity may be due to this new mechanism." They specifically found that low levels of blue light, found in sun rays, makes T cells move faster -- marking the first reported human cell responding to sunlight by speeding its pace. "T cells, whether they are helper or killer, need to move to do their work, which is to get to the site of an infection and orchestrate a response," Ahern says. "This study shows that sunlight directly activates key immune cells by increasing their movement." Ahern also added that while production of vitamin D required UV light, which can promote skin cancer and melanoma, blue light from the sun, as well as from special lamps, is safer. And while the human and T cells they studied in the laboratory were not specifically skin T cells -- they were isolated from mouse cell culture and from human blood -- the skin has a large share of T cells in humans, he says, approximately twice the number circulating in the blood. What drove the motility response in T cells was synthesis of hydrogen peroxide, which then activated a signaling pathway that increases T cell movement. Hydrogen peroxide is a compound that white blood cells release when they sense an infection in order to kill bacteria and to "call" T cells and other immune cells to mount an immune response. "We found that sunlight makes hydrogen peroxide in T cells, which makes the cells move. And we know that an immune response also uses hydrogen peroxide to make T cells move to the damage," Ahern says. "This all fits together." (NEXT)  Capsaicin molecule inhibits growth of breast cancer cells Centre of Genomics, Ruhr-Universität Bochum (Germany), December 22, 2022  Capsaicin, an active ingredient of pungent substances such as chilli or pepper, inhibits the growth of breast cancer cells. This was reported by a team headed by the Bochum-based scent researcher Prof Dr Dr Dr habil Hanns Hatt and Dr Lea Weber, following experiments in cultivated tumour cells. The experiments were carried out with the SUM149PT cell culture, a model system for a particularly aggressive type of breast cancer, i.e. the triple-negative type. Chemotherapy is currently the only available treatment for this type of cancer. In the cultivated cells, the team detected a number of typical olfactory receptors. One receptor occurred very frequently; it is usually found in the fifth cranial nerve, i.e. the trigeminal nerve. It belongs to the so-called Transient Receptor Potential Channels and is named TRPV1. That receptor is activated by the spicy molecule capsaicin as well as by helional – a scent of fresh sea breeze. In collaboration with Dr Gabriele Bonatz from the Augusta clinics in Bochum (Brustzentrum), Hatt's team confirmed the existence of TRPV1 in tumour cells in nine different samples from patients suffering from breast cancer. The researchers activated the TRPV1 receptor in the cell culture with capsaicin or helional, by adding the substances to the culture for a period of several hours or days. As a result, the cancer cells divide more slowly. Moreover, the treatment caused tumour cells to die in larger numbers. The surviving cells were no longer able to move as quickly as heretofore; this implies that their ability to form metastases in the body was impeded. Earlier studies had demonstrated that the chemical arvanil – with a chemical make-up similar to that of the spicy molecule capsaicin – was effective against brain tumours in mice; it reduces tumour growth in the animals. Due to its side effects, however, this substance is not approved for humans. In addition to capsaicin and helional, the endovanilloids, produced naturally in the body, also activate the TRPV1 receptor. (NEXT)  Losing body fat could be facilitated by light evening exercise and fasting Baylor College of Medicine, December 20, 2022 Making muscles burn more fat and less glucose can increase exercise endurance, but could simultaneously cause diabetes, says a team of scientists from Baylor College of Medicine and other institutions. Mouse muscles use glucose (carbohydrate) as fuel when the animals are awake and active and switch to fat (lipid) when they are asleep. The team discovered that disrupting this natural cycle may lead to diabetes but, surprisingly, can also enhance exercise endurance. The switch is controlled by a molecule called histone deacetylase 3, or HDAC3. This finding opens the possibility of selecting the right time to exercise for losing body fat but also raises the concern of using HDAC inhibitors as doping drugs for endurance exercise. The study appears in Nature Medicine. Skeletal muscles, the voluntary muscles, are important in the control of blood glucose in the body. They consume most of the glucose, and if they develop insulin resistance and consequently are not able to use glucose, then diabetes likely will develop. To study the role of HDAC3 in mouse skeletal muscle, Sun and colleagues genetically engineered laboratory mice to deplete HDAC3 only in the skeletal muscles. Then they compared these knocked out mice with normal mice regarding how their muscles burn fuel. When normal mice eat, their blood sugar increases and insulin is released, which stimulates muscles to take in and use glucose as fuel. "When the knocked out mice ate, their blood sugar increased and insulin was released just fine, but their muscles refused to take in and use glucose," said Sun. "Lacking HDAC3 made the mice insulin resistant and more prone to develop diabetes." Yet, when the HDAC3-knocked out mice ran on a treadmill, they showed superior endurance, "which was intriguing because diabetes is usually associated with poor muscle performance," said Sun. "Glucose is the main fuel of muscle, so if a condition limits the use of glucose, the expectation is low performance in endurance exercises. That's the surprise." The researchers then studied what fueled the HDAC3-knocked out mice's stellar performance using metabolomics approaches and found that their muscles break down more amino acids. This changed the muscles' preference from glucose to lipids and allowed them to burn lipid very efficiently. This explains the high endurance, because the body carries a much larger energy reservoir in the form of lipid than carbohydrate. The team performed a number of functional genomics studies that established the link between HDAC3 and the circadian clock. "In normal mice, when the mouse is awake, the clock in the muscle anticipates a feeding cycle and uses HDAC3 to turn off many metabolic genes. This leads the muscles to use more carbohydrate," said Sun. "When the animal is about to go to sleep and anticipates a fasting cycle, the clock removes HDAC3. This leads the muscles to use more lipid." Although these studies were done in mice, the researchers speculate that human muscles most likely will follow the same cycle. The study opens the possibility of promoting body fat burning by increasing exercise activity during the periods in which muscles use lipid, which is at night for people. "Losing body fat would be easier by exercising lightly and fasting at night," said Sun. "It's not a bad idea to take a walk after dinner." (NEXT)  Employees who are open about religion are happier, study suggests Kansas State University, December 17, 2022 It may be beneficial for employers to not only encourage office Christmas parties but also celebrate holidays and festivals from a variety of religions, according to a Kansas State University researcher. Sooyeol Kim was involved in a collaborative study that found that employees who openly discuss their religious beliefs at work are often happier and have higher job satisfaction than those employees who do not. "For many people, religion is the core of their lives," Kim said. "Being able to express important aspects of one's life can influence work-related issues, such as job satisfaction, work performance or engagement. It can be beneficial for organizations to have a climate that is welcoming to every religion and culture." Kim said employers might even want to consider a religion-friendly policy or find ways to encourage religious expression. For example, organizations could have an office Christmas party, but also could celebrate and recognize other religious holidays and dates, such as Hanukkah, Ramadan or Buddhist holidays. For the cross-cultural study, the researchers surveyed nearly 600 working adults from a variety of industries -- including education and finance -- in the U.S. and South Korea. The surveyed employees were all Christian, but identified with a variety of denominations, including Presbyterian, Baptist and Methodist, among others. Results showed that employees who valued religion as a core part of their lives were more likely to disclose their religion in the workplace. Employees who felt pressure to assimilate in the workplace were less likely to disclose their religious identity, Kim said. But most significantly, the researchers found that the employees who disclosed their religion in the workplace had several positive outcomes, including higher job satisfaction and higher perceived well-being. "Disclosing your religion can be beneficial for employees and individual well-being," Kim said. "When you try to hide your identity, you have to pretend or you have to lie to others, which can be stressful and negatively impact how you build relationships with co-workers." Kim said the research on religion in the workplace plays a part into work-life balance. Research continues to show that individual characteristics -- such as family and religion -- can influence work-related issues. (NEXT) New Cannabis Capsule Is So Powerful It's Going To Completely Replace All Pain Killers University of Pennsylvania, December 19, 2022    In places where medical marijuana is legal, opioid abuse and addiction has fallen by 25%, but the government maintain they are stumped as to why Opioid abuse and addiction is a massive problem all over the US, hence why people are eager to find natural alternatives. The health benefits of cannabis are become more and more accepted in mainstream society, as more studies which support cannaboid use are published. This doesn't sit well with big pharma, who are desperate to hold on to the monopoly they control. In the U.S. states where medical marijuana is legal to use, deaths from opioid overdoses have decreased by almost 25 percent, according to a new data. The study was done by Bachhuber, of the Philadelphia Veterans Affairs Medical Center and the University of Pennsylvania, and his colleagues who used state-level death certificate data for all 50 states. According to JAMA Medicine, in states with a medical marijuana law, overdose deaths from opioids like morphine, oxycodone and heroin decreased by an average of 20 percent after just one year. After two years, they continued to decrease to 25 percent. In the mean time, opioid overdose deaths across the country skyrocketed. The cannabis capsules are made from the extract of cannabis flower. The active ingredients are processed without microbials and then packaged with a specific mix of 60 mg of THC (tetrahydrocannabinol) and 10 mg of CBD (cannabidiol). The combination together creates the perfect effect to relieve pain. The THC helps send happy feelings to the brain, while the CBD helps promote relaxation of the muscles. This helps reduce muscle spasms as well as inflammation.

If you're enjoying the content, please like, subscribe, and comment! Dr. Robert Nirschl is a graduate of the Medical College of Wisconsin (Marquette University) and received his orthopaedic surgery training at the Mayo Clinic in Rochester, MN. He holds a Master's Degree in orthopaedic surgery from the University of Minnesota. He served as a Lieutenant Commander in the U.S. Navy as an orthopaedic surgeon after his residency at the Mayo Clinic, before joining the clinical faculty (orthopedic surgery) at Georgetown University Medical Center and starting private practice in Arlington Virginia. Nirschl Orthopaedic Center: https://www.nirschl.com/ Virginia Sports Medicine Institute: https://vasportsmedicine.com/ ______________________ Follow us! @worldxppodcast Instagram - https://bit.ly/3eoBwyr @worldxppodcast Twitter - https://bit.ly/2Oa7Bzm Spotify - http://spoti.fi/3sZAUTG Apple Podcasts - http://apple.co/30uGTny Google Podcasts - http://bit.ly/3v8CF2U Anchor - http://bit.ly/3qGeaH7 YouTube - http://bit.ly/3rxDvUL #orthopedics #sportsmedicine #tenniselbow #surgery #aclsurgery #injury #mayoclinic #medschool #orthopedicsurgery #orthopedicsurgeon #podcastshow #longformpodcast #longformpodcast #podcasts #podcaster #newpodcast #podcastshow #podcasting #newshow #worldxppodcast --- Support this podcast: https://anchor.fm/worldxppodcast/support

In today's episode, Dr. Carrie Jones is joined by Dr. Robert Hedaya, a Neuropsychiatrist, Clinical Professor, and Author. They discuss neuropsychiatric symptoms, brain health, brain inflammation, head trauma, and neurodegenerative conditions. Dr. Robert Hedaya is a Clinical Professor of Psychiatry at Georgetown University Medical Center. He is a neuropsychiatrist that teaches functional medicine, psychiatry, brain health, brain inflammation, head trauma, and neurodegenerative conditions, and the founder of The Whole Psychiatry & Brain Recovery Center. Dr. Hedaya also wrote several books, including Understanding Biological Psychiatry, The Anti-depressant Survival Program, and Depression: Advancing the Treatment Paradigm.

SHOW NOTES4:35 – 35th wedding anniversary5:25 – key qualities to a strong and meaningful relationship6:00 – team approach6:45 – facing unexpected fears, head on, one day at a time7:25 – discovering inner strength7:55 – Olivia, the amazing daughter and sister9:05 – Special Love, Inc., Tom and Sheila Baker9:35 ­– BRASS Camp11:10 – Ryan, first cancer diagnosis at two years old11:35 – ordinary family with an extraordinary circumstance11:50 – leukemia meets it match with Ryan's grit15:00 ­– choosing hope is choosing life15:15 – Make-a-Wish trips16:15 – leading through advocacy17:05 – management is key17:45 – gratitude for such remarkable support – it kept us going, it keeps us going19:25 – Camp Fantastic (Special Love, Inc.)20:15 – no one wants to join the club of parents of children with cancer21:00 – adult skills learned as a child through trial and error23:30 – rhythm of life, impact on traditions, a roller coaster of life24:35 – bringing home a puppy in the midst of the challenges25:45 – ready to go to the hospital on a moment's notice27:10 – selecting quotations that capture the essence of one's thoughts and intended message29:05 – meeting Ryan's bone marrow donor, Scott Harris31:05 – consider joining the bone marrow registry32:00 – graft versus host disease can be deadly32:40 – Sharon and Lee Johnson, the ultimate role models and friends35:15 – manufacturing sunshine36:00 – Ryan's loud pants37:05 – writing a second book (Joyride Journeys)38:30 – naming our cars and upcoming cross-country driving trip39:20 – post-traumatic growth and gains40:05 – how do we channel our loss?41:40 – advocate for yourself Focused Fight bookRyan's speechCamp FantasticBone Marrow Registry Terri's websitePost-Traumatic Growth articleMusic for Lead. Learn. Change. is Sweet Adrenaline by Delicate BeatsPodcast cover art is a view from Brunnkogel (mountaintop) over the mountains of the Salzkammergut in Austria, courtesy of photographer Simon Berger, published on www.unsplash.com.Professional Association of Georgia Educators  David's LinkedIn page

James Giordano is Professor in the Departments of Neurology and Biochemistry, Chief of the Neuroethics Studies Program, and Chair of the Project in Military Medical Ethics of the Pellegrino Center for Clinical Bioethics, at Georgetown University Medical Center. As well he is J5 Donovan Group Senior Fellow, Biowarfare and Biosecurity, at US Special Operations Command. His ongoing research focuses upon the use of advanced neurotechnologies to explore the neurobiology of pain and other neuropsychiatric spectrum disorders; the neuroscience of moral decision-making, and the neuroethical issues arising from the use of neuroscience and neurotechnology in research, clinical medicine, public life, international relations and policy, and national security and defense. --- Support this podcast: https://anchor.fm/out-of-the-blank-podcast/support