Podcasts about Hannover Medical School

Dr. Robert Zweigerdt is a Principal Investigator at Hannover Medical School, where his lab focuses on cardiac differentiation and the scalable culture of PSCs. He talks about regulating the lineage-specific differentiation of hPSCs and generating heart-forming organoids that mirror developmental cardiogenesis. He also discusses the importance of mentorship and the benefits of an international research group.

The latest episode of the Psychedelic Frontiers Podcast focuses on Hallucinogen Persisting Perception Disorder (HPPD) where individuals experience persistent visual hallucinations or perceptual distortions after previous use with drugs, including but not limited to psychedelics such as LSD. HPPD is rarely encountered in clinical settings, and its aetiology is poorly understood. Wide variations across participants are seen in symptoms, frequency and treatment-efficacy in this mysterious disorder, and it's clear more research is needed to identify its risk factors and underlying mechanisms. Today on the Psychedelic Frontiers Podcast, we'll Torsten and Ben discuss what's currently understood about HPPD, and review a recent systematic study exploring the disorder. Dr Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness and psychedelic substances. Torsten was part of the only systematic scientific investigation of more than 20 subjects claiming symptoms of HPPD, and the results have been published in a major neuroscience journal. He has also published the only comprehensive book on the subject of flashback phenomena such as HPPD as after-effects of hallucinogen ingestion, recreational or otherwise. Ben Clayden, the creator and owner is currently studying for an MSci in Natural Sciences specialising in Neuroscience at the University of York. Alongside the podcast, he is the co-chair for Drug Sciences Student Society Network, as well as the president of his university's Drug Science Society. He has a key interest in and neuroimaging neuropsychopharmacology, particularly related to consciousness and mental health.Halpern, J. H., Lerner, A. G., & Passie, T. (2018). A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD. Current topics in behavioural neurosciences, 36, 333–360. https://doi.org/10.1007/7854_2016_457Flashback-Phänomene als Nachwirkung von Halluzinogeneinnahme - Doris Holland, Torstan Passie, 2011 https://books.google.co.uk/books/about/Flashback_Ph%C3%A4nomene_als_Nachwirkung_von.html?id=t2cOMwEACAAJA thank you to Neel Radia, a member of the podcast team who helped with the research and script production for this episodeContact and Extra Information: Keep updated and listen to all our episodes and clips!Podcast Email - psymedpod@gmail.com Listen to the Psychedelic Frontiers Podcast! – https://rss.com/podcasts/psymedpod/ Psychedelic Frontiers Instagram - https://www.instagram.com/psychedelicfrontiers/ Psychedelic Frontiers Twitter - https://twitter.com/in_psychedelics Psychedelic Frontiers TikTok – https://www.tiktok.com/@psychedelicfrontiers

Lung cancer has the highest mortality rate of all cancers. Globally, it is the deadliest cancer among men and women. One of the biggest contributing factors to lung cancer's devastation is that it often goes undetected in its early stages. Because the lungs don't have pain receptors and the chest cavity allows a relatively spacious growing environment for tumors, symptoms typically don't manifest until the disease has progressed significantly. It's for these reasons that screening higher-risk patients for lung cancer is so important, as early detection provides the best chance of survival from the disease.In this episode, Dr. Victoria Schneider, clinical oncology consultant at Siemens Healthineers, is joined by Dr. Richard Booton, clinical director for lung cancer and thoracic surgery at Wythenshawe Hospital and professor of respiratory medicine at the University of Manchester in the UK; Rimma Kondrashova, a radiology resident at Hannover Medical School in Germany; and doctors David Yankelevitz and Claudia Henschke, both radiologists and professors of radiology at Mount Sinai's Icahn School of Medicine in New York City.You'll hear from these experts about the importance of early detection, the programs that have been recently rolled out to increase survival rates, and some of the exciting new advancements in the field.What You'll Learn in This Episode: • Early detection is a key factor in the successful treatment of lung cancer • Government funded screening programs in the US and the UK have made significant headway in early-stage lung cancer diagnoses • In Germany, the HANSE Study was created to assess what a successful national lung cancer screening program might look like for the country • Mobile screening clinics have been implemented in order to move lung cancer screenings out of hospitals and into more readily accessible community spacesAI has had a major impact on several areas of lung cancer screenings, including improving the image resolution of scans and helping radiologists by minimizing the often-tedious work of reading imagesConnect with Victoria SchneiderLinkedInConnect with Richard BootonLinkedInConnect with David YankelevitzLinkedInConnect with Claudia HenschkeLinkedIn Hosted on Acast. See acast.com/privacy for more information.

Dr. Michael S. Lloyd, MD, FHRS of Emory University, Dr. Faisal M. Merchant, MD, FHRS of Emory University School of Medicine, and Dr. David Duncker, MD, FHRS Hannover Heart Rhythm Center, Hannover Medical School, talk about what's new on the afib guidelines. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193 Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Baylis Medical Company, Boston Scientific  Contributor Disclosure(s): F. Merchant: Officer, Trustee, Director, Committee Member: American College of Cardiology D. Duncker: Honoraria/Speaking/Consulting: Pfizer, Inc., Boston Scientific, Boehringer Ingelheim, Abbott Medical, AstraZeneca, Bayer Healthcare Pharmaceuticals, BMS/Pfizer Alliance, CVRx Inc., Medtronic, Zoll Medical Corporation, Sanofi “This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365 https://www.heartrhythm365.org/URL/TheLeadEpisode45.

With Julian Chun, Cardioangiologisches Centrum Bethanien, Frankfurt - Germany and David Duncker, Hannover Medical School, Hannover - Germany.

With David Duncker, Hannover Medical School, Hannover - Germany & Avi Sabbag, Chaim Sheba Medical Center, Ramat Gan - Israel. 

With David Duncker (Host), Hannover Medical School, Hannover - Germany & Dominik Linz (Host), Maastricht University Medical Centre (MUMC), Maastricht - The Netherlands & Michael Lloyd (Guest) - Emory University in Atlanta - USA & Prashanthan Sanders (Guest) - Centre for Heart Rhythm Disorders at the University of Adelaide and the Royal Adelaide Hospital, Adelaide - Australia.

With Johann Bauersachs & Samira Soltani, Hannover Medical School, Hannover - Germany. Link to paper Link to editorial

In recent years, psychedelics have been shown increased interest as a possible therapeutic agent for the treatment of various mood and mental health disorders, ranging from PTSD and Major Depressive Disorder to Anorexia and End of Life Associated Anxiety. Institutions all over the world are running clinical trials, with many producing promising results, however not without complications and challenges. Today on The Psychedelic Frontiers Podcast, we'll discuss Psychedelic Assisted Therapies. For which disorders does this emerging treatment show the most promise for? What are the current methodological issues and challenges facing researchers studying this treatment? How generalizable are the results from recent clinical trials, and does Psychedelic Assisted Psychotherapy have a chance at becoming a mainstream treatment amongst the ever-growing mental health crisis.Dr Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness. Torsten has performed clinical and experimental studies numerous psychoactive and psychedelic compounds including MDMA, Psilocybin, Ketamine, Nitrous Oxide and more.Ben Clayden, the creator and owner is currently studying for an MSci in Natural Sciences specialising in Neuroscience at the University of York. Alongside the podcast, he is the co-chair for Drug Sciences Student Society Network, as well as the president of his universities Drug Science Society. He has a key interest in neuropsychopharmacology, particularly related to the neural correlates of consciousness and altered states of consciousness.Podcast Themes: Psychedelics, Drugs, Science, Medicine, Mental Health, Anxiety, Depression, Consciousness, Biology, Chemistry, Neuroscience, PsychologyContact and Extra Information: Keep updated and listen to all our episodes and clips!Podcast Email - psymedpod@gmail.com Listen to the Psychedelic Frontiers Podcast! – https://rss.com/podcasts/psymedpod/ Psychedelic Frontiers Instagram - https://www.instagram.com/psychedelicfrontiers/ Psychedelic Frontiers Twitter - https://twitter.com/in_psychedelics Psychedelic Frontiers TikTok – https://www.tiktok.com/@psychedelicfrontiers

Prof. Torsten Witte, Director of the Dept. of Rheumatology and Clinical Immunology at the Hannover Medical School in Germany, Prof. Andrea Rubbert-Roth, Chief physician and deputy clinic head at the Clinic of Rheumatology, Canton Hospital, St. Gallen, Switzerland and Dr. Alessandro Giollo, lead of refractory arthritis, synovial biopsy and osteoporosis clinics at the Rheumatology Unit, Department of Medicine, University of Padova, in Italy delve into the latest advancements and offer perspectives in the management of rheumatoid arthritis with a specific focus on optimising methotrexate. This podcast has been funded by Medac Gm-bh.

Recent statistics have shown that more than 100 million people on the planet have used MDMA, making it the second most popular drug worldwide. Commonly reported effects include altered sensations, increased energy, empathy and pleasure. Since its discovery, MDMA has garnered significant interest both from recreational users as a party drug, as well as from the medical and therapeutic communities as a possible therapeutic tool. Today, on the Psychedelic Frontiers podcast (formerly the Psychedelics in Medicine Podcast), we'll take a deep dive into the rich history of MDMA.Dr Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness and psychedelic drugs. He has very recently published a book titled ‘The History of MDMA' with Oxford University Press, the first-ever comprehensive history of MDMA. MDMA has had a complex often misunderstood and multilayered history. The book provides a deeper and more differentiated understanding of MDMA and its history, drawing partially on personal interviews with most of the people significant in the history of MDMA.Ben Clayden, the creator and owner is currently studying for an MSci in Natural Sciences specialising in Neuroscience at the University of York. Alongside the podcast, he is the co-chair for Drug Sciences Student Society Network, as well as the president of his universities Drug Science Society. He has a key interest in neuropsychopharmacology, particularly related to the neural correlates of consciousness and altered states of consciousness.LINK TO TORSTENS NEW BOOK - https://global.oup.com/academic/product/the-history-of-mdma-9780198867364?lang=en&cc=crPodcast Themes: Psychedelics, Drugs, Science, Medicine, Mental Health, Anxiety, Depression, Consciousness, Biology, Chemistry, Neuroscience, PsychologyContact and Extra Information: Keep updated, and listen to all our episodes and clips!Podcast Email - psymedpod@gmail.com Listen to the Psychedelic Frontiers Podcast! – https://rss.com/podcasts/psymedpod/ Psychedelic Frontiers Instagram - https://www.instagram.com/psymedpod/ Psychedelic Frontiers Twitter - https://twitter.com/in_psychedelics Psychedelic Frontiers TikTok – https://www.tiktok.com/@psymedpod

It's another COVID-19 special on this month's JHLT: The Podcast, which features two articles on COVID-19 and thoracic organ transplantation from the April issue of The Journal of Heart and Lung Transplantation.   First, the editors explore a study entitled “Heart transplantation for COVID-19 myopathy in the United States,” which comes from Gill and colleagues at Cedars Sinai Medical Center in Los Angeles.   The editors welcome first author George Gill, MD, to share what brought him from the United Kingdom to the States, and to talk about the findings of the study. The Digital Media Editors want to know how COVID-19 myocarditis impacts immune response in transplantation, how Dr. Gill manages different etiologies of cardiomyopathy, and some of the limitations of the study.   Next, the editors welcome senior author Nicolaus Schwerk, MD, from Hannover Medical School in Germany to discuss the paper, “COVID-19 in pediatric lung transplant recipients: Clinical Course and outcome.”   Dr. Schwerk is an expert in rare diffuse parenchymal lung diseases and end stage lung diseases, as well as congenital thoracic malformations in children, and performs lung transplantation. This single-center study investigated the impact of SARS-COV-2 infection on pediatric lung transplant recipients between March 2020 and June 2022 at Hannover Medical Center. The key finding of the study was that the COVID-19-positive pediatric lung transplant recipients did remarkably well.   The digital media editors dig in with Dr. Schwerk on the pace of COVID-19 infections in Europe, why antivirals are used differently in pediatric patients, and why pediatric patients typically experience a more mild course of disease.   Follow along at www.jhltonline.org/current, or, if you're an ISHLT member, log in at ishlt.org/journal-of-heart-lung-transplantation.  Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.    

Host: Marius M. Hoeper, MD A recent study explored the safety and efficacy of sotatercept on top of background pulmonary arterial hypertension (PAH) therapy. To learn more about this clinical data, Dr. Marius M. Hoeper, a Professor of Medicine and the Deputy Director of the Department of Respiratory Medicine at Hannover Medical School in Hannover, Germany, dives into the results of this trial and explores how they may impact patients with PAH.

The phrase ‘psycholytic therapy' was coined by Ronald A. Sandison, literally meaning soul-dissolving. In contrast to psychedelic therapy, psycholytic therapy places more emphasis on the psychotherapy than the substance. It typically consists of a low-to-medium dose of a psychedelic compound alongside more therapy sessions than its counterpart.In this month's episode of the Psychedelics in Medicine Podcast (PiMPOD), Dr Torsten Passie and Ben Clayden discuss psycholytic therapy. What is the history of substance assisted therapies? What are its differences to psychedelic therapy? Has it shown therapeutic relevance and efficacy? These and much more our discussed in today episode.Dr Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness. Torsten has performed clinical and experimental studies numerous psychoactive and psychedelic compounds ranging from nitrous oxide, to MDMA to ketamine.Ben Clayden is the creator and owner of this Podcast. He is a student at the University of York studying Natural Sciences specialising in Neuroscience. He is co-chair for the Drug Science Student Society Network as well as the president of his University's Psychedelics in Medicine Society.Psychedelics, LSD, Psilocybin, MDMA, Therapy, Doctors, Neuroscience, Medicine Mental Health, Depression, Anxiety, PTSD, Wellbeing, PsycholyticUseful LinksINSTAGRAM - https://www.instagram.com/psymedpod/LINKTREE - https://linktr.ee/psymedpodRSS - https://rss.com/podcasts/psymedpod/

In this episode I continue my investigation into the science of nutrition and food. Today I'm interviewing a physician who has been focusing on a critical evaluation of so-called alternative medicine or SCAM. I want to investigate with him the science behind various detox diets and claims made by nutrition specialists. I expect to receive a very skeptical viewpoint based on his many blog posts suggesting that claims of detoxing are a scam. Edzard Ernst studied psychology and medicine at the Ludwig Maximilians University in Munich. In 1977, he qualified as a physician and completed his MD and PhD theses. He was Professor in Physical Medicine and Rehabilitation (PMR) at Hannover Medical School and Head of the PMR Department at the University of Vienna (Austria). He established the world's first Chair in complementary medicine at Exeter University in 1993. Since 2012, he is Emeritus Professor at the University of Exeter and now lives in Cambridge, UK as well as in Brittany, France. Professor Ernst is/was founder/Editor-in-Chief of three medical journals and has been a columnist for many publications. His work has been awarded 17 scientific awards and two Visiting Professorships. He served on the ‘Medicines Commission' of the British ‘Medicines and Healthcare Products Regulatory Agency'. During the last 25 years, Prof Ernst's research focused on the critical evaluation of most aspects of so-called alternative medicine or SCAM. Become a patron at patron.podbean.com/TheRationalView Join the Facebook discussion @TheRationalView Twitter @AlScottRational Instagram @The_Rational_View #TheRationalView #podcast #alternativemedicine #detox #diets #SCAM

In this month's episode of the Psychedelics in Medicine Podcast (PiMPOD), Dr Torsten Passie and Ben Clayden discuss Self-experimentation with psychedelic substances. What is the history of psychedelic self-experimentation, why is self-experimentation important for therapists conducting psychedelic assisted psychotherapy, which aspects of the trip are particularly important, and what ethical issues may arise if psychedelic therapists are required to take psychedelics before finishing their training? All of these questions and more are covered in our first episode of 2023Dr Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness. Torsten has performed clinical and experimental studies numerous psychoactive and psychedelic compounds ranging from nitrous oxide, to MDMA to ketamine.Ben Clayden is the creator and owner of this Podcast. He is a student at the University of York studying Natural Sciences specialising in Neuroscience. He is co-chair for the Drug Science Student Society Network as well as the president of his University's Psychedelics in Medicine Society.Psychedelics, LSD, Psilocybin, MDMA, Therapy, Doctors Neuroscience, Medicine Mental Health, Depression, Anxiety, PTSD, WellbeingUseful LinksINSTAGRAM - https://www.instagram.com/psymedpod/LINKTREE - https://linktr.ee/psymedpodRSS - https://rss.com/podcasts/psymedpod/TikTok - https://www.tiktok.com/@psymedpod

Ketamine: Anaesthetic, Psychedelic or AntidepressantIn this month's episode of the Psychedelics in Medicine Podcast (PiMPOD), Dr Torsten Passie and Ben Clayden discuss Ketamine, a unique anaesthetic which can produce dissociative and even hallucinogenic states. We'll take a look at Ketamine's history, variations in its use across cultures, its pharmacology and differences between its two enantiomers, before finally discussing its potentially as a rapidly acting antidepressant. Dr Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness. Torsten has performed clinical and experimental studies numerous psychoactive and psychedelic compounds ranging from nitrous oxide, to MDMA to ketamine.Ben Clayden is the creator and owner of this Podcast. He is a student at the University of York studying Natural Sciences specialising in Neuroscience. He is co-chair for the Drug Science Student Society Network as well as the president of his University's Psychedelics in Medicine Society.Psychedelics, Ketamine, Hallucinogens, Anaesthetic, Addition, Drugs Biology, Chemistry, Pharmacology, Neuroscience Mental Health, Depression, Anxiety, PTSD, WellbeingUseful LinksINSTAGRAM - https://www.instagram.com/psymedpod/TWITTER - https://twitter.com/in_psychedelicsLINKTREE - https://linktr.ee/psymedpodRSS - https://rss.com/podcasts/psymedpod/ReferencesPassie, T., Adams, H. A., Logemann, F., Brandt, S. D., Wiese, B., & Karst, M. (2021). Comparative effects of (S)-ketamine and racemic (R/S)-ketamine on psychopathology, state of consciousness and neurocognitive performance in healthy volunteers. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 44, 92–104. https://doi.org/10.1016/j.euroneuro.2021.01.005

In June 2019, Kirsten Muller-Vahl, a psychiatrist at Hannover Medical School and head of its Tourette's outpatient department, noticed unusual symptoms in her new set of patients. To begin with, all of them were teenagers, and they were suffering from sudden and uncontrollable tics. Even though none of them had any history of the condition, they were all shouting different kinds of obscenities. Stay connected with Aperture: Website: https://aperture.gg/ YouTube: https://www.youtube.com/@ApertureScience Instagram: https://www.instagram.com/theapertureyt/ Twitter: https://twitter.com/TheApertureYT Merch: https://aperture.gg/merch

Professor Arndt Vogel from Hannover Medical School in Germany discusses major clinical trials and recent changes in the treatment of advanced hepatocellular carcinoma. CME information and select publications [here] (http://www.researchtopractice.com/OncologyTodayHCC22)

In this month's episode of the Psychedelics in Medicine Podcast (PiMPOD), Dr Torsten Passie and Ben Clayden discuss LSD Derivatives, A nearly identical molecule with just a few differences. We discuss multiple derivatives of LSD, including LSA, 2-Bromo-LSD (BOL-148), 1P-LSD and use them in combination to better understand the intricacies of the neural mechanisms of LSD, and how slight changes to a molecules three-dimensional structure can completely alter their effects, through differences in ligand-receptor binding.We then look at a study using a non-hallucinogenic version of LSD, BOL-148 as preventative treatment for cluster headache, discussing its implications, and further research that could be completed relating to LSD derivatives.Dr Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness. Torsten has performed clinical and experimental studies numerous psychoactive and psychedelic compounds ranging from nitrous oxide, to MDMA to ketamine.Ben Clayden is the creator and owner of this Podcast. He is a student at the University of York studying Natural Sciences specialising in Neuroscience. He is co-chair for the Drug Science Student Society Network as well as the president of his University's Psychedelics in Medicine Society.Psychedelics, LSD, Hallucinogens Biology, Chemistry, Structural Biology, Neuroscience Cluster Headaches,Useful LinksINSTAGRAM - https://www.instagram.com/psymedpod/LINKTREE - https://linktr.ee/psymedpodRSS - https://rss.com/podcasts/psymedpod/ReferencesKarst M, Halpern JH, Bernateck M, Passie T. The non-hallucinogen 2-bromo-lysergic acid diethylamide as preventative treatment for cluster headache: an open, non-randomized case series. Cephalalgia. 2010 Sep;30(9):1140-4. doi: 10.1177/0333102410363490. Epub 2010 Mar 26. PMID: 20713566.

This talk was recorded during the Alps Conference 2022 on psychedelic research in Bern, Switzerland on 30.10.2022. More info on the Alps Conference 2022 Website - Twitter - Facebook - Instagram - Youtube Professor Torsten Passie (MD, PhD) studied philosophy and sociology at Leibniz University Hannover and medicine at Hannover Medical School. Medical dissertation on existential psychiatry. Education at Zürich Psychiatric University Clinic and with Prof. Hanscarl Leuner (1921-1996), the leading European authority on psychedelics and psycholytic therapy. 1997-2010 scientist, psychiatrist and psychotherapist at Hannover Medical School, where he lead the Laboratory for Consciousness and Neurocognition. Professorship thesis about “Psychophysical correlates of altered states of consciousness”. Clinical research on altered states of consciousness, including studies with breathwork, cannabis, MDMA, laughing gas, ketamine and psilocybin. Special expertise on ecstatic states, addictions, and the pharmacology of psychedelics. 2012-2015 Visiting Professor at the Department of Psychiatry of the Harvard Medical School (Boston, USA). Torsten is also the Author of several books, such as “The Science of Microdosing Psychedelics”, “Healing with Entactogens”, and “The Pharmacology of LSD”. More infomation of Professor Torsten Passie https://psychedelic-science.org Dr. Torsten Passie — MDMA, LSD & Psilocybin Slides of the talks on accessible here : https://twitter.com/ALPSconference/status/1586643240375263232?s=20&t=xXH1NgD5PR92lybl4QGo-Q

This discussion was recorded during the Alps Conference 2022 on psychedelic research in Bern, Switzerland on 29.10.2022. More info on the Alps Conference 2022 - Website - Twitter - Facebook - Instagram - Youtube Professor Torsten Passie (MD, PhD) studied philosophy and sociology at Leibniz University Hannover and medicine at Hannover Medical School. Medical dissertation on existential psychiatry. Education at Zürich Psychiatric University Clinic and with Prof. Hanscarl Leuner (1921-1996), the leading European authority on psychedelics and psycholytic therapy. 1997-2010 scientist, psychiatrist and psychotherapist at Hannover Medical School, where he lead the Laboratory for Consciousness and Neurocognition. Professorship thesis about “Psychophysical correlates of altered states of consciousness”. Clinical research on altered states of consciousness, including studies with breathwork, cannabis, MDMA, laughing gas, ketamine and psilocybin. Special expertise on ecstatic states, addictions, and the pharmacology of psychedelics. 2012-2015 Visiting Professor at the Department of Psychiatry of the Harvard Medical School (Boston, USA). Torsten is also the Author of several books, such as “The Science of Microdosing Psychedelics”, “Healing with Entactogens”, and “The Pharmacology of LSD”. More infomation of Professor Torsten Passie https://psychedelic-science.org Dr. Torsten Passie — MDMA, LSD & Psilocybin

In this months episode of PiMPOD, I, Ben Clayden am once again joined with Dr Torsten Passie. Today we'll take a look into the science of microdosing psychedelics.We discuss the background history and science before taking a look at two recent papers looking at the effects of microdosing psilocybin. We take a look into the placebo effect and the role of expectation and finally, Torsten shares his thoughts on methodological approaches to avoiding participants breaking blind, and what a useful placebo may be for microdosing.Dr Torsten Passie is a German psychiatrist, professor at Hannover Medical School and is an expert in altered states of consciousness. In 2019 Torsten published The Science of Microdosing Psychedelics, a comprehensive review of scientific data, where he reveals the rich and little known history of research with micro and low dose psychedelics. The over 200 page book has been revised and recommended by David Nichols, the leading LSD scientist and by the leading microdosing expert, James Fadiman.Ben Clayden is a student at the University of York studying Natural Sciences specialising in Neuroscience. He is co-chair for the Drug Science Student Society Network as well as the president of his Universities Psychedelics in Medicine Society.Useful LinksINSTAGRAM - https://www.instagram.com/psymedpod/LINKTREE - https://linktr.ee/psymedpodRSS - https://rss.com/podcasts/psymedpod/Related TopicsMicrodosing, LSD, Psilocybin, Psychedelics, Medicine, Placebo, Neuroscience, Science, Mental Health, HealthReferencesBalázs SzigetiLaura KartnerAllan BlemingsFernando RosasAmanda FeildingDavid J NuttRobin L Carhart-HarrisDavid Erritzoe (2021) Self-blinding citizen science to explore psychedelic microdosing eLife 10:e62878. https://doi.org/10.7554/eLife.6287van Elk, M., Fejer, G., Lempe, P. et al. Effects of psilocybin microdosing on awe and aesthetic experiences: a preregistered field and lab-based study. Psychopharmacology 239, 1705–1720 (2022). https://doi.org/10.1007/s00213-021-05857-0

With Johann Bauersachs, Hannover Medical School, Hannover - Germany and Karen Olsson Link to paper Link to editorial

Heroin Assisted Therapy has shown large promise in helping 'heroin using humans' improve both in mental and physical health, social integration, crime reduction and decrease of opioid use according to a large study conducted in Germany between 2002-2004.On the first episode of PiMPOD I discuss the history, implications and future of Heroin Assisted Treatment with Dr Torsten Passie, Psychiatrist, leading expert on altered states of consciousness and professor at Hannover Medical School.

With Thomas Thum, Institute for Molecular and Translational Therapeutic Strategies (IMTTS), Hannover - Germany and Bar Christian, Hannover Medical School, Hannover - Germany Link to editorial Link to paper

Join Daniel R. Goldstein, MD, Editor-in-Chief of JHLT, and the JHLT Digital Media Editors for two interviews with authors from the February issue of The Journal of Heart and Lung Transplantation. First, the editors speak with Georg Hansmann, MD, PhD, Associate Professor of Pediatrics at Hannover Medical School. Dr. Hansmann is the lead author on a paper entitled “Full recovery of right ventricular systolic function in children undergoing bilateral lung transplantation for severe PAH.” Beginning at 1:37, Erika Lease, MD, interviews Dr. Hansmann about the findings of the study, follow up recommendations, and potential practice changes in clinical settings. Starting at 14:27, Marty Tam, MD, is in conversation with Jan Griffin, MD, Assistant Professor of Medicine at Columbia University Irving Medical Center, about her study from the February issue: “Surveillance for disease progression of transthyretin amyloidosis (ATTR) post heart transplantation in the era of novel disease modifying therapies.” Dr. Griffin discusses her team's work on transplanting patients with TTR cardiac amyloidosis, a structured surveillance program, and disease modifying agents post-transplant. Follow along in the February issue at www.jhltonline.org/current, or, if you're an ISHLT member, log in at ishlt.org/journal-of-heart-lung-transplantation.  Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.

With David Duncker (Host), Hannover Medical School, Cardiology and Angiology, Hannover, Germany, Dominik Linz (Host), Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, The Netherlands and Dhiraj Gupta, Liverpool Heart and Chest Hospital, United Kingdom

With David Duncker (Host), Hannover Medical School, Cardiology and Angiology, Hannover, Germany and Thomas Deneke, (Guest), Clinic for Interventional Electrophysiology, Heart Center RHÖN-KLINIKUM Campus, Bad Neustadt, Germany Link: https://ag-ep.de/austausch/ This podcast will tackle ‘Esophageal lesions in AF ablation' and more particularly: what's the problem ? risk factors diagnostic work-up how to avoid ? how to manage ?

With David Duncker (Host) , Hannover Medical School, Cardiology and Angiology, Hannover - Germany and Emma Svennberg, Karolinska University Hospital, Stockholm - Sweden This podcast will tackle ‘Screening for AF' and more particularly: why should we screen? screening modes? whom to screen? how to screen? new technologies for screening?

Please join author Milton Packer and Associate Editor Justin Ezekowitz as they discuss the Perspective "Heart Failure and a Preserved Ejection Fraction: A Side-by-Side Examination of the PARAGON-HF and EMPEROR-Preserved Trials." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the Journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center. Dr. Greg Hundley: And I'm Dr. Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Greg, it really is so great to be back with you chatting about the papers here in the Journal. Thank you for going solo and for just being the greatest partner on earth. Thank you for that. For everyone listening in, we are back with some gusto and especially with this feature discussion today. You are not going to want to miss it. We are talking to Dr. Milton Packer as well as Dr. Justin Ezekowitz. We are going to compare PARAGON and EMPEROR-Preserved trials in heart failure with preserved ejection fraction. A really interesting discussion you're not going to want to miss, but now let's start with some papers in today's issue. I'd like to start, please. Dr. Greg Hundley: You bet. Dr. Carolyn Lam: Greg, you know the optimal duration of antiplatelet therapy in patients with high bleeding risk with or without oral anticoagulation after coronary stenting? Well, that still remains a question. Today's paper is a pre-specified subgroup analysis of the MASTER DAPT trial and reports on the outcomes of patients with or without an oral anticoagulation indication in this study. Dr. Greg Hundley: Right, Carolyn. Remind us. What was the MASTER DAPT trial? What did it test? Dr. Carolyn Lam: Ah. MASTER DAPT investigated an abbreviated or one-month versus a non-abbreviated or three to 12-month dual antiplatelet therapy and a stopping of antiplatelet therapy at six months strategy after coronary stenting in an all-comer population at high bleeding risk. Dr. Greg Hundley: Carolyn, what did this subgroup analysis of outcomes in patients with and without oral anticoagulation show? Dr. Carolyn Lam: At 12 months of follow-up, ischemic and net risk did not differ with abbreviated versus non-abbreviated anti-platelet regimens in both subgroups, although significantly fewer clinically relevant bleeding events occurred in the group without an oral anticoagulation indication. Whereas only numerically fewer bleeding events occurred in the group with an oral anticoagulation indication that did not reach statistical significance. This subgroup analysis from the MASTER DAPT trial really adds additional evidence that dual antiplatelet therapy beyond one month in patients with or without an indication for oral anticoagulation really has no benefit and only increases bleeding risk. Dr. Greg Hundley: Oh, very important finding, Carolyn. Great research. Well, Carolyn, how the extracellular matrix microenvironment modulates the contractile phenotype of vascular smooth muscle cells and confers vascular homeostasis really remains elusive. Thus, these investigators led by Professor Wei Kong at Peking University applied protein-protein interaction network analysis to explore novel extracellular matrix proteins associated with the vascular smooth muscle cell phenotype. Dr. Carolyn Lam: Huh. Interesting. What did they find, Greg? Dr. Greg Hundley: Right, Carolyn. By combining an in-vitro and an in-vivo genetic mice vascular injury model, they identified nidogen-2, a basement membrane glycoprotein, as a key extracellular matrix protein for maintenance of vascular smooth muscle cell identity. Nidogen-2 exerted its protective function via direct interaction and modulation of Jagged1-Notch3 signaling. Dr. Carolyn Lam: Wow! Nidogen-2 and Jagged1-Notch3. I always learn so much. What are the clinical implications, Greg? Dr. Greg Hundley: Right, Carolyn. Perhaps targeting nidogen-2 to precisely modulate Jagged1-Notch3 signaling, well, that may provide novel therapeutic strategy for atherosclerosis and post-injury restenosis. Dr. Carolyn Lam: Very nice. Well, in the next paper, we discuss inflammation in heart failure. We know that inflammation contributes to the pathogenesis of heart failure, but there is limited understanding of inflammation's potential benefits. Interesting, huh? Well, these authors, Dr. Wollert and colleagues from Hannover Medical School in Germany, identified an adaptive crosstalk between inflammatory cells and cardiomyocytes that protects against persistent afterload stress-induced heart failure in mice. Monocytes and macrophages produced myeloid-derived growth factor in the pressure overloaded myocardium to augment SERCA2a expression in cardiomyocyte's calcium cycling and contractility. Myeloid-derived growth factor plasma concentrations were also found to be elevated in patients with aortic stenosis and to decline after aortic valve implantation indicating that pressure overload also triggers myeloid-derived growth factor release in humans. Dr. Greg Hundley: Carolyn, really informative preclinical science, but what are the clinical implications? Dr. Carolyn Lam: Ah. These observations molecularly defined a feature of the inflammatory response to hemodynamic overload that protects against heart failure development. Inflammation's beneficial trade therefore need to be considered when developing inflammation as a therapeutic target in heart failure. All of this is really discussed in a lovely editorial entitled Inflammation and Heart Failure: Friend or Foe? That's by Drs. Hajjar and Leopold. Dr. Greg Hundley: Great job, Carolyn. Well, my next paper focuses on resistant hypertension. Carolyn, although lifestyle modifications generally are effective in lowering blood pressure among patients with unmedicated hypertension or those treated with one to two antihypertensive agents, the value of exercise and diet for lowering blood pressure in patients with resistant hypertension is unknown. To address this, Professor James Blumenthal and co-authors at Duke University Medical Center enrolled 140 patients with resistant hypertension with an average age of 63 years, 48% women, 59% black, 31% diabetes, and 21% with chronic kidney disease and randomly assigned them to A, a four-month cardiac rehab center-based program of lifestyle modification. We're going to call that C-LIFE, consisting of dietary counseling, behavior and weight management, and exercise. Or number 2 or the B, a single counseling session providing standardized education and physician advice. We'll call that SEPA. Dr. Greg Hundley: The primary endpoint was clinic measured systolic blood pressure. Secondary endpoints included 24-hour ambulatory blood pressure and selective cardiovascular disease biomarkers including baroreflex sensitivity to quantify the influence of baroreflex on heart rate; high-frequency heart rate variability to assess vagally-mediated modulation of heart rate; flow-mediated dilation to evaluate endothelial function; and pulse wave velocity to assess arterial stiffness; and then finally left ventricular mass to characterize left ventricular structure and remodeling. Dr. Carolyn Lam: Wow! That is a very, first of all, important clinical question. Then also, just very intricate methodology in assessing this. What did they find? Dr. Greg Hundley: Right, Carolyn. Between-group comparisons revealed that the reduction in clinic systolic blood pressure was greater in C-LIFE compared with SEPA. Next, 24-hour ambulatory systolic blood pressure also was reduced in C-LIFE with no change in SEPA. Then next, compared with SEPA, C-LIFE resulted in greater improvements in baroreflex sensitivity, high-frequency heart rate variability, and flow-mediated dilation. There was no between-group differences in pulse wave velocity or LV mass. Dr. Greg Hundley: Carolyn, diet and exercise can lower blood pressure in patients with resistant hypertension. When delivered in a cardiac rehabilitation setting, a four-month program of diet and exercise as adjunctive therapy, results in a significant reduction in clinic and ambulatory blood pressure, and improvement in selected cardiovascular disease biomarkers. Dr. Carolyn Lam: Wow! Really nice, Greg. Okay. Well, looks like we're all going to round up already with what else there is in today's issue. Let me start. There's an exchange of letters between Drs. Fang and Vinceti regarding the article Blood Pressure Effects on Sodium Reduction: Dose-Response Meta-analysis of Experimental Studies. Dr. Greg Hundley: Right, Carolyn. I've got a few things in the mail bag. First, Professor Anker has a Research Letter regarding the Kidney Function After Initiation and Discontinuation of Empagliflozin in Heart Failure Patients With and Without Type 2 Diabetes: Insights From the EMPERIAL Trials. Dr. Gerstenfeld has an ECG challenge entitled Atrioventricular Block with Narrow and Wide QRS: The Pause That Refreshes. Then lastly, Dr. Donald Lloyd-Jones has an AHA update regarding the American Heart Association's focus on primordial prevention. Well, Carolyn, I can't wait to hear this fantastic feature discussion with you and Dr. Packer. How about we jump to that? Dr. Carolyn Lam: Great. Let's go, Greg. Dr. Carolyn Lam: Because side-by-side exam of PARAGON and EMPEROR is like side-by-side of... Dr. Justin Ezekowitz: You can compare our new and our old prime minister much like your paper did. Dr. Milton Packer: Yeah, yeah. Dr. Justin Ezekowitz: There are [crosstalk] and it could be viewed until they perform in the broader world how it goes. You don't quite know. Dr. Milton Packer: The only problem is you can't do a head-to-head comparison of the old prime minister and the new prime minister. Dr. Justin Ezekowitz: That is true except that the head-to-head comparison includes excellent care by both the new and the old. I think that comparison's going to be pretty equal. I think we can case-control that one. Dr. Carolyn Lam: I really liked that that was politically correct because we are recording. Everybody, welcome to the feature discussion. I am here with Dr. Milton Packer from Baylor and he really needs no introduction. We're discussing heart failure with preserved ejection fraction. As well as our associate editor, Dr. Justin Ezekowitz from University of Alberta. Hence, in case anybody's wondering, we were talking about the Canadian elections. Let's just launch straight into it, a side-by-side comparison of PARAGON and EMPEROR-Preserved. Dr. Packer... Milton, if I may, what in the world drove you to do this? Dr. Milton Packer: My God. Oh, my God. Yes. Dr. Carolyn Lam: Tell us about what drove you to do this and please, if you could just summarize the results. Dr. Milton Packer: Well, let me just say from the outset that this was a commentary, not an original research article. Dr. Carolyn Lam: Yes. Dr. Milton Packer: The commentary was motivated by two very straightforward observations. We had two large scale outcome trials of two different drugs in heart failure with a preserved ejection fraction. I was privileged to serve as you were, Carolyn, on the leadership committees of both trials. It's not as if we have involvement in only one trial. We have involvement in both trials and we are very proud of that involvement. Dr. Milton Packer: One trial came in with a effect size of about 13% on its primary endpoint with a borderline P-value. A second trial, EMPEROR-Preserved, came in with a 21% reduction and its primary endpoint with a really small and persuasive P-value. The two patient populations in the two trials were really amazingly similar. We wanted to understand why it was 21% in one trial and persuasively so and why it appeared to be smaller in the PARAGON trial with sacubitril/valsartan. We thought, well, maybe that difference was related to how endpoints were defined or maybe that difference was related to the influence of ejection fraction. The reason we got excited about that was that as almost everyone knows, PARAGON found an influence of ejection fraction on the effect of sacubitril/valsartan in patients with HFpEF. We found an influence of ejection fraction on the effect of empagliflozin in HFpEF in EMPEROR-Preserved. We wanted to understand whether that influence was similar in the two trials. Dr. Milton Packer: Just to make life simple, PARAGON had created certain cut points for ejection fraction. They had presented and previously published in Circulation endpoints based on those cut points of ejection fraction. All we did was we used their endpoints and their cut points, and we put the two trials side by side. We did not do a statistical comparison of the effect size. There're actually no P-values in the whole commentary. But what we wanted to see was: Was the shape of the ejection fraction influence relationship similar or different in the two trials? Well, very simple. In PARAGON, as has been reported, there was a linear relationship: as ejection fraction increased, the effect of sacubitril/valsartan got smaller. In EMPEROR-Preserved, there was also an attenuation at a highest ejection fraction, but the relationship wasn't linear. It was like a hockey stick. It was flat and then went up at an ejection fraction over 62.5, which was the cut point that PARAGON used. Dr. Milton Packer: When we compared patients between the low 40s and the low 60s, the effect size in empagliflozin appeared to be larger than the effect size of sacubitril/valsartan in that ejection fraction group using the same endpoints. In fact, for hospitalizations for heart failure, which is really what SGLT2 inhibitors do, it was twice as great with empagliflozin in EMPEROR-Preserved than with sacubitril/valsartan in PARAGON-HF. We thought this was really interesting. We put the pictures up side by side. We wrote a commentary and Circulation was so kind to accept it. Dr. Carolyn Lam: Oh, but Milton, you were very, honestly as always, very clever to have done this analysis. But if I could reiterate a few things for the audience, which is very important. First of all, as you rightly first pointed out, it's a perspective piece. It is not a head-on comparison with P-values. It could not be. Let's just also give the audience a bit of background in that PARAGON included patients with an ejection fraction of 45% and above. EMPEROR-Preserved was above 40. PARAGON looked at total heart failure hospitalizations and cardiovascular death as a primary outcome. EMPEROR looked at first cardiovascular death or heart failure hospitalization. Dr. Carolyn Lam: Let's just remember the designs were different. Of course in the comparison, PARAGON compared sacubitril/valsartan versus valsartan. I like the way you very carefully wrote in your study that it was more a study of neprilysin inhibition since it's sacubitril/valsartan against valsartan and it was empagliflozin versus placebo. We know that it's important to state that as a basis. Then really important to say to everybody out there, pick up our journal. You must look at this bigger. I myself have already cited it at least twice already, Milton, because people will just naturally ask that. "Are the results different because of ejection fraction or different endpoints?" What you did there in that beautiful figure is that you tried as best as you can to match it up in terms of ejection fraction bins and match it up in terms of hospitalizations. There. I just wanted to state those few things, but I'm really- Dr. Milton Packer: Oh, no. No. Carolyn, you're 100% right. That's why there are couple of things. I just want to underscore what you said because I think your points were spot on. First of all, we really lined up the endpoints and the ejection fraction. We tried our best to compare apples and apples. It would not have been a useful exercise for us to compare different endpoints and different ejection fraction subgroups. But I just want to make sure that everyone understands: I'm a big fan of sacubitril/valsartan and I'm a big fan of neprilysin inhibition. As you know, both PARADIGM-HF and PARAGON-HF weren't really tests of sacubitril/valsartan; they were tests of neprilysin inhibition. They were great tests at that. PARAGON in particular was a great test of that. We're comparing neprilysin inhibition and SGLT2 inhibition. Dr. Milton Packer: But here's my most important point: we do not want people to choose one over the other. That was not the intent. We think that there are data in patients with certain ejection fractions, let's say between 40 and 60, I'm just creating a range, where both interventions are appropriate. Now I understand there are cost considerations and I don't want to minimize that, but we are not suggesting that anyone prefer one drug over the other. All we wanted to do was we wanted to ask the question: Since the effect size in one trial seemed to be different than the effect size in the other trial, what were the ejection fraction subgroups that represented that difference? We found that the patients with ejection fractions greater than 60, 65% did not contribute to that difference. It was the patients with lower ejection fractions that contributed to the difference. I hope that's helpful. Dr. Carolyn Lam: Ah. That's wonderful. Justin, have you recovered from the talk about the Canadian elections? Dr. Justin Ezekowitz: Oh. I have indeed. Dr. Carolyn Lam: I'm on swinging. Dr. Justin Ezekowitz: I have indeed. Thanks for recognizing that Canada just had a major election we carried out in six weeks. But, Milton, I really enjoyed reading this. Maybe I can just ask you about two elements within this perspective piece, which is number 1, what's incredibly concordant is a lack of difference across cardiovascular death for both agents in both trials regardless of the trial differences and the potential differences in patient populations recruited; that's number 1. It's incredibly flat for cardiovascular death. Dr. Justin Ezekowitz: But number 2 is there is a danger in comparing trials even non-statistically. That's often a pitfall we get into, but we have to put some frame of reference on that. What is the one or two key things you think differ between PARAGON and EMPEROR-Preserved that you say, "You really need to look at these trials differently"? Those two questions came to mind when looking at this great figure that you produced. Dr. Milton Packer: Okay. The first question is so much easier and that is that these drugs don't reduce cardiovascular deaths. Full stop. It's really interesting because sacubitril/valsartan reduces cardiovascular death in people with ejection fractions of 40% or less, but not in patients with ejection fraction greater than that. The primary effect is heart failure hospitalizations. Empagliflozin didn't reduce cardiovascular death even in patients with the ejection fraction less than 40% or greater than 40%. What we're really, really talking about two drugs where the major effect is a reduction in heart failure hospitalizations. That comes out whether you do the analysis as time-to-first-event or total heart failure hospitalizations. Dr. Milton Packer: Of course, we're looking forward to the DELIVER trial with dapagliflozin. My own personal expectation is they're going to come out with a very striking effect on heart failure hospitalizations and not on cardiovascular deaths. Cardiovascular deaths in patients with HFpEF is really... It's a hard goal because only half of the deaths are cardiovascular. These patients have so many comorbidities that influence prognosis. The other thing, which is really important, is that heart failure hospitalizations only represented 18% of all hospitalizations in these patients; it's really small. I think of empagliflozin as being a treatment of the heart failure of HFpEF, not a treatment for HFpEF. I hope that makes sense. Justin, what was your second question? Dr. Justin Ezekowitz: Absolutely. Dr. Milton Packer: Oh, the differences between- Dr. Justin Ezekowitz: Yeah. Thank you, Milton. Dr. Milton Packer: Okay. There's always differences between two trials. As I said before, Carol and I were involved in both trials. They were done slightly at different times. They didn't overlap. Remember that the cut points in the two trials, one was 40%, one was 45%, really didn't matter to our analysis because we corrected for that in our ejection fraction subgroups. I was actually really much more impressed by the similarities than by the differences, but here's the catch. HFpEF is an incredibly heterogeneous disease. When we look at baseline characteristics, we're looking at means, medians, percentages. We're not picking up on any heterogeneity and there's a lot of heterogeneity. I actually think that HFrEF is a reasonably homogeneous disease. I think HFpEF is an incredibly diverse disease with a whole host of different disorders. What I'm amazed by is that we actually got an effect size that was greater than 20% in an all-comers HFpEF analysis. Dr. Milton Packer: But in all honesty, Justin, it wasn't really all-comers. We excluded people with BMIs over 45. There are a lot of patients who are obese and had BMIs greater than 45 who have HFpEF. By the way, especially in Texas. I didn't say that. We didn't enroll those patients. In all honesty, if I had to do it all over again, I would have. By the way, PARAGON didn't enroll them either. Dr. Carolyn Lam: Well, this is an incredible conversation. I know that we could just do a whole hour of chatting about what this implies for the higher ejection fraction, what this implies for how we should be treating heart failure. I don't even dare to ask for some last words maybe from both Justin and Milton, but recognizing that the time is short, anything else to add? Dr. Milton Packer: I think Justin should do last words. Dr. Justin Ezekowitz: Well, let me summarize by saying there is a hockey stick. We love hockey sticks in Canada. A simple and an excellent comparison. I think people should really look at that figure to understand it, but do not undertreat your patients with HFpEF and look at these with a grain of salt. Thanks for joining us, Milton. Thanks, Carolyn. Dr. Milton Packer: Thank you so much. Dr. Carolyn Lam: On behalf of Greg and I, you've been listening to Circulation on the Run. Thank you so much for joining us today and don't forget to tune in again next week. Dr. Greg Hundley: This program is copyright of the American Heart Association 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors, or of the American Heart Association. For more, visit ahajournals.org.

Slovenia is currently presiding the council of EU until 2022. In the first week of September, the members of the Slovenian health tech ecosystem organized a conference about examples of good practices in healthcare digitalization across Europe. In one of the previous episodes, you were able to listen to the panel discussion on the healthcare strategy in Catalonia. Today's episode is an adapted recording of the panel about Germany, and the upcoming two episodes will be the adapted discussions about healthcare digitalization in Israel and Finland.  In the past two years, a lot of efforts have been put in place to accelerate the progress on the digitalization of the healthcare digital infrastructure in Germany. Many laws were passed, the country received a lot of international attention about the DIGA process, which enables startups to make their apps reimbursable. The bigger national projects which saw the day of life this year, however, were the introduction of electronic patient records, telemedicine, and e-prescriptions.  On the funding side, the federal ministry of health and the federal states are investing EUR 4,3 billion for concrete projects that work towards the digitalization of hospitals.  In this discussion, we're going to scratch the surface of the design of the national strategy and digital health infrastructure in Germany. and look at the practical example of the Medical informatics Initiative. Medical Informatics Initiative is a separate project to improve medical research and patient care.   You will hear more from five speakers. The panel discussion was moderated by Maja Dragović, a former journalist for digitalhealth.net, now a Business Developer at Better. She will also present the speakers.    Speakers:  Dr. Michael Marschollek  - professor for Medical Informatics at Hannover Medical School (Germany) and executive director of the Peter L. Reichertz Institute for Medical Informatics of TU-Braunschweig and Hannover Medical School.  Johannes Starlinger, an MD, working as an Interdisciplinary Digital Health Consultant, Howto Health GmbH, Germany Mark Langguth, eHealth Consultant, Former Senior Product Manager at Gematik Fabien Prasser, Professor of Medical Informatics at the Berlin Institute of Health at the Charite University Hospital Berlin We were also supposed to be joined by Anka Bolka, Head of Director of Field for Development and Analysis, Health Insurance Institute of Slovenia, but since she couldn't make it, Tomaž Mračun, who manages the application development department at Health Insurance Institute of Slovenia (HIIS).   Recap of the Days of eHealth: https://www.facesofdigitalhealth.com/blog/days-of-ehealth-healthcare-digitalization-in-catalonia-germany-finland-and-israel  Join the EPF Congress: https://epfcongress.eu/  Podcast Website: www.facesofdigitalhealth.com 

Vidcast:  https://youtu.be/dZ_q5BJtlzQ Women who use assisted reproduction techniques including in-vitro fertilization and intracystoplasmic sperm injection are 5 times more likely to suffer pregnancy-associated heart failure.  This conclusion comes from a study at Germany's Hannover Medical School presented last week to the European Society of Cardiology.   This pregnancy-associated heart failure is due to so-called peripartum cardiomyopathy or PPCM, and this condition affects one in every 1000 pregnant women around the world.  It threatens the life of mother and baby alike.  Assisted reproduction is now added to known risk factors including twin pregnancy, many past pregnancies, very young or very old mothers, obesity, and substance abuse.   PPCM is heralded by shortness of breath, leg edema and swelling, and excessive nighttime urination.  Since these same symptoms are all too common during the late third trimester, the study authors suggest that all women who conceive with medical help have a cardiology consultation and an echocardiogram shortly before their due date or just after delivery.   European Society of Cardiology. "In vitro fertilization linked to deadly heart disease in pregnancy." ScienceDaily. ScienceDaily, 25 May 2019. www.sciencedaily.com/releases/2019/05/190525132201.htm     #IVF #assistedreproduction #heartfailure #peripartumcardiomyopathy #obstetrics #womenshealth  

Dr. Lattermann is the Chief of Sports Medicine Service and Director of Cartilage Repair Center in the Department of Orthopedic Surgery at Brigham and Women’s Hospital. Dr. Lattermann completed his medical education at the Hannover Medical School in Hannover, Germany. From there, he went on to complete his residency in orthopedic surgery at the University of Pittsburgh School of Medicine. Following that, he completed fellowships in sports medicine at the University of Pittsburgh and Rush University Medical Center. In this podcast, Dr. Lattermann talks about what it’s like to be an Orthopedic Surgeon specializing in Sports Medicine and his incredibly busy schedule, his unique perspective into the field of medicine due to his international experience, the importance of balancing work and personal life, and the importance of compassion in medicine. White Coat Story is a podcast series for school students to gain first-person insights into the practice of medicine, and what it takes to get there.

Dr Renu Eapen is a Consultant Urologist in the Genitourinary Oncology service at the Austin Hospital Olivia Newton-John Cancer Centre and the Peter MacCallum Cancer Centre. Dr Eapen undertook research in Female Pelvic Medicine and Reconstructive Surgery at University of Texas Southwestern Dallas. She went on to complete a subspecialty Fellowship at the University of Toronto, Canada and subsequently obtained her robotics and uro-oncology Fellowship at University of California, San Francisco. She is currently undertaking her PhD at the University of Melbourne. Axel Merseburger is Professor of Urology and Chairman of the Department of Urology at University Hospital Schleswig Holstein, Campus Lübeck, in Lübeck, Germany. He was appointed Associate Professor, in 2009, and Professor, in 2012, at Hannover Medical School. He is Principal Investigator for multiple phase 2 and phase 3 clinical trials. Prof. Merseburger is as an advisor for the European Association of Urology (EAU) Guidelines Group for Renal Cancer and has previously served as Chairman of the EAU Guidelines Group for Lasers and Technologies. Prof. Merseburger acts as a reviewer and editorial board member for several urology and oncology indexed journals, is Associate Editor of the World Journal of Urology, and is Editor-in-Chief of European Oncology & Haematology.

Today we spoke with Torsten Passie MD, PhD. Torsten is Professor of Psychiatry and Psychotherapy at Hannover Medical School (Germany) and currently Visiting Scientist at Goethe University in Frankfurt/Main (Germany). He studied philosophy, sociology (MA) at Leibniz-University, Hannover and medicine at Hannover Medical School. From 1998 to 2010 he was a scientist and psychiatrist at Hannover Medical school (Germany) where he researched the addictions and the psychophysiology of altered states of consciousness and their healing potential, including clinical research with hallucinogenic drugs (cannabis, ketamine, nitrous oxide, psilocybin). In 2012-2015 he was Visiting Professor at Harvard Medical School (Boston, USA). He is the author of the science of microdosing psychedelics, available through Psychedelic Press. We discussed -Hallucinogen Persisting Perception Disorder -MDMA assisted psychotherapy -The future of psychedelic training for health professionals Thanks for listening, check out more at mindmanifestpodcast.com If you have any questions, queries or suggestions for people you would like to hear interviewed, please email hello@mindmanifest.com . We love to hear from listeners!

Download In this episode, Kyle sits down with Dr. Torsten Passie, Professor of Psychiatry and Psychotherapy with the Hanover Medical School in Germany. In the show, they cover a range of topics on Dr. Passie’s studies on microdosing. Dr. Torsten Passie will be taking part in a special panel dedicated to microdosing at Breaking Convention 2019 (August 16-18, Greenwich, London), also featuring Amanda Fielding of the Beckley Foundation, Dr David Erritzoe of Imperial College, London, Dr Devin Turhune (Goldsmiths), and Dimitris Liokaftos, exploring myriad aspects of microdosing, including its effects, unknowns, and media representation presented by BC director Nikki Wyrd. Find out more about Breaking Convention: https://www.breakingconvention.co.uk/ 3 Key Points: Psychedelic research in the University setting died off after 2004, but is finally seeing an increase as the psychedelic revolution continues to grow. There is very little to no documentation of doctors doing self-experimenting with psychedelic drugs. It's becoming popular for therapists to use the substances used on their patients, more common to do the self-work before doing the work on others. Even if microdosing does not produce any significant effects and it is all placebo, the trend is a new way to introduce it into our society. The Science of Microdosing Psychedelics Support the show Patreon Leave us a review on iTunes Share us with your friends – favorite podcast, etc Join our Facebook group - Psychedelics Today group – Find the others and create community. Navigating Psychedelics Trip Journal                                              Integration Workbook Show Notes About Dr. Passie Dr. Passie has been researching psychedelics for 25 years He specializes in the therapeutic use of psychedelic drugs He has found difficulties in researching psychedelics during prohibition Dr. Passie had a mystical experience before using psychedelics and then became interested in psychedelic use He had grown up as an atheist, a materialist, and his experience required him to change his psychological state His perception of reality was irritated and he had to see a therapist to integrate this experience He said that this was frustrating because he was young and still in search for his identity Through all of this, he decided to study medicine and become a psychedelic doctor He became very conscious that he was on the right track Research Studies The researchers were the only ones doing studies on psychedelic states, there wasn't much happening at the Universities He did studies with cannabis, ketamine and even laughing gas The research then was on how cannabinoids can help with psychosis They were not successful with that, but it came to be that CBD was a neuroleptic and an anti-psychotic Research pretty much stopped after 2004 due to new laws and the cost of the research Dr. Passie does mention that in the past 10 years research has really taken off again and that we are really seeing the renaissance of psychedelic culture In most of the literature of doctors doing self-experimenting, there is very little to no documentation of doctors doing self-experimenting with psychedelic drugs Kyle mentions that MAPS has included into their training protocol to allow for therapists to have self-experiments with the substances that they are using on patients Kyle also mentions he can't imagine trying to hold space in breathwork without having had his own experiences with breathwork Dr. Passie says that the history of self-experimentation with psychedelics has shown that the participants can become ‘gurus’ and lose their objectivity, he uses Timothy Leary as an example But with only a few times of self-experimentation, maybe 2-4 times, he doesn't see risks HPPD Hallucinogen persisting perception disorder (HPPD) is a disorder in which a person has flashbacks of visual hallucinations or distortions experienced during a previous hallucinogenic drug experience Dr. Passie thinks there is a selection bias in what is published about HPPD Its more common to have a study published that talks about an adverse effect of LSD than a benefit of it Hundreds of thousands of studies were conducted in the 50’s, and no one claimed that this phenomenon came up And now one person has conducted a study, claiming that this phenomena exists Dr. Passie says that this pattern happens among people who are prone to anxiety and who are dissociative He says that most subjects that claim to experience HPPD, have experienced visuals even before ever taking LSD Microdosing It has been known to not have any effects from 15-20 micrograms of LSD 20-50 micrograms of LSD is considered mini-dosing, where you can feel some type of effects from it, but not as much as the full dose Dr. Passie says it is strange for people to claim to have increased cognition during microdosing based on conventional data that shows that LSD produces poor cognitive function He thinks that whatever the effects are of LSD at a high dose, that the effects at a low dose are the same, just less, not completely different effects He believes that there is some placebo effect with microdosing In terms of the microdosing trend, Dr. Passie is critical about the productivity factor, he does believe in the creativity factor though The flow state may also be increased with microdosing He claims that in his own experience with microdosing, he doesn't experience the flow state, in fact he experiences a feeling of agitation Combinations In a study, when patients took a microdose first, and then a little while later, they took a different full psychedelic dose, the microdose impacted the experience of the full dose It lessened the effects of the full dose psychedelic Psychedelics and Sleep Dr. Passie mentions a study where patients were given LSD, both high and low doses, during sleep What was found was that LSD impacts REM sleep patterns The dreams were not altered The REM phases got longer during the beginning of sleep, and then much shorter near the end of sleep It shows that the impact of sleeping patterns brings someone to feel much different the next day The Microdosing Trend Microdosing has much to be explored yet But even if microdosing does not produce effects, the trend is a new way to introduce it into our society “Microdosing might be a new assimilation process of psychedelics into our culture” - Torsten Instead of the 60’s where we are taking huge doses, we are taking tiny doses as a slow approach to assimilate psychedelics back into society Links The Science of Microdosing Psychedelics About Dr. Torsten Passie Torsten is a professor of psychiatry and psychotherapy affiliated with Hannover Medical School, and led the Laboratory for Consciousness and Neurocognition. He has conducted clinical research on psychoactive substances and has written several books including The Pharmacology of LSD (2010) and Healing with Entactogens (2012). Between 2012 and 2015 he was visiting professor at Harvard Medical School.

The May episode of 3-Minute 3Rs from the North American 3Rs Collaborative (www.na3rsc.org), the NC3Rs (www.nc3rs.org.uk), and Lab Animal (www.nature.com/laban) Papers: 1. https://bit.ly/2vYuUPR 2. https://go.nature.com/2w2tzre 3. https://go.nature.com/2VEjEHz [NA3RC] Early mortality of pups in breeding colonies can reach upwards of 50% or higher depending upon the strain. While high pup mortality is often considered "normal", it instead may be indicative of an underestimated animal welfare issue that requires attention. Leidinger and colleagues investigate the influence of environmental enrichment as one way to mitigate early pup mortality rates. Enrichment, with nesting material and a shelter, protected against early mortality. Survival rates of pups born into enriched environments were more than double that of pups born into impoverished environments. The impoverished environment also had a negative impact on the developmental course of the remaining pups. Enrichment, among many potential benefits, may have reduced maternal stress and improved thermoregulation, which is particularly important for newborn pups. The findings suggest that early pup mortality is an animal welfare problem that can be improved through the characterization and selection of appropriate enrichment strategies. The refinement in breeding conditions can improve pup welfare and survival and lead to the need for smaller breeding colonies. [LA] Enrichment helps pups, check. But how can you tell how they're doing in the first place? Invasive measures are challenging in such small animals, and pups lack features like fur and certain behaviors that can visually indicate health in adults. Dorothee Viemann and colleagues at Hannover Medical School recently proposed a new clinical health scoring system for neonatal mice to solve the pup assessment problem. They developed a score sheet based on observations of movement, nursing, and skin color and from quick examinations of capillary refill time, dehydration, reaction to tactile stimulus, and abdominal palpitation. They put their scoring to the test with healthy Black6 pup and two sepsis models known to cause mortality. The scoring correlated well with diseases, and was even more sensitive than blood-based biomarkers... [NC3Rs]…most creatures take great efforts to separate their ‘doings' from anything else they do. Rodents especially will almost always have a dedicated latrine area away from their nest site. Laboratory mice, typically housed in small, open chambers are prevented from performing this instinctual behavior, and their nesting material is often found in close contact with their droppings. Joanna Makowska from the University of British Columbia and her colleagues have investigated how this housing arrangement affects the behavior of these animals. Groups of mice were kept in one of two housing systems. A standard single cage or a rather more luxurious series of three interconnected cages set up in a similar manner to rodent burrows in the wild. Mice in the triple cages were observed to segregate their nesting and latrine areas between different cages. Single cage mice attempted to separate these sites with their cage, urinating and defecating away from their nests. However the day to day movements of the animals invariably scattered the contents of the enclosure. Notably, mice housed in triple cages showed more affiliative behaviors, such as grooming or resting with one another than those in single enclosures. indicating a stronger social bond between the animals. They also were less disturbed by weekly cage cleaning, a typically stressful and highly disruptive event for lab mice. In the paper, published in Scientific Reports this April the authors conclude that mice find being housed in contact with their waste aversive, and that facilitating separation of nesting and latrine areas could be a simple, effective way of improving the welfare. See acast.com/privacy for privacy and opt-out information.

Dr Carolyn Lam:                Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr Greg Hundley:             And I'm Greg Hundley, also associate editor from VCU Health Systems, the Poly Heart Center in Richmond, Virginia. Dr Carolyn Lam:                So arrhythmogenic cardiomyopathy that will make most of us think of right ventricular disease and fatty infiltration of the muscle, but could arrhythmogenic cardiomyopathy really be a bi-ventricular disease? Well you've got to stay tuned to find out more in a fantastic interview coming right up after our little coffee chat. So Greg, what are your picks this week? Dr Greg Hundley:             My first paper is from Chris Lim at NYU in New York. And it's looking at the relationship between Mediterranean diet, air pollution and cardiovascular events.                                                 So, it's unknown whether usual individual dietary patterns can modify the association between long-term air pollution exposure and health outcomes. And so, in this large cohort with detailed diet information at the individual level, they had 548000 individuals across six states and two cities within the U.S. and a follow up period of 17 years. And that occurred between 1995 and 2011. And they evaluated whether a Mediterranean Diet modified the association between long-term exposure to ambient air pollution and then cardiovascular disease and mortality risk. And so, the average exposures to parts per billion and nitric oxide air pollution that the residential census track level were measured, and the investigators found that for the particulate matter there were elevated significant associations with cardiovascular disease. So, a hazard ratio of 1.13, ischemic heart disease similar hazard ratio and cerebrovascular disease with also a similar hazard ratio.                                                 For the nitric oxide, there were also significant associations with cardiovascular disease, as well as ischemic heart disease. And then the analysis indicated that Mediterranean diet modified the relationships. Those with a higher Mediterranean diet score had significantly lower rates of air pollution related mortality. These results therefore indicate Carolyn, that Mediterranean diet reduce cardiovascular disease mortality related to long-term exposure to air pollutants in a large perspective, U.S. cohort. Can you believe increased consumption of foods rich in antioxidant compounds actually may aid in reducing the considerable disease burden associated with ambient air pollution? Dr Carolyn Lam:                Oh wow. That is hugely interesting. Gosh, what do we do about this clinically now?  Dr Greg Hundley:            Remember, first of all, this is an associate study, so we can't infer cause effect. And what we need next are some more independent studies from other cities around the world, prospective cohorts, examinations of clinical outcomes and randomize interventions. And so, I think the results add to a growing body of literature suggesting that dietary patterns may help reduce cardiovascular events in these high air pollution exposure areas. And how does this work? Well, potentially through augmenting antioxidants and reducing oxidative stress. Dr Carolyn Lam:                That's really cool. So from one region, talking about air pollution to another region that often reports about air pollution and that's China. But this study from China is actually the largest registry study to evaluate sex related differences and hospital management and outcomes of patients with acute coronary syndrome in China.                                                 This is from corresponding author Dr Zhao from Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease. With colleagues of the improving care for cardiovascular disease in China, Acute Coronary Syndrome project, which is an ongoing nationwide registry of the American Heart Association and the Chinese Society of Cardiology. So, the authors use data from this project and evaluate at sex differences in the acute management, medical therapies for secondary prevention and in hospital mortality in more than 82000 patients admitted for acute coronary syndrome in 192 hospitals across China from 2014 to 2018. Dr Greg Hundley:             What did they show in this study? Dr Carolyn Lam:                They showed that women hospitalized for acute coronary syndrome in China less frequently received acute treatments and strategies for secondary prevention and had a higher in hospital mortality rate than men. Now the observed sex differences in this in hospital mortality were likely due to older age, worse clinical profiles and fewer evidence base acute treatments provided to women. And that's because the sex differences were no longer observed after adjustment for these clinical characteristics and acute treatments.                                                 What this all means though is specifically targeted quality improvement programs may be warranted to narrow these sex related disparities in patients with acute coronary syndrome in China.  Dr Greg Hundley:            Very interesting. I'm going to take sort of the next paper and it's looking at a different aspect of acute myocardial infarction. And these papers from Yong Wang from the Division of Molecular and Translational Cardiology at Hannover Medical School in Hanover, Germany.                                                 Now as we know, the heart can undergo deleterious changes and left ventricular geometry and function during that vulnerable period before scar formation has stabilized the infarct area. And so inflammatory cell trafficking from hematopoietic organs like the spleen to sites of tissue injury is coordinated by chemokine chemokine receptor networks. Therapeutically modulating these chemokine chemokine receptor interactions may promote infarct healing by limiting excessive inflammation induced tissue damage or by enhancing the recruitment of angiogenic cell populations to the infarct or the wound. Inflammatory cell trafficking after a myocardial infarction is controlled by a CXC motif chemokine ligand 12 or CXCL12 and its receptor CXC motif chemokine receptor 4. CXC receptor 4 antagonists, mobilize inflammatory cells and promote infarct repair. But the cellular mechanisms are unclear.                                                 So, what do these investigators do? In mouse models, the investigators found that inflammatory cell trafficking between a hematopoietic organs and sites of tissue injury is controlled by CXCL12 and its receptor CXC receptor 4. And bolus injectives of a highly selected peptidic macrocycles CXC receptor 4 antagonist, enhanced tissue repair and functional recovery after re-perfused acute myocardial infarction in mice. And interestingly, the therapeutic effects require a dendritic cell priming and we're specifically mediated by t-regulator cells. Intermittent CXC R4 blockade mobilized the t-regulator cells from their splenic reservoir. Leading to their enhanced recruitment to the infarct region. Dr Carolyn Lam:                So bring it home for us, Greg. What does this mean clinically for MI management in humans? Dr Greg Hundley:             Right. Highlighting the translational potential. What we might infer is that CXC receptor 4 blockade reduces infarct volume and improved systolic function in a porcine close chest model of re-perfuse acute myocardial infarction.                                                 And so, the results of both the mouse experiments and this sort of translational model in pigs should stimulate further research into therapeutic potential of CXC R4 blockade after MI and in other acute conditions were excessive, innate or adaptive immune responses cause immunopathology. Dr Carolyn Lam:                Fascinating. So from one preclinical paper to another, but this time focused on heart failure. And focus specifically on titin. Titin is this giant elastic protein that spans the half-sarcomere from the Z-disk to the M band, and it acts like a molecular spring and a mechanosensor that has been linked to striated muscle disease. Now the pathways that govern tight independent cardiac growth and contribute to disease are diverse and have been really difficult to dissect. And so corresponding author Dr Gotthardt, from Max Delbruck Center for Molecular Medicine and the German Center for Cardiovascular Research and his colleagues aimed to study titin deficiency versus titin dysfunction.                                                 And how they did that is they generated and compared striatum muscles specific knockouts with progressive postnatal loss of the complete titin protein. And that's by removing Exxon 2. Or an M-band truncation that eliminates the proper structure and integration, but retains all the other functional domains. So they then evaluated cardiac function, cardiomyocytes mechanics, and the molecular basis of the phenotype. Now, what they found was that progressive depletion of titin led to sarcomere disassembly an atrophy in striated muscle. And in the complete knockout, remaining titin molecules had increased strain resulting in mechanically induce trophic signaling and eventual dilated cardiomyopathy.                                                 On the other hand, the truncated titin helped maintain passive properties and thus reduced mechanically and do signaling. In other words, truncations versus loss of titin, differentially affected cardiac pathology with atrophy versus dilated cardiomyopathy respectively. And together, these findings really contribute to the molecular understanding of why titin mutations differentially affect cardiac growth and have implications importantly for genotype, phenotype relations that support a personalized approach to the diverse titinopathy. Dr Greg Hundley:             Interesting, Carolyn. All this information on titin. So why is it clinically important? Dr Carolyn Lam:                Well, first of all, tightened mutations are the most common genetic basis of heart disease and the findings are clinically relevant, as I said, for understanding the genotype phenotype relations at the Titin mutation. But understanding the integration of Titin based signaling and sarcomere biology could indeed help personalize diagnostics by improved clinical decisions and maybe identify suitable therapeutic targets for these titinopathy. But that of course requires much further work. Well that brings us to the end of our summaries. Let's go to our feature discussion.  Dr Greg Hundley:            Welcome everyone to our second segment of our program. We're discussing an interesting paper today entitled Sudden Death and Left Ventricular Involvement in Arrhythmogenic Cardiomyopathy. And we want to welcome our coauthors Elijah Behr and Mary Sheppard from St George's University in London. And also, our own associate editor, Sami Viskin to discuss this paper. Mary, can you tell us a little bit about your study design here, the population and the hypothesis and some of your results? Dr Mary Sheppard:          I am a cardiac pathologist of 20 years and I have a special interest in sudden death. Over this time, I've established a national pathology database, where pathologists throughout the country when they have a sudden death, which is likely cardiac and non-ischemic, they will send the heart or tissue blocks insides to me for my opinion concerning the death. We have as a result developed a large number, over 5200 cases which has now built up to 6000. It's the largest pathological series in the world.                                                 And I was also discovering the pathologists were either under or over diagnosing all types of cardiomyopathy but particularly ergogenic cardiomyopathy. And that is why with Chris Miles, our research fellow, we looked in detail at what I had diagnosed, or the pathologist as ergogenic cardiomyopathy and we actually honed are pathological diagnostic criteria for this very important entity. Establishing that left ventricular is five and ventricular and left and ventricular is the norm almost. That right or left ventricular is unusual by themselves and even in 20%, one in five, the heart can look macroscopically normal. So that histology is essential when you're making this diagnosis. You cannot make the diagnosis pathologically without histologically examining the heart. Dr Greg Hundley:             Very good, Mary. And did you also examine some genetic markers in some of the subsets of the patients? And how did you decide who those individuals would be that received the genetic analysis? Dr Mary Sheppard:          A small subset and I will hand over to Elijah Behr, my colleague concerning that. Dr Elijah Behr:                   The genetic tissue is only available in a minority of cases. We've developed a pipeline now with the referring pathologists who are increasingly they're sending samples of spleen suitable for DNA extraction that allow us then to do a retrospective postmortem genetic testing or molecular autopsy. But unfortunately, in this particular series we only had a small proportion. I think there were roughly about 24 out of the 202 cases, so just over ten percent. And interestingly, while we didn't necessarily mirror the expected yield of genetic testing that is seen in clinical cases, where you may see about 40% carrying pathogenic variance. We certainly picked up some important pathogenic variance, particularly those that are often associated with highly penetrant and more severe disease. In particular TMEM43 and desmoplakin. These findings may reflect the small size of the sample, but it also may reflect where the greatest risk for sudden death from ergogenic cardiomyopathy lies. Dr Greg Hundley:             Elijah, getting back to some of the patients that experienced the sudden death in the study population Mary was referring to, were there characteristics that were associated with the sudden death? For example, those that might be related to gender or activity? Dr Elijah Behr:                   So the majority of the cases were male. The majority has never had prior symptoms. These were unheralded deaths. The majority did not have a family history and I think the majority were addressed, but those that were athletes, we're much more likely to have died during exertion. So as we found with ergogenic cardiomyopathy in general and exertion is a trigger to sudden death. The risk was higher and compared to the athletes in death during exertion was associated with being younger as well. I think exertion and sports clearly play a role in ergogenic cardiomyopathy. It didn't appear to play a role in whether there was left ventricular involvement or not, but certainly a role at more severe presentation.  Dr Greg Hundley:            Maybe both Mary and Elijah answering this. You found histopathological evidence of fibrosis and fatty infiltration. How extensive was that? And do you think that could be identified with a test like maybe magnetic resonance imaging? Dr Mary Sheppard:          Yes. Our diagnostic criteria which is illustrated in the addendum is that it was at least two blocks of tissue. We always look at 10 to 12 to 15 blocks of tissue from both right and left ventricle. And at least two of the blocks had to have fibrosis with fat in 20% of the area examined. We did not include inflammation because inflammation is, an important histological criterion in our experience. We were very precise about that because you need that much at least to make the diagnosis. A little bit of fibrosis or a little bit of fat is not sufficient by itself. Dr Greg Hundley:             When you mention a block, for us clinically, how much myocardium would that be? For example, on an imaging test like an echo or an MRI scan. Dr Mary Sheppard:          One to two centimeters squared. Dr Greg Hundley:             So quite a bit. Dr Elijah Behr:                   You're looking at probably around two to four millimeters of potential depth of fibrosis. And what we've seen clinically in LV involvement of MRI scans is miss two epicardial late enhancement. Now the question is whether our scans are sensitive enough to pick that up? Given the technology available or a sense to the histopathology and I think that's why maybe some of the clinical studies have tended to miss the true proportion of left ventricular involvement. Because of the relative subtlety of the fibrosis compared to the technological ability to discriminate it. I mean certainly when you look at our cases that were diagnosed previously with cardiomyopathy, either they were arrhythmogenic or dilated, many did have imaging findings if MRI was performed, that would indicate or suggest some left ventricular involvement. But as you know, the task force criteria for arrhythmogenic cardiomyopathy having very much right ventricular focus. An LV imaging findings and LV ECG findings are just not part of those at the moment. Dr Greg Hundley:             Was there a particular location within the heart where there was a predilection toward the findings of fibrosis and fat? Dr Mary Sheppard:          In the posterior basal wall particularly, transmural involves going from the epicardium to the sub endocardium and also the interior walls of the left ventricular were the predilection areas. Dr Elijah Behr:                   I think that's what we see on our MRI scans as well. When you look at these patients, that posterior basal area, is the one that tends to light up the most. Dr Mary Sheppard:          It is believed that increased stress in that area gives more damage because of the stretching away from the septum. Dr Greg Hundley:             Very interesting. So Elijah, you had mentioned task force criteria. I want to shift to Sami now and ask, Sami, can you help us put this in perspective relative to the existing task force criteria and then the findings in this study? And how that could lead to subsequent changes down the road?  Dr Sami Viskin:                 Okay, so it is difficult to place this in the context of the task force because mentioned by Elijah, the taskforce are focused on a disease that is believed to be in the right ventricle. And the study shows that many of the sudden death cases will involve the left ventricle. One of the most important messages of this paper is importance of her forensic examination. And importance of making it for anything examination in the center of expertise. We know of patients that will travel a thousand miles to undergo surgery or an ablation procedure, but families do not think that way when there is casualty or family dies. You may take a postmortem as a given, but in many countries, including my own, most cases of sudden death would not be followed by a post mortem and will not go into center of expertise. And you cannot overemphasize the importance of doing that because then you have to know what you are looking for in the remaining relatives is extremely important. Dr Greg Hundley:             Very good. How about from the perspective as an electrophysiologist? Does this impact in any way how you might evaluate a younger person with syncope? Dr Sami Viskin:                  Well, it is difficult to conclude from this paper about how to evaluate patients with syncope because most of the cases in this series don't have symptoms at all. But this paper calls to very interesting investigations by Mario del Mar and others in New York. Looking about the electrophysiology consequences of a disease like right ventricle are like a bit mechanical in [inaudible 00:21:58] The tissues becomes editing the disease, the electrical properties how the patients in brugada can cause malfunction of this sodium channel and create a disease that is more like brugada and dysplasia at the beginning. So, the entire correlation between a morphologic disease and the metrical disease and we used to think they are two different things. And now we see that we can actually put them together and you can go through stages where one disease is before an electrical disease and only at later stages it becomes a morphological evident disease.  Dr Greg Hundley:            A fantastic discussion on pathologic findings. Sami making the point that certainly in cases for young individuals having a postmortem examination performed at centers that have expertise such as what Mary's described, can be very important. And then Elijah, helping us to understand with arrhythmogenic cardiomyopathy, number one, findings are not, we shouldn't just be thinking about the right ventricle in isolation, but also the left ventricle. Fibro fatty infiltration, particularly in the posterior basal wall could be an important thing to look for, for those that are performing the magnetic resonance imaging exams. And then lastly, many of the patients in the study like this, the first presentation was of sudden death. And we need to be cognizant that this condition could be prevalent in the population and not necessarily appreciated by some of our current task force guidelines and examinations. So, what an outstanding discussion. And I think for today, we want to thank our authors and our associate editor and wish everyone a great week.                                                 On behalf of Carolyn and myself, we look forward to seeing you next week. Thank you very much. Dr Carolyn Lam:                This program is copyright American Heart Association 2019.  

Dr Torsten Passie is a professor of psychiatry and psychotherapy at Hannover Medical School, and one of the world's leading experts on the science of psychedelics. In this conversation, Torsten shares his insight into psychedelic experience, therapy, culture, and the current science of microdosing. Torsten’s latest book is titled The Science Of Microdosing Psychedelics, and can be purchased using this link: https://psychedelicpress.co.uk/products/the-science-of-microdosing-psychedelics-by-torsten-passie Watch, read more and download the podcast at wp.me/p2UC3z-n0

Functional Magnetic Resonance Imaging has been around since 25 years. Last year, in 2016, a scientific article has been published stating that perhaps 40,000 published neuroimaging works are flawed. This article, published in the prestigious journal PNAS, has brought the authors and this topic abruptly into the focus. Most media coverage drastically truncated their core message, stating only that fMRI produced incorrect results and that one analysis software contained a bug. Scientific colleagues vehemently criticized the far-reaching statements of the three authors. But what is actually true? Do we have to deal here with a bankruptcy of a whole scientific branch? How many studies are affected? The number has been corrected by the authors from 40.000 to 3.500 studies which might have not used appropriate, i.e. too lenient statistical correction methods. In this episode, I'm going to talk not only to one expert but to four neuroscientists about this subject: John Dylan Haynes is a Professor at the Bernstein Center for Computational Neuroscience in Berlin, Germany and director of the Berlin Center for Advanced Neuroimaging. He has become particularly known through his work on free will. For this work, he employed new methods which identify and classify recurring patterns in brain activation which allows for conclusions about the underlying subjective processes by means of the fMRI data only. Rainer Goebel is a Professor of Cognitive Neurosciences at the University of Maastricht in the Netherlands and developer of the commercial software BrainVoyager. His field of research covers the areas of high-field MRI and neurofeedback. As a third guest, I am very pleased to be able to interview one of the authors of this notorious study. Tom Nichols is a Professor in Coventry in the Department of Statistics (University of Warwick), as well as Senior Research Fellow at the Alan Turing Institute. He has published numerous papers in particular on statistical procedures in neuroimaging. These interviews are completed by Dina Wittfoth, head of the fMRI unit at Hannover Medical School’s Institute of Neuroradiology, Germany. Her research expertise is built around the neural and behavioral correlates of emotion regulation. She also enjoys teaching and offers workshops for data analysis in neuroimaging which focus on learning-by-doing. In these interviews you will hear neuroscience experts’ perspectives on the allegations that most fMRI studies are flawed. More information and shownotes at inside-brains.com

Welcome to our first interview of 2017! Our guest Dr Edzard Ernst trained as a physician in Germany in the late 1970s, as well as in acupuncture, autogenic training, herbalism, homoeopathy, massage therapy and spinal manipulation. After occupying professorships at the Hannover Medical School and University of Vienna, he became became the Chair in Complementary […]

MicroRNAs are present in body fluids and have the potential to serve as disease biomarkers. A study in the April 2013 issue of Clinical Chemistry explored the clinical value of microRNAs in serum and urine as biomarkers for idiopathic childhood nephrotic syndrome.  This paper was accompanied by an editorial by Johan Lorenzen and Thomas Thum, both from the Hannover Medical School in Hannover, Germany. They both join us today in this podcast.

Background. Posttransplantation lymphoproliferative diseases (PTLD) are mainly Epstein-Barr virus (EBV)-associated disorders of B-cell origin. Due to the rarity of monomorphic T-cell PTLD (T-PTLD), knowledge about pathogenesis, risk factors, therapy, and prognosis relies predominantly on case reports and small series. Therefore, we aimed to provide an overview and a retrospective analysis of this rare PTLD subtype. Methods. We analyzed all available articles on T-PTLD in the PubMed database as well as in our own databases (Institute of Pathology/Department of Paediatric Haematology and Oncology, Hannover Medical School) from 1988 to 2010. Reevaluated parameters were gender, age, transplanted organ, immunosuppressant regimen, time between transplantation and T-PTLD manifestation, T-PTLD subtype, virus positivity, localization, therapy, and follow-up. Results. A total of 163 cases were evaluated. We found that hematopoietic stem cell transplantation was associated with early-onset T-PTLD, whereas late onset occurred after immunosuppression with steroids and azathioprine without administration of calcineurin inhibitors. The major independent favorable prognostic factors were T-PTLD of the large granular lymphocytic leukemia subtype, young age, and a combination of radiotherapy/radiochemotherapy and reduced immunosuppression, whereas the hepatosplenic T-cell lymphoma subtype and cases with involvement of bone marrow, the central nervous system, or graft had an adverse prognosis. Conclusion. T-PTLD is a heterogeneous group of different aberrant T-cell proliferations and represents a significant complication following transplantation, showing a uniformly poor prognosis.

Our daily lives rely on the power of computers. So why not medical diagnosis? Getting the right diagnosis is a challenge, particularly in the emergency room, where up to 15% of patients are misdiagnosed. Could computers lend a guiding hand? Doctors have been trying to use computerized support for decades - but current systems are quite crude, built to deliver 'yes' or 'no' answers. Lorenz Grigull and his colleague Werner Lechner from the Hannover Medical School, Germany, have been working on something new. See acast.com/privacy for privacy and opt-out information.

Regenerative Medicine Today welcomes Frank Witte, MD, PhD, Diego Mantovani, PhD, Prashant Kumta, PhD, and Charles Sfeir, MD, PhD. Dr. Witte is the Director of Biomaterial Research at the Laboratory for Biomechnics and Biomaterials, Hannover Medical School in Germany; Dr. Mantovani is the Director at the Laboratoire de biomatériaux et bioingénierie at the [...]

Toni Cathomen, Hannover Medical School, Experimental Hematology, Hannover, GERMANY speaks on "Zinc positive: designer nucleases in gene therapy". This seminar has been recorded by ICGEB Trieste