Podcasts about Incidence

Un nouvel épisode du Pharmascope est disponible! Dans ce 169e épisode dédié aux questions de nos auditeurs, Nicolas et Olivier tentent de pondre des réponses intelligentes à vos excellentes questions. Au menu : trouble d'usage lié à l'alcool, mélatonine et insuffisance cardiaque, taux sérique et hautes doses de vitamine D… et hypertension artérielle chez les plus jeunes! Les objectifs pour cet épisode sont les suivants: Discuter de la combinaison de naltrexone et de gabapentine en trouble d'usage lié à l'alcool Examiner les risques allégués de la mélatonine pour l'insuffisance cardiaque Discuter de la façon d'établir des seuils dits « normaux » de taux sériques de vitamine D Présenter les résultats de certaines études concernant l'innocuité de doses élevées de vitamine D Examiner les bénéfices du traitement de l'hypertension dans une population pédiatrique Ressources pertinentes en lien avec l'épisode Anton RF, et coll. Gabapentin combined with naltrexone for the treatment of alcohol dependence. Am J Psychiatry. 2011 Jul;168(7):709-17. Nnadi, et coll. Abstract 4371606: Effect of Long-term Melatonin Supplementation on Incidence of Heart Failure in Patients with Insomnia. Circulation. 2025; 152(Suppl_3). Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. Sanders KM, et coll. Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA. 2010 May 12;303(18):1815-22. Burt LA, et coll. Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength: A Randomized Clinical Trial. JAMA. 2019 Aug 27;322(8):736-745. Dionne JM, et coll; Hypertension Canada Guideline Committee. Hypertension Canada’s 2017 Guidelines for the Diagnosis, Assessment, Prevention, and Treatment of Pediatric Hypertension. Can J Cardiol. 2017 May;33(5):577-585. Chaturvedi S ,et coll. Pharmacological interventions for hypertension in children. Cochrane Database Syst Rev. 2014 Feb 1;2014(2):CD008117.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Ivabradine and Atrial Fibrillation Incidence: A Nested Matching Study.

ChairProfessor Yoshikatsu EtoAdvanced Clinical Research Center, Southern Tohoku Research Center for Neuroscience, Tokyo, JapanSpeakersDr Nicole Muschol International Center for Lysosomal Disorders (ICLD), University Medical Center, Hamburg-Eppendorf, GermanyProfessor Patrício AguiarInborn Errors of Metabolism Reference Center, Unidade Local de Saúde de Santa Maria / Faculty of Medicine, Lisbon University, PortugalDr Robert HopkinCincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USAProfessor Yoshikatsu EtoWelcome to the Chiesi symposium. The title of this symposium, Catching the Clues, Changing the Cause of Lysosomal Storage Disease: Illuminating Complex Pathway of Rare Disease with Fabry Disease, Alpha-Mannosidosis, in Focus.This is a disclaimer: Following discussion does not focus on or depict any specific products manufactured by any pharmaceutical company. Patient cases are for medical discussion only and reflect the faculty own experience. They represent a typical clinical scenario. This presentation in part and whole may not be reproduced and not copy and not recording.I'm Dr. Eto from Tokyo, Japan, and the three distinguished speakers: Dr. Nicole Muschol from Germany, Eppendorf University. Professor Aguiar, the Portuguese, The Inborn Errors of Metabolism Reference Center, and also Professor Robert Hopkin, Cincinnati Children's Hospital, United States.The purpose of this symposium: Explore the patient journey across the LSD continuum, focusing on the unmet needs and diagnosis, and treatment initiation, and long-term management, and utilize case-based discussion focused on Alpha-mannosidosis, Fabry disease to highlight disease-specific challenges. Access where challenge persist in patient journey, and where tailored intervention can improve outcomes.Introduction of LSD patient journey with a spotlight on Fabry disease, Alpha-mannosidosis. Challenge to the diagnosis and then treatment and monitoring. Common LSD challenges over the patient journey, as shown here, and at least more than 70 different lysosomal diseases known. Incidence is about 1:5,000-1:8,000 in newborn. In the literature, much higher incidence.Multi-organ manifestation in many organ involved, and clinical heterogeneity are very complicated. The new screen method has been established already. Identify patient presymptomatically. That important by the newborn screening, something like that, early treatment essential. After the diagnosis treatment start, early and the presymptomatic treatment initiation, and usually delayed diagnosis, delayed treatment. Perceived burden of treatment may delay treatment start in patient milder form. Milder form is very difficult in the many cases, and particularly for Fabry disease also.After the treatment start and then monitoring, as you know, we discussed about the monitoring rely on the combination of clinical assessment, laboratory test, biomarkers, and imaging, and several other factors. Biomarkers and ADA drug assay lack standardization. Actually, the Alpha, and Beta, or [inaudible 00:03:19] Fabry disease, different ADA-titled measurement. Also, the patient experience between clinical visit, ERT infusion is under-reported.We discuss today two topics, two disease. Alpha-mannosidosis is very rare. In Japan, only few cases, and caused by the deficiency of Alpha-mannosidase, an accumulation of mannose-rich oligosaccharides and inheritance of autosomal-recessive. Age of onset is a very early period and younger period, adult period. Incidence approximately is very rare, 1:500,000.There are diseases we don't know exactly. If you have a treatment, maybe your incidence is much increased, and severe or attenuated [inaudible 00:04:09]. Alpha-mannosidosis is still a new disorder, and must differentiate from Mucopolysaccharidosis.On the other hand, the Fabry disease I think is very common. There are many discussion already in the past 20 years. Deficiency of a-Gal A, accumulation of Gb3⁵­­ or Lyso-Gb3, many other glycoprotein, which a terminal of a-Gal A, and X-chromosome. This is very important X-chromosomal inheritance. In case of this, and usually, female does not affect, but in case of Fabry, more of female also involved.First symptom, imagine at any age. Then incidence about 1:40,000-1:60,000. But depending on the country, as you know, classical form, about 1:40,000. Recently, after the newborn screening, late onset, very high incidence. About 90% of it—actually, we carried out a newborn screening in Japan—90% are late onset. But the clinical variety, so many clinical varieties, so incidents here, 1:3,000-1:4,000, something like that. Now, using the Alpha-mannosidosis and Fabry disease as an illustrative example, we will explore these disorders.

durée : 00:01:31 - Le billet sciences - Plus de 5 000 personnes ont découvert leur séropositivité en 2024 en France. Les autorités sanitaires incitent à poursuivre les efforts de prévention et de dépistage. Vous aimez ce podcast ? Pour écouter tous les autres épisodes sans limite, rendez-vous sur Radio France.

My guest is Dr. Thaïs Aliabadi, MD, board-certified OB/GYN, surgeon and leading expert in women's health. We discuss polycystic ovary syndrome (PCOS) and endometriosis, two very common yet frequently undiagnosed causes of female infertility. Dr. Aliabadi explains the symptoms, underlying causes and evidence-based treatments for both conditions, including supplement and lifestyle interventions. We also discuss breast cancer risk and screening, pregnancy, perimenopause and menopause, and the hormone tests that women should request. This conversation offers empowering, potentially life-changing information for women of all ages to take control of their hormone, reproductive and overall health. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AGZ by AG1: https://drinkagz.com/huberman Lingo: https://hellolingo.com/huberman Our Place: https://fromourplace.com/huberman Joovv: https://joovv.com/huberman LMNT: https://drinklmnt.com/huberman Function: https://functionhealth.com/huberman Timestamps 00:00 Thaïs Aliabadi 02:56 Why Endometriosis & Polycystic Ovary Syndrome (PCOS) Go Undiagnosed 08:16 Infertility, Tool: Early Screening 10:54 Sponsors: Lingo & Our Place 14:07 Women's Health Education Gap 15:24 PCOS Overview: Symptoms, Diagnosis, AMH, Disordered Eating 21:28 Irregular Periods, Teenage PCOS Diagnosis 24:36 Diagnosis, Pelvic Ultrasound; PCOS Naming 27:49 Thinning Hair & Acne; 4 PCOS Phenotypes; Mood & Treatment 35:54 Underlying Pillars of PCOS; HPA Axis, Androgens, Menstruation & Ovulation 40:30 Insulin Resistance & PCOS, Visceral Fat & Inflammation 46:30 Sponsors: AGZ by AG1 & Joovv 49:10 PCOS, Chronic Inflammation, Genetics & Lifestyle; Mood 52:31 PCOS, Fertility, Freezing Eggs, Tool: Egg Count & AMH Range By Age 58:34 Women's Health Education, AI, Clinicians; Cataracts Analogy 1:01:20 Stress; PCOS Treatment, Birth Control, Insulin Resistance & Metformin 1:06:44 PCOS Risk Calculator, Supplements, Lifestyle Factors; GLP-1s 1:12:32 Berberine, Metformin; GLP-1s, Food Anxiety & Alcohol 1:19:13 PCOS Prescriptions & Fertility; PCOS Co-Occurrence with Endometriosis 1:21:56 Sponsor: LMNT 1:23:16 PCOS Treatment, Freezing Eggs, Egg Quality; Advocate For Your Health 1:32:02 PCOS Key Takeaways: Symptoms, Tests, Supplements & Lifestyle 1:36:03 Undiagnosed Endometriosis, Fertility 1:39:26 Endometriosis: Symptoms, Diagnosis, Painful Periods, Infertility 1:42:30 Male vs Female Health Issues, Undiagnosed Endometriosis 1:47:01 Inflammation, Ectopic Implants, Chronic Pelvic Pain; Adenomyosis 1:50:36 Egg Quality, Endometriosis, Tools: Egg Counts; Pelvic Ultrasound 1:54:29 Sponsor: Function 1:56:13 Pain & Health Testing, Tool: Endometriosis Symptoms, Screening & Tests 2:01:32 Treatment, Surgery, Different Types of Endometriosis 2:05:22 Endometriosis Causes, Inflammation; Incidence, PCOS 2:11:58 Obstetrics & Gynecology Separation, Surgery 2:16:00 Endometriosis Key Takeaways: Symptoms, Treatment & Diagnosis 2:17:04 Treatment, Estrogen & Progesterone, Birth Control, GnRH Antagonists 2:22:39 Endometriosis Stage & Pain, Endometriosis Types 2:23:49 Pregnancy; Postpartum Depression, Menopause; Frustration for Patients 2:29:55 Fibroids, Surgery, Uterine Septum, Tool: Pelvic Ultrasound 2:34:05 Tool: Assessing Your & Partner's Fertility; Autoimmune Conditions 2:37:51 Breast Cancer, Tool: Lifetime Risk Calculator & Breast Imaging; Mastectomy 2:49:47 Endometriosis Tests, Autoimmune Disease; Brain Fog & Menopause; Inositol 2:53:06 Undiagnosed Infertility; PMDD Treatment; Fasting & Low-Carbohydrate Diets 2:57:21 Hair Loss & Perimenopause; Egg Quality; Endometriosis & Menopause 3:00:40 Increase Progesterone; Diet, Hormone & Menopause; Prolong Fertility 3:04:54 Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

Drs Joseph Mikhael and Sigurdur Y. Kristinsson discuss whether it is time to screen for multiple myeloma and what we can learn from the iStopMM study. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002717. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Multiple Myeloma https://emedicine.medscape.com/article/204369-overview Screening in Multiple Myeloma and Its Precursors: Are We There Yet? https://pubmed.ncbi.nlm.nih.gov/38175579/ Iceland Screens, Treats, or Prevents Multiple Myeloma (iStopMM): A Population-Based Screening Study for Monoclonal Gammopathy of Undetermined Significance and Randomized Controlled Trial of Follow-Up Strategies https://pubmed.ncbi.nlm.nih.gov/34001889/ Identifying Associations Between Race and Gender in the Incidence and Mortality of Patients With Multiple Myeloma https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.e20052 Revisiting Wilson and Jungner in the Genomic Age: A Review of Screening Criteria Over the Past 40 Years https://pubmed.ncbi.nlm.nih.gov/18438522/ International Myeloma Foundation https://www.myeloma.org/ Prevalence of Monoclonal Gammopathy of Undetermined Significance https://pubmed.ncbi.nlm.nih.gov/16571879/ Monoclonal Gammopathy of Undetermined Significance https://www.ncbi.nlm.nih.gov/books/NBK507880/ Prevalence and Risk of Progression of Light-Chain Monoclonal Gammopathy of Undetermined Significance: A Retrospective Population-Based Cohort Study https://pubmed.ncbi.nlm.nih.gov/20472173/ Mode of Progression in Smoldering Multiple Myeloma: A Study of 406 Patients https://pubmed.ncbi.nlm.nih.gov/38228628/ Observation or Treatment for Smoldering Multiple Myeloma? A Systematic Review and Meta-Analysis of Randomized Controlled Studies https://pubmed.ncbi.nlm.nih.gov/40419473/

Five articles from the November 2025 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles this month are, "Metformin Reduces the Incidence of Shoulder Stiffness After Arthroscopic Rotator Cuff Repair: A Randomized, Double-Blinded, Placebo-Controlled Trial," "Delayed Surgery and Adenosine, Lidocaine, and Mg2+ Immunomodulatory Therapy Improve Joint Recovery in a Sex-Specific Manner After Anterior Cruciate Ligament Reconstruction in a Rat Model," "Comparison of Anchor Hole Enlargement Between Biodegradable and All-Soft Suture Anchors After Arthroscopic Bankart Repair: Longitudinal 2-Year Follow-up Study," "Sports Participation 25 Years After Anterior Cruciate Ligament Reconstruction: A Prospective Longitudinal Study Comparing Patients With Patellar Tendon and Hamstring Tendon Grafting to Uninjured Controls," and "Risk Profile for Cyclops Syndrome Necessitating Reoperation After Anterior Cruciate Ligament Reconstruction." Click here to read the articles.

1er épisode / 5, de la série sur l'Artérite à cellules géantes.  Episode 1 : Maladie rare – Qu'appelle-t-on artérite à cellules géantes ou maladie de Horton ?  Invité : Pr Hubert de Boysson, médecin interniste au sein du service de médecine interne du CHU de Caen Normandie, médecin référent du CeRAINOM, le centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe de la filière FAI2R et coordinateur du PNDS sur les artérites à cellules géantes.  https://www.chu-caen.fr/page-services/medecine-interne/  https://www.fai2r.org/les-centres-fai2r/centres-de-reference-fai2r/cerainom-aaouba/   https://www.fai2r.org/   1️⃣ Qu'appelle-t-on artérite à cellules géantes ou maladie de Horton ? [0'46 – 2'00]  ✔️ Vascularite systémique la plus fréquente chez l'adulte, touchant les gros et moyens vaisseaux, en particulier l'aorte et ses branches. ✔️ Affecte les personnes de plus de 50 ans, avec une prédominance féminine (2–3 femmes pour 1 homme). ✔️ Incidence en France : ~10 cas pour 100 000 habitants >50 ans, plus fréquente dans le nord de l'Europe. Pour plus d'informations, retrouvez notre page article : https://rarealecoute.com/arterite-a-cellules-geantes-ou-maladie-de-horton/ 2️⃣   Quelle est la physiopathologie de cette maladie rare ? [2'01 – 3'49]  ✔️ Activation immunitaire anormale des cellules dendritiques et lymphocytes T, entraînant inflammation par cytokines (IL-6, IL-17, IFN-γ). ✔️ Formation de cellules géantes et sécrétion d'enzymes destructrices endommageant la paroi vasculaire. ✔️ Remodelage vasculaire provoquant sténoses et occlusions responsables des symptômes ischémiques. 3️⃣   Quels signes cliniques sont évocateurs d'une artérite à cellules géantes, dans quel contexte apparaissent-ils ? [3'50 -5'48]  ✔️ Suspecter la maladie devant céphalées, altération de l'état général, fièvre. ✔️ Bilan initial : rechercher des symptômes cardinaux et un syndrome inflammatoire biologique (CRP, fibrinogène). 4️⃣   À qui adresser les patients en cas de suspicion d'artérite à cellules géantes ? [5'49 – 7'36]  ✔️ Prise en charge hospitalière : médecine interne ou rhumatologie via des filières rapides pour confirmer le diagnostic et débuter le traitement si nécessaire. ✔️ Situation urgente en ville : début immédiat de corticoïdes si symptômes cardinaux avec signes visuels (vision flou, diplopie, cécité) et CRP élevée. 5️⃣ Comment s'organise la prise en charge de l'artérite à cellules géantes en France ? [7'37 – 8'57]  ✔️ Filières de prise en charge rapide dans de nombreux hôpitaux français pour examens et traitement initial. ✔️ Groupes et réseaux spécialisés (FAI2R, GEFA) pour homogénéiser les pratiques et diffuser les recommandations. ✔️ Protocoles nationaux de diagnostic et de soins (PNDS) régulièrement actualisés pour garantir une prise en charge standardisée et optimale.   L'équipe : Virginie Druenne – Ambassadrice RARE à l'écoute Cyril Cassard – Journaliste/Animation Hervé Guillot - Production Crédits : Sonacom _______________________________________________________ RARE à l'écoute est le 1er média d'influence entièrement dédié aux maladies rares : Un podcast pour faire entendre les voix de celles et ceux qui vivent, soignent et accompagnent ces maladies souvent invisibles. Les Revues Horizon pour mettre en lumière les meilleures initiatives des centres experts, pour inspirer et connecter les professionnels de santé. Des Lives engagés, pensés pour les patients, leurs proches et les associations. Un média indépendant, engagé et utile, au service d'un meilleur parcours de soin pour les patients atteints de maladies rares. Toutes nos ressources utiles sont accessibles gratuitement sur : www.rarealecoute.com

Dr. Kenneth Ellenbogen, Deputy Editor of JACC: Clinical Electrophysiology, discusses Mental Disorders Following Implantable Cardioverter-Defibrillator Therapy: Incidence and Prognostic Implications in a Nationwide Cohort Study.

PodChatLive 203: Patients trust imaging more than clinicians, lower limb apophysitis incidence & risk factors, and The Centre for Podiatry HistoryContact us: getinvolved@podchatlive.comLinks from this episode:“It's hard to trust an individual, it's easier to trust an image”—patients with low back pain want imaging as a means of coping with uncertaintyIncidence of and Risk Factors for Lower Extremity Apophysitis in Children and Adolescents

Incidence & Experience with Homelessness | Beyond Four Walls | Calgary BusinessYou're not going to want to miss this one. On a very special (and very real) episode of Beyond Four Walls, host Sean Mackenzie sits down with Stephen Vaivada to unpack something that too many people still get wrong — how we talk about and reference people experiencing homelessness.This isn't just another business podcast. It's about humanity, humility, and how the language we use shapes the way we see others. Of course, there's also a healthy dose of storytelling, a few laughs, and a little chaos — because that's what makes Beyond Four Walls tick. Grab your coffee (or something stronger), because this one will make you think, laugh, and maybe even squirm a little — in the best way.#yycbusiness #BeyondFourWalls #HomelessnessAwareness #WorkNicer #CommunityMatters #BusinessWithHeart #RealTalkPodcast #HumanityFirst #LanguageMatters #EmpathyInAction #CanadianPodcasts #SocialImpact #AuthenticConversationshttps://yyccalgarybusiness.ca/blog/beyond-four-walls-277/incidence-experience-with-homelessness-beyond-four-walls-1330About the Guest: Steven Vaivada is the founder and CEO of Scout Engineering Consulting, an Indigenous-owned firm dedicated to advancing infrastructure, governance, and economic development projects in partnership with First Nations communities across Canada. A professional engineer and proud member of the Blood Tribe, Steven is committed to creating meaningful, lasting connections between Indigenous communities, government, and industry.Connect with Steven on LinkedIn at: https://www.linkedin.com/in/stevenvaivadaAbout Sean & Beyond Four Walls: Sean Mackenzie, Prime Mover at Work Nicer Coworking, brings his passion for connection and business development to the forefront as host of Beyond Four Walls: Business Stories from the Work Nicer Community. This inspiring and insightful interview series dives deep into the real people behind the brands, their bold ideas, defining challenges, and pivotal moments of growth. With Sean's authentic, conversational style, Beyond Four Walls celebrates collaboration, shared spaces, and the relentless spirit of entrepreneurship. It's more than business—it's the human stories that make it all possible.You Can Connect with Sean on LinkedIn at: https://www.linkedin.com/in/sean-mackenzie-75558671As an interviewer, Sean is the ideal choice to share your knowledge and experience in leading a business to success. Promote your brand and story on Beyond Four Walls and:-Reach a global audience via the YYC Business website and the MegaPixxMedia YouTube channel.-Gain additional viewers of your Culture Hack episodes through free publication on YYC Business social media platforms.-Download your Beyond Four Walls episode to your personal and company social media pages.Episodes are also available in podcast format and you can listen to them on Spotify, Apple Podcast, and Google Podcasts.Filmed and edited by ENTA Solutionshttps://www.entasolutions.orgExclusive Partners:Enta Solutions: https://entasolutions.org/Performance Freight Management: https://pfmfreight.com/Dream, Reach...Achieve: https://dreamreachachieve.com/Good Deal Tire: https://gooddealtire.ca/Murch Group: https://www.murchgroup.com/Digital Monk Marketing: https://digitalmonkmarketing.com/

While we're making progress in TREATING cancer, worldwide cancer INCIDENCE is soaring, especially among young people; New guidelines for colon cancer screening urge earlier start at age 45; Rates of peanut allergy are declining as more parents follow revised advice to introduce nuts earlier to kids; What's with all the buzz about methylene blue? Legalization and stronger pot are creating an epidemic of ER visits for uncontrolled vomiting, debilitating abdominal pain; New smart toilet gives you a report card on your poop; When Zoloft doesn't work for anxiety.

Brendan Kelly, Professor of Psychiatry at Trinity College Dublin

Commentary by Dr.  Jian'an Wang.

Commentary by Dr. Yoshihiro Miyamoto.

We review the diagnosis, risk stratification, & management of acute pulmonary embolism in the ED. Hosts: Vivian Chiu, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Acute_Pulmonary_Embolism.mp3 Download Leave a Comment Tags: Pulmonary Show Notes Core Concepts and Initial Approach Definition: Obstruction of pulmonary arteries, usually from a DVT in the proximal lower extremity veins (iliac/femoral), but may be tumor, air, or fat emboli. Incidence & Mortality: 300,000–370,000 cases/year in the USA, with 60,000–100,000 deaths annually. Mantra: “Don't anchor on the obvious. Always risk stratify and resuscitate with precision.” Risk Factors: Broad, including older age, inherited thrombophilias, malignancy, recent surgery/trauma, travel, smoking, hormonal use, and pregnancy. Clinical Presentation and Risk Stratification Presentation: Highly variable, showing up as anything from subtle shortness of breath to collapse. Acute/Subacute: Dyspnea (most common), pleuritic chest pain, cough, hemoptysis, and syncope. Patients are likely tachycardic, tachypneic, hypoxemic on room air, and may have a low-grade fever. Chronic: Can mimic acute symptoms or be totally asymptomatic. Pulmonary Infarction Signs: Pleuritic pain, hemoptysis, and an effusion. High-Risk Red Flags: Signs of hypotension (systolic blood pressure < 90 mmHg for over 15 minutes),

Program notes:0:40 Private equity takeover of hospitals1:40 Reduced salaries or staffing2:40 Patients likely to cost system3:30 Use of anti thymocyte globulin to slow down T1D in youth4:30 Diagnosed within 9 weeks prior5:30 Serum sickness in 82% of highest dose group6:30 Incidence increasing by 2% per year over 20 years7:00 Aspirin in CRC8:00 1100 patients with mutation9:00 Can this mutation be acquired?9:15 Alcohol and dementia10:15 Confounding factors relative to alcohol use11:15 Is there a safe level of consumption?12:40 End

Howie and Harlan are joined by Kate Heilpern, president of Yale New Haven Hospital, to discuss the innovation and adaption needed to lead NewYork-Presbyterian Hospital through the worst of the COVID-19 pandemic, and how Yale New Haven Health structures itself to provide quality care across five hospitals. Harlan reflects on the many biotech startups emerging from Yale; Howie responds to the Trump administration's assertion of a link between acetaminophen and autism.  Links: Biotech at Yale and Beyond “Investors Flock Back to Biotech After a Long, Cold Spell “Boom, Bust and Recover: What Happens Next as Biotech VC Cycle Resets”. “Pfizer to Buy Weight-Loss Drug Developer Metsera for Up to $7.3 Billion” Yale Ventures Health & Veritas Ep. 80: Josh Geballe: Turning Yale Innovation into Startups Yale Ventures Annual Report 2025 Cloverleaf Bio Allyx Therapeutics EvolveImmune Therapeutics Normunity Inozyme Pharma “BioMarin to buy rare disease drugmaker Inozyme for $270M” “Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018” Kate Heilpern “Yale New Haven Hospital announces new president” “Yale New Haven Health announces Katherine Heilpern, MD, as the new president of Yale New Haven Hospital” “Heilpern sees society reflected in the busy ER” “Meet the Heroes Fighting on the Front Lines Against Covid-19” “'Adrenaline, Duty, and Fear': Inside a New York Hospital Taking on the Coronavirus” Health & Veritas Ep. 116: Christopher O'Connor: Hospital Leadership in Trying Times “Saving America's ERs” “The 600 Pathways Yale New Haven Health Takes to Improved Care Delivery” Tylenol and Autism “Trump Issues Warning Based on Unproven Link Between Tylenol and Autism” “Trump links autism and Tylenol: is there any truth to it?” “Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability” “Study reveals no causal link between neurodevelopmental disorders and acetaminophen exposure before birth” “Does Stress Cause Ulcers?” “The Effect of Vitamin E and Beta Carotene on the Incidence of Lung Cancer and Other Cancers in Male Smokers” “The U.S. government has jumped the public health shark” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

This study examined outcomes of patients with atrial fibrillation treated with pulsed field ablation (PFA) and found a notably high incidence of phrenic nerve injury during the procedure. Most injuries were transient, but some persisted beyond the immediate peri-procedural period, raising concerns about long-term safety. The findings highlight the need for refined techniques and monitoring strategies to mitigate phrenic nerve injury risk with PFA. Please join host Michael S. Lloyd, MD, FHRS as he discusses the finding of this study with his guests Andrea M. Russo, MD, FHRS and Birju Rao, MD, Msci in Atlanta at the HRX Live 2025 conference. Learning Objective:  Examine outcomes of patients with atrial fibrillation treated with pulsed field ablation (PFA). Article AuthorsLouis Chéhirlian, MD, Linda Koutbi, MD, Julien Mancini, MD, PhD, Jérôme Hourdain, MD, Robin Richard-Vitton, MD, Marie Wilkin, MD, Jean-Claude Deharo, MD, Baptiste Maille, MD, PhD, Frédéric Franceschi, MD, PhD  Podcast Contributors Michael S. Lloyd, MD, FHRS | Emory University Andrea M. Russo, MD, FHRS | Cooper University Health Care Birju Rao, MD, Msci | Emory University Contributor Disclosure(s): M. Lloyd:   •Membership on Advisory Committees: Boston Scientific •Speaking/Teaching/Consulting: Medtronic, ArgaMedtech, Circa Scientific   B. Rao •Nothing relevant to disclose. A. Russo: •Honoraria/Speaking/Consulting: Pacemate, Abbott Medical, Medtronic, BiosenseWebster, Inc., AtriCure, Inc., Bayer Healthcare Pharmaceuticals, Boston Scientific •Research: Medtronic, Boston Scientific, Abbott, Bayer Healthcare Pharmaceuticals •Royalty Income: UpToDate,Inc. •Fellowship Support: Medtronic, Inc.   Bonus video of this episode, recorded at HRX Live 2025 in Atalnta, can be found on HRS365 and the HRX Innovation Hub.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Trends in Risk Factor Prevalence and Incidence of Acute Myocardial Infarction in Young Adults.

Joseph Mikhael, MD, and Krina K. Patel, MD, MSc, discuss considerations for CAR T-Cell therapy in multiple myeloma, including age, access, and bridging therapy. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002715. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Multiple Myeloma https://emedicine.medscape.com/article/204369-overview CARTITUDE-1 Final Results: Phase 1b/2 Study of Ciltacabtagene Autoleucel in Heavily Pretreated Patients With Relapsed/Refractory Multiple Myeloma https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.8009 Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/37272512/ Plain Language Summary of the KarMMa-3 Study of Ide-cel or Standard of Care Regimens in People With Relapsed or Refractory Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/38651976/ CAR T-Cell Therapy Toxicity https://www.ncbi.nlm.nih.gov/books/NBK592426/ Immunomodulatory Drugs in Multiple Myeloma: Mechanisms of Action and Clinical Experience https://pubmed.ncbi.nlm.nih.gov/28205024/ Incidence and Outcomes of Cytomegalovirus Reactivation After Chimeric Antigen Receptor T-Cell Therapy https://pubmed.ncbi.nlm.nih.gov/38838226/ Long-Acting Granulocyte Colony-Stimulating Factor in Primary Prophylaxis of Early Infection in Patients With Newly Diagnosed Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/35064823/ Revisiting the Role of Alkylating Agents in Multiple Myeloma: Up-to-Date Evidence and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/37244325/ Bispecific Antibodies for the Treatment of Relapsed/Refractory Multiple Myeloma: Updates and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/38660139/ FDA Eliminates REMS for Approved CAR T-Cell Therapies https://www.aabb.org/news-resources/news/article/2025/06/30/fda-eliminates-rems-for-approved-car-t-cell-therapies

In this new episode of Speaking of SurgOnc, Dr. Rick Greene discusses with Dr. Faina Nakhlis the upgrade rate to ductal carcinoma in situ or invasive cancer following excision for patients diagnosed with flat epithelial atypia on core biopsy, as reported in the article, "Incidence of Adjacent Synchronous Ipsilateral Infiltrating Carcinoma and/or Ductal Carcinoma In Situ in Patients Diagnosed with Flat Epithelial Atypia by Core Needle Biopsy (TBCRC 034).”

PennHIP for the Win on Reducing Incidence of Hip Dysplasia [caption id="attachment_14411" align="alignleft" width="399"] Dr. Karen Potter showing one of her German Wirehaired Pointers.[/caption] Host Laura Reeves is joined by Dr. Karen Potter to discuss the value of PennHIP evaluations to reduce the incidence of hip dysplasia in a breeding program. “While yes, I do PennHIP my dogs,” Potter said, “I typically will go back and still get an OFA score on them. So I have both avenues to look at as I'm going through my breeding. With Penn Hip, we're able to have a number that I can use in order to then go forward with breeding and that gives me an idea of if I have a dog with a higher laxity score to then breed that to a dog with a lower laxity score to try to continue to bring the number down in the offspring trying to improve the quality. “What the PennHIP program has done is they determined the laxity score, which is how much the hip joint is able to luxate during movement. We all know the hip is a ball and socket joint and the laxity being how much the ball can come out of the socket. And so when that ball comes out of the socket, in each step, they found that those forces and each concussive force is what we then develop osteoarthritis from. “When we're looking at a PennHIP score, we're looking for a score that is smaller, lower numbers are better. So it's a distraction value saying this is how much we can passively distract the hip from the socket. And I say passively because we're doing this while the dogs are under heavy sedation or anesthesia.” Listen in to take a deep dive into the world of PennHIP scores, how the test works, what it tells breeders and how to use the scores in a breeding program. For additional information on the studies done on the efficacy of this testing method check out this LINK.

Joseph Mikhael, MD, and Surbhi Sidana, MD, discuss the importance of balancing treatment intervals, managing side effects, and maximizing quality of life in multiple myeloma patients. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002713. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients https://pubmed.ncbi.nlm.nih.gov/22222250/ Monitoring, Prophylaxis, and Treatment of Infections in Patients With MM Receiving Bispecific Antibody Therapy: Consensus Recommendations From an Expert Panel https://pubmed.ncbi.nlm.nih.gov/37528088/ Characterization of Dysgeusia and Xerostomia in Patients With Multiple Myeloma Treated With the T-Cell Redirecting GPRC5D Bispecific Antibody Talquetamab https://pubmed.ncbi.nlm.nih.gov/38092979/ Idecabtagene Vicleucel for Relapsed/Refractory Multiple Myeloma: Real-World Experience From the Myeloma CAR T Consortium https://pubmed.ncbi.nlm.nih.gov/36623248/ Incidence, Prognostic Impact and Clinical Outcomes of Renal Impairment In Patients With Multiple Myeloma: A Population-Based Registry https://pubmed.ncbi.nlm.nih.gov/31773154/ International Myeloma Working Group https://www.myeloma.org/international-myeloma-working-group IMWG Scientific and Working Committees https://www.myeloma.org/international-myeloma-working-group/imwg-scientific-working-committees

In medicine, the hardest critic you'll face is often yourself. In this episode of BackTable Urology, Dr. Michelle Van Kuiken joins host Dr. Lindsay Hampson to unpack the realities of imposter syndrome in urology practice and discuss its impact on trainees and professionals --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS Dr. Van Kuiken and Dr. Hampson explain the basics of imposter syndrome, its prevalence, and the many ways it can show up in medical training and practice. They also share candid personal experiences and practical strategies for overcoming self-doubt, from reframing negative thoughts to embracing feedback as a tool for growth. The doctors highlight the value of mentorship, peer support, and celebrating achievements, as well as the importance of creating a culture where vulnerability and open conversations are encouraged. --- TIMESTAMPS 00:00 - Introduction02:29 - Defining Imposter Syndrome04:24 - Personal Experiences with Imposter Syndrome08:44 - Impact of Imposter Syndrome in Medicine10:39 - Strategies to Overcome Imposter Syndrome13:59 - The Role of Mentorship16:28 - Gender and Mentorship in Medicine27:24 - Peer Support and Building Community32:13 - Final Thoughts and Takeaways --- RESOURCES Medical Trainees and the Dunning–Kruger Effect: When They Don't Know What They Don't Know:https://doi.org/10.4300/JGME-D-20-00134.1 Imposter Syndrome in Surgical Trainees: Clance Imposter Phenomenon Scale Assessment in General Surgery Residents:https://doi.org/10.1016/j.jamcollsurg.2021.07.681 Defining the Incidence of the Impostor Phenomenon in Academic Plastic Surgery: A Multi-Institutional Survey Study:https://doi.org/10.1097/prs.0000000000010821 Academic Urology Endowments and Leadership Roles are Disproportionately Held by Male Urologists:https://doi.org/10.1016/j.urology.2025.04.038 Implementation of a “Best Self” Exercise to Decrease Imposter Phenomenon in Residents:https://doi.org/10.4300/JGME-D-23-00873.1 Keep-Stop-Start Framework:https://meded.ucsf.edu/sites/meded.ucsf.edu/files/2024-06/TipSheet-Feedback.pdf Lean In: https://leanin.org/ W. Brad Johnson, PhD: https://www.wbradjohnson.com/

My guest is Dr. Sergiu Pașca, MD, professor of psychiatry and behavioral sciences at Stanford University. We discuss the biology and genetics of autism, why autism diagnoses are increasing and recent progress in using stem cells to understand and treat profound autism and other brain disorders. Dr. Pașca explains “organoids and assembloids”—human stem cell–derived tools he pioneered to study, treat and cure complex brain diseases. We also discuss ethical and safety issues with using gene editing and stem cells in humans. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman David: https://davidprotein.com/huberman Helix: https://helixsleep.com/huberman BetterHelp: https://betterhelp.com/huberman Function: https://functionhealth.com/huberman Timestamps (00:00) Sergiu Pașca (02:08) Autism Spectrum Disorder, Incidence, Genetics (07:16) Is Autism More Common in Males? (09:35) Sponsors: David & Helix Sleep (11:56) Eye Contact in Babies, Fever; Proposed Causes of Autism; Genes (18:48) Genetic or Idiopathic Autism Diagnoses, Timothy Syndrome (21:37) Rise in Autism Diagnoses (26:46) Cause, Correlation & Neurological Disease; Schizophrenia, Do Vaccines Cause Autism? (31:34) Global Increase in Autism; Gene Therapy, CRISPR, Follistatin (41:05) Sponsors: AG1 & BetterHelp (43:41) Stem Cells, Ethics, Yamanaka Factors, Human Stem Cell Models (52:03) Umbilical Stem Cells; Stem Cell Injections & Dangers, Autistic Kids (59:30) Organoids, Modeling Brain Development, Intrinsic Development Timer (1:12:22) Assembloids, Brain Cell Migration & Circuit Formation, Self-Organization (1:21:22) Four-Part Assembloid, Sensory Assembloid, Pain Conditions (1:25:45) Sponsor: Function (1:27:33) Future Medical Therapies, Cell Banking, Immortalize Tissues, Rejuvenate Cells (1:34:56) Assembloids & Ethics, Importance of Nomenclature, Science Collaboration & Self-Correction (1:45:38) Cell Transplantation & Ethics, Timing (1:55:05) Genetic Testing for Parents, Genetic Penetrance (2:02:36) Assembloids, Timothy Syndrome, Epilepsy, Schizophrenia, Dystonia (2:14:30) Scientific Career, Walking, Art, Medical School (2:20:44) Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

Department of redundancy department

In this episode, my guest is Dr. Michael Kilgard, PhD, a professor of neuroscience at the University of Texas at Dallas and a leading expert on neuroplasticity and learning across the lifespan. We discuss the need for alertness, effortful focus, post-learning reflection and sleep to induce neuroplasticity, and how dopamine, acetylcholine, serotonin and norepinephrine are each involved. He explains the behavioral steps for neuroplasticity, as well as vagal nerve stimulation (VNS) and other therapies for tinnitus, stroke, depression, PTSD and paralysis. This episode ought to be of use to anyone interested in understanding the modern science of brain rewiring and learning to improve cognitive or motor skills or treat sensory or motor disorders. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Eight Sleep: https://eightsleep.com/huberman Wealthfront*: https://wealthfront.com/huberman Carbon: https://joincarbon.com/huberman Function: https://functionhealth.com/huberman *This experience may not be representative of the experience of other clients of Wealthfront, and there is no guarantee that all clients will have similar experiences. Cash Account is offered by Wealthfront Brokerage LLC, Member FINRA/SIPC. The Annual Percentage Yield (“APY”) on cash deposits as of December 27,‬ 2024, is representative, subject to change, and requires no minimum. Funds in the Cash Account are swept to partner banks where they earn the variable‭ APY. Promo terms and FDIC coverage conditions apply. Same-day withdrawal or instant payment transfers may be limited by destination institutions, daily transaction caps, and by participating entities such as Wells Fargo, the RTP® Network, and FedNow® Service. New Cash Account deposits are subject to a 2-4 day holding period before becoming available for transfer. Timestamps (00:00) Michael Kilgard (03:24) Neuroplasticity (05:13) Child vs Adult Plasticity, Childhood Development & Learning (09:37) Sponsors: Eight Sleep & Wealthfront (12:41) Kids, Real vs Artificial Experiences & Balance, Video Games, Natural World (21:13) Social Media & Videos, Kids, Overstimulation & Development (33:42) Early Language Development, Passive vs Real Experiences, Kids & Adults (39:23) Sponsors: AG1 & Carbon (42:44) Learning & Plasticity Requirements; Focus, Friction, Rest & Reflection (52:24) Brain Connections, Complexity, Life Experiences & Plasticity (1:02:51) Learning, Reflection, Visualization, Testing (1:09:45) Experience Diversity & Time, Happiness, Life Appreciation (1:18:05) Sponsor: Function (1:19:53) Learning & Life Meaning (1:23:25) Neuromodulators, Brain Complexity, Synaptic Eligibility Trace & Learning (1:34:28) Synapses, Therapy for PTSD, Rewiring the Brain (1:39:01) Vagus Nerve Stimulation (VNS), Stroke, Spinal Cord Injury, Tinnitus, PTSD (1:47:33) Psychedelics, Neurostimulation, Importance of Timing (1:57:47) Electroconvulsive Therapy (ECT) & Major Depression (2:01:51) Psychedelics/SSRIs as Plasticity Tools, SSRIs & Bone Strength, Failed Clinical Trials (2:13:18) Can VNS Accelerate Learning? (2:16:01) VNS Surgery, Patient Use & Specificity, Closed-Loop Vagus Nerve Stimulation (2:18:18) Tinnitus Cause, Incidence & Self-Amplification; PTSD & Control (2:28:12) VNS for Tinnitus; Disease Complexity & Treatments, Lazy Eye (2:41:05) Complexity of Disease Treatments & Combination Therapies (2:48:50) Brain-Machine Interfaces, Information & Experiences; Closed-Loop Feedback; Resilience (2:59:09) Evolving Clinical Trials, Combination Treatments & Disease Complexity (3:05:21) Acknowledgements (3:07:04) Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

About this Episode Episode 48 of “The 2 View” – Burn Tx, Marijuana & CV Risk, Ocular Syphilis, and HSV 1 & 2 Segment 1 – Thermal Burn Treatment Levin NJ, Erben Y, Li Y, et al. Edited by Muacevic A, Adler JR. A Systematic Review and Meta-Analysis Comparing Burn Healing Outcomes Between Silver Sulfadiazine and Aloe vera. Cureus. 2022;14(10):e30815. Accessed August 11, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC9621733/ Aziz Z, Abdul Rasool Hassan B. The effects of honey compared to silver sulfadiazine for the treatment of burns: A systematic review of randomized controlled trials. Burns. 2017;43(1):50-57. Accessed August 11, 2025. https://pubmed.ncbi.nlm.nih.gov/27576926/ Segment 2A – Marijuana and Cardiovascular Risk Mohammadi L, Navabzadeh M, Jimenez-Tellez N, et al. Association of Endothelial Dysfunction With Chronic Marijuana Smoking and THC-Edible Use. JAMA Cardiol. Published online May 28, 2025. doi:10.1001/jamacardio.2025.1399. Accessed August 11, 2025. https://jamanetwork.com/journals/jamacardiology/fullarticle/2834540 Storck W, Elbaz M, Vindis C, et al. Eifling KP, Gaudio FG, Dumke C, et al. Cardiovascular risk associated with the use of cannabis and cannabinoids: a systematic review and meta-analysis. Heart. Published online June 17, 2025. doi:10.1136/heartjnl-2024-325429. Accessed August 11, 2025. https://pubmed.ncbi.nlm.nih.gov/40527600/ Page II RL, Allen LA, Kloner RA, et al. Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2020;142(10);e131-152. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000883 Segment 2B – Ocular Syphilis Zhou LR, Kirupaharan N, Birkenstock MK. Incidence and Prevalence of Syphilitic Uveitis and Associated Ocular Complications in the TriNetX Database. Am J Ophthalmol. 2025;277:387-394. https://www.sciencedirect.com/science/article/pii/S0002939425002843 Segment 3 - HSV 1 & 2 Langenberg AGM, Corey L, Ashley RL, et al. A Prospective Study of New Infections with Herpes Simplex Virus Type 1 and Type 2. N Engl J Med. 1999;341:1432-1438. https://www.nejm.org/doi/full/10.1056/nejm199911043411904 Lebrun-Vignes B, Bouzamondo A, Dupuy A, et al. A meta-analysis to assess the efficacy of oral antiviral treatment to prevent genital herpes outbreaks. J Am Acad Dermatol. 2007;57(20):238-246. Recurring Sources Center for Medical Education. http://ccme.org The Proceduralist. http://www.theproceduralist.org The Procedural Pause. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. http://www.thesgem.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to.

Interview with Sameer Jauhar, PhD, author of Incidence and Nature of Antidepressant Discontinuation Symptoms: A Systematic Review and Meta-Analysis. Hosted by John Torous, MD. Related Content: Incidence and Nature of Antidepressant Discontinuation Symptoms

Does psychiatric medication withdrawal exist — or is it just a myth?For anyone who's lived through it, the question alone can feel insulting.Psychiatric drug withdrawal is real. While the experience varies widely, for many, it's not “brief and mild” as many guidelines state it is. It can be intense, destabilizing, and often misunderstood. One of the most painful challenges is trying to determine whether what you're experiencing is withdrawal or relapse.Unfortunately, current clinical guidelines don't help. They often frame withdrawal as short-lived and minor, dismissing anything more severe as a return of illness. A potentially dangerous oversimplification that can leave patients feeling gaslit or unsupported.In this interview, Dr. Mark Horowitz, a psychiatrist and researcher who's both studied and experienced withdrawal firsthand, unpacks a new JAMA study that exemplifies the problem: guidelines built on inadequate evidence.In this episode, you'll hear:Why current drug withdrawal guidelines fall shortOverview of the new JAMA paper Incidence and Nature of Antidepressant Discontinuation SymptomsThe critical distinction between withdrawal and relapseThe truth about psychiatric drug withdrawalHow to design better research that reflects real-world experiencesWhy this information is often not reaching cliniciansHow we can conduct research that can better inform patient supportDr. Horowitz's story is one of courage and insight. As a clinician, he had no idea how wrong the guidelines were, until he tried coming off medication himself. What he discovered was far more complex than anything he'd been taught.To those navigating psychiatric medication withdrawal — especially in the face of oversimplified headlines and a healthcare system not yet equipped to support you — our hearts go out to you. You deserve care that is informed, compassionate, and grounded in lived experience as well as science. We won't stop until you have this.Expert Featured:Dr. Mark HorowitzX: @markhoroWebsite: https://markhorowitz.org/Resources Mentioned:Incidence and Nature of Antidepressant Discontinuation Symptoms A Systematic Review and Meta-Analysishttps://jamanetwork.com/journals/jamapsychiatry/article-abstract/28362623 Long-Term Psychiatric Medication Studieshttps://www.biologicalpsychiatryjournal.com/article/S0006-3223(98)00126-7/abstracthttps://journals.lww.com/intclinpsychopharm/abstract/2002/09000/discontinuation_symptoms__comparison_of_brief.2.aspxhttps://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/interruption-of-selective-serotonin-reuptake-inhibitor-treatment/F0241958CB073C51F366E2AABE636B5DOutro Clinichttps://www.outro.com/The Maudsley Desprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Incidence of Stroke in Adults With Congenital Heart Disease: A Systematic Review and Meta-Analysis.

Have “get the epidural” circled on your birth plan? Or maybe you're curious but not sure if it's for you? In this episode, we're pulling back the curtain on what epidurals really are, how they work, what they don't do—and why preparation still matters deeply, even if you're planning on pain meds.We'll explore:What epidurals actually do (and don't do)How they're administered, and what it feels likeCommon misconceptions that leave people unpreparedSide effects and interventions that often come with themWhat to do if an epidural fails or doesn't fully workWhy birth prep is still crucial with or without medsThe essential tools every birthing person needs—no matter the planIf you're planning an epidural, undecided, or just open to options, this episode will leave you feeling informed, empowered, and ready to advocate for the birth you deserve.Resources Mentioned:The Path to a Powerful Birth – Clara's childbirth course blending research, mindfulness, advocacy, and surrender.Research Citations:Anim-Somuah, M., Smyth, R. M. D., & Cyna, A. M. (2018). Epidural versus non-epidural or no analgesia in labour. Cochrane Database of Systematic Reviews, (5), CD000331. https://doi.org/10.1002/14651858.CD000331.pub4Sharma, S. K., & McGrady, E. (2014). Early versus late initiation of epidural analgesia for labour. Cochrane Database of Systematic Reviews, (10), CD007238. https://doi.org/10.1002/14651858.CD007238.pub3Pan, P. H., Bogard, T. D., & Owen, M. D. (2004). Incidence and characteristics of failed conversion of labor epidural analgesia to cesarean delivery anesthesia: A retrospective analysis of 19,259 deliveries. Anesthesiology, 100(4), 908–914. https://doi.org/10.1097/00000542-200404000-00014Torvaldsen, S., Roberts, C. L., Simpson, J. M., Thompson, J. F., & Ellwood, D. A. (2006). Intrapartum epidural analgesia and breastfeeding: A prospective cohort study. International Breastfeeding Journal, 1, 24. https://doi.org/10.1186/1746-4358-1-24Beilin, Y., Bodian, C. A., Weiser, J., Hossain, S., Arnold, I., Feierman, D. E., & Martin, G. (2005). Effect of labor analgesia with and without fentanyl on infant breastfeeding: A prospective, randomized, double-blind study. Anesthesiology, 103(6), 1211–1217. https://doi.org/10.1097/00000542-200512000-00018Get 20% off your first monthly subscription with NEEDED Vitamins 

The incidence of early onset colorectal cancer (EOCRC) has been rising prompting the change in change in screening guidelines to 45 years of age for average risk patients. Join us for an in-depth discussion with guest speakers Dr. Andrea Cercek and Dr. Nancy You, where we provide a comprehensive look at the growing challenge of EOCRC. Hosts: - Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center - Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian - Dr. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center  - Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center - Dr. Andrea Cercek - Gastrointestinal Medical Oncologist at Memorial Sloan Kettering Cancer Center - Dr. Y. Nancy You, MD MHSc - Professor, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Learning objectives:  - Describe trends in incidence of colorectal cancer, with emphasis on the rise of EOCRC. - Identify age groups and demographics most affected by EOCRC. - Summarize USPSTF recommendations for colorectal cancer screening. - Distinguish between screening methods (e.g., colonoscopy, FIT-DNA) and their sensitivity. - Understand treatment approaches for colon and rectal cancer (CRC) - Understand the role of mismatch repair (MMR) status in guiding treatment. - Outline the importance of genetic counseling and testing in young patients. - Discuss racial, ethnic, and socioeconomic disparities in CRC incidence and outcomes. - Describe the impact of cancer treatment on fertility and sexual health. -  Review fertility preservation options. - Identify the value of integrated care teams for young CRC patients. References: 1.         Siegel, R. L. et al. Colorectal Cancer Incidence Patterns in the United States, 1974–2013. JNCI J. Natl. Cancer Inst. 109, djw322 (2017). https://pubmed.ncbi.nlm.nih.gov/28376186/ 2.         Abboud, Y. et al. Rising Incidence and Mortality of Early-Onset Colorectal Cancer in Young Cohorts Associated with Delayed Diagnosis. Cancers 17, 1500 (2025). https://pubmed.ncbi.nlm.nih.gov/40361427/ 3.         Phang, R. et al. Is the Incidence of Early-Onset Adenocarcinomas in Aotearoa New Zealand Increasing? Asia Pac. J. Clin. Oncol.https://pubmed.ncbi.nlm.nih.gov/40384533/ 4.         Vitaloni, M. et al. Clinical challenges and patient experiences in early-onset colorectal cancer: insights from seven European countries. BMC Gastroenterol. 25, 378 (2025). https://pubmed.ncbi.nlm.nih.gov/40375142/ 5.         Siegel, R. L. et al. Global patterns and trends in colorectal cancer incidence in young adults. (2019) doi:10.1136/gutjnl-2019-319511. https://pubmed.ncbi.nlm.nih.gov/31488504/ 6.         Cercek, A. et al. A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. J. Natl. Cancer Inst. 113, 1683–1692 (2021). https://pubmed.ncbi.nlm.nih.gov/34405229/ 7.         Zheng, X. et al. Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer. JNCI J. Natl. Cancer Inst. 113, 543–552 (2021). https://pubmed.ncbi.nlm.nih.gov/33136160/ 8.         Standl, E. & Schnell, O. Increased Risk of Cancer—An Integral Component of the Cardio–Renal–Metabolic Disease Cluster and Its Management. Cells 14, 564 (2025). https://pubmed.ncbi.nlm.nih.gov/40277890/ 9.         Muller, C., Ihionkhan, E., Stoffel, E. M. & Kupfer, S. S. Disparities in Early-Onset Colorectal Cancer. Cells 10, 1018 (2021). https://pubmed.ncbi.nlm.nih.gov/33925893/ 10.       US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 325, 1965–1977 (2021). https://pubmed.ncbi.nlm.nih.gov/34003218/ 11.       Fwelo, P. et al. Differential Colorectal Cancer Mortality Across Racial and Ethnic Groups: Impact of Socioeconomic Status, Clinicopathology, and Treatment-Related Factors. Cancer Med. 14, e70612 (2025). https://pubmed.ncbi.nlm.nih.gov/40040375/ 12.       Lansdorp-Vogelaar, I. et al. Contribution of Screening and Survival Differences to Racial Disparities in Colorectal Cancer Rates. Cancer Epidemiol. Biomarkers Prev. 21, 728–736 (2012). https://pubmed.ncbi.nlm.nih.gov/22514249/ 13.       Ko, T. M. et al. Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer. Surgery 176, 626–632 (2024). https://pubmed.ncbi.nlm.nih.gov/38972769/ 14.       Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A. & Jemal, A. Colorectal cancer statistics, 2023. CA. Cancer J. Clin. 73, 233–254 (2023). https://pubmed.ncbi.nlm.nih.gov/36856579/ 15.       Jain, S., Maque, J., Galoosian, A., Osuna-Garcia, A. & May, F. P. Optimal Strategies for Colorectal Cancer Screening. Curr. Treat. Options Oncol. 23, 474–493 (2022). https://pubmed.ncbi.nlm.nih.gov/35316477/ 16.       Zauber, A. G. The Impact of Screening on Colorectal Cancer Mortality and Incidence: Has It Really Made a Difference? Dig. Dis. Sci. 60, 681–691 (2015). https://pubmed.ncbi.nlm.nih.gov/25740556/ 17.       Edwards, B. K. et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116, 544–573 (2010). https://pubmed.ncbi.nlm.nih.gov/19998273/ 18.       Cercek, A. et al. Nonoperative Management of Mismatch Repair–Deficient Tumors. New England Journal of Medicine 392, 2297–2308 (2025). https://pubmed.ncbi.nlm.nih.gov/40293177/ 19.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Molecular Heterogeneity in Early-Onset Colorectal Cancer: Pathway-Specific Insights in High-Risk Populations. Cancers 17, 1325 (2025). https://pubmed.ncbi.nlm.nih.gov/40282501/ 20.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Ethnicity-Specific Molecular Alterations in MAPK and JAK/STAT Pathways in Early-Onset Colorectal Cancer. Cancers 17, 1093 (2025). https://pubmed.ncbi.nlm.nih.gov/40227607/ 21.       Benson, A. B. et al. Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw. JNCCN 19, 329–359 (2021). https://pubmed.ncbi.nlm.nih.gov/33724754/ 22.       Christenson, E. S. et al. Nivolumab and Relatlimab for the treatment of patients with unresectable or metastatic mismatch repair proficient colorectal cancer. https://pubmed.ncbi.nlm.nih.gov/40388545/ 23.       Dasari, A. et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. The Lancet 402, 41–53 (2023). https://pubmed.ncbi.nlm.nih.gov/37331369/ 24.       Strickler, J. H. et al. Tucatinib plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (MOUNTAINEER): a multicentre, open-label, phase 2 study. Lancet Oncol. 24, 496–508 (2023). https://pubmed.ncbi.nlm.nih.gov/37142372/ 25.       Sauer, R. et al. Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer. N. Engl. J. Med. 351, 1731–1740 (2004). https://pubmed.ncbi.nlm.nih.gov/15496622/ 26.       Cercek, A. et al. Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer. JAMA Oncol. 4, e180071 (2018). https://pubmed.ncbi.nlm.nih.gov/29566109/ 27.       Garcia-Aguilar, J. et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J. Clin. Oncol. 40, 2546–2556 (2022). https://pubmed.ncbi.nlm.nih.gov/35483010/ 28.       Schrag, D. et al. Preoperative Treatment of Locally Advanced Rectal Cancer. N. Engl. J. Med. 389, 322–334 (2023). https://pubmed.ncbi.nlm.nih.gov/37272534/ 29.       Kunkler, I. H., Williams, L. J., Jack, W. J. L., Cameron, D. A. & Dixon, J. M. Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer. N. Engl. J. Med. 388, 585–594 (2023). https://pubmed.ncbi.nlm.nih.gov/36791159/ 30.       Jacobsen, R. L., Macpherson, C. F., Pflugeisen, B. M. & Johnson, R. H. Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer. JCO Oncol. Pract. (2021) doi:10.1200/OP.20.00840. https://pubmed.ncbi.nlm.nih.gov/33566700/ 31.       Ruddy, K. J. et al. Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer. J. Clin. Oncol. (2014) doi:10.1200/JCO.2013.52.8877. https://pubmed.ncbi.nlm.nih.gov/24567428/ 32.       Su, H. I. et al. Fertility Preservation in People With Cancer: ASCO Guideline Update. J. Clin. Oncol. 43, 1488–1515 (2025). https://pubmed.ncbi.nlm.nih.gov/40106739/ 33.       Smith, K. L., Gracia, C., Sokalska, A. & Moore, H. Advances in Fertility Preservation for Young Women With Cancer. Am. Soc. Clin. Oncol. Educ. Book 27–37 (2018) doi:10.1200/EDBK_208301. https://pubmed.ncbi.nlm.nih.gov/30231357/ 34.       Blumenfeld, Z. How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries. The Oncologist 12, 1044–1054 (2007). 35.       Bhagavath, B. The current and future state of surgery in reproductive endocrinology. Curr. Opin. Obstet. Gynecol. 34, 164 (2022). 36.       Ribeiro, R. et al. Uterine transposition: technique and a case report. Fertil. Steril. 108, 320-324.e1 (2017). 37.       Yazdani, A., Sweterlitsch, K. M., Kim, H., Flyckt, R. L. & Christianson, M. S. Surgical Innovations to Protect Fertility from Oncologic Pelvic Radiation Therapy: Ovarian Transposition and Uterine Fixation. J. Clin. Med. 13, 5577 (2024). 38.       Holowatyj, A. N., Eng, C. & Lewis, M. A. Incorporating Reproductive Health in the Clinical Management of Early-Onset Colorectal Cancer. JCO Oncol. Pract. 18, 169–172 (2022). ***Behind the Knife Colorectal Surgery Oral Board Audio Review: https://app.behindtheknife.org/course-details/colorectal-surgery-oral-board-audio-review Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this JACC Deep Dive, Harlan M. Krumholz, MD, SM, FACC, discusses a new study in the July 8 issue of JACC, authored by Saket Girotra MD, SM, et al. In the study, which links national registry and Medicare data, the authors found striking hospital-level variation in cardiac arrest rates and outcomes—and identified better nurse staffing as a key factor in both preventing arrests and improving survival. Behind the scenes, the manuscript underwent multiple rounds of revision, with close collaboration between editors and authors to strengthen the analysis, add new visualizations, and clarify key takeaways. The study underscores the need to invest in systems and staffing that detect clinical deterioration before it becomes irreversible.

Episode 198: Fatigue.  Future doctors Redden and Ibrahim discuss with Dr. Arreaza the different causes of fatigue, including physical and mental illnesses. Dr. Arreaza describes the steps to evaluate fatigue. Some common misconceptions are explained, such as vitamin D deficiency and “chronic Lyme disease”. Written by Michael Ibrahim, MSIV, and Jordan Redden, MSIV, Ross University School of Medicine. Edits and comments by Hector Arreaza, MDYou 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.Dr. Arreaza: Today is a great day to talk about fatigue. It is one of the most common and most complex complaints we see in primary care. It involves physical, mental, and emotional health. So today, we're walking through a case, breaking down causes, red flags, and how to work it up without ordering the entire lab catalog.Michael:Case: This is a 34-year-old female who comes in saying, "I've been feeling drained for the past 3 months." She says she's been sleeping 8 hours a night but still wakes up tired. No recent illnesses, no weight loss, fever, or night sweats. She denies depression or anxiety but does report a lot of work stress and taking care of her two little ones at home. She drinks 2 cups of coffee a day, doesn't drink alcohol, and doesn't use drugs. No medications, just a multivitamin. Regular menstrual cycles—but she's noticed they've been heavier recently.Jordan:Fatigue is a persistent sense of exhaustion that isn't relieved by rest. It's different from sleepiness or muscle weakness.Classification based on timeline:    •   Acute fatigue: less than 1 month    •   Subacute: 1 to 6 months    •   Chronic: more than 6 monthsThis patient's case is subacute—going on 3 months now.Dr. Arreaza:And we can think about fatigue in types:    •   Physical fatigue: like muscle tiredness after activity    •   Mental fatigue: trouble concentrating or thinking clearly (physical + mental when you are a medical student or resident)    •    Pathological fatigue: which isn't proportional to effort and doesn't get better with restAnd of course, there's chronic fatigue syndrome, also called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which is a diagnosis of exclusion after 6 months of disabling fatigue with other symptoms.Michael:The differential is massive. So, we can also group it by systems.Jordan:Let's run through the big ones.Endocrine / Metabolic Causes    • Hypothyroidism: A classic cause of fatigue. Often associated with cold intolerance, weight gain, dry skin, and constipation. May be subtle and underdiagnosed, especially in women.    • Diabetes Mellitus: Both hyperglycemia and hypoglycemia can cause fatigue. Look for polyuria, polydipsia, weight loss, or blurry vision in undiagnosed diabetes.    • Adrenal Insufficiency: Think of this when fatigue is paired with hypotension, weight loss, salt craving, or hyperpigmentation. Can be primary (Addison's) or secondary (e.g., due to long-term steroid use).Michael: Hematologic Causes    • Anemia (especially iron deficiency): Very common, especially in menstruating women. Look for fatigue with pallor, shortness of breath on exertion, and sometimes pica (craving non-food items).     • Vitamin B12 or Folate Deficiency: B12 deficiency may present with fatigue plus neurologic symptoms like numbness, tingling, or gait issues. Folate deficiency tends to present with megaloblastic anemia and fatigue.    • Anemia of Chronic Disease: Seen in patients with chronic inflammatory conditions like RA, infections, or CKD. Typically mild, normocytic, and improves when the underlying disease is treated.Michael: Psychiatric Causes    • Depression: A major driver of fatigue, often underreported. May include anhedonia, sleep disturbance, appetite changes, or guilt. Sometimes presents with only somatic complaints.    • Anxiety Disorders: Mental fatigue, poor sleep quality, and hypervigilance can leave patients feeling constantly drained.    • Burnout Syndrome: Especially common in caregivers, healthcare workers, and educators. Emotional exhaustion, depersonalization, and reduced personal accomplishment are key features.Jordan: Infectious Causes    • Epstein-Barr Virus (EBV):Mononucleosis is a well-known cause of fatigue, sometimes lasting weeks. May also have sore throat, lymphadenopathy, and splenomegaly.    • HIV:Consider it in high-risk individuals. Fatigue can be an early sign, along with weight loss, recurrent infections, or night sweats.    • Hepatitis (B or C):Can present with chronic fatigue, especially if liver enzymes are elevated. Screen at-risk individuals.    • Post-viral Syndromes / Long COVID:Fatigue that lingers for weeks or months after viral infection. Often, it includes brain fog, muscle aches, and post-exertional malaise.Important: Chronic Lyme disease is a controversial term without a consistent clinical definition and is often used to describe patients with persistent, nonspecific symptoms not supported by objective evidence of Lyme infection. Leading medical organizations reject the term and instead recognize "post-treatment Lyme disease syndrome" (PTLDS) for persistent symptoms following confirmed, treated Lyme disease, emphasizing that prolonged antibiotic therapy is not effective. Research shows no benefit—and potential harm—from extended antibiotic use, and patients with unexplained chronic symptoms should be thoroughly evaluated for other possible diagnoses.Michael: Cardiopulmonary Causes    •   Congestive Heart Failure (CHF): Fatigue from poor perfusion and low cardiac output. Often comes with dyspnea on exertion, edema, and orthopnea.    •   Chronic Obstructive Pulmonary Disease (COPD): Look for a smoking history, chronic cough, and fatigue from hypoxia or the work of breathing.    •   Obstructive Sleep Apnea (OSA): Daytime fatigue despite adequate hours of sleep. Patients may snore, gasp, or report morning headaches. High suspicion in obese or hypertensive patients.Jordan:Autoimmune / Inflammatory Causes    •   Systemic Lupus Erythematosus (SLE): Fatigue is often an early symptom. May also see rash, arthritis, photosensitivity, or renal involvement.    •   Rheumatoid Arthritis (RA): Fatigue from systemic inflammation. Morning stiffness, joint pain, and elevated inflammatory markers point to RA.    •   Fibromyalgia: A chronic pain syndrome with widespread tenderness, fatigue, nonrestorative sleep, and sometimes cognitive complaints ("fibro fog").Cancer / Malignancy    •   Leukemia, lymphoma, or solid tumors: Fatigue can be the first symptom, often accompanied by weight loss, night sweats, or unexplained fevers. Consider when no other cause is evident.Michael:Medications:Common culprits include:    ◦   Beta-blockers: Can slow heart rate too much.    ◦   Antihistamines: Sedating H1 blockers like diphenhydramine.    ◦   Sedatives or sleep aids: Can cause grogginess and daytime sedation.    •   Substance Withdrawal: Fatigue can be seen in withdrawal from alcohol, opioids, or stimulants. Caffeine withdrawal, though mild, can also contribute.Dr. Arreaza:Whenever we evaluate fatigue, we need to keep an eye out for red flags. These should raise suspicion for something more serious:    •   Unintentional weight loss    •   Night sweats    •   Persistent fever    •   Neurologic symptoms    •   Lymphadenopathy    •   Jaundice    •   Palpitations or chest painThis patient doesn't have these—but that doesn't mean we stop here.Dr. Arreaza:Those are a lot of causes, we can evaluate fatigue following 7 steps:Characterize the fatigue.Look for organic illness.Evaluate medications and substances.Perform psychiatric screening.Ask questions about quantity and quality of sleep.Physical examination.Undertake investigations.So, students, do we send the whole lab panel?Michael:Not necessarily. Labs should be guided by history and physical. But here's a good initial panel:    •   CBC: To check for anemia or infection    • TSH: Screen for hypothyroidism    • CMP: Look at electrolytes, kidney, and liver function    • Ferritin and iron studies    • B12, folate    • ESR/CRP for inflammation (not specific)    • HbA1c if diabetes is on the radarJordan:And if needed, consider:    • HIV, EBV, hepatitis panel    • ANA, RF    • Cortisol or ACTH stimulation testImaging? Now that's rare—unless there are specific signs. Like chest X-ray for possible cancer or TB, or sleep study if you suspect OSA.Dr. Arreaza:Unaddressed fatigue isn't just inconvenient. It can impact on quality of life, affect job performance, lead to mood disorders, delay diagnosis of serious illness, increase risk of accidents—especially driving. So, don't ignore your patients with fatigue!Jordan:And some people—like women, caregivers, or shift workers—are especially at risk.Michael:The cornerstone of treatment is addressing the underlying cause.Jordan:If it's iron-deficiency anemia—treat it. If it's depression—get mental health involved. But there's also: Lifestyle Support: Better sleep hygiene, light physical activity, mindfulness or CBT for stress, balanced nutrition—especially iron and protein, limit caffeine and alcoholDr. Arreaza:Sometimes medications help—but rarely. And for chronic fatigue syndrome, the current best strategies are graded exercise therapy and CBT, along with managing specific symptoms. Beta-alanine has potential to modestly improve muscular endurance and reduce fatigue in older adults, but more high-quality research is needed.SSRI: fluoxetine and sertraline. Iron supplements: Even without anemia, but low ferritin [Anecdote about low ferritin patient]Jordan:This case reminds us to take fatigue seriously. In her case, it may be multifactorial—work stress, caregiving burden, and possibly iron-deficiency anemia. So, how would we wrap up this conversation, Michael?Michael:We don't need to order everything under the sun. A focused history and exam, targeted labs, and being alert to red flags can guide us.Jordan:And don't forget the basics—sleep, stress, and nutrition. These are just as powerful as any prescription.Dr. Arreaza:We hope today's episode on fatigue has given you a clear framework and some practical tips. If you enjoyed this episode, share it and subscribe for more evidence-based medicine!Jordan:Take care—and get some rest~___________________________Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:DynaMed. (2023). Fatigue in adults. EBSCO Information Services. https://www.dynamed.com (Access requires subscription)Jason, L. A., Sunnquist, M., Brown, A., Newton, J. L., Strand, E. B., & Vernon, S. D. (2015). Chronic fatigue syndrome versus systemic exertion intolerance disease. Fatigue: Biomedicine, Health & Behavior, 3(3), 127–141. https://doi.org/10.1080/21641846.2015.1051291Kroenke, K., & Mangelsdorff, A. D. (1989). Common symptoms in ambulatory care: Incidence, evaluation, therapy, and outcome. The American Journal of Medicine, 86(3), 262–266. https://doi.org/10.1016/0002-9343(89)90293-3National Institute for Health and Care Excellence. (2021). Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: Diagnosis and management (NICE Guideline No. NG206). https://www.nice.org.uk/guidance/ng206UpToDate. (n.d.). Approach to the adult patient with fatigue. Wolters Kluwer. https://www.uptodate.com (Access requires subscription)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

In this compelling episode of the Bendy Bodies Podcast, Dr. Linda Bluestein is joined by her longtime mentor and internationally respected EDS expert, Dr. Pradeep Chopra. Together, they tackle some of the most frustrating—and frequently misunderstood—questions surrounding hypermobile Ehlers-Danlos Syndrome (hEDS). From major flaws in the 2017 diagnostic criteria to the hidden surgical risks that could lead to serious complications like CCI (craniocervical instability), this conversation dives deep into clinical insights and lived experience. Listeners will also hear the surprising story of how Dr. Chopra helped inspire Dr. Bluestein to open her own practice. Whether you're a patient, parent, or provider, this episode just might change how you see joint hypermobility and connective tissue disorders forever. Takeaways Why men and boys may be getting overlooked by the current EDS diagnostic model The difference between dislocations and subluxations—and why that matters A surprising source of CCI: what your dentist, surgeon, and anesthesiologist may not know The 2017 criteria: well-meaning, but are they dangerously outdated? What every hypermobile patient should bring to their next surgery (yes, it's a hack) Want to follow along? Find the episode transcript here. References: Episode 70: https://youtu.be/BoRyQh12X2c Episode 71: https://youtu.be/yDT3JTzfiJk Episode 72: https://youtu.be/CYhnKkVjIxM Episode 73: https://youtu.be/2OxtZGNswfo Episode 77: https://youtu.be/d9A1aJB5GRo Episode 151: https://youtu.be/ho0rRcjUobI Perioperative Care in Patients with EDS by Linda Bluestein & Pradeep Chopra: https://www.scirp.org/journal/paperinformation?paperid=97524 Diagnostic Criteria: https://www.bendybodiespodcast.com/p/diagnostic-criteria-checklist/ The Incidence of Misdiagnosis in Patients with EDS: https://www.mdpi.com/2227-9067/12/6/698 Living Well with Orthostatic Intolerance by Peter C. Rowe: https://www.amazon.com/shop/hypermobilitymd/list/2LQLPARJY3CDS?linkCode=sl2&tag=onamzlindablu-20&ref_=aip_sf_list_spv_ofs_mixed_d 2023 Diagnostic Framework: https://www.ehlers-danlos.com/diagnosis/new-diagnostic-framework-for-pediatric-joint-hypermobility-v2/ Want more Dr. Pradeep Chopra?  Website: https://www.painri.com/ Contact Dr. Chopra's Office: snapa102@gmail.com Want more Dr. Linda Bluestein, MD? Website:  ⁠⁠https://www.hypermobilitymd.com/⁠⁠. YouTube: ⁠⁠⁠youtube.com/@bendybodiespodcast⁠⁠⁠  Instagram: ⁠⁠⁠https://www.instagram.com/hypermobilitymd/⁠⁠⁠  Facebook: ⁠⁠⁠https://www.facebook.com/BendyBodiesPodcast⁠⁠⁠  X: ⁠⁠⁠https://twitter.com/BluesteinLinda⁠⁠⁠  LinkedIn: ⁠⁠⁠https://www.linkedin.com/in/hypermobilitymd/⁠⁠⁠  Newsletter: ⁠⁠⁠https://hypermobilitymd.substack.com/⁠⁠⁠ Shop my Amazon store ⁠⁠⁠https://www.amazon.com/shop/hypermobilitymd⁠⁠⁠ Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Join YOUR Bendy Bodies community at ⁠⁠https://www.bendybodiespodcast.com/⁠⁠. YOUR bendy body is our highest priority! Use this affiliate link for Algonot to get an extra 5% off your entire order: ⁠⁠https://algonot.com/coupon/bendbod/⁠⁠ Learn more about Human Content at ⁠⁠⁠http://www.human-content.com⁠⁠⁠ Podcast Advertising/Business Inquiries: ⁠⁠⁠sales@human-content.com⁠⁠⁠ Part of the Human Content Podcast Network FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links Learn more about your ad choices. Visit megaphone.fm/adchoices

In this compelling episode of the Bendy Bodies Podcast, Dr. Linda Bluestein is joined by her longtime mentor and internationally respected EDS expert, Dr. Pradeep Chopra. Together, they tackle some of the most frustrating—and frequently misunderstood—questions surrounding hypermobile Ehlers-Danlos Syndrome (hEDS). From major flaws in the 2017 diagnostic criteria to the hidden surgical risks that could lead to serious complications like CCI (craniocervical instability), this conversation dives deep into clinical insights and lived experience. Listeners will also hear the surprising story of how Dr. Chopra helped inspire Dr. Bluestein to open her own practice. Whether you're a patient, parent, or provider, this episode just might change how you see joint hypermobility and connective tissue disorders forever. Takeaways Why men and boys may be getting overlooked by the current EDS diagnostic model The difference between dislocations and subluxations—and why that matters A surprising source of CCI: what your dentist, surgeon, and anesthesiologist may not know The 2017 criteria: well-meaning, but are they dangerously outdated? What every hypermobile patient should bring to their next surgery (yes, it's a hack) Want to follow along? Find the episode transcript here. References: Episode 70: https://youtu.be/BoRyQh12X2c Episode 71: https://youtu.be/yDT3JTzfiJk Episode 72: https://youtu.be/CYhnKkVjIxM Episode 73: https://youtu.be/2OxtZGNswfo Episode 77: https://youtu.be/d9A1aJB5GRo Episode 151: https://youtu.be/ho0rRcjUobI Perioperative Care in Patients with EDS by Linda Bluestein & Pradeep Chopra: https://www.scirp.org/journal/paperinformation?paperid=97524 Diagnostic Criteria: https://www.bendybodiespodcast.com/p/diagnostic-criteria-checklist/ The Incidence of Misdiagnosis in Patients with EDS: https://www.mdpi.com/2227-9067/12/6/698 Living Well with Orthostatic Intolerance by Peter C. Rowe: https://www.amazon.com/shop/hypermobilitymd/list/2LQLPARJY3CDS?linkCode=sl2&tag=onamzlindablu-20&ref_=aip_sf_list_spv_ofs_mixed_d 2023 Diagnostic Framework: https://www.ehlers-danlos.com/diagnosis/new-diagnostic-framework-for-pediatric-joint-hypermobility-v2/ Want more Dr. Pradeep Chopra?  Website: https://www.painri.com/ Contact Dr. Chopra's Office: snapa102@gmail.com Want more Dr. Linda Bluestein, MD? Website:  ⁠⁠https://www.hypermobilitymd.com/⁠⁠. YouTube: ⁠⁠⁠youtube.com/@bendybodiespodcast⁠⁠⁠  Instagram: ⁠⁠⁠https://www.instagram.com/hypermobilitymd/⁠⁠⁠  Facebook: ⁠⁠⁠https://www.facebook.com/BendyBodiesPodcast⁠⁠⁠  X: ⁠⁠⁠https://twitter.com/BluesteinLinda⁠⁠⁠  LinkedIn: ⁠⁠⁠https://www.linkedin.com/in/hypermobilitymd/⁠⁠⁠  Newsletter: ⁠⁠⁠https://hypermobilitymd.substack.com/⁠⁠⁠ Shop my Amazon store ⁠⁠⁠https://www.amazon.com/shop/hypermobilitymd⁠⁠⁠ Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Join YOUR Bendy Bodies community at ⁠⁠https://www.bendybodiespodcast.com/⁠⁠. YOUR bendy body is our highest priority! Use this affiliate link for Algonot to get an extra 5% off your entire order: ⁠⁠https://algonot.com/coupon/bendbod/⁠⁠ Learn more about Human Content at ⁠⁠⁠http://www.human-content.com⁠⁠⁠ Podcast Advertising/Business Inquiries: ⁠⁠⁠sales@human-content.com⁠⁠⁠ Part of the Human Content Podcast Network FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links Learn more about your ad choices. Visit megaphone.fm/adchoices

In today's episode we are discussing 2 journal club articles relating to risk factors of glaucoma with our Mayo Clinic colleague Dr Arthur Sit.   Long-Term Systemic Use of Calcium Channel Blockers and Incidence of Primary Open-Angle Glaucoma - Ophthalmology Glaucoma Relationship between Intraocular Pressure Fluctuation and Visual Field Progression Rates in the United Kingdom Glaucoma Treatment Study - PubMed Subscribe to the podcast:  https://MayoClinicOphthalmology.podbean.com Follow and reach out to us on X and IG: @mayocliniceye

Interview with Sameer Jauhar, PhD, author of Incidence and Nature of Antidepressant Discontinuation Symptoms: A Systematic Review and Meta-Analysis. Hosted by John Torous, MD. Related Content: Incidence and Nature of Antidepressant Discontinuation Symptoms

Interview with Sameer Jauhar, PhD, author of Incidence and Nature of Antidepressant Discontinuation Symptoms: A Systematic Review and Meta-Analysis. Hosted by John Torous, MD. Related Content: Incidence and Nature of Antidepressant Discontinuation Symptoms

Selon les règles du feng shui, la place de nos meubles aurait un impact sur notre santé et notre bien-être. Distribué par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Welcome to episode 183 of Growers Daily! We cover: garlic rust and what to do about it, how to tell if your soil is healthy, and it's feedback friday! We are a Non-Profit! 

God orchestrates incidents in the journeys of people in order to actualise destiny

Featuring perspectives from Ms Kathryn M Lyle, Dr Ritu Salani, Ms Jaclyn Shaver and Dr Brian M Slomovitz, including the following topics: Introduction: Overview of Endometrial Cancer (0:00) First-Line Therapy for Advanced or Recurrent Endometrial Cancer (11:01) Role of Lenvatinib/Pembrolizumab in the Management of Progressive Advanced Endometrial Cancer (39:09) Novel Investigational Strategies for Newly Diagnosed Advanced Endometrial Cancer (1:00:15) Incidence and Management of HER2-Positive Endometrial Cancer (1:17:52) NCPD information and select publications  

Welcome to the podcast with Dr. Brendan McCarthy!   This episode takes you deep into the real-world practice of prescribing testosterone therapy for women. This is not a high-level overview—this is a nuts and bolts breakdown: ✅ Who it's for ✅ How it's dosed ✅ What labs to run ✅ What delivery methods are safest ✅ Why it's often done wrong—and how to get it right   With over 20 years of clinical experience, Dr. McCarthy shares the insights no seminar or textbook can offer, including the emotional and psychological challenges women face when beginning testosterone therapy, and the very real fears around side effects and community stigma.  

My guest is Dr. Roger Seheult, M.D., a board-certified physician in internal medicine, pulmonary diseases, critical care, and sleep medicine at Loma Linda University. We discuss the powerful benefits of light therapy, including infrared light, red light, and sunlight, for improving mitochondrial function in all the body's organs. We also explore ways to reduce the risk of influenza, colds, and other illnesses that affect the lungs, sinuses, and gut. Topics include the flu shot, whether handwashing truly prevents illness transmission, and treatments for long COVID and mold toxicity. We review the efficacy of N-acetylcysteine (NAC), the power of hydrotherapy for combating infections, and strategies for improving sleep and overall health. Additionally, we discuss air quality. This episode provides actionable, science-based tools for preventing and treating infectious illnesses. Read the full show notes for this episode at hubermanlab.com. Sponsors AG1: https://drinkag1.com/huberman Joovv: https://joovv.com/huberman Eight Sleep: https://eightsleep.com/huberman LMNT: https://drinklmnt.com/huberman Function: https://functionhealth.com/huberman Our Place: https://fromourplace.com/huberman Timestamps 00:00:00 Dr. Roger Seheult 00:02:16 Avoiding Sickness, Immune System, Tool: Pillars of Health, NEWSTART 00:08:03 Sponsors: Joovv & Eight Sleep 00:10:46 Sunlight, Mitochondria, Tool: Infrared Light & Melatonin 00:19:09 Melatonin Antioxidant, Reactive Oxygen Species (ROS)/Free Radicals 00:26:38 Infrared Light, Green Spaces, Health & Mortality 00:31:35 Infrared Light, Mitochondrial Dysfunction, Disease 00:38:46 Sunlight & Cancer Risk?, Tools: UV Light, Clothing & Sunlight Exposure 00:41:01 Sponsors: AG1 & LMNT 00:43:32 Sunlight, Incidence of Influenza or COVID 00:48:41 Tools: Sunlight Exposure Duration, Winter Months 00:55:18 Infrared Lamps?, Winter Sunlight Exposure; Obesity & Metabolic Dysfunction 00:59:48 Cloudy Days; Sunlight, Primitive Therapy, Hospitals 01:11:33 Sponsor: Function 01:13:21 Artificial Lights, Hospitals & Light Therapy?, ICU Psychosis 01:22:16 Sleep & Darkness, Tools: Eye Mask, Bathroom Navigation; Meals & Light 01:28:27 Influenza, Flu Shots, Swiss Cheese Model; Flu Shot Risks? 01:38:13 Masks?, Flu; Handwashing 01:42:16 Sponsor: Our Place 01:43:57 Water, Sodium; Innate Immune System, Fever & Hydrotherapy 01:53:46 Fever, Heat Hydrotherapy, Interferon & Immune System 01:58:25 Cold Hydrotherapy, Vasoconstriction & White Blood Cells 02:09:56 N-Acetyl Cysteine (NAC), Glutathione, White Clots, Flu, Covid 02:19:28 Tool: NAC Dose & Regimen; Mucous, Flu Symptoms 02:25:25 Zinc Supplementation, Copper; Exogenous Interferon 02:28:40 Eucalyptus Oil, Inhalation 02:32:22 Air, Smoking, Vaping, Nicotine Gum 02:36:49 Fresh Air, Forest Bathing, Tool: Go Outdoors 02:40:09 Nature vs Inside Environments, Dark Days/Bright Nights Problem 02:52:38 Long COVID, Mitochondrial Dysfunction, Intermittent Fasting, Sunlight 03:00:43 Covid & Varied Severity, Smell Loss Recovery 03:05:04 Mold Toxicity, Lungs, Germ vs Terrain Theory, Immunocompromised 03:11:46 Trust, Spirituality, Community, Faith; Forgiveness 03:19:46 Hospital Admission, Tool: Asking Questions 03:25:42 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures