Medical school in Boston, MA
You are going to learn so much from this episode!! And get to listen to a live demo of Dr Schwartz doing parts work with me. Richard Schwartz began his career as a family therapist and an academic at the University of Illinois at Chicago. There he discovered that family therapy alone did not achieve full symptom relief and in asking patients why, he learned that they were plagued by what they called “parts.” From these explorations with parts work, the Internal Family Systems (IFS) model was born in the early 1980s. IFS is now evidence-based and has become a widely-used form of psychotherapy, particularly with trauma. It provides a non-pathologizing, optimistic, and empowering perspective and a practical and effective set of techniques for working with individuals, couples, families, and more recently, corporations and classrooms. In 2013 Schwartz left the Chicago area and now lives in Brookline, MA where he is on the faculty of the Department of Psychiatry at Harvard Medical School.
For decades, our understanding of how the brain works has advanced dramatically. Using new theories, methods and tools, like fMRI technology, scientists are beginning to reveal the mysteries of this truly remarkable and complex organ.One scientist on the cutting edge of this research is Michael Ferguson, a BYU grad who is now researching and teaching at Harvard. For Michael, the most exciting result of all this new knowledge of the brain is how it might transform our spiritual lives and help us connect more fully to the divine. He is a pioneer in a field called neurospirituality and his research has been in part inspired by Latter-day Saint theology, in particular the idea that spirit and matter are on a continuum, not radically different substances. In this episode, Michael was interviewed by Zach Davis and Terryl Givens about these fascinating subjects, and the most important insights he's gained from his research.Michael is an Instructor in Neurology at Harvard Medical School, a Lecturer at Harvard Divinity School, and a neuroscientist at the Center for Brain Circuit Therapeutics at Brigham and Women's Hospital in Boston. He earned his Doctorate in Bioengineering at the University of Utah, after which he completed post-doctoral fellowships at Cornell University and Beth Israel Deaconess Medical Center.Join us for Restore: A Faith Matters Gathering on October 7-8 in Salt Lake City. Learn more and register here.
It might be hard to remember the last time you got really angry with someone who respects you. That's because of the unique role that respect plays in our emotional regulation and interactions with others. Dr. Joseph Shrand, a triple board certified psychiatrist, explains how this feeling can change your interactions with everyone from complete strangers to those you're closest with. We'll also discuss how to get respect, simple ways to show others you value and respect them, and Dr. Shrand's I-M Method, which reminds us we're all doing the best we can. To learn more -- or read the transcript -- please visit the show's official episode page. Guest Bio Dr. Joseph Shrand is Chief Medical Officer of Riverside Community Care headquartered in Dedham, Massachusetts. He has been a Lecturer of Psychiatry at Harvard Medical School and an adjunct faculty of Boston Children's Hospital. He is triple board certified in adult psychiatry, child and adolescent psychiatry, and addiction medicine. He is also a diplomate of the American Board of Addiction Medicine. Dr. Shrand hosts a weekly radio show on WATD 95.9 FM, The Dr. Joe Show, exploring who we are and why we do what we do. He is the author of “Unleashing the Power of Respect: The I-M Approach,” “Manage Your Stress: Overcoming Stress in the Modern World;” “Outsmarting Anger: 7 Strategies for Defusing Our Most Dangerous Emotion” the winner of the 2013 Books for a Better Life Awards, Psychology self-help category; “The Fear Reflex: Five Ways to Overcome It and Trust Your Imperfect Self;” and “Do You Really Get Me? Finding Value in Yourself and Others Through Empathy and Connection.” “Outsmarting Anger” has recently been republished in paperback due to demand. Among colleagues and staff, he is affectionately called “Doctor Joe,” as he was “Joe” in the original children's cast of the PBS series “Zoom.” Find out more about him at https://www.drshrand.com/. Inside Mental Health Podcast Host Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can't imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
If you think about our phones, we all essentially have the same phone yet, it's a deeply personalized experience for each one of us. What if healthcare was like that? - Personalized and holistic, thinking about you, where you are.Vivian S. Lee, M.D., Ph.D., M.B.A., is the President of Verily Health Platforms, overseeing all health care platforms, including Onduo, Healthy at Work, and Verily's Value Suite, among others. She is also the author of The Long Fix: Solving America's Health Care Crisis with Strategies that Work for Everyone. As a healthcare executive, she formerly served as the medical school dean, SVP, and CEO of the University of Utah Health, a $3.5 billion integrated health system and health plan that ranked first among university hospitals in quality and safety. Over her career as an NIH-funded MRI researcher, she has published over 200 articles in leading journals including JAMA and the New England Journal of Medicine and received the Gold Medal of the International Society for Magnetic Resonance in Medicine.If that wasn't enough, Dr. Lee was elected to the National Academy of Medicine in 2015 and was ranked #11 among Becker's 100 most influential people in healthcare in 2019. A Rhodes Scholar, she is a graduate of Harvard College, Oxford University, Harvard Medical School, and NYU Stern School of Business.On this episode of HLTH Matters, Vivian joins hosts Dr. Gautam Gulati and Patricia Bradley to discuss the intersection of health and tech and how it can be very transformative on health care. She describes strategies to solve America's healthcare crisis and how these strategies can not only work for everyone, but also advance healthcare faster than ever before. Listen in for insight on the future of health platforms and the potential they have to advance population health.Topics CoveredVivian's background in medicine and what she does now with VerilyInsight on Vivian's book, The Long Fix: Solving America's Health Care Crisis with Strategies that Work for EveryoneWhat the average individual can do to contribute to the ongoing change of healthcareWhere all the costs of healthcare are coming fromThe Surf and Turf ProblemHow the healthcare system is only designed to treat instead of preventWhat Vivian took away when writing her bookWho Verily is and their purposeVivian's insight on how much more personal healthcare could be and the goal around thatVivian's insight on how unique and personalized healthcare could and should beThe ways Onduo plans on providing more personal results and solutions for peopleThe vision of Verily Health PlatformsHow Vivian defines health as the ability to really live our lives in a productive, comfortable and safe wayVivian's belief that healthcare for every single person in America is the answer to health Connect with Vivian LeeVerily Connect with Dr. Gautam GulatiHLTHDr. Gulati on TwitterDr. Gulati on LinkedIn ResourcesThe Long Fix: Solving America's Health Care Crisis with Strategies that Work for EveryoneOnduoHealthy at WorkVerily's Value Suite Introductory Quote[19:05–19:34]“Even though my book is called The Long Fix, I'm hoping that it's going to be less long now because of the pandemic and the acceleration of these digital health approaches that can be a lot more personalized and holistic, and thinking about you, where you are. So, if you think about our phones, we all essentially have the same phone...but yet it's a very deeply personalized experience for each of us. Now, think about if healthcare were like that.
After 20 years of a distinguished career as an endocrinologist at Harvard's Joslin Diabetes Center, Dr. William Hsu joined L-Nutra in 2019 as Chief Medical Officer. In this role, Dr. Hsu leads the clinical development effort at L-Nutra, oversees the Medical Affairs Department, and advances the education and adoption of fasting and Fasting Mimicking Diet as an innovative tool to extend human healthspan. Among his prior roles, he served as Vice President at Joslin Diabetes Center, a teaching affiliate of Harvard Medical School, responsible for its international education and healthcare advisory programs. He served on multiple national-level professional committees, including the American Diabetes Association, setting national standards of medical care in diabetes. His previous research interests focused on the pathophysiology of diabetes and the application of digital technology in chronic care. Dr. Hsu went to Cornell University for college and received his medical degree from Mount Sinai School of Medicine. He completed his Internal Medicine residency training at Yale School of Medicine and completed his fellowship training in Endocrinology and Metabolism at Harvard Medical School. He was Assistant Professor of Medicine at Harvard Medical School. Links provided: https://l-nutra.com/ https://twitter.com/lnutraofficial https://www.linkedin.com/in/william-hsu-md/
Join Dr. Danielle Belardo and her expert of the week, obesity and nutritional epidemiologist Dr. Deirdre Tobias, for a masterclass on nutrition epidemiology and its impact on public health. Diedre opens up her nutrition epidemiology toolbox to explain the research and data supporting healthy dietary patterns and what nutrition tips you can implement in your own life. Danielle and Deirdre also bust the myth that whole grains and fruit are evil, so forget what you've read on social media! Whether or not you're in the medical field or just a hobbyist trying to learn to interpret science in a more robust way, this is the episode for you. Danielle and Deirdre discuss: The basics of nutritional epidemiology and role of a nutritional epidemiologist General healthy dietary patterns and the problems with a western diet The reasons whole grains and fruits have been demonized The table 1 method and how it can help you interpret scientific data Dr. Deirdre Tobias is an obesity and nutritional epidemiologist at the Brigham and Women's Hospital and Harvard Medical School in Boston. She received her doctorate and postdoctoral training at the Harvard T.H. Chan School of Public Health. Dr. Tobias was appointed as the Academic Editor for the American Journal of Clinical Nutrition in 2019. Her research focuses on the role of diet and lifestyle for obesity and its major chronic diseases, including gestational diabetes and type 2 diabetes, and has been published in leading peer-reviewed journals, including the New England Journal of Medicine and the Journal of the American Medical Association. She is assistant professor and co-Instructor for Nutritional Epidemiology at the Harvard T.H. Chan School of Public Health. For more information on the research Deirdre does at Harvard, visit www.hsph.harvard.edu/deirdre-tobias Thank you so much for taking the time to contribute to a generation that values fact over fiction! Be sure to rate, review, and follow on your favorite podcast app and let us know which not-so-wellness trend you'd like to hear debunked. Follow your host on Instagram @daniellebelardomd and the podcast @wellnessfactvsfiction. Follow Deirdre @deirdre_tobias. Thank you to our sponsors for making this episode possible. Check out these deals just for you: COZY EARTH - Go to cozyearth.com and enter WELLNESS at checkout to SAVE thirty-five Percent.
Dr. John Abramson (@drjohnabramson) is a physician, lecturer of health care policy at Harvard Medical School, and author of Overdosed America: The Broken Promise of American Medicine. His latest book is Sickening: How Big Pharma Broke American Health Care and How We Can Repair It. What We Discuss with Dr. John Abramson: Despite spending an excess $1.6 trillion on healthcare per year compared to other wealthy countries, the amount of time that Americans live in good health ranks a lowly 68th in the world. The pharmaceutical industry, aka Big Pharma, is more focused on making money for its shareholders than maintaining or improving the health of those who rely on its products. Big Pharma funds most clinical trials, controls the research agenda, withholds real data from those trials as corporate secrets, and shapes most of the information relied upon by health care professionals. The US and New Zealand are the only two countries in the world that allow pharmaceutical companies to advertise. The difference: Big Pharma doesn't have to endure the same level of oversight in the US as it does in New Zealand. While healthcare reform may seem like an uphill battle against an entrenched infrastructure of corruption, John does offer hope that it can be overhauled to benefit people over profits. And much more... Full show notes and resources can be found here: jordanharbinger.com/709 Sign up for Six-Minute Networking -- our free networking and relationship development mini course -- at jordanharbinger.com/course! Miss the interview we did with sleep doctor Matthew Walker? Catch up with episode 126: Matthew Walker | Unlocking the Power of Sleep and Dreams here! Like this show? Please leave us a review here -- even one sentence helps! Consider including your Twitter handle so we can thank you personally!
This week, please join authors John McMurray and David Cherney, editorialist Kausik Umanath, as well as Associate Editors Ian Neeland and Brendan Everett as they discuss the original research articles "Initial Decline (Dip) in Estimated Glomerular Filtration Rate After Initiation of Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction: Insights from DAPA-HF" and "Renal and Vascular Effects of Combined SGLT2 and Angiotensin-Converting Enzyme Inhibition" and editorial ""Dip" in eGFR: Stay the Course With SGLT-2 Inhibition." 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 Centre and Duke National University of Singapore. Dr. Greg Hundley: I'm Dr. Greg Hundley, Associate Editor and director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Greg, it's the season of double features. Except this time, we're having a forum discussion of two related articles and an editorial that discusses both. What is it on? SGLT2 inhibitors. In the first paper, an analysis from the DAPA-HF trial, looking specifically at that initial dip in GFR that follows initiation of dapagliflozin in patients with HFrEF. Then we will discuss further, in a mechanistic way, the renal and vascular effects of combining SGLT2 inhibition on top of ACE inhibition. Lots and lots of good learning and insights, but let's go on first to the other papers in today's issue. Shall we? Dr. Greg Hundley: You bet, Carolyn, and I'm going to grab a cup of coffee. Carolyn, in this issue, wow, so many exciting original articles. In fact, there are two more articles that were going to pair together, both clinical and pertaining to TAVR procedures. In the first one, it was a group of authors led by Dr. Duk-Woo Park from the Asan Medical Center at the University of Ulsan College of Medicine. They conducted a multicenter, open-label randomized trial comparing edoxaban with dual antiplatelet therapy or DAPT, aspirin plus clopidogrel, in patients who had undergone successful TAVR and did not have an indication for anticoagulation. Now in this study, Carolyn, the primary endpoint was an incidence of leaflet thrombosis on four-dimensional computed tomography, CT, performed at six months after the TAVR procedure. Key secondary endpoints were the number and volume of new cerebral lesions on brain magnetic resonance imaging or MRI and the serial changes of neurological and neurocognitive function between six months and that time immediately post the TAVR procedure. Dr. Carolyn Lam: Oh, interesting. What did they find? Dr. Greg Hundley: Right, Carolyn. In patients without an indication for long-term anticoagulation after successful TAVR, the incidence of leaflet thrombosis was numerically lower with edoxaban than with dual antiplatelet therapy, but this was not statistically significant. The effect on new cerebral thromboembolism and neurological or neurocognitive function were also not different between the two groups. Now because the study was underpowered, the results should be considered really as hypothesis generating, but do highlight the need for further research. Dr. Greg Hundley: Carolyn, there's a second paper pertaining to transcatheter aortic valve prosthesis. It's led by a group directed by Dr. Paul Sorajja from the Minneapolis Heart Institute Foundation and Abbott Northwestern Hospital. Carolyn, these authors prospectively examined 565 patients with cardiac CT screening for HALT, or what we would define as hypoattenuating leaflet thickening, at 30 days following balloon-expandable and self-expanding TAVR. Now, deformation of the TAVR prosthesis, asymmetric prosthesis leaflet expansion, prosthesis sinus volumes, and commissural alignment were analyzed on the post-procedural CT. For descriptive purposes, an index of prosthesis deformation was calculated, with values greater than 1 representing relative midsegment underexpansion. A time-to-event model was also performed to evaluate the association of HALT with the clinical outcomes. Dr. Carolyn Lam: Oh, interesting. What did they find? Dr. Greg Hundley: Right, Carolyn. Nonuniform expansion of TAVR prosthesis resulting in frame deformation, asymmetric leaflet, and smaller neosinus volume was related to the occurrence of HALT in patients who underwent TAVR. What's the take home here, Carolyn? These data may have implications for both prosthesis valve design and deployment techniques to improve clinical outcomes in these patients. Now, Carolyn, both of these articles are accompanied by an editorial from Dr. Raj Makkar from the Smidt Heart Institute at Cedars-Sinai's Medical Center. It's a very lovely piece entitled Missing Pieces of the TAVR Subclinical Leaflet Thrombosis Puzzle. Well, how about we check what else is in this issue? My goodness, this was a packed issue. First, Carolyn, there are three letters to the editor from Professors Ennezat, Dweck, and then a response from Dr. Banovic pertaining to a follow-up from a previously published study, the AVATAR study, in evaluating valve replacement in asymptomatic aortic stenosis. There's also a Perspective piece from Dr. Wells entitled “Treatment of Chronic Hypertension in Pregnancy: Is It Time For A Change?” There's a Global Rounds piece from Professor Berwanger entitled “Cardiovascular Care in Brazil: Current Status, Challenges, and Opportunities.” Then there's also a Research Letter from Professor Eikelboom entitled “Rivaroxaban 2.5 mg Twice Daily Plus Aspirin Reduces Venous Thromboembolism in Patients With Chronic Atherosclerosis.” Dr. Carolyn Lam: There's another Research letter by Dr. Borlaug on longitudinal evolution of cardiac dysfunction in heart failure with normal natriuretic peptide levels. There's also a beautiful Cardiology News piece by Bridget Kuehn on the post-COVID return to play guidelines and how they're evolving. Well, that was a great summary of today's issue. Let's hop on to our feature forum. Shall we? Dr. Greg Hundley: You bet, Carolyn. Can't wait. Dr. Carolyn Lam: Today's feature discussion is actually a forum because we have two feature papers in today's issue. They all surround the cardiorenal interaction, should I say, of the SGLT2 inhibitors. For the first paper, discussing that initial decline or that dip in the GFR following initiation of dapagliflozin would be Dr. John McMurray, who's the corresponding author of this paper from DAPA-HF. Dr. John McMurray's from the University of Glasgow. Now next, we have also the corresponding author of another paper, really going into the mechanistic insights of the renal and vascular effects of combined SGLT2 and ACE inhibition. Dr. David Cherney is from Toronto General Hospital, University of Toronto. Dr. Carolyn Lam: We have the editorial list of these two wonderful papers, Dr. Kausik Umanath from Henry Ford Health in Michigan. Finally, our beloved associate editors, Dr. Ian Neeland from Case Western Reserve and Dr. Brendan Everett from Brigham and Women's Hospital, Harvard Medical School. Thank you, gentlemen. Now with all of that, what an exciting forum we have in front of us. Could I start by asking, of course, the respective authors to talk a little bit about your papers? I think a good place to start would be with Dr. McMurray. John, please. Dr. John McMurray: Thanks, Carolyn. I think our paper had three key messages. The early dip in eGFR that we saw was, on average, very small in patients with heart failure, about 3 mLs/min or about 5%. Very few patients had a large reduction in the eGFR. It was around 3%. Dapagliflozin-treated patients had a 30% or greater decline compared to about 1% of placebo patients. Finally, very few of those patients had a decline in the eGFR below a critical threshold, which for cardiologists might be around 20 mLs/min. We saw that in only five patients; that's 0.2% of the dapagliflozin-treated patients. Second message was that that early decline partially reverses. The nadir in our study was about 14 days. But by 60 days, on average, eGFR had increased again. Hold your nerve if you see an early decline in eGFR. Dr. John McMurray: Maybe the most important message was that that decline in the eGFR is not associated with worse cardiovascular or renal outcomes. In fact, if anything, the opposite. If you look at the patients in the dapagliflozin group with a 10% or greater decline in eGFR, then compare it to patients who didn't have that decline, these individuals were about 27% less likely to experience the primary composite outcome of worsening heart failure and cardiovascular death. If you look at the placebo group, we saw exactly the opposite. Amongst those who had a greater than 10% decline in eGFR compared to those who didn't, those people with the early decline in eGFR were 45% more likely to experience the primary composite endpoint. The same is true for other cardiovascular outcomes for worsening kidney function. In the dapagliflozin group, decline in eGFR was not associated with more adverse events, not associated with more treatment discontinuation. That small decline in the eGFR is not a bad prognostic sign. If anything, it might be the opposite. Dr. Carolyn Lam: Thank you so much. That was really clear. David, are you going to tell us why this decline occurs? Dr. David Cherney: Yeah. Perhaps the paper that we published gives some insights into the mechanisms that are responsible for some of those changes in GFR that are thought to be acute hemodynamic effects. In the between trial, which is the trial that we published examining the effect of ACE inhibition followed by SGLT2 inhibition in patients with type 1 diabetes, we also saw that there was an expected effect of adding SGLT2 inhibition on top of an ACE inhibitor in people with uncomplicated type 1 diabetes. This acute dip in GFR was seen in this cohort of patients. We included only 30 patients in this small mechanistic study. At the same time, along with that dip in GFR, we also saw an increase in measures of proximal natriuresis. That proximal sodium loss is linked with changes in sodium handling in the kidney, which then causes changes in both probably afferent and efferent tone, which causes this dip in GFR primarily through natriuresis in this phenomenon called tubuloglomerular feedback. That was one major observation that gives insight into what we see in larger trials around the dip in GFR. Dr. David Cherney: In our mechanistic study, we also saw an additive effect on blood pressure. Blood pressure went down further with the addition of empagliflozin on top of an ACE inhibitor. In terms of the mechanisms that are responsible for the reduction in blood pressure, natriuresis certainly may be in part responsible, but we also saw a novel observation whereby there was a reduction in peripheral vascular resistance using noninvasive measures. There are likely several mechanisms that are responsible for the reduction in blood pressure. Then finally, we also saw reductions in markers of oxidative stress, which may also account for some of the effects that we see in blood pressure, as well as potentially some of the anti-inflammatory and anti-fibrotic effects that we see at least in experimental models that may have some clinical translatability to humans as well around the clinical benefits. I think the blood pressure, the renal hemodynamic effects, and some of the neurohormonal mechanisms are the major observations that we saw that may in part explain some of the really nice changes that were seen in Dr. McMurray's study. Dr. Carolyn Lam: Right. Thanks, David. But these were patients with type 1 diabetes and no heart failure. John, do you have any reflections or questions about how that may apply? By the way, what a beautiful study. Thank you, David. Dr. David Cherney: Pleasure. Thank you. Dr. John McMurray: Yes, David. I really enjoyed your study. In fact, I think, Carolyn, it does shed some insights perhaps to what's going on. As David pointed out, the reduction in peripheral arterial resistance, reduction in blood pressure, that may play some role in that early dip in eGFR as well as autoregulation in the kidney. Then the other interesting thing is that the distal nephron seems to adapt to that effect in the proximal tubule. Again, that may account for some of that recovery in eGFR, that reversal in the early dip that I spoke about, and which I think is very clinically important because, of course, physicians should make sure that they recheck eGFR if they see that early dip. Because they may find that few weeks later that that dip is much smaller and of much less concern. Dr. Carolyn Lam: Thank you, John. In fact, you're saying, stay the course, right- Dr. John McMurray: I have. Dr. Carolyn Lam: ... with the SGLT2 inhibitors. I'm actually stealing the words of the title of the editorial, a beautiful editorial by Kausik. I love that. Stay the course. Kausik, please, could you frame both papers and then with an important clinical take home message for our audience? Dr. Kausik Umanath: Sure. I think the analysis by John and his group was really relevant with the large sample size. What's impressive? Similar to a lot of these other SGLT2 studies that have come out, both in heart failure and in kidney disease progression and so on, it's remarkable how the other analysis, like the analysis of EMPA-REG and CREDENCE and so on, of similar dips. All show more or less the same magnitude, the same relative proportions of this GFR trajectory. I think the mechanistic study only highlights that though it's working with a slightly different population of type 1 patients and much earlier in their course in terms of where their GFRs are. Dr. Kausik Umanath: The other piece is that ultimately we need to understand this dip and know to monitor for it and so on. But I think the general clinician should really understand that a dip of greater than 10% really occurs in less than half the population that takes these agents. That dip, if it occurs, certainly doesn't do any harm. That said, if they see a bigger dip in the 30% range, monitor more closely and consider making sure that there aren't any other renal issues out there for that patient because they are a much smaller proportion of patients in these large trials that generate that level of dip. They should be monitored. Dr. Kausik Umanath: The other thought that we had, and thinking through this in a practical sense, is because you expect this dip, many of our cardiologists or even the nephrologists when we titrate these drugs, they're on a suite of other drugs. It's probably best to not adjust their Lasix or their loop diuretic, or their RAAS inhibitor at the same time as you're adjusting the SGLT2 inhibitor or starting it because then you may just introduce more noise into the GFR changes that you see over the next several weeks. It may be a sequential piece or at least holding those other agents constant while this gets titrated and introduced is a prudent course of action, so you don't misattribute changes. Dr. Carolyn Lam: Thanks so much. What clinically relevant points. In fact, that point about the diuretic especially applies in our heart failure world. You see the dip. Well, first, make sure the patient's not overdiuresed. Remember, there's more that the patient's taking. Thank you. That was a really great point. Brendan and Ian, I have to get you guys to share your views and questions right now. But before that, can I take a pause with you and just say, aren't you just so proud to be AEs of Circulation when we see papers like these and we just realize how incredible the data are and the clinical implications are? I just really had to say that. All right. But with that, please, what are your thoughts, Brendan? Dr. Brendan Everett: Yeah, sure. Thank you, Carolyn. Hats off to all three of our authors today for doing some amazing science. Thank you for sending it to Circulation. I think, in particular, I handled David's paper. I'm not a nephrologist and I'm probably the furthest thing from a nephrologist. Had to do my best to try and understand these concepts that I'm not sure I ever even was exposed to in medical school many years ago. I think it shows the breadth of the interest in our readership. The fact that these changes in eGFR have become a primary focus for our cardiovascular patients and that the clinical implications are really important. I guess my question, David, is... In your paper, you talked a little bit about this hypothesis of hyperfiltration and the role that hyperfiltration plays in setting patients with diabetes up for kidney disease. Is that playing a role in John's observation or not? Again, as a non-nephrologist, I have trouble connecting the dots in terms of that hypothesis and John's observation of the clinical benefit for patients that have a reduction in eGFR as opposed to no change. Dr. David Cherney: Yeah. It's a great question. It's very difficult to know with certainty in a human cohort because we can't measure the critical parameter, which is intraglomerular pressure, which we think these changes in GFR are a surrogate for. But if we go along with that train of thought, along reductions in glomerular hypertension, it very much makes sense that the patients who dip are those who have the... They're taking their medication, number one. Number two, they respond physiologically in the way that you expect them to, which is that their GFR dips at least transiently and then goes back up again through some of the compensatory mechanisms that John mentioned earlier. As was mentioned not only in this paper, but also in previous analyses from CREDENCE and previous analyses from VERTIS CV and others have shown that indeed that dip in GFR is linked with longer term renal benefits, at least. That is reflected in a reduction in the loss of kidney function over time. Dr. David Cherney: The patients who are on an SGLT2 inhibitor and those who dip by around 10% or less, those patients tend to do the best over time in terms of preserving GFR, not losing kidney function compared to patients who are on an SGLT2 inhibitor but do not dip, or those patients who actually have an increase in GFR. That is consistent with this idea that there may be a reduction in glomerular pressure, which is protective over the long term. That ties back into your question around hyperfiltration that this may indeed be due to a reduction in glomerular pressure, which is linked with risk over the long term. Dr. Carolyn Lam: Ian? Dr. Ian Neeland: I wanted to echo Brendan's comments about the excellent science. When I read these papers, it really speaks to the existential struggle that cardiologists have between kidney function and these medications that we know have cardiovascular benefits. How do we manage that practically? It's so clinically relevant, both the observation that John's paper made about the dip in the DAPA-HF trial as well as, David, your mechanistic insights. Dr. Ian Neeland: I wanted to ask John potentially about the most fascinating aspect to me of this paper was that patients with a dip of 10% or more actually ended up doing better in terms of cardiovascular outcomes, specifically hospital heart failure and hospitalizations than people on placebo with a greater than 10% dip. It speaks to the fact that... Is the physiology going on here different between those individuals whose GFR went down on placebo versus those who are on SGLT2 inhibitors? All the mechanistic insight that David's paper had in terms of blood pressure and intraglomerular pressure, how does that feedback and speak to why heart failure is strongly linked to this mechanism? We see this not just with SGLT2 inhibitors, but there are other medications now coming out showing that there's a relationship between this dip in GFR and heart failure. Can you speak to why this heart failure-kidney connection is so important and becoming greater and greater in terms of our understanding? Dr. John McMurray: Well, thank you for asking me the hardest question and one that I truly don't think I have a good answer to. I think it's obvious to all of us that the kidney is central in heart failure and perhaps cardiologists have neglected that fact, focusing more on the other organ. But by definition, almost the fluid retention that characterizes heart failure in terms of signs, and probably is the primary cause of symptoms, that clearly is a renally-mediated phenomenon. The kidney must be central to all of this. I think David right. I think the decline in eGFR that you see with this drug is simply a marker that the drug is having its physiological effect or effects. Whatever those are, they're beneficial. Clearly, patients who have an eGFR decline on placebo are different and they reflect, again, the patients that we see all the time. As our patients with heart failure deteriorate, one of the things that we commonly see, in fact becomes one of the biggest problems that we have to deal with, is that their kidney function declines. As their symptoms get worse, as their cardiac function gets worse, their kidney function also declines. Dr. John McMurray: I think you're seeing two contrasting effects here. One is the background change in eGFR, which is the placebo patients, and we've always known that that's a bad thing. Then we're seeing that early within 14 days marker of the pharmacological or physiological action of the drug. I hope you don't ask me how SGLT2 inhibitors work in heart failure. That's the other most difficult question I can think of, but I think this is just a marker of the fact that they are working. Dr. David Cherney: Yeah. Just to add to that briefly, there is this difficulty in sorting out the mechanisms that are relevant around the acute effects in the kidney that the dip in GFR reflects natriuresis that could keep patients out of heart failure; that the reduction in glomerular pressure reduces albuminuria. Albuminuria reduction is linked with kidney protection. It's linked with heart failure and ASCVD protection. Then there's also this concept of if you dip and then you stay stable afterwards, your GFR stays stable afterwards, those patients with stable kidney function that's not declining, the dippers in other words, those patients are probably able to maintain salt and water homeostasis better than someone who's declining more rapidly. All these things probably tie together in order to reflect, of course, there's a renal protective effect, but that some of those mechanisms may also tie into the heart failure mechanisms that John was mentioning. Dr. John McMurray: But, David, it's hard to imagine if we don't protect the kidney, we won't protect patients with heart failure given how fundamental, as I said, the kidney is, and how fundamentally important worsening kidney function is. Not only because it is a marker of things going badly, but also because it often results in discontinuation or reduction in dose of other life-saving treatments. To Kausik's point, it was very important about the risk of changing background life-saving disease modifying therapy. Actually, we didn't see that in DAPA-HF, which was very intriguing. There was no reduction in use of renin-angiotensin system blockers or mineralocorticoid receptor antagonists. Dr. Carolyn Lam: Thank you so much, gentlemen. Unfortunately, we are running out of time, but I would really like to ask one last question to the guests, if possible. Where do you think the field is heading? What next? What's the next most important thing we need to know? David, do you want to start? Then John, then Kausik. Dr. David Cherney: I think one of the aspects that we need to know in the future is where else can we extend these therapies into novel indications and extend the boundaries of where we currently work with these therapies. People with type 1 diabetes, for example, with either heart failure or with significant kidney disease, patients with kidney transplantation, is there a renal or cardiovascular protective effect? Then another high risk cohorts who have not been included in trials, those on immunosuppressants, for example, who were excluded from the trials. I think those are some of the areas that we need to extend into now that we understand how these therapies work in even very sick patients and that we also know that they likely have at least some benefit through suppressing inflammation, and possibly reducing infectious risks. That would provide a rationale for extending into some of these new areas. I think that's certainly, hopefully on the horizon for us. Dr. Carolyn Lam: John? Dr. John McMurray: Carolyn, obviously I think looking at post myocardial infarction population, that's an obvious place to go. There are a couple of trials there. I suppose the trial that I would love to see, and which I think would address the core question that we've been discussing today, which is: Is this all about the effect in the kidney and how important is the diuretic and natriuretic action of these drugs in heart failure? I think the key study that would address this would be doing a study in patients on dialysis. Because in those patients we could, I think, separate the issue of natriuresis, diuresis, and maybe even the dip in EGR that we've been talking about. If these drugs prove to be effective in end-stage kidney disease, patients on dialysis, that would be really fascinating. Dr. Carolyn Lam: Kausik? Dr. Kausik Umanath: That is a very interesting point. I don't know that we know necessarily outcomes, but I think from working with the DAPA-CKD, we do have a little bit of the safety data because we did continue it. I was the US MLI for that study and we did continue the SGLT2 passed into renal failure. There is a little bit of safety data there. But I don't think once you've declared an outcome, you're not collecting outcomes data after that point. That's a very interesting area to look into. Dr. Kausik Umanath: I also think the other place where this field's heading is trying to better tier and layer the multitude of agents. I think we've been waiting for about 20 to 30 years, at least in the kidney field, for something new to affect the progression of kidney disease after the ACE/ARB trials and so on. This one we've got SGLT2 inhibitors. We've got the new MRA, finerenone, and so on, which also have very beneficial cardiovascular effects. The question becomes: How do we layer these therapies? Which sequence to go in? Some of the others that are in pipeline as well that are out there that have very beneficial cardiovascular effects that may indeed also help kidney function and diabetes control, which do you go with first and so on? Dr. Carolyn Lam: Wow! Thank you so much. We really could go on forever on this topic, but it has been tremendous. Thank you once again. On behalf of Brendan, Ian, Greg, thank you so much for joining us today in the audience. You've been listening to Circulation On the Run. Don't forget to tune in again next week. Dr. Greg Hundley: This program is copyright of the American Heart Association 2022. 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, please visit ahajournals.org.
The theme this week on the Retirement Quick Tips Podcast is Habits that lead to happiness in retirement. According to the article that was the basis for this week's theme: “In 1938, researchers at Harvard Medical School lit upon a visionary idea: They would sign up a bunch of men then studying at Harvard and follow them from youth to adulthood. Every year or two, researchers asked the participants about their lifestyles, habits, relationships, work, and happiness. The study has since expanded to include people beyond men who went to Harvard, and its results have been updated regularly for more than 80 years. Those results are a treasure trove…You look at how people lived, loved, and worked in their 20s and 30s, and then you can see how their life turned out over the following decades. And from this crystal ball of happiness, you can learn how to invest in your own future well-being.As the participants in the Harvard Study of Adult Development have aged, researchers have categorized them with respect to happiness and health. There is a lot of variation in the population, but two distinct groups emerge at the extremes. The best off are the “happy-well,” who enjoy good physical health as well as good mental health and high life satisfaction. On the other end of the spectrum are the “sad-sick,” who are below average in physical health, mental health, and life satisfaction.” So today, I want to focus on 2 health habits that emerge from the data on this study: Don't smoke & Watch your drinking These recommendations are nothing new. The research pointing to smoking and excessive drinking as a major source of health problems is vast and quite conclusive. If you're a smoker, you've probably already tried to quit many, many times. And if you're not a smoker, you're no doubt happy that you don't have to battle that addiction. Alcohol however, is more insidious, because its negative effects aren't as obvious. One of the most powerful predictors of people who end up in the sad-sick category was problem drinking. And unlike the typical stereotype of an alcoholic, the reality is that a lot of successful and hard-working people are highly functioning alcoholics. Some research indicates that many of the personality traits that predict success, are also strong predictors of addiction. The bottom line is that if you don't quit smoking and don't stop problem-drinking, you're much more likely to be in the miserable, sad-sick category of retirees. That's it for today. Thanks for listening! My name is Ashley Micciche and this is the Retirement Quick Tips podcast. ---------- >>> Subscribe on Apple Podcasts: https://apple.co/2DI2LSP >>> Subscribe on Amazon Alexa: https://amzn.to/2xRKrCs >>> Visit the podcast page: https://truenorthra.com/podcast/ ---------- Tags: retirement, investing, money, finance, financial planning, retirement planning, saving money, personal finance
https://drleroy.com/ Dr. Andrée LeRoy is both a Harvard-trained medical doctor and a medical intuitive. She is an expert in lifestyle, functional, integrative, and rehabilitation medicine. She comes from a long lineage of western medicine-trained physicians and holistic healers which has shaped her unique and science-based approach to integrative and individualized care. Upon receiving her Bachelor's degree from the University of Illinois at Urbana in Molecular and Integrative Physiology, she completed her thesis in Medicinal plants and Herbology. She expanded her knowledge of the body systems and mechanics by practicing as a licensed massage therapist before graduating from the University of Illinois at Chicago Medical School in 2006. She then completed her residencies in Physical Medicine and Rehabilitation at Harvard Medical School in Boston, Massachusetts in 2010 and the Durant Fellowship in Global Health and Refugee Medicine from Massachusetts General Hospital in 2011. While working at Massachusetts General Hospital and Spaulding Rehabilitation, Harvard's official teaching hospital for physical medicine and rehabilitation ranked as top 3 rehabilitation hospitals in the United States, she also remained on faculty at Harvard Medical School for 8 years. She completed her Master's degree in Spiritual Psychology with an emphasis in Consciousness, Health & Healing from the University of Santa Monica in 2016. In 2018 she moved to Los Angeles to pursue her dream of creating a patient centered model of healthcare that combines the best art and science to facilitate healing. This model takes a comprehensive mental, spiritual, and physical approach to bring health issues to resolution. She received training in Lifestyle Medicine, Functional Medicine, Reiki, Energy Medicine, and Ayurvedic medicine, making her a catalyst for integrating a holistic approach to her practice. Over the past several years, Dr. LeRoy has worked closely with a high-achieving, heart-centered professionals to take all aspects of their lives to the next level. She has seen how important it is to educate professionals on the importance of creating a healthy work-life balance that results in optimal health, wellness, and vitality. ----------- Sharon T McLaughlin MD FACS is the founder of Mind Lull and Female Physicians Entrepreneurs. Today we speak about being a better speaker. Planning tools for women entrepreneurs who feel stuck so that they can focus and achieve their desired goals. Learn more about Mind Lulls Journals https://mindlull.com Female Physician Entrepreneur Group If you are a women physician, join us at Female Physician Entrepreneurs Group We learn and grow together https://www.facebook.com/groups/FemalePhysicianEntrepreneurs Our website https://FPEStrong.com #physicianentreprener #physiciansidehustle #physiciansidegig #physiciansidegigs #businessgrowth #businessmarketing #offlinebusinessmarketing #womenphysician #womenentreprenuer #physicianspeaker
Videos: The healthcare system is a giant SCAM (that you pay for) – Sorelle Amore Finance Failure after failure: Private hospitals' appalling treatment of pregnant mum | 60 Minutes Australia HEALTH NEWS B vitamins can potentially be used to treat advanced non-alcoholic fatty liver disease Decreased acetyl-L-carnitine levels associated with depression Skip the texts: Face-to-face meetings make college students happier Eating more plant protein associated with lower risk of death Heat therapy boosts mitochondrial function in muscles Your soap and toothpaste could be messing with your microbiome B vitamins can potentially be used to treat advanced non-alcoholic fatty liver disease Duke University Medical School, August 6, 2022 Scientists at Duke-NUS Medical School have uncovered a mechanism that leads to an advanced form of fatty liver disease—and it turns out that vitamin B12 and folic acid supplements could reverse this process. These findings could help people with non-alcoholic fatty liver disease, an umbrella term for a range of liver conditions affecting people who drink little to no alcohol, which affects 25% of all adults globally, and four in 10 adults in Singapore. Non-alcoholic fatty liver disease involves fat build-up in the liver and is a leading cause of liver transplants worldwide. When the condition progresses to inflammation and scar tissue formation, it is known as non-alcoholic steatohepatitis (NASH). Dr. Tripathi, study co-author Dr. Brijesh Singh and their colleagues in Singapore, India, China and the US confirmed the association of homocysteine with NASH progression in preclinical models and humans. They also found that when homocysteine attached to a protein called syntaxin 17, it blocked the protein from performing its role of transporting and digesting fat (known as autophagy, an essential cellular process by which cells remove malformed proteins or damaged organelles) in fatty acid metabolism, mitochondrial turnover, and inflammation prevention. This induced the development and progression of fatty liver disease to NASH. Importantly, the researchers found that supplementing the diet in the preclinical models with vitamin B12 and folic acid increased the levels of syntaxin 17 in the liver and restored its role in autophagy. It also slowed NASH progression and reversed liver inflammation and fibrosis. Decreased acetyl-L-carnitine levels associated with depression Stanford University, July 30 2022. An article that in the Proceedings of the National Academy of Sciences reported a link between low levels of acetyl-L-carnitine and a greater risk of depression. Acting on the findings of animal research conducted by lead author Carla Nasca, PhD, the researchers recruited men and women between the ages of 20 and 70 years who had been admitted to Weill Cornell Medicine or Mount Sinai School of Medicine for treatment of acute depression. Clinical assessments were conducted upon enrollment and blood samples were analyzed for levels of acetyl-L-carnitine. In comparison with levels measured in blood samples provided by 45 demographically matched healthy men and women, acetyl-L-carnitine blood levels in depressed subjects were substantially lower. Acetyl-L-carnitine levels were lowest among depressed patients who had severe symptoms, a history of treatment resistance, or early onset disease. Having a history of childhood abuse was also associated with low acetyl-L-carnitine levels. “We've identified an important new biomarker of major depression disorder,” Dr Rasgon stated. What's the appropriate dose, frequency, duration? We need to answer many questions before proceeding with recommendations, yet. Skip the texts: Face-to-face meetings make college students happier University of Hamburg (Germany), August 5, 2022 In a world where everyone spends more and more time with eyes fixed on their phones, new research suggests young people feel happier after socializing with friends in person rather than virtually The conclusion is an outgrowth of nearly four years spent analyzing how social habits of more than 3,000 college students affected their state of mind. “The findings of this study suggest that talking to people face to face makes us feel better than texting back and forth, for example,” said James Maddux, senior scholar at the Center for the Advancement of Well-Being in Fairfax, Va., who reviewed the results. Led by Lara Kroencke, of the University of Hamburg in Germany, the researchers noted that other studies have consistently shown that people tend to feel better after socializing with others.To better explore that question, Kroencke's team conducted three studies between 2017 and 2020 with students from the University of Texas at Austin. Researchers chose that age group because of the “intense” socializing that tends to take place during that phase of life. Participants between 18 and 24 years old; 37% were white, 23% were Asian, 23% were Hispanic, nearly 5% were Black, and the rest identified as multiracial. The result: Students tended to feel best after interacting with others in person or through a mix of in person and virtual, versus entirely by computer or phone. Interacting only virtually was, however, better for well-being than no interaction at all, the team stressed. They also found that socializing with close friends brought about a greater overall sense of well-being than engaging with either family or someone a person didn't know so well. And those who tended towards high levels of neuroticism were likely to benefit the most from in-person interactions. Eating more plant protein associated with lower risk of death Massachusetts General Hospital & Harvard Medical School, July 31, 2022 Eating more protein from plant sources was associated with a lower risk of death and eating more protein from animals was associated with a higher risk of death, especially among adults with at least one unhealthy behavior such as smoking, drinking and being overweight or sedentary, according to an article published online by JAMA Internal Medicine. Mingyang Song, M.D., Sc.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and coauthors used data from two large U.S. studies that had repeated measures of diet through food questionnaires and up to 32 years of follow-up. Among 131,342 study participants, 85,013 (64.7 percent) were women and the average age of participants was 49. Median protein intake, measured as a percentage of calories, was 14 percent for animal protein and 4 percent for plant protein. The authors report: After adjusting for major lifestyle and dietary risk factors, every 10 percent increment of animal protein from total calories was associated with a 2 percent higher risk of death from all causes and an 8 percent increased risk of death from cardiovascular disease death. In contrast, eating more plant protein was associated with a 10 percent lower risk of death from all causes for every 3 percent increment of total calories and a 12 percent lower risk of cardiovascular death. Increased mortality associated with eating more animal protein was more pronounced among study participants who were obese and those who drank alcohol heavily. The association between eating more plant protein and lower mortality was stronger among study participants who smoked, drank at least 14 grams of alcohol a day, were overweight or obese, were physically inactive or were younger than 65 or older than 80. Substituting 3 percent of calories from animal protein with plant protein was associated with a lower risk of death from all causes: 34 percent for replacing processed red meat, 12 percent for replacing unprocessed red meat and 19 percent for replacing eggs. Heat therapy boosts mitochondrial function in muscles Brigham Young University, August 2, 2022 A new study finds that long-term heat therapy may increase mitochondrial function in the muscles. The discovery could lead to new treatments for people with chronic illness or disease. The study–the first of its kind in humans–is published in the Journal of Applied Physiology. Mitochondria, the “energy centers” of the cells, are essential for maintaining good health. Exercise has been shown to create new mitochondria and improve function of existing mitochondria. However, some people with chronic illnesses are not able to exercise long enough–previous research suggests close to two hours daily–to reap the benefits. Rodent studies have suggested that heat exposure may also induce the production of more mitochondria. Researchers from Brigham Young University in Utah studied 20 adult volunteers who had not participated in regular exercise in the three months prior to the study. The research team applied two hours of shortwave diathermy–a type of heat therapy generated by electrical pulses–to the thigh muscles of one leg of each person every day. The researchers based the six-day trial of heat on the minimum amount of exercise needed to measure changes in muscle, or about two hours each day. They designed the treatment to mimic the effects of muscle heating that occurs during exercise. The therapy sessions increased the temperature of the heated leg by approximately 7 degrees F. Each participant's other leg served as a control, receiving no heat therapy or temperature change. The researchers looked at mitochondria content in the muscles on the first day of therapy and 24 hours after the last treatment. Mitochondrial function increased by an average of 28 percent in the heated legs after the heat treatment. The concentration of several mitochondrial proteins also increased in the heated legs, which suggests that “in addition to improving function, [repeated exposure to heat] increased mitochondrial content in human skeletal muscle,” the research team wrote. Your soap and toothpaste could be messing with your microbiome University of Chicago, August 2, 2022 Antimicrobial chemicals found in common household products could be wreaking havoc with people's guts, according to a research paper out this week in the journal Science. Triclosan is an antibacterial compound used in soaps, detergent and toothpaste, as well as toys and plastics. It was originally only used in hospitals, but it found its way into homes as Americans became more germ-phobic. (However, recent studies have found it no more effective at killing bacteria than plain soap. ) Now, there are growing concerns about the possible negative effects of the chemical on human health and the environment. According to the US Food and Drug Administration (FDA), animal studies have shown that the chemical can act as a hormone disruptor. A study found traces of triclosan in the urine of 75% of the participants – some as young as six. The chemical has also been found in more than half of freshwater streams in the US. The latest research paper, written by academics from the University of Chicago, focused on the lesser-known effects of triclosan exposure on the bacteria in people's guts. Disturbing the human microbiome has been “linked to a wide array of diseases and metabolic disorders, including obesity, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and behavioral and metabolic disorders,” wrote the paper's authors, Alyson L Yee and Jack A Gilbert. To test the chemical's effect in humans, researchers from Stanford and Cornell universities gave seven volunteers triclosan-containing products, such as toothpaste and liquid soap, to use for four months. After that period, the same volunteers were switched to products without triclosan. The volunteers were compared with a second group who first used the non-triclosan products, then changed to those containing triclosan. The results showed that more triclosan was found in the urine of all the participants during the periods when they were using triclosan-containing products. Yee and Gilbert also suggested that exposure to triclosan could be even more detrimental to the health of developing fetuses and newborns than to adults. A 2014 New York University study found that gut disruptions in early infancy could have lasting negative effects on immune and brain development.
Richard C. Schwartz speaks to Banyen Books & Sound about his new book, No Bad Parts. Richard C. Schwartz, PhD, is the creator of Internal Family Systems, a highly effective, evidence-based therapeutic model that de-pathologizes the multi-part personality. His IFS Institute offers training for professionals and the general public. Formerly an associate professor in the Department of Psychiatry at the University of Illinois at Chicago and later at Northwestern University, he is currently on the faculty of Harvard Medical School. He has published five books and is a sought-after presenter. For more, visit ifs-institute.com.
“The concept came to me for a book series, or media series, called What Your Doctor Wants You to Know when I realized that I was having the same conversation with patients and there were just things that I wanted to scream from the rooftops.” - Dr. Virgie Bright Ellington, Internal Medicine Physician and Author of What Your Doctor Wants You to Know Book Series Approximately 8-9 medical bills out of 10 generated in the U.S. contain errors that do not benefit the patient. Today, DocWorking brings guest speaker Dr. Virgie Bright Ellington, MD and author of her book series What Your Doctor Wants You to Know to Crush Medical Debt onto the podcast. CEO of DocWorking and cohost of the podcast Dr. Jen Barna has an informational conversation with Dr. Ellington about how you can best confront medical billing to assess for errors. The passionate Dr. Ellington speaks with listeners about her book series and the steps she encourages you to take to tackle medical debt. Hear how Dr. Ellington's background in internal medicine and balancing work and life as a doctor mom inspired her to write this book series. What Your Doctor Wants You to Know to Crush Medical Debt: A Health System Insider's 3 Steps to Protect Yourself from America's #1 Cause of Bankruptcy by Dr. Virgie Bright Ellington Virgie Bright Ellington, MD, is an internal medicine physician and medical billing expert. A dedicated patient advocate, Dr. Virgie earned her degree at the University of Michigan Medical School and trained at the Cambridge Hospital of Harvard Medical School. After practicing more than 20 years in primary care and psychiatric settings and as a health insurance executive, Dr. Virgie now helps patients understand complex medical procedures, communicate effectively with their healthcare providers, and avoid financial devastation from crushing medical bills through her What Your Doctor Wants You to Know series. She also hosts a weekly radio show on VoiceAmerica by the same name. Dr. Virgie is a former NY1 News health contributor and has been featured in Dallas Fox News, several podcasts, and national magazines. Dr. Virgie lives in Westchester County, New York, with her husband and three children. Learn more at www.crushmedicaldebt.com. Find full transcripts of DocWorking: The Whole Physician Podcast episodes on the DocWorking Blog The past few weeks have been busy at DocWorking! We have been working behind the scenes to add even more CME credits to the THRIVE memberships. Let your CME budget help you prioritize your own wellness so you can get on with living your best life on your own terms, as defined by you, with DocWorking THRIVE. You can take the first step today by taking our 2 Minute Balance to Burnout Quiz! Where are you on the Balance to Burnout Continuum? Take the quiz and find out today! DocWorking empowers physicians and entire health care teams to get on the path to achieving their dreams, both in and outside of work, with programs designed to help you maximize life with minimal time. Are you a physician who would like to tell your story? Please email Amanda Taran, our producer, at email@example.com to be considered. And if you like our podcast and would like to subscribe and leave us a 5 star review, we would be extremely grateful! We're everywhere you like to get your podcasts! Apple iTunes, Spotify, iHeart Radio, Google, Pandora, Stitcher, PlayerFM, ListenNotes, Amazon, YouTube, Podbean You can also find us on Instagram, Facebook, LinkedIn and Twitter. Some links in our blogs and show notes are affiliate links, and purchases made via those links may result in payments to DocWorking. These help toward our production costs. Thank you for supporting DocWorking: The Whole Physician Podcast! Occasionally, we discuss financial and legal topics. We are not financial or legal professionals. Please consult a licensed professional for financial or legal advice regarding your specific situation. Podcast produced by: Mara Heppard
Dr. Tony Breu describes how social media can augment health profession education and shares his path to becoming an expert in the use of social media. Dr. Tony Breu is the Director of Resident Education at VA Boston Healthcare System and Assistant Professor of Medicine at Harvard Medical School.Listeners are encouraged to visit the VA Boston Education homepage for faculty development programming and other tools to develop as educators.https://www.va.gov/boston-health-care/work-with-us/internships-and-fellowships/faculty-development/
Psychiatrists Discuss The State of Mental Health in the Black Community pt. 2 For season six, we are working to curate panels with expertise on specific topics. We are always trying to bring more, and we are truly delivering. This week, we are continuing an incredible discussion about mental health in the Black Community. Drs. Danielle Hairston, Kevin Simon and Amanda Calhoun are each highly prolific, dynamic writers, speakers and educators within this space. We were very fortunate that they took the time to answer questions and share their experiences as Black Psychiatrists. We start with a conversation about the burden Black physicians carry in contrast with our colleagues. We talk about experiences with patients, co-workers and supervisors. We talk about burnout and how it is manifested and overcome by those in medical training, and those that have graduated and are practicing. The views discussed in this episode MUST be taken in context and do not reflect upon our employers. How do we deal with burnout? How does the experience of Black medical students and physicians differ from our counterparts? How can we help our underrepresented patients navigate a health system that was not built for us? This episode features: Dr. Danielle Hairston a double-board certified Psychiatrist and the youngest Black, female residency program director in the US. (Dr. Hairston was my resident when I was a medical student at Howard University College of Medicine). She is also a young APA Black Caucus President and Black Psychiatrist of America Scientific Program Committee Chair and has written extensively about bias in Psychiatry. She has consulted with companies like Google, and Youtube. Origins of Racism in American Medicine and Psychiatry Sociodemographic and clinical correlates of the frequently hospitalized African American patients with severe and persistent mental illness Dr. Kevin Simon the inaugural Chief Behavioral Health Officer for the City of Boston. He is a Harvard-trained Board Certified Psychiatrist. Dr. Simon serves as an Attending Psychiatrist at Boston Children's Hospital, an Instructor in Psychiatry at Harvard Medical School, a Commonwealth Fund Fellow in Health Policy at Harvard University, and the Medical Director of Wayside Youth & Family Support Network. Clinically, he practices as a Child, Adolescent, and Adult Psychiatrist and Addiction Medicine specialist caring for youth, young adults, and families through the Adolescent Substance Use & Addiction Program (ASAP). Daughters' Keeper — The Care and Treatment of Black Girls in America Adolescent Substance Use Disorders Dr. Amanda Calhoun an Adult/Child Psychiatry Resident . Dr. Calhoun is also the assistant editor of the Connecticut Psychiatric Society Newsletter and an Associate Editor of the American Journal of Psychiatry Residents' Journal. Dr. Calhoun seeks to expose and eradicate racism in the medical system using a direct and heartfelt approach. Dr. Calhoun's anti-racism work spans from writing anti-racism curriculum, standing up for her patients in real-time, public speaking, research, and writing. She believes that all doctors should be activists, and that social justice should be integrated with medical education. All Doctors Should Be Activists. Sincerely, a Psychiatry Intern The Face of Medicine Is Not My Face…But, It Should Be You asked and we delivered: The Black Doctors Podcast Swag is now available? Click HERE to order. **Interested in starting a podcast? Check out Riverside for your remote recording needs: RIVERSIDE.FM If you enjoyed this episode, please share with a friend and leave a comment and rating on iTunes. TBDP is a volunteer passion project with the goal of inspiring all who listen. In-house music and audio production, so any ideas for improvements or suggestions for future guests are welcome. Visit www.StevenBradleyMD.com to learn more about our host. He is available for consultations or speaking engagements regarding health equity and medical ethics. Leave a voice memo that we can include in a future episode: Pass The Mic
Dr. Phil Kantoff is the CEO and Co-Founder of Convergent Therapeutics, a clinical-stage pharmaceutical company focused on developing next-generation radiopharmaceutical therapies for prostate and other cancers. The company's proprietary technology involves dual-targeted radionuclide therapy developed by Dr. Neil Bander, Professor of Urologic Oncology at Weill Cornell Medicine. Prior to founding the company, Dr. Kantoff spent six years as Chairman of the Department of Medicine at Memorial Sloan Kettering Cancer Center, caring for cancer patients and developing improved cancer testing and cancer therapies. He is the Emeritus Jerome and Nancy Kohlberg Chair in Medicine at Harvard Medical School, and he was the Chief of the Solid Tumor Oncology Division and Director of the Lank Center for Genitourinary Oncology, at Dana Farber Cancer Institute.In this episode, we discuss Phil's transition out of academic medicine, the field of radiopharmaceuticals, Convergent's approach to drug development, and specific business considerations for a unique class of molecules.Hosted by Joe Varriale.
Gastric or stomach cancer is one of the most malignant human cancers, ranking 3rd as the most common cause of cancer death globally. If detected at an early stage, treatments can control and even cure the disease. In our final show, Dr. Sam Klempner, oncologist and hematologist from Massachusetts General Hospital, Harvard Medical School will […] The post New Insights into Stomach Cancer, Part 3 appeared first on Paul Christo MD.
Christopher M. Palmer, MD, received his medical degree from Washington University School of Medicine and completed his internship and psychiatry residency at McLean Hospital, Massachusetts General Hospital, and Harvard Medical School. He is currently the director of the Department of Postgraduate and Continuing Education at McLean Hospital and an assistant professor of psychiatry at Harvard Medical School. For over 20 years, Dr. Palmer's clinical work has focused on treatment resistant cases, and recently he has been pioneering the use of the ketogenic diet in psychiatry, especially treatment resistant cases of mood and psychotic disorders. You can find Dr. Palmer at https://www.chrispalmermd.com/, IG: https://www.instagram.com/chrispalmermd/, Twitter: https://twitter.com/ChrisPalmerMD/, Youtube: https://www.youtube.com/channel/UC_dTM-I4jnN5gHVyXkrCXcA/, and FB: https://www.facebook.com/ChrisPalmerMD/. 00:00 Introduction 02:52 Mental disorders as metabolic disorders of the brain 09:13 Insulin resistance and mental illness 12:23 Role of serotonin in mental health 17:25 Schizoaffective disorder, bipolar, and ketogenic diets 21:08 Diet and mental health 25:55 Metabolic labs for mental illness 31:12 Obesity and mental health disorders 33:30 Ketogenic diets and seizures, fasting, authophagy 35:38 Serum cholesterol, suicidality, violent crime 40:54 Alzheimer's disease and brain insulin resistance 44:50 Younger people getting diagnosed with mental disorders 47:26 Mental illness in society 52:46 Exogenous ketones See open positions at Revero: https://jobs.lever.co/Revero/ Join Carnivore Diet for a free 30 day trial: https://carnivore.diet/join/ Book a Carnivore Coach: https://carnivore.diet/book-a-coach/ Carnivore Shirts: https://merch.carnivore.diet Subscribe to our Newsletter: https://carnivore.diet/subscribe/ . #revero #shawnbaker #Carnivorediet #MeatHeals #HealthCreation #humanfood #AnimalBased #ZeroCarb #DietCoach #FatAdapted #Carnivore #sugarfree
Jennifer Sucre, MD, is an Assistant Professor of Pediatrics and Cell and Developmental Biology at Vanderbilt University School of Medicine. She graduated from Harvard Medical School, trained in pediatrics at Washington University in St. Louis, and completed fellowship in Neonatal-Perinatal Medicine at UCLA. Since joining the Vanderbilt faculty in 2016, she has established a research program focused on understanding the molecular mechanisms of lung development and lung disease across the lifespan with a particular focus on developing novel 4D imaging approaches to study alveologenesis and on understanding molecular drivers of bronchopulmonary dysplasia, the leading complication in survivors of preterm birth. Her clinical experience treating premature infants provides a unique perspective for studying lung development, and she has cultivated new ex vivo, in vitro, and in vivo models of lung injury. Dr. Sucre has combined these models with single-cell biology and spatial transcriptomics to gain insights into cellular specialization and dynamics in the developing lung, elucidated age-regulated host susceptibility factors to SARS-CoV-2 infection, and defined previously unrecognized cell types in chronic respiratory diseases.Find out more about Jennifer and this episode at: www.the-incubator.org______________________________________________________________________________________As always, feel free to send us questions, comments or suggestions to our email: firstname.lastname@example.org. You can also contact the show through instagram or twitter, @nicupodcast. Or contact Ben and Daphna directly via their twitter profiles: @drnicu and @doctordaphnamd. enjoy!This podcast is proudly sponsored by Chiesi.
White House Declares Monkeypox Outbreak A Public Health Emergency The Biden administration declared the monkeypox outbreak a public health emergency on Thursday. Earlier in the week the White House appointed Robert Fenton, regional administrator at FEMA to direct the federal government's response to the monkeypox outbreak, along with a deputy director from the CDC. This comes after criticism from activists and public health experts, who have said that the federal government has been dragging its feet on access to vaccines, testing and treatment for the virus. Ira talks with Tim Revell, deputy United States editor for New Scientist, about the latest monkeypox updates and other top science stories including; new research into the shape of the human brain; how hand gestures can improve zoom calls and a plant that harnesses the power of a raindrop to gulp down insects. New Steps Toward a Vaccine For Cancer Vaccines have long been used to prevent infection from viruses. But now, scientists are working on a different kind of vaccine—one that targets cancer. Dr. Kai Wucherpfennig is working on a cancer vaccine that would target tumors that tend to spread quickly and are resistant to treatment, like melanoma and triple negative breast cancer. This type of vaccine is intended to be used after a patient has had their tumor removed. The goal is to prevent the spread of cancer cells to other parts of the body, which is called metastasis. So far, this type of cancer vaccine is effective in animals, and the results were recently published in the journal Nature. Ira talks with Dr. Kai Wucherpfennig, chair of cancer immunology and virology at the Dana-Farber Cancer Institute and professor of neurology at Harvard Medical School, about his latest research into cancer vaccines, and how recent advances in understanding the immune system has jump-started research into new types of cancer immunotherapies. Restoring A Sensitive Ecosystem, One Wildflower At A Time The New England blazing star is more than just a pretty blossom: it's an integral part of a globally-rare ecosystem called a “sandplain grassland.” Just like the name suggests, sandplain grasslands have sandy soil with tall grass, no trees and an exceptionally high number of rare plant and animal species. That includes plants like the New England blazing star, an important food source for various grassland insects. Today volunteers would plant 1,000 of them to help restore Bamford Preserve, a 60-acre parcel of sandplain grassland on Martha's Vineyard. As climate change threatens both human health and the natural world, experts say that protecting biodiversity hotspots like this one will offer the most bang-for-the-buck — protecting threatened species while offering other ecosystem benefits, like open space and flood protection. Read the full story on sciencefriday.com. A Fish By Any Other Name: Inside The Effort To Bring ‘Copi' To Dinner People who live near freshwater rivers or lakes are likely familiar with Asian Carp. The fish are not native to the U.S., but over the last few decades their populations have exploded in waterways like the Mississippi River Basin and the Illinois River. Over the last few years, there's been a major PR campaign to move away from the name Asian Carp, in favor of a new name: “Copi.” The reason is two-fold: First, it joins a general trend of moving species' names away from nationalistic associations, considering anti-Asian hate crimes during the COVID-19 pandemic. The other goal is to make the fish sound more delicious—creating a market that would incentivize fishing the Copi, hopefully reducing their populations. Joining Ira to talk about this is Jim Garvey, director of fisheries, aquaculture and aquatic sciences at Southern Illinois University in Carbondale, Illinois. Transcripts for each segment will be available the week after the show airs on sciencefriday.com.
Nutritional psychiatrist, brain expert, and faculty member at Harvard Medical School, Dr. Uma Naidoo, joins Lisa Dent on Chicago’s Afternoon News to discuss the top vitamin that keeps her brain “young and healthy” and the different foods that can help maintain brain health. Dr. Naidoo highlights leafy greens, legumes, yogurt, and other foods rich in […]
A very special Fanbase Feature! At San Diego Comic-Con 2022, Fanbase Press Editor-in-Chief Barbra Dillon moderated the "Comics Catalog Curation for Adults" panel (originally recorded on Thursday, July 21, 2022) during Matthew Noe (librarian, Harvard Medical School), Moni Barrette (director of Collection Development & Publisher Relations, Library Pass), Jordan Hart (writer, Ripple Effects), and Jameson Rohrer (judge, 2022 Eisner Awards) discussed what they consider when curating a comics catalog for adult readers, including avenues for finding both mainstream and independent titles, how to curate an inclusive catalog in terms of creators, characters, and stories, how to navigate challenging themes and content, and more.
Does obesity increase your likelihood of certain cancers? A new study might surprise you…Dr. Scott Shikora, Director of Metabolic and Bariatric Surgery at Brigham & Women's Hospital and Professor of Surgery at Harvard Medical School joined Dan to discuss a new JAMA (Journal of the American Medical Association) study that analyzed the connection between obesity and cancer.
WARNING: It is paramount to understand that this episode is an exploration of the MAPS-sponsored, FDA-approved, MDMA assisted therapy trials, which is utilizing professional licensed psychotherapists who are rigorously trained in how to conduct safe MDMA assisted psychotherapy. This episode does not advocate unlawful use of MDMA or other psychedelic drugs as therapeutic treatment without proper professional supervision. In this episode we speak with Dr. Jim Hopper about his groundbreaking research and experimental trials with MDMA assisted therapy for PTSD. We learn about the details of MDMA assisted therapy and discuss its use as a means to heal from trauma. Dr. Jim Hopper is an independent consultant and Teaching Associate in Psychology at Harvard Medical School, and consultant to the Outpatient Addictions Service of the Cambridge Health Alliance. For over 25 years Dr. Hopper's research, clinical and consulting work has focused on the psychological and biological effects of child abuse, sexual assault, and other traumatic experiences. As a clinician Dr. Hopper works with traumatized adults and is a therapist in the Boston site of the MAPS-sponsored, FDA-approved phase 3 trial of MDMA-assisted therapy for PTSD. He also provides ketamine-assisted psychotherapy in private practice. Dr. Hopper consults and teaches nationally and internationally to clinicians as well as investigators, prosecutors, judges, and other professionals. A long-time meditator, Dr. Hopper co-edited the book, Mindfulness-Oriented Interventions for Trauma: Integrating Contemplative Practices. Jim Hopper Website, Articles, and publications https://jimhopper.com/ Jim Hopper YouTube https://www.youtube.com/c/JimHopperPhD Podcast URLS Spotify https://open.spotify.com/show/254sEJYVMdKL5JaY0nskit Apple https://podcasts.apple.com/us/podcast/from-trauma-to-triumph-with-wade-robson-and-james-safechuck/id1625756728 YouTube https://www.youtube.com/c/FromTraumaToTriumphPodcast/ Google Podcast https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy85OGFhMjhkMC9wb2RjYXN0L3Jzcw Social Wade Robson Instagram https://www.instagram.com/waderobsoncreations/ James Safechuck Instagram https://www.instagram.com/james.safechuck/
Dr. Philip Levy is an Assistant Professor of Pediatrics at Harvard Medical School and a physician in the Division of Newborn Medicine here at Boston Children's Hospital. His patient-oriented and translational research initiatives focus on cardiac mechanics in congenital and acquired cardiopulmoanry diseases in the neonatal and pediatric population. His professional activities span the realm of clinical service, research and teaching. Dr. Levy's research is part of a larger international collaborative that was established to examine emerging measures of cardiac function and pulmonary hemodynamics in large preterm birth cohorts to define physiological and pathological patterns of postnatal cardiac adaptation. Phil and his collaborators have introduced novel approaches for non-invasive quantitative cardiac focused imaging that yield sensitive and specific methods of assessment and management of neonatal cardiopulmonary diseases. At NeoHeart Dr. levy will be talking about the respiratory phenotype that presents immediately following definitive closure of the PDA. In addition, he will ask be sharing insight about Postnatal cardiac adaptation following selective laser therapy for twin to twin transfusion. Find out more about Philip and this episode at: www.the-incubator.org________________________________________________________________________________________As always, feel free to send us questions, comments or suggestions to our email: email@example.com. You can also contact the show through instagram or twitter, @nicupodcast. Or contact Ben and Daphna directly via their twitter profiles: @drnicu and @doctordaphnamd. enjoy!This podcast is proudly sponsored by Chiesi.
My guest today is Dr. Ron Siegel. Ron is an author and Assistant Professor of Psychology at Harvard Medical School, where he has taught for over 35 years. He is a long time student of mindfulness meditation and serves on the Board of Directors and faculty of the Institute for Meditation and Psychotherapy. He teaches internationally about the application of mindfulness practice in psychotherapy and other fields, and maintains a private clinical practice in Lincoln, MassachusettsSome of the topics we explore include:-What process behind Dr. Siegel's new book, The Extraordinary Gift of Being Ordinary-The science behind our pursuit of specialness and comparison-How to focus on making connections, not am impressions with others-How social media can amplify our suffering -How stressful early life experiences or trauma intersects with these processes-The potential healing power of psychedelic-assisted therapy-The connection between psychopathology and self preoccupation -And we end by discussing some practical tips to shift unhelpful evaluative processes—————————————————————————Dr. Siegel's website: https://drronsiegel.com/The Extraordinary Gift of Being Ordinary: https://www.amazon.com/Extraordinary-Gift-Being-Ordinary-Happiness/dp/1462548547—————————————————————————If you find value in the podcast, would you please consider leaving a short review on Apple Podcasts/iTunes? It plays an important role in being able to get new guests. I also love reading them! Connect with me on Instagram. https://www.instagram.com/mentallyflexible/Check out my song “Glimpse at Truth” that you hear in the intro/outro of every episode. https://tomparkes.bandcamp.com/track/glimpse-at-truth
Have you ever been hypnotized? When you hear the word hypnosis, I'm willing to bet the first thing you think of is those stage performances where an audience member is instructed to do something ridiculous. But in reality, hypnosis is so much more than that, and it can truly benefit you in many ways. Whether you want to stress less, sleep better, manage pain, lose weight, overcome fears, or improve professional performance, hypnosis can help you do it. This week's Beyond Influential guest, Dr. David Spiegel is the expert when it comes to clinical hypnosis, and his mission is to help destigmatize hypnosis and show you how you can use the power of your own mind to heal and achieve. I wanted to have Dr. Spiegel on because this isn't pseudoscience; what we discuss today is backed by decades of scientific research and clinical experience. Dr. Spiegel has a laundry list of accomplishments and accolades, including degrees from Yale and Harvard Medical School. He is currently serving as Willson Professor and Associate Chair of Psychiatry & Behavioral Sciences, Director of the Center on Stress and Health, and Medical Director of the Center for Integrative Medicine at Stanford University School of Medicine, where he has been a member of the academic faculty since 1975. Dr. Spiegel has more than 40 years of clinical and research experience studying psycho-oncology, stress and health, pain control, sleep, hypnosis, and more. He has published thirteen books, over 400 scientific journal articles, and contributed over 170 book chapters on hypnosis, psychosocial oncology, stress physiology, trauma, and psychotherapy. His research has been supported by the National Institute of Mental Health, the National Cancer Institute, the National Institute on Aging, and several other organizations. He is Past President of the American College of Psychiatrists and the Society for Clinical and Experimental Hypnosis. He was also invited to speak on hypnosis at the World Economic Forum in Davos in 2018. On top of all of this, Dr. Spiegel is also the Co-Founder and Chief Scientific Officer at Reveri, which is an app designed to help you learn and use the proven techniques of self-hypnosis to experience the benefits of hypnosis quickly and conveniently. On Ep. 182, we cover: Hypnosis: What it is & how it works Benefits of Hypnosis: How it can help with everything from reducing stress, anxiety, and depression to overcoming addiction, trauma, and phobias, to pain management, weight loss, better sleep, and improved focus Clinical vs. Stage Hypnosis: What's the difference? Can you be hypnotized? How to tell if you're hypnotizable Hypnosis vs. meditation: Similarities and differences Induction techniques and best practices for self-hypnosis Reveri: building the app, and the future of hypnosis Book Recommendation Trance and Treatment: Clinical Uses of Hypnosis by Herbert Spiegel, MD and David Spiegel, MD https://amzn.to/3JjA0es App I've been loving! I want to share a breathwork app that I've been loving that I think you'll really love too. It's called Othership, and it's really helped me better manage stress and anxiety, and improve my sleep, focus, and mindfulness. Othership usually offers a 7-day free trial, but with my link, you can get 14-days for free! https://www.brittanykrystle.com/othership Free Resource! Get my 3 favorite FREE self-compassion guided meditations for entrepreneurs from Dr. Kristin Neff here! https://www.brittanykrystle.com/meditations Try Reveri and experience self-hypnosis for yourself! https://www.reveri.com/ Want to Support the Podcast for free? Leaving a rating goes a long way and allows me to continue putting out quality content! You can leave one on Apple (https://apple.co/3GWz0vq) or Spotify (https://spoti.fi/3Mrnppp)! Take a screenshot while listening to the episode and share it in your Instagram Stories—and make sure to tag me @brittanykrystle! To connect with Dr. Spiegel: Website: https://med.stanford.edu/profiles/david-spiegel Stanford Center on Stress and Health: https://med.stanford.edu/stresshealthcenter.html Reveri: https://www.reveri.com/ To connect with me, Brittany Krystle: Website: https://www.brittanykrystle.com/ Instagram: https://www.instagram.com/brittanykrystle/ Twitter: https://www.twitter.com/brittanykrystle/ LinkedIn: https://www.linkedin.com/in/brittanykrystle/ Facebook: https://www.facebook.com/brittanykrystlexoxo/ Pinterest: https://www.pinterest.com/brittanykrystle/ YouTube: https://www.youtube.com/channel/UC1f0uI6wzWqp58n7fk-7-1g Don't want to miss an episode (or valuable free resources!)? Get on my list here: https://www.brittanykrystle.com/subscribe *Disclosure: These show notes may contain affiliate links. If you choose to purchase through them, I may earn a commission which helps me continue to create this content (at no extra cost to you). Thank you so much for your support.
Jenn talks to Dr. Lisa Coyne about how to maintain healthy relationships with family members, friends, and significant others. Lisa highlights the effects of mental wellness on relationships, explores the ways in which communication can positively impact the relationships' dynamic, and answers audience questions about the importance of working through challenges together.Lisa W. Coyne, PhD, is an assistant professor of psychology in the Department of Psychiatry, part-time, at Harvard Medical School, and is a senior clinical consultant at the Child and Adolescent OCD Institute (OCDI Jr.) at McLean Hospital. Dr. Coyne has published numerous peer-reviewed articles and chapters on anxiety, OCD, and parenting. She is the author of “The Joy of Parenting: An Acceptance and Commitment Therapy Guide to Effective Parenting in the Early Years,” a book for parents of young children.RELEVANT CONTENT:– More about the episode: mclean.link/ba4– Read the episode transcript: mclean.link/bfc- - -The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.© 2022 McLean Hospital. All Rights Reserved.
Dr. Navin Kumar, an attending Gastroenterologist at Brigham and Women's Hospital, medical educator at Harvard Medical School, and co-founder of the Run the List podcast, and Dr. Walker Redd, a Gastroenterology fellow at the University of North Carolina and co-founder of RTL, discuss variceal upper GI bleeding to build upon the principles discussed in the non-variceal UGIB episode. In this episode, Navin and Walker use a case discussion to emphasize the importance of recognizing which patients are at risk for variceal bleeding, what distinguishes variceal GI bleeding from other sources of GIB, initial steps in management, and additional considerations to keep in mind when caring for these patients.
Dr. Andi Flory, an accomplished veterinary medical oncologist, joins Dr. Andy Roark to discuss the OncoK9 multi-cancer early detection test, a “liquid biopsy” capable of detecting 30 different types of canine cancer. She explains why this test is so different from traditional aspirate and biopsy approaches, what scenarios it might be used in, and how its utilization may increase longevity and quality of life for some cancer patients. She reviews the CANDiD Study and discusses sensitivity and specificity of the OncoK9 "liquid biopsy" test across various types of canine cancers. LINKS: - PetDx: https://petdx.com/ - The CANDiD Study: https://assets.petdx.com/m/611713b73a939868/original/The-CANDiD-Study-Summary.pdf/?utm_source=PetDx.com&utm_campaign=OncoK9&utm_content=CANDiD&utm_medium=Link Clinical validation of a next-generation sequencing-based multi-cancer early detection “liquid biopsy” blood test in over 1,000 dogs using an independent testing set: The CANcer Detection in Dogs (CANDiD) study - OncoK9 Cancer SAFE Tool: https://cancersafe.petdx.com/?utm_source=PetDx.com&utm_campaign=Cancer-SAFE&utm_medium=Link The OncoK9 Cancer SAFE™ (Screening Age For Early detection) tool uses data from over 3,000 cancer-diagnosed dogs to determine the age at which it may be appropriate to start annual cancer screening for your dog. - Resources page: https://petdx.com/resources/ Browse supporting resources, including our clinical validation study, continuing education (CE) programs, research publications and posters, and product documentation. ABOUT OUR GUEST: Dr. Andi Flory, DVM, DACVIM (Oncology) Chief Medical Officer, PetDX Dr. Flory is a specialist in medical oncology with nearly two decades of experience practicing and publishing in the areas of early cancer diagnosis, treatments, trials, and novel diagnostic test evaluation. A diplomate of the American College of Veterinary Internal Medicine in oncology, Dr. Flory graduated from the Ohio State University of College of Veterinary Medicine and completed additional training at Florida Veterinary Specialists and Cancer Treatment Center in Tampa, Florida, and Cornell University. In 2019, she treated a small dog named Poppy for pancreatic cancer. Poppy lost her battle with the disease, but left an indelible mark on Dr. Flory, leading her to a newfound passion for cancer genomics. Soon after, Dr. Grosu tapped Dr. Flory to launch PetDx and serve as its first chief medical officer. Prior to PetDx, most recently she co-directed the oncology internship and served as a medical oncologist at Veterinary Specialty Hospital in San Diego. Dr. Flory founded the medical oncology service at a sister hospital, Veterinary Specialty Hospital - North County. Prior to that she was a staff oncologist, resident advisor and co-chief of the oncology department at The Animal Medical Center in New York City. She has served as a principal investigator for national and international multi-site clinical investigational studies. Dr. Flory is constantly expanding her knowledge in cutting-edge areas of veterinary medicine. She holds a certificate in genomics from The Johns Hopkins University along with certificates in cancer genomics and precision oncology, and genetic testing and sequencing technologies from Harvard Medical School. In addition, Dr. Flory is a skilled lecturer. An avid snowboarder and passionate foodie, when not keeping up with two preschoolers, Dr. Flory loves to travel, spend time with her husband, sons, their cat Mochi, and dog Cheyenne.
Psychiatrists Discuss The State of Mental Health in the Black Community pt. 1 For season six, we are working to curate panels with expertise on specific topics. We are always trying to bring more, and we are truly delivering. Tune in the next two weeks to hear an incredible discussion about mental health in the Black Community. Drs. Danielle Hairston, Kevin Simon and Amanda Calhoun are each highly prolific, dynamic writers, speakers and educators within this space. We were very fortunate that they took the time to answer questions and share their experiences as Black Psychiatrists. We start with a conversation about the burden Black physicians carry in contrast with our colleagues. We talk about experiences with patients, co-workers and supervisors. We talk about burnout and how it is manifested and overcome by those in medical training, and those that have graduated and are practicing. The views discussed in this episode MUST be taken in context and do not reflect upon our employers. How do we deal with burnout? How does the experience of Black medical students and physicians differ from our counterparts? How can we help our underrepresented patients navigate a health system that was not built for us? This episode features: Dr. Danielle Hairston a double-board certified Psychiatrist and the youngest Black, female residency program director in the US. (Dr. Hairston was my resident when I was a medical student at Howard University College of Medicine). She is also a young APA Black Caucus President and Black Psychiatrist of America Scientific Program Committee Chair and has written extensively about bias in Psychiatry. She has consulted with companies like Google, and Youtube. Origins of Racism in American Medicine and Psychiatry Sociodemographic and clinical correlates of the frequently hospitalized African American patients with severe and persistent mental illness Dr. Kevin Simon the inaugural Chief Behavioral Health Officer for the City of Boston. He is a Harvard-trained Board Certified Psychiatrist. Dr. Simon serves as an Attending Psychiatrist at Boston Children's Hospital, an Instructor in Psychiatry at Harvard Medical School, a Commonwealth Fund Fellow in Health Policy at Harvard University, and the Medical Director of Wayside Youth & Family Support Network. Clinically, he practices as a Child, Adolescent, and Adult Psychiatrist and Addiction Medicine specialist caring for youth, young adults, and families through the Adolescent Substance Use & Addiction Program (ASAP). Daughters' Keeper — The Care and Treatment of Black Girls in America Adolescent Substance Use Disorders Dr. Amanda Calhoun an Adult/Child Psychiatry Resident . Dr. Calhoun is also the assistant editor of the Connecticut Psychiatric Society Newsletter and an Associate Editor of the American Journal of Psychiatry Residents' Journal. Dr. Calhoun seeks to expose and eradicate racism in the medical system using a direct and heartfelt approach. Dr. Calhoun's anti-racism work spans from writing anti-racism curriculum, standing up for her patients in real-time, public speaking, research, and writing. She believes that all doctors should be activists, and that social justice should be integrated with medical education. All Doctors Should Be Activists. Sincerely, a Psychiatry Intern The Face of Medicine Is Not My Face…But, It Should Be You asked and we delivered: The Black Doctors Podcast Swag is now available? Click HERE to order. **Interested in starting a podcast? Check out Riverside for your remote recording needs: RIVERSIDE.FM If you enjoyed this episode, please share with a friend and leave a comment and rating on iTunes. TBDP is a volunteer passion project with the goal of inspiring all who listen. In-house music and audio production, so any ideas for improvements or suggestions for future guests are welcome. Visit www.StevenBradleyMD.com to learn more about our host. He is available for consultations or speaking engagements regarding health equity and medical ethics. Leave a voice memo that we can include in a future episode: Pass The Mic