Podcasts about Immunosuppression

Beyond the Digest are bonus episodes to the DermSurgery Digest that include reviews of interesting and relevant articles from the Journal of the American Academy of Dermatology (JAAD), British Journal of Dermatology (BJD) and JAMA Dermatology.Articles featured in this episode include: “Part 1: Management of antithrombotic medications in dermatologic surgery.” JAAD + “Part 2: Management of intraoperative and perioperative bleeding.” JAAD“5-fluorouracil 5% cream for squamous cell carcinoma in situ: Factors impacting treatment response.” JAAD“Risk of Death Due to Melanoma and Other Causes in Patients With Thin Cutaneous Melanomas.” JAMA Dermatology “Improved disease-specific survival in lentigo maligna treated with Mohs surgery over wide local excision: a retrospective cohort analysis.” BJD, research letter + “Surviving by a margin: Mohs outperforms wide local excision for lentigo maligna.” BJD, commentary on the research letter“Thin and in situ melanomas of unfavorable prognosis: A retrospective observational analysis of local recurrence, metastasis, and death in early-stage disease.” JAAD“Merkel Cell Carcinoma and Immunosuppression, UV Radiation, and Merkel Cell Polyomavirus.” JAMA Dermatology“Reduction of masseter muscle prominence after treatment with onabotulinumtoxinA: Primary results from a randomized phase 2 study.” JAAD“Improvement of platysma prominence with onabotulinumtoxinA: Safety and efficacy results from a randomized, double-blinded, placebo-controlled phase 3 trial.” JAAD Beyond the Digest Contributors include Naomi Lawrence, MD, Dermatologic Surgery Digital Content Editor; Yesul Kim, MD, Beyond the Digest Co-host; Ami Greene, MD; Tara Jennings, MD; Payvand Kamrani, DO; Sydney Proffer, MD; Kathryn Shahwan, MD; and Yssra Soliman, MD. Your feedback is encouraged. Please contact communicationstaff@asds.net.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SVZ865. CME/MOC/AAPA/IPCE credit will be available until February 18, 2026.Improving Kidney Transplant Access and Equity With Innovative Immunosuppression Strategies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.

In this episode of "Ask the Expert," Dr. Eoin Flanagan joined Dr. GG deFiebre of SRNA. Dr. Flanagan explained how immunosuppressive medications impact the immune system and the efficacy of vaccines [00:02:45]. He discussed the primary concerns and risks of vaccinating individuals on these therapies, including avoiding live vaccines and the need for additional booster doses [00:04:52]. Dr. Flanagan also talked about the recommended vaccines for those with conditions like NMOSD or MOGAD, and underlined the importance of getting vaccinated to prevent severe infections [00:09:40]. He addressed common misconceptions and emphasized the role of healthcare providers in educating and supporting their patients regarding vaccinations [00:15:32].Eoin Flanagan, MB, BCh is a Professor of Neurology and Consultant in the departments of Neurology and Laboratory Medicine and Pathology at the Mayo Clinic (Rochester, MN). He completed his medical school training at University College Dublin in Ireland in 2005. He did a medical residency in Ireland and then completed neurology residency, fellowships in neuroimmunology and a masters in clinical and translational science at Mayo Clinic (Rochester, MN). He works in the Autoimmune Neurology and Multiple Sclerosis Clinics and the Neuroimmunology Laboratory at the Mayo Clinic. His clinical expertise and research are focused on inflammatory myelopathies and their imaging patterns, myelin oligodendrocyte glycoprotein (MOG) antibody associated disorder, neuromyelitis optica spectrum disorders, autoimmune encephalitis, paraneoplastic neurologic disorders, and multiple sclerosis. He is principal investigator on an NIH RO1 grant studying MOG antibody associated disorder.00:00 Introduction 00:47 Understanding Immunosuppressants and Vaccines01:28 Primary Concerns with Vaccinating Immunosuppressed Patients02:30 Recommended Vaccines for Immunosuppressed Patients07:11 Timing and Effectiveness of Vaccinations08:21 Measuring Vaccine Response09:24 Addressing Missed Doses and Safety Considerations16:41 Public Health Implications and Patient Advocacy17:56 Advice for Vaccine-Hesitant Patients19:06 Healthcare Providers' Role in Vaccination20:03 Conclusion and Final Thoughts

In this episode, we meet up with Josh Conklin, a seasoned bone marrow transplant (BMT) nurse at the University of Michigan Hospital, to explore his experiences, insights, and tips for managing chronic graft-versus-host disease (GVHD). With 11 years of inpatient experience, Josh offers a comprehensive view of the challenges and triumphs in caring for patients undergoing BMT.Josh explains that his primary role involves guiding patients through the most critical stages of their transplant journey, from chemotherapy conditioning to the stem cell infusion and the vulnerable recovery period afterward. He emphasizes the delicate balance required in managing GVHD, a condition that plays a dual role: while some GvHD is beneficial in suppressing cancer recurrence (graft-versus-leukemia effect), too much can lead to severe complications.Long-term immunosuppression is a cornerstone of GVHD management. Josh highlights the reliance on drugs like tacrolimus and, when necessary, steroids. However, we note the adverse effects of prolonged steroid use, such as muscle wasting, infections, and physical deconditioning. Emerging monoclonal antibody therapies are offering new hope, aiming to reduce these side effects.The discussion also sheds light on the psychological toll of repeated hospitalizations and the role caregivers play in patient success. Josh describes caregivers as essential for monitoring symptoms, administering medications, and providing emotional support. However, he acknowledges the significant strain caregiving can impose, especially during the critical first 100 days post-transplant when patients are highly vulnerable.Josh shares stories of resilience and purpose among his patients, underscoring the importance of a positive outlook and having something meaningful to strive for. He reflects on the impact of a strong support system, whether it's family, friends, or peer mentorship programs, in helping patients navigate their “new normal.” Despite the challenges, Josh finds inspiration in his patients' ability to find joy and purpose, even in difficult circumstances.  He shares his experience with one woman in particular.This heartfelt conversation highlights the physical, emotional, and relational dynamics of BMT care, offering a glimpse into the profound impact of dedicated healthcare professionals like Josh.More:GVHD Alliance: https://www.gvhdalliance.orgLink to LLS free Nutrition Consultations: https://www.lls.org/managing-your-cancer/food-and-nutritionThank you to our sponsors. This season is supported by a healthcare contribution from Sanofi  https://www.sanofi.com/ National Bone Marrow Transplant Link - (800) LINK-BMT, or (800) 546-5268.nbmtLINK Website: https://www.nbmtlink.org/nbmtLINK Facebook Page: https://www.facebook.com/nbmtLINKFollow the nbmtLINK on Instagram! https://www.instagram.com/nbmtlink/The nbmtLINK YouTube Page can be found by clicking here.To participate in the GVHD Mosaic, click here: https://amp.livemosaics.com/gvhd

This Real Science Exchange podcast episode was recorded during a webinar from Balchem's Real Science Lecture Series. You can find it at balchem.com/realscience.Feeding rumen-protected choline in early lactation has consistently increased milk yield and energy-corrected milk yield, which is more pronounced when cows are fed diets low in metabolizable methionine. Choline feeding also increases milk fat and protein yield, minimizes body condition loss in early lactation, and reduces postpartum disease incidence. Dr. McFadden presents three topics about choline biology in the dairy cow. (01:45)Why should we consider fatty acid feeding when feeding methyl donors like choline and methionine?Choline degradation in the rumen and small intestine, focusing on the role of triethylamine oxide Why should we consider lysophosphatidylcholine as an immunomodulator in fresh cows and preweaning calves?Fatty acid nutrition to optimize methyl donor efficiency. (4:02)Fatty liver is a concern for fresh cows because of its relationship with ketosis, poor fertility and compromised milk production. Cows with fatty liver exhibit low circulating concentrations of phosphatidylcholine, which is a component of very low-density lipoproteins (VLDL) that transport triglycerides out of the liver. Feeding rumen-protected choline lowers liver triglyceride deposition by supporting the synthesis of phosphatidylcholine and thus, VLDL. Dr. McFadden goes on to explain the two different pathways for phosphatidylcholine in the liver and how those interact with fatty acid metabolism. He describes several experiments that have investigated how rumen-protected choline and supplemental fatty acids interact in lactating cows. Low phosphatidylcholine supply is a key feature of fatty liver in dairy cows, likely due to low polyunsaturated fatty acid (PUFA) and low choline supplies. Delivery of post-ruminal PUFA may support phosphatidylcholine synthesis with accompanying improvements in insulin sensitivity, body condition maintenance, and inflammation, but interactions with dietary fatty acid digestibility should be considered. Dr. McFadden gives a list of considerations for fresh cow diets incorporating fat and choline supplementation. Gastrointestinal choline degradation and trimethylamine N-oxide (TMAO)  (16:58)Unprotected choline is almost totally degraded in the rumen. Microbes convert choline into trimethylamine (TMA) which is then converted to TMAO in the liver. Rumen-protected choline allows for a large proportion of choline to reach the small intestine intact. However, research shows that choline can also be degraded by microbes in the small intestine in the same pathway, limiting choline bioavailability. Plasma TMAO accumulation is associated with non-alcoholic fatty liver disease, inflammation, insulin resistance, obesity, oxidative stress, and cardiovascular disease in rodent and human models. Little research was available regarding if the relationship between TMAO and poor health was causative or just associative. Dr. McFadden's lab infused cows intravenously with TMAO and found that TMAO did not modify milk production or glucose tolerance in early lactation cows.  TMAO does not appear to influence energy metabolism or health in early lactation cows. Choline is subject to both ruminal and lower-gut degradation to TMA, and that influence on choline bioavailability needs to be defined. Data in non-ruminants suggests that unsaturated fatty acid feeding can shift the gut microbes to slow TMA formation. Lysophosphatidylcholine and immunomodulation (28:45)Dr. McFadden gives an overview of neutrophil activation and the oxidative burst that contributes to pathogen killing. The ability to elicit the oxidative burst is diminished in pre-weaned calves and transition cows. When cows were given endotoxin to cause an immune response, circulating lysophosphatidylcholine was decreased. In rodent models, lysophosphatidylcholine promotes the oxidative burst and suppresses long-term inflammation in response to bacterial infection. Dr. McFadden cultured neutrophils from pre-weaned calves with lysophosphatidylcholine and observed an enhanced oxidative burst.Immunosuppression is characterized by low circulating lysophosphatidylcholine concentrations in dairy cows. In  vitro data suggests lysophosphatidylcholine can activate neutrophils, and rumen-protected choline increases circulating lysophosphatidylcholine. Future research is likely to define an immunomodulatory role for choline. Dr. McFadden takes questions from the webinar audience. (38:07)Please subscribe and share with your industry friends to invite more people to join us at the Real Science Exchange virtual pub table.  If you want one of our Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll mail you a shirt.

On the second December episode of JHLT: The Podcast, the Digital Media Editors explore another paper from the December issue of JHLT, entitled “Long-term follow-up of the randomized, prospective Scandinavian heart transplant everolimus de novo study with early calcineurin inhibitors avoidance (SCHEDULE) trial.” First author Entela Bollano, MD, PhD, and senior author Niklas Bergh, MD, PhD, both from the Sahlgrenska University Hospital in Sweden, join the podcast to discuss their work. You'll hear about: Past outcomes of the SCHEDULE trial, including reduced CAV in patients on everolimus over patients on CNIs How this study filled the need for long-term follow up on randomized studies on immunosuppression Limitations of the study, and what additional follow up might teach us For the latest studies from JHLT, visit www.jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at www.ishlt.org/jhlt. Lung clinicians: if you haven't yet tuned in for the first episode from this month, check it out! The paper discusses the effects of pollution post lung transplantation. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.

References Nature 2024.volume 635, pages 1010–1018 Front. Immunol. 2024. Sec. Multiple Sclerosis and Neuroimmunology Volume 15. J Immunol 2017. 199 (3) 874-884. Hunter-Garcia.1970 "Cumberland Blues" on Workingman's Dead https://open.spotify.com/track/2op5szd2IY8bOPzumqmFY3?si=8e3061b4559a4a31 Mozart. WA. 1791. Clarinet Concerto in A K 622 https://open.spotify.com/album/5WZELp7jlJNdS2xgLRknwe?si=ROhHJdu2RWCIpqnL7KXFUg --- Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support

Dennis O. Clegg, Ph.D., discusses treatments for age-related macular degeneration (AMD), a condition that causes vision loss. Clegg explains that while patients often report improved vision after receiving implants, objective tests don't always confirm this. He explores the potential differences in patients' responses based on genetics and disease progression. There is also an ongoing challenge in finding the best ways to reduce immune rejection of these treatments. New trials are underway to test implants in earlier stages of the disease, and researchers are looking at different strategies like localized immunosuppression. Additionally, some studies suggest that secretions from retinal cells may help preserve vision. Overall, there are many open questions, but advances in the field offer hope for better AMD treatments. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39459]

Dennis O. Clegg, Ph.D., discusses treatments for age-related macular degeneration (AMD), a condition that causes vision loss. Clegg explains that while patients often report improved vision after receiving implants, objective tests don't always confirm this. He explores the potential differences in patients' responses based on genetics and disease progression. There is also an ongoing challenge in finding the best ways to reduce immune rejection of these treatments. New trials are underway to test implants in earlier stages of the disease, and researchers are looking at different strategies like localized immunosuppression. Additionally, some studies suggest that secretions from retinal cells may help preserve vision. Overall, there are many open questions, but advances in the field offer hope for better AMD treatments. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39459]

Dennis O. Clegg, Ph.D., discusses treatments for age-related macular degeneration (AMD), a condition that causes vision loss. Clegg explains that while patients often report improved vision after receiving implants, objective tests don't always confirm this. He explores the potential differences in patients' responses based on genetics and disease progression. There is also an ongoing challenge in finding the best ways to reduce immune rejection of these treatments. New trials are underway to test implants in earlier stages of the disease, and researchers are looking at different strategies like localized immunosuppression. Additionally, some studies suggest that secretions from retinal cells may help preserve vision. Overall, there are many open questions, but advances in the field offer hope for better AMD treatments. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39459]

Dennis O. Clegg, Ph.D., discusses treatments for age-related macular degeneration (AMD), a condition that causes vision loss. Clegg explains that while patients often report improved vision after receiving implants, objective tests don't always confirm this. He explores the potential differences in patients' responses based on genetics and disease progression. There is also an ongoing challenge in finding the best ways to reduce immune rejection of these treatments. New trials are underway to test implants in earlier stages of the disease, and researchers are looking at different strategies like localized immunosuppression. Additionally, some studies suggest that secretions from retinal cells may help preserve vision. Overall, there are many open questions, but advances in the field offer hope for better AMD treatments. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39459]

Dennis O. Clegg, Ph.D., discusses treatments for age-related macular degeneration (AMD), a condition that causes vision loss. Clegg explains that while patients often report improved vision after receiving implants, objective tests don't always confirm this. He explores the potential differences in patients' responses based on genetics and disease progression. There is also an ongoing challenge in finding the best ways to reduce immune rejection of these treatments. New trials are underway to test implants in earlier stages of the disease, and researchers are looking at different strategies like localized immunosuppression. Additionally, some studies suggest that secretions from retinal cells may help preserve vision. Overall, there are many open questions, but advances in the field offer hope for better AMD treatments. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39459]

Dennis O. Clegg, Ph.D., discusses treatments for age-related macular degeneration (AMD), a condition that causes vision loss. Clegg explains that while patients often report improved vision after receiving implants, objective tests don't always confirm this. He explores the potential differences in patients' responses based on genetics and disease progression. There is also an ongoing challenge in finding the best ways to reduce immune rejection of these treatments. New trials are underway to test implants in earlier stages of the disease, and researchers are looking at different strategies like localized immunosuppression. Additionally, some studies suggest that secretions from retinal cells may help preserve vision. Overall, there are many open questions, but advances in the field offer hope for better AMD treatments. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39459]

Dennis O. Clegg, Ph.D., discusses treatments for age-related macular degeneration (AMD), a condition that causes vision loss. Clegg explains that while patients often report improved vision after receiving implants, objective tests don't always confirm this. He explores the potential differences in patients' responses based on genetics and disease progression. There is also an ongoing challenge in finding the best ways to reduce immune rejection of these treatments. New trials are underway to test implants in earlier stages of the disease, and researchers are looking at different strategies like localized immunosuppression. Additionally, some studies suggest that secretions from retinal cells may help preserve vision. Overall, there are many open questions, but advances in the field offer hope for better AMD treatments. Series: "Stem Cell Channel" [Health and Medicine] [Science] [Show ID: 39459]

In this episode, we talk with Rachael Sommer, a dedicated mother and caregiver from Cleveland, Ohio. Rachael shares the journey of her daughter Maddie, who was diagnosed with Hepatosplenic T-cell Lymphoma in October 2023, after several months of mysterious symptoms. Treated at Nationwide Children's Hospital in Columbus, Maddie's condition has profoundly impacted their lives.Rachael recounts their initial stay at the Ronald McDonald House post-diagnosis, highlighting the physical and emotional changes Maddie experienced. Maddie's extreme fatigue and breathlessness were particularly challenging, and Rachael emphasizes the importance of adjusting to a "new normal" while staying in constant communication with doctors. Rachael found solace in the Ronald McDonald House's facilities, specifically the fitness room, which helped her manage her own stress.The conversation shifts to the emotional toll on Maddie, who struggled with isolation from friends and the mental burden of not being able to participate in normal activities. Despite the support of friends and thoughtful gestures like sending cards, nothing could replace the physical presence of her peers. Rachael's creativity shone through when she set up a Google camera to allow Maddie to see her cats, Binks and Leon, while they were away.Rachael discusses the importance of recognizing and respecting individual emotional needs. Maddie's withdrawal from activities she once enjoyed, like listening to music, was particularly hard for Rachael, who feared losing her daughter's spirited personality. Eventually, Maddie slowly began to regain her sarcasm and interactions with her younger brother, Ezekiel, signaling a return to her usual self.The financial strain of Maddie's illness is another significant aspect of their journey. Rachael praises the support from various organizations, including Carrie's Cause, Fight Like A Dozer, and the Leukemia & Lymphoma Society, which provided crucial financial aid. This support allowed Rachael to focus on Maddie's care without the added burden of financial stress.Rachael also shares her career transition to consulting, driven by the need for greater flexibility to support her family. Her faith in God has been a cornerstone throughout this journey, providing spiritual strength and community support.Finally, Rachael reflects on the importance of savoring small moments of joy amidst the challenges. She encourages other caregivers to focus on what truly matters, finding moments of normalcy and joy, and maintaining hope and strength for their loved ones.Resources:Nationwide Children's Hospital, Columbus, Ohio: https://www.nationwidechildrens.org/Fight Like a Dozer: https://www.fightlikeadozer.org/Leukemia & Lymphoma Society (LLS): https://lls.org/NMDP (formerly Be The Match): https://bethematch.org/The Bible Recap: https://www.thebiblerecap.com/National Bone Marrow Transplant Link - (800) LINK-BMT, or (800) 546-5268.nbmtLINK Website: https://www.nbmtlink.org/nbmtLINK Facebook Page:  https://www.facebook.com/nbmtLINKnbmtLINK YouTube Page can be found by clicking here.Thank you to our sponsors. This season is supported by a healthcare contribution from Sanofi  https://www.sanofi.com/ Follow the nbmtLINK on Instagram! https://www.instagram.com/nbmtlink/

Breast implants are said to be a transformative solution for individuals seeking aesthetic enhancement or breast reconstruction. However, beneath their promise of confidence and beauty lie potential risks that are often overlooked. Breast Implant Illness (BII) underscores the importance of thorough patient education and informed consent, highlighting the complexities and implications associated with implants. That is why there is a need for us to raise more awareness about the realities of breast implant surgery, ensuring that patients are fully informed about the risks and potential consequences. I'm thrilled to introduce our guest for today's episode – Dr. Thomas Chung. We share a similar background in terms of experience and training, which initially intrigued me since he has a clear and insightful understanding of breast implant illness, and we'll delve into that throughout this episode. Plastic surgery career, including microsurgery and breast reconstruction What struck me about Dr. Chung is his extensive experience in microsurgery, a field in which we've both worked. Dr. Chung's journey began with his training in the Navy, where he completed his internship and general surgery residency at Walter Reed, then part of the National Naval Medical Center consortium in DC. During his residency, he managed numerous casualties from conflicts like Fallujah, serving as chief of the trauma service with a daily census of 30 to 40 injured veterans. After finishing his general surgery training, he pursued a fellowship at Johns Hopkins, launching his plastic surgery career before returning to Walter Reed to handle more trauma cases. His work involved extensive microsurgery, such as reconstructing an entire abdominal wall for a survivor of a suicide bombing and performing numerous extremity-free flaps and breast reconstructions using deep inferior epigastric perforator (DIEP) flaps. Over the first seven to eight years, Dr. Chung climbed the Navy's ranks, taking on leadership roles like Chief of Surgery, Chair of the Medical Executive Committee, and ultimately Chief Medical Officer for the San Diego region. Dr. Chung remains passionate about plastic and aesthetic surgery despite his executive responsibilities. Notably, he performs many explant surgeries for patients experiencing issues after long-term breast implant use. Immunosuppression in organ transplants and chronic inflammation In my previous episodes, I've extensively discussed breast implant illness and Dr. Chung agrees that implants may cause more than just localized pain or discomfort. He believes there's something inherently toxic about implants that science can explain and this understanding aligns with groundbreaking surgical advancements by the Nobel Prize winner, Dr. Joseph Murray. Dr. Murray's work on organ transplants demonstrates the need for immunosuppression to prevent rejection. In transplants, immunosuppression is crucial to avoid rejection, but this concept can also apply to implants. Patients often react negatively to treatments like steroids or methotrexate, fearing the medications rather than understanding their role in managing symptoms. We see chronic inflammation in patients with implants, similar to organ rejection. In both scenarios, if the initial post-surgery period goes well, complications are less likely. However, issues during this time can lead to significant problems. For cancer patients undergoing reconstruction, immunosuppression can exacerbate complications, demonstrating the delicate balance required to manage immune responses. Transplant rejection and the use of splint analogy to explain the concept Using analogies from organ transplants helps patients understand that their bodies might be "rejecting" implants, causing chronic inflammation. This perspective can help them grasp the need for proper management and treatment strategies, even if those include higher doses of immunosuppressants like prednisone to manage their symptoms effectively. When it comes to resolving issues with breast implants, focusing on the concept of explants and the importance of addressing capsules surrounding the implants is vital. We use the splinter analogy to explain the body's reaction to foreign objects. Just as a splinter in your finger causes pain and inflammation until it's removed, so does the body react to implants, leading to discomfort and potential toxicity. Removing the splinter provides immediate relief, compared to the relief patients might experience after explant surgery. Dr. Chung appreciates the simplicity of this analogy, which helps patients understand the body's rejection response. He relates it to his experience on transplant rotations, where managing immune responses to transplanted organs was crucial. He emphasizes the importance of detailed procedures in removing implants, akin to meticulous methods used in cancer surgeries to reduce recurrence risks. Breast implant illness, implant removal, and fat transfers as an alternative Both Dr. Chung and I have extensive experience dealing with complications from implants, whether in cancer patients or veterans needing reconstructive surgery. We emphasize that implants can be a necessary part of treatment but also come with risks that must be clearly communicated to patients. Dr. Chung admitted that he initially didn't know much about implant-related issues despite performing many breast augmentations. He often dealt with patients who had capsular contracture, a condition where the scar tissue around the implant tightens and causes pain or deformity. In these cases, he would remove the implant and the capsule and then insert a new implant, only for the problem to eventually recur. I would like to highlight fat transfers as a viable alternative to implants. Fat transfers can help refine and improve reconstructive results by adding volume, achieving a natural look without the risks associated with implants. Dr. Chung supports this approach, noting that while fat transfers don't create the same pressure as implants, they offer a safe and effective option for many patients. Fat transfer vs implant for breast augmentation, with pros and cons for each method Implants provide more projection and pressure, pushing out the skin envelope, especially beneficial for patients with tighter skin or certain deformities like tuberous breasts. Fat transfers, on the other hand, follow the natural curvature of the breast, adding volume and creating a natural look without the risks associated with implants. Fat transfers are particularly effective for patients who have more lax skin, often due to previous pregnancies, breastfeeding, or prior implants, which act like tissue expanders. While fat transfers don't provide the same upper pole fullness or projection as implants, they can achieve a satisfactory result by filling out the skin and providing a natural appearance. The success rate of fat transfers is generally high, especially in younger patients with adequate fat, countering any misconceptions that they don't work well. This method is also frequently used in oncologic reconstruction to refine and improve outcomes. The success of fat transfers is influenced by various factors, each playing a significant role in determining the outcome of the procedure. One crucial factor is the age of the patient. Younger individuals, typically those in their 20s, often experience better outcomes from fat transfers. This is attributed to their more favorable hormone levels and metabolism, which contribute to enhanced tissue regeneration and integration of the transferred fat. Additionally, younger patients tend to have healthier skin with better elasticity, allowing for more seamless integration of the injected fat and resulting in a more natural appearance. Conversely, older patients, particularly those over the age of 35, may encounter challenges that can affect the success of fat transfers. Hormonal imbalances, a common occurrence with age, can impact the body's ability to heal and regenerate tissue effectively. Metabolic issues, such as slower metabolism or insulin resistance, can also hinder the body's ability to process and integrate the transferred fat. Furthermore, poor diet and nutritional deficiencies prevalent in some older individuals can compromise tissue health and overall healing capacity, leading to suboptimal outcomes from fat transfer procedures. On the technical aspects of fat transfer, there is about 20-30% of the injected fat that typically gets absorbed by the body. This process is influenced by the patient's skin condition, with factors like previous pregnancies, weight changes, and age affecting skin expansion and the overall success of the procedure. It's essential for patients and surgeons to recognize these factors and consider them when planning and performing fat transfer procedures. Tailoring the approach to address specific challenges associated with age can help optimize outcomes and ensure patient satisfaction. Moreover, implementing comprehensive preoperative assessments and postoperative care regimens that address hormonal balance, metabolic health, and nutritional status can further enhance the success of fat transfer procedures in older patients. We want to emphasize that the technical process of fat transfer—harvesting, processing, and reinjecting fat—is not the issue. Instead, the patient's overall health and wellness play a critical role in the success and maintenance of the results. That's why I developed a comprehensive program that addresses genetics, detoxification, toxicity issues, gut health, food sensitivities, and hormone balance to optimize recovery and maintain results. Visit our website at https://drrobssolutions.com/ to explore our range of solutions, including high-grade supplements, medical-grade skincare, lab testing, and expert advice. Whether you're recovering from surgery or seeking to enhance your overall wellness, Dr. Rob's Solutions provides the resources and support you need to achieve your goals. Don't let uncertainty hold you back. Trust the experts at Dr. Rob's Solutions to guide you on your journey to healing and wellness. Links and Resurces Dr. Robert Whitfield's Website (https://drrobssolutions.com/) Follow Dr. Rob on Instagram https://www.instagram.com/drrobertwhitfield/ For more information on Virtual and In Person Consultations, we always answer our messenger personally: https://www.drrobertwhitfield.com/contact/ Try the Echo Hydrogen Water Bottle (https://echowater.com/?oid=21&affid=720) Code is DRROB10. About Dr. Rob Dr. Robert Whitfield (https://www.drrobertwhitfield.com/dr-whitfield-2/) In 2012, Dr. Whitfield came to Austin and became renowned for his breast surgery expertise. He set up his own practice in 2017. Here, he offers the men and women of Austin a full range of cosmetic procedures, both surgical and non-surgical, addressing the full array of breast, body and face. Born and bred in Las Vegas, Austin plastic surgeon Dr. Whitfield received his medical degree from the University of Las Vegas School of Medicine. This was followed by six years of surgical training, as well as his plastic surgery residency at Indiana University Medical Center. He returned to Nevada for a one year microsurgery fellowship before settling down to practice and teach at the Medical College of Wisconsin for seven years. Board-certified by the American Board of Plastic Surgery, Dr. Whitfield's approach to medicine has really been shaped by both his upbringing and his education. As a child of the “wild west,” he was born with an adventurous spirit. One of the reasons that he was drawn to plastic surgery is the constant innovation. In the field of plastic surgery, with innovative techniques and technologies developed each year, there are simply issues for which a solution has yet to be invented. Dr. Whitfield tempers his intrepid attitude with Midwestern pragmatism. It makes for a pretty winning combination.

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.

During pharmacy school, we had one lecture on solid organ transplantation. With this podcast, we hope to provide tips and tricks to help non-transplant pharmacists decide the best course of action when they come across a solid organ transplant recipient. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Join us on this episode of the Flex Diet Podcast for a riveting conversation with Dr. Dwayne Jackson as we explore the world of neuro-protection and the critical role nutrition plays in it. We dig into the potentially harmful effects of inflammation and how it can lead to chronic traumatic encephalopathy (CTE). We also highlight the importance of entering sports activities in the least inflammatory state possible and how a balanced diet and supplements can assist.If you enjoyed this podcast, you can get more from me at MikeTNelson.com/podcast. You can see all the other podcasts and guest episodes I've done. Then if you scroll down, you can subscribe to my Fitness Insider Newsletter.Episode Chapters:(0:00:01) - Neuro-Protection and Nutrition(0:07:57) - Colorful Diet(0:13:01) - Exploring Variety in Food and Supplements(0:24:38) - CBD's Impact on Immunosuppression and Neurology(0:29:43) - Microdosing Mushrooms and Lyon's Main(0:39:13) - BHB, Ketone Supplements for Concussions(0:51:40) - Podcast Disclaimer for Health AdviceConnect with Dr. Dwayne Jackson:InstagramWebsitePrevious Podcast:Flex Diet Podcast Episode 202: Cold water immersion and the body's regulation systems: An interview with Dr. Dwayne Jackson

Laura Beaton talks to Professor Gayle Ross, a Dermatologist at Royal Melbourne Hospital, about treating atopic dermatitis, otherwise known as eczema. If you're itching for more information on the latest treatment options, this conversation will scratch that itch! Read the full article in Australian Prescriber.

Drs. Daniel Cattran and Sean Barbour summarize the main results of their study, "Anti-PLA2R Antibody Levels and Clinical Risk Factors for Treatment Nonresponse in Membranous Nephropathy," on behalf of their colleagues.

Dr. Anna Wolska from the Lupus Foundation of America interviews Drs. Ana Malvar and Brad Rovin. They discuss using repeat tissue biopsies to understand progression of lupus nephritis over time. They offer conjecture that both immunosuppression as well as mitigation of tissue fibrosis, resulting from inflammatory resolution, are needed in order to preserve kidney function and prevent progression to kidney failure.   Read the related article - http://dx.doi.org/10.1136/lupus-2023-000932

References Luigi Boccherini: Symphony Op. 12 No. 4 in D Minor JCI Insight. 2016 Nov 17; 1(19): e87748 Front Immunol. 2023; 14: 1149366 Adv Biol Regul.2019 Jan;71:41-54. Int. J. Mol. Sci. 2019, 20(6), 1505 --- Send in a voice message: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/message Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support

On this podcast episode, I cover etanercept pharmacology, adverse effects, drug interactions and much more. Etanercept is classified as a DMARD but is different from older DMARDs in that it is a biologic agent and needs to be injected. Vaccination assessment in patients is important prior to initiating etanercept due to the fact that the medication may blunt the effectiveness of the vaccines. Immunosuppression from etanercept can lead to an increased risk for infection and malignancy.

In this special issue of JHLT: The Podcast, the JHLT Digital Media Editors explore just one study—and devote the second half of the episode as a tribute to recently retired Editor-in-Chief, Dr. Daniel R. Goldstein. Digital Media Editor Van-Khue Ton, MD, heart failure and transplant cardiologist at Massachusetts General Hospital, hosts this episode.   First, hear from senior author William F. Parker, MD, MS, PhD, on his team's study “Association of high-priority exceptions with waitlist mortality among heart transplant candidates.” Dr. Parker is a pulmonary and critical care physician, health services researcher, and clinical medical ethicist, and he runs a R01 funded lab focusing on the allocation of scarce healthcare resources.   In the study, Dr. Parker and colleagues set out to examine the Scientific Registry of Transplant Recipients (SRTR) to compare medical urgency of heart transplant patients listed with exception vs. those listed according to standard guidelines. The study's main finding: after controlling for status as a time-varying covariate, candidates with an exception had a 45% lower hazard of waitlist mortality compared with standard criteria candidates. The Digital Media Editors want to know all the details and talk with Dr. Parker about the wait-list mortality and post-transplant survival of status 1, 2, 3, and 4 candidates, plus what next steps could be in ensuring a fair allocation system.   The episode's special tribute to Dr. Daniel R. Goldstein features Michelle Kittleson, MD, PhD, Interim Editor-in-Chief of JHLT; Andrew Gelman, PhD, Deputy Editor at JHLT; Andrew Fisher, FRCP, PhD, past president of ISHLT and Chair of the Publications Oversight Committee; Daniel Tyrrell, PhD, a former post-doc of Dr. Goldstein's; and Judy Chen, PhD, a former immunology PhD student in Dr. Goldstein's lab.   These heartfelt tributes to Dr. Goldstein are worth a listen—and we thank Dr. Goldstein for his vision and leadership at the Journal.   Follow along at www.jhltonline.org/current, or, if you're an ISHLT member, log in at ishlt.org/journal-of-heart-lung-transplantation.  Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.    

Dr. Amy Ross Russell (1) is joined by the authors of the paper “First-line immunosuppression in neuromuscular diseases”, Dr Michael Foster, Prof Michael Lunn, Dr Aisling Carr (2). Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/23/4/327) and the August print issue of the journal. The paper is also discussed by the Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://pnbmj.podbean.com/e/editors-highlights-of-the-august-2023-issue/ (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, London, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

The JHLT Digital Media Editors explore two manuscripts from the August issue of The Journal of Heart and Lung Transplantation—the first on immunosuppression in pediatric heart transplantation, and the second TA-NRP in DCD lung transplantation. Digital Media Editor Van-Khue Ton, MD, heart failure and transplant cardiologist at Massachusetts General Hospital, hosts this episode.   First, hear from senior author Steven C. Greenway, MSc, MD, on his team's study “Single-drug immunosuppression is associated with noninferior medium-term survival in pediatric heart transplant recipients.” Dr. Greenway shares his journey from enzyme biochemistry in mollusks, snails, and frogs to pediatric cardiology, then outlines the results of the paper.   The study queried the Pediatric Heart Transplant Society's registry to determine the efficacy and safety of monotherapy immunosuppression. The results showed better graft survival and less coronary allograft vasculopathy in the monotherapy group, even after adjusted for age at transplant, sex, neonatal transplant, infection, PTLD, and etiology of cardiomyopathy. Dr. Greenway and the digital media editors discuss the burning questions that obviously arise from the study's findings, the limitations of the paper, and what follow-up studies might start generating the answers that might eventually change clinical practice.   Next, the editors welcome first author Jad Malas, MD, to discuss the paper “The impact of thoracoabdominal normothermic regional perfusion on early outcomes in donation after circulatory death lung transplantation.” This study utilized the United Network of Organ Sharing (UNOS) database to identify DCD donors whose heart was procured in order to evaluate lung utilization rates and early post-lung transplant outcomes. Lung utilization was similar between the groups—14.9% for the NRP group and 13.8% for direct procurement. Post-lung transplant rates of ECMO and mechanical ventilation at 72 hours were not statistically different, and 6-month survival was equivalent.   Dr. Malas and the Digital Media Editors discuss the study's findings and implications, including exploring the background of NRP's relationship to lung allografts, differences in assessment or procurement techniques, and what might be needed to further evaluate this procurement technique for lung allografts.   Follow along at www.jhltonline.org/current, or, if you're an ISHLT member, log in at ishlt.org/journal-of-heart-lung-transplantation.  Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.   This episode of JHLT: The Podcast, but not the studies within, is sponsored by Natera.

Guests: Omid McDonald, Vodkow; Andres Ortega & Dr. Mike Van Amburgh, Cornell University; Matheus Santos & Dr. Eduardo Ribeiro, University of Guelph; Dr. Faith Reyes, University of Wisconsin-Madison; Mariana Marinho and Dr. José Santos, University of Florida; and Dr. Alex Tebbe, Purina MillsToday's episode was filmed at the American Dairy Science Association Annual Meeting in Ottawa, Ontario, Canada. Joining us are researchers with abstracts of interest chosen by the Balchem technical team.The first guest is Omid McDonald, founder of Vodcow, the chosen drink at tonight's pubcast. Vodcow is made with a dairy byproduct called milk permeate. The sugar is fermented and turned into alcohol, with which they make vodka and blend it with Canadian Cream. (4:11) Our second guest is Andres Ortega and Dr. Mike Van Amburgh from Cornell University. In Andres's research, to represent mp, they tried to show metabolizing all proteins and break that down into the individual essential and nonessential amino acids. They created two diets; one that met all of the MP requirements and one that didn't. Based on the difference of MP there, they knew how much they would infuse. (12:07) Andre's presentation is titled:  Abomasal infusion of essential and non-essential amino acids to evaluate energy and amino acid utilization, productive efficiencies, and metabolism in lactating dairy cattle. Next in our lineup are Matheus Santos and Dr. Eduardo Ribeiro from the University of Guelph. Matheus' research found that lower feed intake and greater body weight had a less positive energy balance. A negative energy balance can lead to high immunosuppression and development of clinical disease. (24:14) Matheus' poster is titled: Prepartum feed intake level is associated with transition metabolism and subsequent milk production in dairy cows. Our third guest is Dr. Faith Reyes from the University of Wisconsin. Dr. Faith said that in dairies, we would like to see decreased competition. Previous literature has shown a linear relationship when you increase the stocking density leads to increased competition. In her research, Dr. Faith found that there was the most competition at a two-to-one stocking density. (35:02) Faith's research is titled: Individual feeding consistency across stocking densities and feed efficiency in lactating cows. Joining us now is Mariana Marinho and Dr. Jose Santos from the University of Florida. Mariana mentioned that more efficient cows have improved rumination per kilogram of intake. More efficient cows also have lower pH and more concentration of ammonia nitrogen. With the findings from her research, Mariana suggests that the site of digestion plays a more important role in differentiating more efficient versus less efficient cows. (52:45) Mariana's presentation is titled: Associations between residual feed intake(RFI) and digestibility or hepatic mitochondrial respiration in Holstein cows. Be sure to subscribe so you don't miss the additional highlights from the 2023 ADSA Annual Meeting in future podcast episodes. Lastly, we are joined by Alex Tebbe from Purina Mills. Alex is focused on transition cows, both the dry period and fresh period and how they are so influential to the cow's long-term performance. Alex said that we could hone in on the nutrition of dry cows and fresh cows to produce a lot of milk in the future. (59:52)Alex's presentation is titled: Dairy nutrition to improve feed utilization - Recognizing the contributions of ADSA Fellow Dr. Bill Weiss beyond prevention of metabolic diseases: Feeding transition dairy cows for optimal performance. If you want one of our new Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll get a shirt in the mail to you.

In this episode we'll discuss common skin conditions in those who are immunosuppressed. In particular, we'll explore skin malignancies in the immunosuppressed, common immunosuppressant medications and their relative immunosuppressant activity, in addition to other fungal, bacterial and benign skin conditions that may be encountered.  Our panel of experts for this episode includes consultant dermatologists A/Prof Alvin Chong and Dr Sarah Brennand.See omnystudio.com/listener for privacy information.

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: FDA approval for a pancreatic islet cell therapy to treat type 1, stem cell research moves ahead, big news from the ADA Scientific Sessions about what's next for medications like Mounjaro and a pill form of semaglutide. Dexcom announces a sensor for people with type 2 who don't use insulin, Libre moves ahead with Ketone monitoring and more.   Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines happening now XX In the news is brought to you by the T1D Exchange a nonprofit organization dedicated to improving outcomes for the entire T1D population. XX Big week of news following the 2023 ADA Scientific Sessions conference. What follows is just the tip of the information iceberg, so please follow the links in the show notes to much more. -- XX Top story though isn't from ADA – but a new FDA approval.. for a pancreatic islet cell therapy to treat type 1. It's called donislecel, developed from cadaver donors and giving as a single infusion straight into the liver. Immunosuppression is required to maintain cell viability, just as it is required to support a transplanted kidney or other organ. Approval was based on what seems to be a very small study – 30 people with type 1 who had hypoglycemic unawareness and who received between one and three infusions of donislecel. After one year, 11 people did not need to dose insulin.. 10 stayed that way for more than five years. But five people in the study were not able to stop dosing insulin at all. This method is different from what Vertex and Sernova are trying to do with stem cell therapy. https://www.medscape.com/viewarticle/993854 XX Vertex moves forward on their clinical trial of islet stem cell therapy. All six patients treated with VX-880 had undetectable fasting C-peptide (endogenous insulin secretion) at baseline, a history of recurrent SHEs in the year prior to treatment and required an average of 34.0 units of insulin per day. Following treatment, all six patients demonstrated endogenous insulin secretion, improved glycemic control as measured by HbA1c, improved time-in-range on continuous glucose monitoring, and reduction or elimination of exogenous insulin use. Two patient are completely insulin independent after one year – with an A1C of 5.3 compard to 8.6 at baseline.. the other 6.0 with a 7.6 at baseline – again the ”after” number is without taking insulin. As a result of these safety and efficacy data in Parts A and B, the independent data review committee has recommended moving to Part C of the trial, which allows for concurrent dosing of patients at the full target dose of VX-880. https://www.businesswire.com/news/home/20230623446641/en/Vertex-Presents-Positive-VX-880-Results-From-Ongoing-Phase-12-Study-in-Type-1-Diabetes-at-the-American-Diabetes-Association-83rd-Scientific-Sessions XX Sernova also reports good results with their cell pouch system. Five of the six patients who have completed implantation continue to experience insulin independence for periods ranging from six months to more than three years. The sixth patient only recently completed the protocol-defined islet transplants.. so no results yet. There is a second group testing a larger cell pouch. https://www.drugdeliverybusiness.com/sernova-interim-data-cell-pouch-system/ XX Big news from ADA about all of the type 2 and obesity drugs you've likely heard about.. here are some headlines: SURMOUNT-2 clinical trial evaluating tirzepatide – brand name Mounjaro - for weight loss in adults with obesity or overweight and type 2 diabetes. Average weight loss was 15.7% at the highest dose, with many other health benefits such as lower A1C levels; reduction in waist circumference, and body mass index; and improvements in cardiometabolic disease risk factors such as lipid levels, cholesterol, and blood pressure. That 15 percent weight loss was about 34 pounds and the a1c reduction for half of those in the study went down to 5.7 which is considered nondiabetic. Mounjaro is currently approved for type 2 and the FDA could approve Mounjaro regardless of diabetes status later this year. https://diatribe.org/new-lilly-trial-results-show-big-weight-loss-results-positioning-mounjaro-obesity-drug-approval XX A study called PIONEER looks at oral semaglutides – some calling it the Ozempic pill. When compared to other anti-diabetic medications such as Jardiance, Januvia and Victoza, people taking the oral semaglutide say 1% or or more reduction of HbA1c compared to those treated with other anti-diabetic medicines. They also were more like to achieve a 5% or more reduction of body weight. Note: this was not a study comparing a semaglutide pill with the same type of injection. https://www.news-medical.net/news/20230607/Oral-semaglutide-outperforms-other-medications-in-type-2-diabetes-treatment-significantly-reducing-HbA1c-and-body-weight.aspx XX And look for two additional new drugs to treat obesity in the next few years.. orforglipron, is easier to use and to produce, and it will probably be cheaper than existing treatments. The second, retatrutide, has an unprecedented level of efficacy, and could raise the bar for pharmacological obesity treatment. Orforglipron and retatrutide both mimic hormones produced by the lining of the gut in response to certain nutrients. These hormones help to slow the passage of food through the digestive tract and lower appetite by acting on receptors in the brain — both effects that reduce people's desire to eat and help them to lose weight. Orfoglipron is a non-peptide molecule that researchers say is easy to produce and is a pill.. a lower price is anticipated for this one. Retratritude looks like it could help people lose even more weight than Mounjaro. https://www.nature.com/articles/d41586-023-02092-9 XX Dexcom announces a new product in the US – coming in 2024 – designed for people with type 2 who don't use insulin. This will be built on the G7 hardware, but with different software and a 15 day sensor. CEO Kevin Sayer also announced that the G7 will be able to share data direct to the apple watch https://www.businesswire.com/news/home/20230623025076/en/Global-Continuous-Glucose-Monitoring-Pioneer-Dexcom-Reveals-New-Plans-to-Bring-Sensing-Technology-to-Millions-More XX Abbott will partner with Weight Watchers - people who have been prescribed one of Abbott's FreeStyle Libre 14-Day or FreeStyle Libre 2 sensors and who are using the WeightWatchers diet plan to see their CGM data directly in the WeightWatchers app. This is also a study where Abbott will launch two pilot programs directed at using CGM data to help people with Type 2 diabetes adjust and manage their dietary habits, regardless of whether they're on insulin therapy. XX A little bit more news about Abbott's dual glucose and ketone sensor under development. Announced a last year's ADA, the company says it's moving forward through R&D Separately from the Type 2 CGM push, Taub also offered an update on the dual glucose ketone sensor that's currently under development at Abbott and that the company first announced at last year's ADA conference. The sensor will be aimed at catching rising ketone levels as early as possible to help avoid cases of diabetic ketoacidosis. An Abbot executive says – quote - “There's so much that we stand to learn about ketones because there hasn't been a continuous sensor for them before, so there's really very little we know about the evolution of ketones “ https://www.fiercebiotech.com/medtech/ada-abbott-pushes-widespread-cgm-use-type-2-diabetes-weightwatchers-ada-collabs XX Commercial XX Beta Bionics has received FDA 510(k) clearance for the compatibility of the Fiasp Pumpcart prefilled insulin cartridge with the iLet automated insulin-delivery system. The iLet is a bionic pancreas that fully automates 100% of all user insulin doses, providing users with the choice of three insulins, Novolog; Humalog; and Fiasp Pumpcart. The device eases diabetes management in everyday life and almost eliminates the expertise that has been required in the past to set up and manage a traditional insulin pump. In May 2023, Beta Bionics was awarded FDA approval for the iLet device. The iLet manages glucose levels with just a meal announcement and is paired with a Dexcom G6 Continuous Glucose Monitoring System for glucose readings. All that is required for set-up is the user's weight. While there is a need for carbohydrate awareness, no carb counting is necessary. Bolusing, correction factors, insulin-to-carb ratios, and pre-set basal rates are also unnecessary. Beta Bionics president and CEO Sean Saint said: “Beta Bionics has been working tirelessly to create an insulin delivery system that offers less burden and more convenience for the type 1 community. Since launching last month, the iLet bionic pancreas is now available and clinics and users are being trained on its simple design and easy management features. “When Fiasp Pumpcart prefilled cartridges are available, users will save time not having to manually fill cartridges and will have more choice for their diabetes management.” https://www.medicaldevice-network.com/news/beta-bionics-gains-fda-clearance-for-prefilled-insulin-cartridge/ XX Oura – the ring that tracks your sleep – will start sending info to three CGM info companies.. January, Supersapiens and Veri. All three of these companies provide software based off of the Libre CGM. These companies will now be receiving sleep scores and other biometric data from Oura so they can see how these measurements affect users' glucose levels and overall health. https://www.forbes.com/sites/andrewwilliams/2023/06/27/oura-smart-ring-can-be-used-to-help-monitor-blood-sugar/?sh=2520116c2b10 XX Just a fun fact here – there is a Facebook group called type 1 diabetics for 50 plus years. And it looks like this week they passed over 1500 members. XX On the podcast next week.. I sat down with Dexcom's new Chief Commercial officer to talk about their announcements from this week about the type 2 market and other features important to people with type 1. Our last epoisde is all about Kickass Healthy LADA That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Episode 143: Pulmonary Cocci BasicsDr. Lovedip Kooner explains the history, diagnosis, and treatment of pulmonary coccidioidomycosis (cocci for short.) Disseminated cocci infection was also discussed. Dr. Arreaza added some anecdotes of patients seen with this infection.  Written by Lovedip Kooner, MD. Comments by Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Definition:Coccidioidomycosis, also known as Valley Fever, is an infection caused by the fungi Coccidioides immitis and Coccidioides posadasii. Coccidioides is also referred to as cocci. Generally speaking, C. immitis is found in California and C. posadasii is found in Arizona, and Central and South America. More recently Cocci has also been found as far north as Washington and British Columbia. History:The fungal infection was first reported by Wernicke and Posadas in Argentina in 1892 where they described a case where a man had cutaneous cocci of the head, arm, and trunk. To this day, the head is preserved in Argentina. 4 For many years, only disseminated cases were recognized and described as “coccidioidal granulomas.” The work of Dixon and Gifford in 1935 elucidated that a pneumonic disease of unknown cause termed “San Joaquin Valley Fever” was, in fact, the primary coccidioidal infection and the port of entry of almost all coccidioidal disease. Initial infection occurs predominantly by inhalation of aerosolized arthroconidia and rarely by direct cutaneous inoculation.1,2Coccidioides spp. survive best in areas with low rainfall (12–50 cm per year), limited winter freezes, and alkaline soils. With climate change models, predicting the geographical range expansion.These dimorphic fungi exist in a mycelial form in the soil. Coccidioides species have been found in animal burrows near the Kern River and in Armadillo burrows in South American countries like Brazil. The mycelia produce arthroconidia (spores) that are ultimately airborne and inhaled.The inoculum required for infection is low and in animal models as few as a single arthroconidium may cause infection.3 Infection:Once arthroconidia are inhaled into the lung, there is typically a 1-3-week incubation period. The arthroconidia undergo morphologic changes into spherules, which are large structures that contain endospores.4 As spherules mature, they rupture and release endospores. Endospores can be spread hematogenous or through lymphatics to essentially any organ, leading to the development of new spherules and potentially disseminated disease.5 Not everyone who inhales the arthroconidia gets the infection. Clinical Manifestations.About 60% of patients who inhale arthroconidia are asymptomatic. 30% have a mild respiratory illness, like the flu. 10% have a more serious disease course and are diagnosed. Other symptoms may include fever, drenching night sweats, and weight loss. Extreme fatigue that limits baseline activity may also raise concerns. Symptom onset up to 2 months after endemic exposure should lead to coccidioidomycosis on the differential. Coccidioidomycosis cases have been documented in Michigan, Europe, and China. These cases were of people who traveled to endemic areas for as little as a few days and then were later diagnosed. 1-3% of all coccidioidomycosis cases are disseminated, severe, or chronic pulmonary infections. If undiagnosed, coccidioidomycosis may lead to significant morbidity and mortality. Dissemination sites include the skin, lymph nodes, bones, and Central Nervous System (CNS) which is the most severe. Any organ can be infected, including documented cases of the prostate and adrenal gland. Arreaza: Recap: 60% are subclinical, 30% are mild, 10% serious, 1-3% are disseminated. What are some risk factors for severe infection? Should I stop biking?Risk factors for severe infection:Severe pulmonary infections can happen in anyone but occur more commonly in diabetics, tobacco users, and people older than 65 years of age.Oceanic or Filipino ethnicity and black or African American have a higher rate of dissemination. Immunosuppression, including HIV, transplant patients, and immunosuppressive medications like corticosteroids or TNF-alpha inhibitors have been shown to be risk factors for dissemination. Pregnant patients, particularly in the third trimester have higher rates of severe infection as well.Arreaza: How do we diagnose the disease?Diagnosis:Diagnosis is commonly made serologically. EIA (enzyme immunoassay) is used more often. There are more false positives than false negatives and varies by manufacturer. Kern County Health Department uses Immunodiffusion IgG and IgM and Complement Fixation are used. Immunodiffusion IgG and IgM are scaled by non-reactive, weakly reactive, reactive and strongly reactive. Compliment fixations are scaled by a ratio/dilution. Serum Compliment fixations

I recently traveled to Seattle to visit my specialists. I saw my lung docs as well as a rheumatology specialist. Antisynthetase syndrome is rare enough that my local rheumatologist treats only me with the disease. There I learned a lot about Ig. For many of us IVIg and SCIg is a live-giving therapy. It has changed the course of my illnesses even though I have an adverse reaction to it. Those of us with autoimmune diseases are fighting our own bodies, in order to control that, doctors put us on drugs that suppress our immune systems. Naturally, that impacts our ability to fight disease and other external threats. In recent years, my chief complaint has been that being around people makes me sick. Even when those people aren't sick. In Ep 350 I talk about getting my Ig tested to see if I was mounting autoantibodies for the COVID vaccine. The rheumatologist in Seattle looked back at those labs from May and said my Ig numbers were too low. One's Ig numbers should not fall below 600. Mine were barely above 500. There are two ways to remedy this: give Ig (SCIg or IVIg) or reduce immunosuppression. For me, that means reducing my Rituxan. Here, 10 years into living with autoimmune disease I'd never heard of measuring my Ig levels, or learned about the 600 threshold, and that being on a heavy-hitting drug like mine, these levels should be monitored quarterly. That seemed like information worth sharing. Are you on chemotherapy or other strong immunosuppressive drugs? Do you get your Ig tested regularly? Did you know about the 600 threshold? Sound off! I'm Annette Leonard, speaker, coach, and sick person who believes that my illnesses do not define me. If health is the absence of disease and wellness is the presence of wholeness, then no matter what your disease status, we can work toward your wellness, your wholeness. Whether or not you are ever "healthy" on paper, you can be well. Join me and others on the path back to wholeness at AnnetteLeonard.com. Whether you are a person experiencing chronic illness or are someone who loves or serves people with chronic illness I have great resources here on this channel or on my website for you.

References Front. Immunol. 2015. 6: 493. Prostaglandins Leukot Essent Fatty Acids. 2015 Jul;98:49-55 --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message

Fernando Carnavali, MD; Renslow Sherer, MD; and Joseph Torrisi, PharmD, BCIDP, discuss how new COVID-19 vaccines may affect risk stratification, including:Omicron-specific vaccineRole of vaccination in risk stratificationPresenters:Fernando Carnavali, MDAssociate Professor of MedicineDivision ChiefGeneral Internal MedicineDepartment of MedicineSite Director COVID Center of Excellence Satellite-AnsoniaMount Sinai Health SystemNew York, New YorkRenslow Sherer, MDDirectorInternational HIV Training CenterProfessor of MedicineSection of Infectious Diseases and Global HealthDepartment of MedicineUniversity of ChicagoChicago, IllinoisJoseph Torrisi, PharmD, BCIDPClinical Pharmacy SpecialistInfectious DiseasesPharmacyGrady Health SystemAtlanta, GeorgiaLink to slides:https://bit.ly/3WDYeFKLink to full program: https://bit.ly/3WJdIbs

In this week's episode, we will review a study that cell-free hemoglobin S was found to induce high levels of pro-inflammatory cytokine production in monocytes. The effect is mediated by Toll-like receptor 4, or TLR4, suggesting intriguing therapeutic possibilities for sickle cell disease.  Secondly, germinal center B cells with aberrant expression profiles undergo independent clonal evolution in the microenvironment of angioimmunoblastic T-cell lymphoma. New findings published in Blood elucidate mechanisms of disease pathogenesis and uncover a new potential target for treatment. Finally, an upfront combination of three immunosuppressive agents was highly effective and well tolerated in patients with acquired hemophilia A. Although prospective studies are needed, the triple regimen could be an attractive treatment option, particularly for elderly and frail patients.

In this episode of Health411, Dr. Jonathan Karp and producer Daniel Geller discuss the immune system and why sometimes it is better to downregulate it rather than have it be turned all the way on all the time. Different types of immunosuppressant drugs are discussed, as well as their differences and why having an overactive immune system can cause disease.

 What is involved in coming home and living after a lung transplant? Learn from this week's guest. Stevan shares his experience after a lung transplant: complex medication regimen, immunosuppression, increased risk for skin cancer, and vital caregiver help.

  Vidcast:  https://youtu.be/01gypflxR3M   The reactivated poliovirus that first spread from Israel to upstate New York State's Rockland and then Orange Counties, has now spread to the adjacent Sullivan County.  No surprise, since the virus was already been detected downstate in the New York City's wastewater systems.   Many people contract the poliovirus without becoming symptomatic, but, once infected, they can pass it on to others.  One in every 200 infected persons will become paralyzed, often for life.   What you need to do is make certain that you are protected?  If you live or will be traveling in the areas I mentioned or in any area where the poliovirus is circulating, say overseas, make certain that you are vaccinated and, if necessary boosted.  If you never received the vaccine or aren't certain, check with your medical team about beginning the 3 dose immunization series.  If you were vaccinated years ago and were never boosted, get the one shot booster.  This is particularly important if you are older, weakened by medical problems, or have known immunosuppression.   https://www.cdc.gov/vaccines/vpd/polio/public/index.html   #polio #vaccination #booster #cdc #travel #immunosuppression  

In this episode, I am joined by Dan Brennan, Professor of Medicine at Johns Hopkins School of Medicine and Director of the Comprehensive Transplant Center at Johns Hopkins. He shares his experiences and the contributions he has made in his career. We are looking at a case and treatment options of a 52 year old man with a history of diabetes, hypertension, end stage kidney disease and kidney transplant roughly a month ago. He has CMV donor positive, recipient negative status.

This episode contains soundbites from an interview published by EpochTV in May of '22.  The interview is quite long in its entirety, so it is crucial that we find ways to allow more people to hear the truth from the world's best and brightest. Dr. Vanden Bossche's credentials and integrity in the field of immunology, vaccinology and scientific research merit that of some of the best in the world. He was working with the B & M Gates Foundation. The level of censorship and the importance of Dr. Vanden Bossche's message is of utmost importance for the world to hear. This is a shortcut to the high points of the documentary done by TheEpochTimes.com. All credit goes to their producers, videographers, and film team for their wonderful work. I've attempted to share the link in many other forms with limited success. You'll soon understand why Dr. V. Bossche has been silenced.  I highly encourage you to watch the documentary at TheEpochtimes.com/c-live in its entirety. It is packed with great education and logical explanations.  

Episode 69 - Addressing Immunosuppression: Mold, Covid-19, and Vaccinations with Dr. Jess PeatrossDr. Jess Peatross is a former hospitalist, internal medicine physician, and a certified Gerson Practitioner. Her passion lies in uncovering the mystery behind chronic illnesses. She is an expert in the areas of stealth infections, environmental toxicity, regenerative medicine, and ozone. After working as an M.D. in a hospital for 6 years, Dr. Jess realized that she needed to investigate alternatives to today's modern medical industry, which “treats every ill with a pill.” She is now an expert in the field of Lyme, parasites, and the health hazards of mold. Recently, Dr. Jess made the choice not to continue her board certification with the AMA as she no longer practices pharmaceutical based medicine and is able to get to the root cause to heal people without the need for narcotics, immunosuppressants, antidepressants, antibiotics or steroids. In this episode, we dive into the aspects of medical ethics, Covid-19, vaccinations, and what role mold plays in immunosuppression. Transcript: https://bit.ly/3t48RoSFind us on Linktree, Facebook, Instagram, Twitter,  TikTok and YoutubeNeed help navigating your mold injury without breaking the bank? Join our low cost education group: patreon.com/exposingmoldSponsors: Michael Rubino, The Mold Medic and  All American Restoration,  the first and only mold remediation company in the country specializing in remediating mold for people with underlying health conditions or mold sensitivities. They've quickly become the most recommended remediation company  from doctors and mold inspectors nationwide. Pick up your copy of Michael Rubino's book, “The Mold Medic: An Expert's Guide on Mold Remediation, " here: https://amzn.to/3t7wtaUExposing Mold is officially a non-profit! To support our efforts donate here: Support the show

James Roguski310-619-3055http://dontyoudare.info/https://jamesroguski.substack.com/archiveGO HERE FIRST - https://jamesroguski.substack.com/p/wake-up-and-smell-the-burning-of?s=r The Free America PodcastWebsite - https://www.freeamericapodcast.com/Bitchute - https://www.bitchute.com/channel/XUMguOqsBvbm/Rumble - https://rumble.com/user/FreeAmericaPodcastAlternate Social MediaGab - https://gab.com/FreeAmericaPodcastMewe - https://mewe.com/i/freeamerica2 Action ItemsAdditional WHO Documents - https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75_18-en.pdfEU Draft of Pandemic Treaty - https://www.consilium.europa.eu/en/policies/coronavirus/pandemic-treaty/Send This Info to Your Elected Representatives - https://jamesroguski.substack.com/p/wake-up-and-smell-the-burning-of?s=rHelp Fund Free America and Save $$$ on Your Mobile Bill! Go to https://patriotmobile.com/ and Use Referral Code: Nick Yaya News Itemshttps://www.thedailybeast.com/told-you-sothe-ba2-variant-proves-it-was-way-too-soon-to-lift-covid-mask-mandates?source%3Dpolitics%26via%3Drsshttps://www.usatoday.com/story/news/health/2022/04/17/covid-vaccines-americans-must-reset-their-expectations-experts-say/9510264002/?gnt-cfr=1https://www.wnd.com/2022/04/obama-scolds-unvaxxed-hey-clinically-tested-shots-billions-people/?ats_es=1c0954f1b62809b09a100d75c701d474https://westernstandardonline.com/2022/04/study-shows-microplastics-found-in-covid-masks-present-in-patients-lungs/(Study) https://www.sciencedirect.com/science/article/pii/S0048969722020009#!https://www.theepochtimes.com/fda-and-pfizer-knew-covid-shot-caused-immunosuppression_4404366.html?est=aWVtBGnZ4hY3VvPQhT5RZf01Wgg2kY9EDS5aG4vaVUofrc%2ByaK29op4DSHY%3Dhttps://www.wnd.com/2022/04/famous-democrat-consultant-fda-knew-vaccine-not-safe-effective/?ats_es=1c0954f1b62809b09a100d75c701d474https://www.thegatewaypundit.com/2022/04/update-jaw-dropping-769-athletes-collapsed-competing-past-year-avg-age-players-suffering-cardiac-arrest-just-23-video/https://www.theepochtimes.com/more-than-1-million-covid-vaccine-injuries-nearly-27000-deaths-reported-to-vaers-cdc-data-show_4409514.html?est=OqvcEikLTKABgkcRJ9zYpLztlefzlacvUZoiGzUifIaqEm7M7NwovIOEdOQ%3D

In this episode we are joined by Dr. Jim Rosenbaum and Dr. Kevin Winthrop to discuss special considerations regarding immunosuppression during the COVID pandemic.