Podcasts about Incidence

Ce 216e épisode de Pos. Report reçoit deux marins qui, du 14 au 22 juin, disputeront le Tour de Bretagne à la voile entre Perros-Guirec et Quiberon, Alexis Loison (Groupe Réel) et Alexis Thomas (Wings of the Ocean).Nos deux invités commencent par évoquer cette épreuve qui fête cette année sa 15e édition, avec toujours le même format, à savoir qu'elle se court en double et par étapes. Alexis Loison, qui y a participé huit fois et l'a gagnée à deux reprises, avec Fred Duthil en 2029 puis Guillaume Pirouelle il y a deux ans, explique que la clé est la régularité, tandis qu'Alexis Thomas se souvient d'une première participation, en 2021, qui s'était terminée sur un caillou de l'Aber Wrac'h.Ils expliquent ensuite le choix de leurs co-skippers respectifs, Corentin Horeau pour le Normand, Malo Wessely pour le Rochelais, qui raconte au passage comment il est venu à la voile de compétition et au Figaro en particulier, sa famille étant très proche de celle des Levaillant père et fils (Jean-Baptiste et Arthur).Nous évoquons ensuite avec eux leur début de saison, marqué par une première victoire sur le circuit Figaro lors de la Solo Guy Cotten pour Alexis Thomas, qui l'explique notamment par un budget enfin à la hauteur de ses ambitions et l'arrivée de Romen Richard comme entraîneur du pôle de La Rochelle. Et même si la Transat Paprec s'est avérée frustrante (9e avec Pauline Courtois après avoir fait une partie de la course aux avant-postes), il estime avoir trouvé quelque chose en termes de vitesse, notamment au portant.Quant à Alexis Loison, il explique comment il “jongle” entre son travail à la voilerie Incidence et les navigations, notamment sur le nouveau JPK 1050 qu'il met actuellement au point. Nous enchaînons sur leur grand objectif de la saison, la Solitaire du Figaro, la 19e d'Alexis Loison, la 5e d'Alexis Thomas. Le premier présente le parcours et revient sur quelques souvenirs marquants, entre son unique victoire d'étape à Plymouth et la première du Figaro 3, en 2019.Diffusé le 10 Juin 2025Générique : Fast and wild/EdRecordsPost-production : Grégoire LevillainHébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

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.  

Welcome to the podcast with Dr. Brendan McCarthy!   In this episode we dive deep into one of the most misunderstood and debated topics in hormone health: testosterone replacement therapy (TRT) for women. You may have heard horror stories—or glowing reviews. But what's the truth? Dr. McCarthy discusses: - Why testosterone matters for women's health - How it affects brain chemistry, mood, bone density, and even breast tissue - Its role after estrogen-suppressing breast cancer treatments - The difference between safe and unsafe TRT - What your provider should be doing to monitor and manage it effectively   Dr. Brendan McCarthy founded Protea Medical Center in 2002. While he's been the chief medical officer, Protea has grown and evolved into a dynamic medical center serving the Valley and Central Arizona. A nationally recognized as an expert in hormone replacement therapy, Dr McCarthy s the only instructor in the nation who teaches BioHRT on live patients. Physicians travel to Arizona to take his course and integrate it into their own practices. Besides hormone replacement therapy, Dr. McCarthy has spoken nationally and locally before physicians on topics such as weight loss, infertility, nutritional therapy and more.   Citations: Popma, Arne, et al. "Cortisol moderates the relationship between testosterone and aggression in delinquent male adolescents." Biological psychiatry 61.3 (2007): 405-411 Likhtik, E., Stujenske, J. M., Topiwala, M. A., Harris, A. Z. & Gordon, J. A. Prefrontal entrainment of amygdala activity signals safety in learned fear and innate anxiety. Nat. Neurosci. 17, 106–113 (2014). Brannon, Skylar M., et al. "Exogenous testosterone increases sensitivity to moral norms in moral dilemma judgements." Nature Human Behaviour 3.8 (2019): 856-866.. * M.H.M. Hutschemaekers, R.A. de Kleine, M.L. Davis, M. Kampman, J.A.J. Smits, K. Roelofs,Endogenous testosterone levels are predictive of symptom reduction with exposure therapy in social anxiety disorder,Psychoneuroendocrinology,Volume 115,2020,104612 Barel, E, Abu‐Shkara, R, Colodner, R, et al. Gonadal hormones modulate the HPA‐axis and the SNS in response to psychosocial stress. J Neuro Res. 2018; 96: 1388– 1397. https://doi.org/10.1002/jnr.24259 * Buades-Rotger, M., Engelke, C., Beyer, F. et al. Endogenous testosterone is associated with lower amygdala reactivity to angry faces and reduced aggressive behavior in healthy young women. Sci Rep 6, 38538 (2016). https://doi.org/10.1038/srep38538 Ando, Sebastiano, et al. "Breast cancer: from estrogen to androgen receptor." Molecular and cellular endocrinology193.1-2 (2002): 121-128. Somboonporn, Woraluk, and Susan R. Davis. "Testosterone effects on the breast: implications for testosterone therapy for women." Endocrine reviews 25.3 (2004): 374-388. Donovitz, Gary, and Mandy Cotten. "Breast cancer incidence reduction in women treated with subcutaneous testosterone: testosterone therapy and breast cancer incidence study." European journal of breast health 17.2 (2021): 150. Glaser, Rebecca L., Anne E. York, and Constantine Dimitrakakis. "Incidence of invasive breast cancer in women treated with testosterone implants: a prospective 10-year cohort study." BMC cancer 19.1 (2019): 1271.   Thank you for tuning in and don't forget to hit that SUBSCRIBE button! Let us know in the COMMENTS if you have any questions or what you may want Dr. McCarthy to talk about next!   Check out Dr. Brendan McCarthy's Book! https://www.amazon.com/Jump-Off-Mood-...   -More Links- Instagram: www.instagram.com/drbrendanmccarthy TikTok: www.tiktok.com/drbrendanmccarthy Clinic Website: www.protealife.com

Featuring a slide presentation from Dr Matthew Matasar and related discussion from Dr Carla Casulo, Dr Matasar and Dr Laurie H Sehn, including the following topics: Overview of Chimeric Antigen Receptor (CAR) T-Cell Therapies for Relapsed/Refractory Follicular Lymphoma (FL) (0:00) Case: A man in his late 60s with relapsed FL who received axicabtagene ciloleucel (axi-cel) but experienced cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome and chronic cytopenia (3:50) Published Clinical Data Involving Axi-cel (10:24) Case: A man in his mid 60s with multiple comorbidities and progressive FL who received tisagenlecleucel (tis-cel) (15:34) Published Clinical Data Involving Tis-cel (19:47) Case: A woman in her late 40s with multiple comorbidities and refractory FL who received lisocabtagene maraleucel (liso-cel) after prior mosunetuzumab (22:43) Published Clinical Data Involving Liso-cel (26:05) Incidence and Management of Toxicities Associated with CAR T-Cell Therapy (27:48) Sequencing Considerations and Ongoing Trials Involving CAR T-Cell Therapy (30:35) Practical Considerations and Referrals for CAR T-Cell Therapy Administration (31:59) CME information and select publications

In this episode of the Science of Slink podcast, Dr. Rosy Boa delves into the intricacies of learning pole dance at home. With a background in pole dance since 2012 and instruction since 2018, she brings extensive experience and scientific insights to the discussion. The episode covers the effectiveness of home-based exercise supported by recent research, methods to maintain motivation, and strategies to avoid common injuries. Dr. Boa shares her 'pyramid of pole' framework to guide beginners through physical conditioning, technical learning, and artistic expression. The episode also explores how to adapt training routines to home environments, addressing space limitations, flooring types, and unique home dynamics like pets or kids. Finally, Dr. Boa highlights the importance of appropriate movement levels and offers specific recommendations for home pole dance practice, urging listeners to be patient and consistent in their training.Are you a pole nerd interested in trying out online pole classes with Slink Through Strength? We'd love to have you! Use the code “podcast” for 10% off the Intro Pack and try out all of our unique online pole classes: https://app.acuityscheduling.com/catalog/25a67bd1/?productId=1828315&clearCart=true Citations: McDonagh, S. T., Dalal, H., Moore, S., Clark, C. E., Dean, S. G., Jolly, K., ... & Taylor, R. S. (2023). Home‐based versus centre‐based cardiac rehabilitation. Cochrane database of systematic reviews, (10).Schutzer, K. A., & Graves, B. S. (2004). Barriers and motivations to exercise in older adults. Preventive medicine, 39(5), 1056-1061.Lee, J. Y., Lin, L., & Tan, A. (2019). Prevalence of pole dance injuries from a global online survey. The Journal of sports medicine and physical fitness, 60(2), 270-275.Nicholas, J., Weir, G., Alderson, J. A., Stubbe, J. H., Van Rijn, R. M., Dimmock, J. A., ... & Donnelly, C. J. (2022). Incidence, mechanisms, and characteristics of injuries in pole dancers: a prospective cohort study. Medical problems of performing artists, 37(3), 151-164.Dang, Y., Chen, R., Koutedakis, Y., & Wyon, M. A. (2023). The efficacy of physical fitness training on dance injury: a systematic review. International journal of sports medicine, 44(02), 108-116.Ambegaonkar, J. P., Chong, L., & Joshi, P. (2021). Supplemental training in dance: a systematic review. Physical Medicine and Rehabilitation Clinics, 32(1), 117-135.Bohm, S., Mersmann, F., & Arampatzis, A. (2015). Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Sports medicine-open, 1, 1-18.Chapters:00:00 Introduction to the Science of Slink Podcast02:24 The Benefits of Home-Based Pole Dance Training06:54 Building Physical Capacity for Pole Dance08:23 Cross Training and Injury Prevention14:09 Considerations for Home Pole Dancers18:00 Recommendations for Beginners21:20 The Science of Slink Membership23:21 Conclusion and Final Thoughts

Aujourd'hui, Antoine Diers, Fatima Aït-Bounoua et Jérôme Marty débattent de l'actualité autour d'Alain Marschall et Olivier Truchot.

Dr. Edmund Tsui interviews authors Dr. Muhammad Z. Chauhan and Dr. Krishna S. Kishor on the risk of uveitis among patients starting topical glaucoma therapy. From their Ophthalmology Glaucoma article, “Incidence of Uveitis Following Initiation of Prostaglandin Analogs versus Other Glaucoma Medications.” Incidence of Uveitis Following Initiation of Prostaglandin Analogs versus Other Glaucoma Medications. Chauhan, Muhammad Z.Amin, Sejal et al. Ophthalmology Glaucoma, Volume 8, Issue 2, 126 – 132.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Mario Castillo-Sang, the Surgical Director of Mitral Valve and Heart Failure Therapies at St. Elizabeth Healthcare, Edgewood, Kentucky, USA, about totally endoscopic cardiac surgery. Chapters 00:00 Intro 01:17 Minimal Access Bedside Cardiac 04:37 Lung Cancer, Histological Subtype 09:29 TAVR vs SAVR, AS & CAD 12:22 Biopros TVR Outcomes 15:48 Mitral Annular Disjunction, MVR 18:47 Ozaki Technique, AV Reconst 20:46 Redo LVOT Reconst for Endocarditis 22:33 Totally Endoscopic ASD Closure TVR 24:08 Dr. Castillo-Sang, MI Bedside Endoscopy 40:51 Closing They explore key highlights from Dr. Castillo-Sang's CTSNet series Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach, his journey in performing endoscopic surgeries, and how he learned the techniques. Dr. Castillo-Sang shares the advantages of endoscopic surgery, as well as tips and recommendations for those wanting to learn this approach. He emphasizes the importance of the instruments he has worked with, detailing how these have improved over time. Additionally, they explore Dr. Castillo-Sang's involvement with the Endoscopic Cardiac Surgeons Club, discussing how he got involved and providing details about the club's upcoming annual meeting.   Joel also highlights recent JANS articles on the estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time, transcatheter vs surgical aortic valve replacement in Medicare beneficiaries with aortic stenosis and coronary artery disease, long-term outcomes after bioprosthetic tricuspid valve replacement, and outcomes of patients with mitral annular disjunction undergoing mitral valve repair.  In addition, Joel explores aortic valve reconstruction using the Ozaki technique, redo LVOT reconstruction for endocarditis, and totally endoscopic ASD closure with tricuspid valve repair. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Estimated Worldwide Variation and Trends in Incidence of Lung Cancer by Histological Subtype in 2022 and Over Time: A Population-Based Study  2.) Transcatheter vs Surgical Aortic Valve Replacement in Medicare Beneficiaries With Aortic Stenosis and Coronary Artery Disease  3.) Long-Term Outcomes After Bioprosthetic Tricuspid Valve Replacement: A Multicenter Study  4.) Outcomes of Patients With Mitral Annular Disjunction Undergoing Mitral Valve Repair  CTSNET Content Mentioned  1.) Aortic Valve Reconstruction—The Ozaki Technique  2.) Redo LVOT Reconstruction for Endocarditis  3.) Totally Endoscopic ASD Closure With Tricuspid Valve Repair  Other Items Mentioned  1.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach  2.) Endoscopic Cardiac Surgeons Club  3.) Mini Heart Valves   4.) Aortic Valve Replacement Series     5.) Career Center 6.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

The average person spends up to 18 hours in their home. Therefore, our homes are not just places to rest. They're also environments that significantly impact our health and well-being.Spending so much time indoors makes it important to ensure our homes have as minimal harmful chemicals in the environment as possible. Our homes are often considered our safety nests, where we seek comfort and security, but they can also harbor hidden dangers if not properly maintained.That's why we're so glad to chat on IG Live with Alexandra Destler, Founder and CEO of SafetyNEST.SafetyNEST is an award-winning digital platform committed to providing the most credible information about the effects of toxic chemicals on prenatal and early childhood health in order to safeguard children's health and reduce the incidence of preventable diseases.During this Live, we're going to discuss overlooked environmental health factors in our homes, how they impact pregnancy outcomes, resources and tools people can use, and so much more!Learn more about SafetyNEST: https://www.mysafetynest.com/Get tested for BPA, phthalates, parabens, and other hormone-disrupting chemicals with Million Marker's Detect & Detox Test Kit: https://www.millionmarker.com/

Cori is a hard-working corporate employee who dutifully contributes to America's tax base. Nina is a low-income artist with Crohn's Disease whose medical expenses make her a net parasite, despite also paying taxes. After a surprise performance of improvised music by soda-can virtuoso Cori, we discuss tariffs, security, Medicaid, FICA, “maxing out contributions,” Incidence of Taxation, employment benefits, monetary incentives, distortions, the Tragedy of the Commons, suckers, rationalizations, population collapse/explosion, and episodic disability. Is art, work? How hard is it to be poor? Can air be privatized? Like Life itself, our tax/benefits system isn't fair, and it cannot go on forever. So a big Thank You to all American taxpayers who support unproductive, under-productive, post-productive, and ill members of society like your show-notes writer.Links:Leta Boylan testimonyTerminator 2: https://www.imdb.com/title/tt0103064/Tragedy of the Commons: https://en.wikipedia.org/wiki/Tragedy_of_the_commonsThe Economist on more people claiming entitlements: https://www.economist.com/britain/2025/04/02/the-tyranny-of-tiktokkers-who-turn-up Get full access to Heterodorx Podcast at heterodorx.substack.com/subscribe

Nonunion following naviculocuneiform (NC) joint arthrodesis is a well-recognized complication. Most studies reporting nonunion rates involve a limited number of cases or focus on a single disease entity. Moreover, there is variation between studies with regard to the number of articular facets included in the arthrodesis as well as the fixation construct used, with no clear evidence indicating how these factors influence union. This study, using the largest cohort to date, aims to investigate the nonunion rate following NC joint arthrodesis and to identify demographic and surgical factors associated with nonunion.   In conclusion, this study demonstrates a significant rate of nonunion following NC joint arthrodesis, exceeding that previously reported. We found that the rate of nonunion significantly increased in arthrodeses involving only the medial NC facet as compared to those including multiple NC facets.     Click here to read the article.

Join the conversation by letting us know what you think about the episode!According to the National Breast Cancer Foundation, 1 in 8 women will be diagnosed with breast cancer in her lifetime. Breast Cancer Facts & Stats 2024 - Incidence, Age, Survival, & More. Our guest, Erica Neubert Campbell is one of those women. Having lived through her mother's experience with breast cancer, Erica wasn't surprised when she was diagnosed with the same illness. In The Mastectomy I Always Wanted: A Breast Cancer Memoir, Erica takes us along with her from expectation to diagnosis to reconstruction and beyond. The end result is a resource for all of us - cancer warriors and survivors, their caregivers, and the people who love them.Where to find Erica Neubert Campbell:Website:  www.ericaneubertcampbell.comAmazon link:  https://amzn.to/4ck4Di1Facebook: https://www.facebook.com/erica.neubert/Instagram: https://www.instagram.com/erica.n.campbell/LinkedIN: https://www.linkedin.com/in/erica-neubert-campbell-936279/Support the showBe part of the conversation by sharing your thoughts about this episode, what you may have learned, how the conversation affected you. You can reach Raquel and Jennifer on IG @madnesscafepodcast or by email at madnesscafepodcast@gmail.com.Share the episode with a friend and have your own conversation. And don't forget to rate and review the show wherever you listen!Thanks!

Les accidents vasculaires cérébraux (AVC) constituent une préoccupation majeure en santé publique, avec plus de 120 000 cas recensés chaque année en France, entraînant environ 30 000 décès. Traditionnellement associés aux personnes âgées, les AVC touchent également des populations plus jeunes, une tendance mise en lumière par des études récentes.​Incidence des AVC selon l'âgeSelon le bulletin épidémiologique publié le 4 mars 2025 par Santé publique France, l'âge moyen des patients hospitalisés pour un AVC en 2022 était de 73,2 ans, avec une différence notable entre les sexes : 70,5 ans pour les hommes et 76,3 ans pour les femmes. La moitié des patients avaient plus de 75 ans au moment de l'AVC, et 25,4 % étaient âgés de moins de 65 ans. Ces chiffres illustrent que, bien que l'incidence des AVC augmente avec l'âge, une proportion significative touche des individus de moins de 65 ans. ​Le risque d'AVC augmente significativement avec l'âge, atteignant son maximum chez les personnes de 85 ans et plus. Augmentation des AVC chez les moins de 65 ansBien que le vieillissement de la population explique en partie l'augmentation globale des AVC, un "signal épidémiologique" préoccupant est observé chez les adultes de moins de 65 ans depuis une quinzaine d'années. Cette tendance suggère une hausse de l'incidence et des hospitalisations pour AVC dans cette tranche d'âge, nécessitant une attention particulière. ​Facteurs de risque chez les moins de 65 ansPlusieurs facteurs peuvent contribuer à cette augmentation chez les moins de 65 ans :​Hypertension artérielle : facteur de risque majeur d'AVC.​Diabète : augmente le risque de maladies vasculaires, y compris les AVC.​Tabagisme : endommage les vaisseaux sanguins et favorise les caillots.​Sédentarité et obésité : contribuent à l'hypertension et au diabète.​Consommation excessive d'alcool : peut entraîner une hypertension et des troubles du rythme cardiaque.​L'adoption de modes de vie sains, incluant une alimentation équilibrée, une activité physique régulière et l'arrêt du tabac, est essentielle pour réduire ces risques.​ConclusionBien que le risque d'AVC augmente avec l'âge, touchant principalement les personnes de plus de 75 ans, une proportion notable survient chez les moins de 65 ans. L'augmentation de l'incidence dans cette tranche d'âge souligne l'importance de la prévention et de la sensibilisation aux facteurs de risque modifiables, afin de réduire l'impact des AVC sur cette population. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Autoimmune conditions are common, and people may be affected by more than one. In this episode of the Clinical Update podcast, the MIMS Learning editors discuss tips on identifying key symptoms and the importance of timely referral.Conditions discussed include type 1 diabetes, rheumatoid arthritis, psoriasis, coeliac disease and the blistering skin condition bullous pemphigoid. Learn about the ‘4 Ts' that could suggest type 1 diabetes in children, the three 3 key symptoms that should prompt timely referral for suspected rheumatoid arthritis, and possible variations in presentations of psoriasis. Also covered are the non-classical symptoms associated with undiagnosed coeliac disease, and how bullous pemphigoid may present in older peopleYou can access the website version of this podcast on MIMS Learning to make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.Further learning on MIMS LearningThe presentation and management of type 1 diabetes in young peopleRheumatoid arthritis: clinical reviewPsoriasis in primary care: clinical reviewCoeliac disease: clinical reviewBullous pemphigoid: clinical reviewReferenceConrad N, Misra S, Verbakel J et al. Incidence, prevalence and co-occurrence of autoimmune disorders over time and by age, sex and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. The Lancet 2023; 401: 10391, 1878-1890. Hosted on Acast. See acast.com/privacy for more information.

The diagnosis of cancer is rising in young adults (

In this episode of the Movement Logic Podcast, hosts Laurel Beversdorf and Dr. Sarah Court critically examine common beliefs surrounding spinal flexion exercises and osteoporosis, particularly from a yoga and Pilates perspective. They delve into two pivotal studies on exercise and fracture risk, both led by Dr. Mehrsheed Sinaki, a renowned specialist in physical medicine and rehabilitation at the Mayo Clinic in Rochester, Minnesota.The first study, Postmenopausal Spinal Osteoporosis: Flexion versus Extension Exercises, is frequently cited on Pilates websites and in yoga and Pilates teacher trainings as evidence that spinal flexion is risky for individuals with osteoporosis—even during bodyweight exercises. However, despite its widespread use to justify movement restrictions, the study has notable methodological flaws. The second study, Stronger Back Muscles Reduce the Incidence of Vertebral Fractures: A Prospective 10-Year Follow-up of Postmenopausal Women, suggests that progressively overloaded back strengthening exercises can reduce fracture risk—even if the strengthening occurred only for a few years in the distant past. Yet, this study also has its own limitations.When viewed together, these studies present an intriguing contrast: one warns of the potential dangers of spinal flexion (even under low loads) based on weak evidence, while the other highlights the lasting protective benefits of strength training. Laurel and Sarah explore why bodyweight spinal flexion is often singled out as risky and question whether this caution is always justified.They also discuss the ethical implications and the boundaries of a movement teacher's scope of practice—particularly when making broad recommendations to avoid certain movements based on limited or flawed research. The hosts emphasize the importance of individualized context in exercise prescriptions, the need to follow medical guidance from a student's doctor, the evidence-backed benefits of strength training, and the necessity of empowering students with the autonomy to make informed movement choices.Get on the wait list for our Bone Density Course: Lift for LongevityFollow Movement Logic on Instagram00:56 Podcast Production & Content Creation01:33 Bone Density & Squat Depth02:20 Benefits of Full ROM Strength Training08:24 Is Spinal Flexion Dangerous for OP?10:00 Issues with Yoga/Pilates for OP Classes18:43 1984 Paper: Flexion vs. Extension for OP40:22 Flaws in the 1984 Study41:57 2002 Study: Stronger Back Muscles & Fractures43:03 2002 Study Design & Methods46:35 2002 Study Key Findings52:09 2002 Study Limitations56:30 Practical Takeaways01:06:15 Ethics for Movement Teachers01:17:43 ConclusionReferences:Episode 77: Make Dr. Loren Fishman Make SenseEpisode 92: Are You Getting Dexa Scammed? 1984 Sinaki paper 2002 Sinaki paper

In This Episode Kathleen investigates the connection between dietary fibre and cancer. Peter talks about future guests and our featured author. Increasing your intake of fibre can help with immune support, hormone health and overall metabolic stability. Furthermore, fibre has been shown in studies to help curb cancers such as gastric, ovarian and endometrial. If you're not used to high fibre, start slowly and gradually increase. This Week's Health Tip It's time for a Spring Clean – not just in your home but also your body and digestive system. Kathleen spoke about the Dr. Morse Herbal Health products that can help you do this. You can see all the products Kathleen mentioned on the Dr. Morse Herbal Health website. Use code Yakking Show for a 5% discount.  Mentioned On The Show Thea Trussler          www.petassistancetraining.com Logan Wright           www.grecogum.com Dr. Carol Remz        www.drcarolremz.com Dr. Mercola                 fibre consumption article Dr. Morse's episode          Video, audio and Spotify. Next Guest On the 1st of April we will explore the incredible benefits of mastic gum with Logan Wright, Co-Founder of Greco Gum. Mastic gum, harvested from the ancient Chios mastic tree, has been used for centuries for its oral health, jaw and facial muscle development, and gut health benefits. Featured Author. Our featured author this week is Eli LeClaire from episode 337 with her children's book “Adoption: A Beautiful Fulfillment of Life”. For parents of adopted children to help them prepare for the inevitable questions “Are you my mommy? Are you my daddy?” The Yakking Show is brought to you by Peter Wright & Kathleen Beauvais contact us to be a guest on our show. https://TheYakkingShow.com   peter@theyakkingshow.com    kathleen@theyakkingshow.com  Join our community today so you don't miss out on advance news of our next episodes. https://bit.ly/40GdxCG Yakking Show Affiliates Dr. Morse's Herbal Health Club Remedies https://bit.ly/3Oc2J8L  Science Driven Supplements - Circuguard & OxyBoost https://bit.ly/3VPzsV8  MyWayCBD https://bit.ly/4jFzmd0  BAM Metrics Exercise Equipment https://bit.ly/3SMnZom  B3 Sciences BFR bands  https://bit.ly/4g9HmzV  Chatterboss Virtual Assistants https://bit.ly/3Obmzlb  Follow us on social media Spotify   https://open.spotify.com/show/1N3yM4lUuBYGMByhwuUDVy  Facebook Group https://www.facebook.com/groups/480434235068451  FaceBook Page  https://www.facebook.com/theyakkingshow  Twitter  X   https://x.com/YakkingShow  Instagram  https://www.instagram.com/theyakkingshow/  Here are some of the tools we use to produce this podcast. Kit for sending emails and caring for subscribers Hostgator for website hosting. Podbean for podcast hosting Airtable for organizing our guest bookings and automations.   Clicking on some links on this site will let you buy products and services which may result in us receiving a commission, however, it will not affect the price you pay.            

Join JACC: Executive Associate Editor Mitsuaki Sawano, MD, FACC, and author Mats Lassen, MD discuss Dr. Lassen's study on the link between acute respiratory syncytial virus (RSV) infection and an increased incidence of cardiovascular events, particularly in older adults, using comprehensive nationwide data from Denmark. The findings, published in JACC and presented at ACC.25, highlight the need for heightened awareness among healthcare providers, potential adjustments in patient management during RSV season, and further research into whether RSV vaccines may help reduce cardiovascular complications. #jacc #jaccjournals #acc.25

Send us a textDeclining Incidence of Postoperative Neonatal Brain Injury in Congenital Heart Disease.Peyvandi S, Xu D, Barkovich AJ, Gano D, Chau V, Reddy VM, Selvanathan T, Guo T, Gaynor JW, Seed M, Miller SP, McQuillen P.J Am Coll Cardiol. 2023 Jan 24;81(3):253-266. doi: 10.1016/j.jacc.2022.10.029.PMID: 36653093 Free PMC article.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

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

A study published in Gut Microbes from Mass General Brigham found that long-term consumption of a popular fermented food may help to protect against the development of colorectal cancer. Dr. Bob Martin answers callers' health questions on a variety of topics   Health Alternative of the WeekHealth Outrage of the WeekProduct Recall of the WeekHealth Mystery of the Week

Title: Episode 4- Incidence, prevalence & Study Definitions Target Audience This activity is directed to physicians who take care of hospitalized children, medical students, nurse practitioners, and physician assistants working in the emergency room, intensive care unit, or hospital wards. Objectives: Upon completion of this activity, participants should be able to: 1.      Review incidence in research. 2.      Review prevalence in research. 3.      Review screening and how it pertains to research. Course Directors: Tony R. Tarchichi MD — Associate Professor, Department of Pediatrics, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC.) Paul C. Gaffney Division of Pediatric Hospital Medicine. No relationships with industry relevant to the content of this educational activity have been disclosed. Philana Lin M.D. MSc - University of Pittsburgh School of Medicine - Associate Professor in the Department of Pediatrics - Pediatric Infectious Disease Division Dr. Lin receives grant/research support from Pfizer (funds investigator initiated seroprevalance study on invasive pneumococcal infection), and NIH (Investigator initiated research on tuberculosis). Conflict of Interest Disclosure: No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose. Accreditation Statement: In support of improving patient care, the University of Pittsburgh 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.  The University of Pittsburgh School of Medicine designates this enduring material activity for a maximum of 0.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.   Disclaimer Statement: The information presented at this activity represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine.  Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses. Released 2/20/2025,  Expires 2/20/2028 The direct link to the course is provided below: https://cme.hs.pitt.edu/ISER/app/learner/loadModule?moduleId=25577&dev=true

Featuring a slide presentation and related discussion from Dr Surbhi Sidana, including the following topics: Key clinical data of FDA-approved chimeric antigen receptor (CAR) T-cell therapies (0:00) Real-world evidence evaluating utility of CAR T-cell therapies in the clinic (8:08) Impact of prior BCMA-targeted treatment on CAR T-cell therapy efficacy (12:55) Investigational CAR T-cell therapies in clinical development (15:08) Incidence and management of toxicities associated with CAR T-cell therapy (18:21) CME information and select publications

2/13/2025Seven Minute Summary1. High Dose vs. Low dose TXA in Adult deformity Surgery. JBJS. Dec 20242. Incidence of revision surgery and outcomes following surgery for spondylolisthesis. JNS. Jan 2025

Abdullah Al-Abcha, MD, social media editor of JACC: Cardiovascular Interventions, and Thomas Pilgrim, MD, MSc, discuss a recently published manuscript reporting the incidence, predictors, and clinical outcomes hemodynamic valve deterioration after transcatheter aortic valve replacement.

Hey Friends,This podcast episode goes out to all of you that LOVE to be in control... and find it hard to surrender to a greater plan, even more surrender to your manifestations...In this episode, I share my recent experiences navigating the ups and downs of life as I dealt with the news of gestational diabetes and big adjustments to our wedding plans.

Située à la base du cou, la thyroïde est une glande dont le rôle est de produire des hormones essentielles au bon fonctionnement du corps.   Dr Charles HALIM, endocrinologue, diabétologue dans le Centre anti-diabète Marc Sankalé au sein de l'Hôpital Abass Ndao, rattaché à l'Université Cheikh Anta Diop de Dakar au Sénégal     Retrouvez l'émission dans son intégralité iciQuestions de femmes : troubles et maladies de la thyroïde

Tune in to learn about a key aspect of a pet's general wellness care that can significantly affect the incidence of systemic disease. Overlooking this key health concern can increase the incidence of kidney failure, congestive heart failure, and liver disease by 150%, as well as significantly increase the incidence of certain type of cancers. Send listener emails for consideration to be addressed by Dr. Roger on the air to comments@web-dvm.net. Follow Dr. Roger's Facebook posts (including new podcast episodes) by sending a friend request to his public profile, Roger Welton DVM. Dr. Roger Welton, aka "Dr. Roger," is a practicing veterinarian and highly regarded media personality through a number of platforms. He is the author of his top selling memoir ⁠The Man In The White Coat: A Veterinarian's Tail Of Love.⁠  In addition to this podcast, Dr. Roger has a global blog, ⁠The Web-DVM⁠, where he regularly posts articles. He is the CEO and chief attending veterinarian of  ⁠Premier Veterinary Care⁠ in Viera, FL.

Fliessend Fremdsprachen sprechen mit KI-Hilfe – das Ziel rückt näher. Ausserdem: Berner Forschende lüften eiskalte Klima-Geheimnisse aus der Zeit der Urmenschen. Und: Möglicherweise triggert das Coronavirus die vererbte Form der Diabetes. (00:00) Schlagzeilen (00:42) Mit KI-Hilfe Fremdsprachen sprechen Meta und andere Tech-Firmen versuchen sich daran, KI-basierte Dolmetscher zu entwickeln, die in Echtzeit übersetzen. Ganz ausgereift ist die Technologie noch nicht, finden Expertinnen, aber sie hat grosses Potential. (Sandro della Torre) (06:49) Meldungen Neue kommerzielle Rakete im Testflug / Weniger Tiefsee-Fischerei in EU-Sperrzonen / Horizon Europe wieder (fast) ganz offen für die Schweiz. (Anita Vonmont) (11:54) Uraltes Eis erzählt vom Klima vor über 1 Million Jahren Forschenden ist es gelungen, den bisher ältesten, kontinuierlich geschichteten Eisbohrkern zu bergen. Die darin eingeschlossenen Luftbläschen sollen Aufschluss geben darüber, wie die Atmosphäre auf dem Planeten Erde vor schätzungsweise 1.5 Mio Jahre zusammengesetzt war – und wie sie sich anschliessend im Verlauf der Jahre verändert hat. Von Anfang an mit dabei war ein Forschungs-Team der Universität Bern. Reportage aus dem Eislabor. (Cathrin Caprez) (18:21) Kann das Corona-Virus Diabetes triggern? Zur Zeit der Corona-Pandemie vermehrte sich die Neuansteckungsrate bei der vererbten, unheilbaren Form der Diabetes (Typ1) um das bis zu Zehnfache. Mittlerweile belegen mehrere Studien diese Korrelation klar. Dennoch muss noch genauer untersucht werden, ob das Corona-Virus Diabetes auslösen kann. (Mirjam Stöckel) Links: Ältestes Eis und Klima: beyondepica.eu/en/ Fliessend Fremdsprachen sprechen mit KI-Hilfe: nature.com/articles/d41586-025-00045-y Tiefseefischerei: science.org/doi/10.1126/sciadv.adp4353 Horizon Europe: snf.ch/de/PIgvZDNljXgiJ59U/news/horizon-europe-fuer-schweizer-forschende-wieder-offen?utm_source=newsletter&utm_medium=email&utm_content=lang-de&utm_campaign=snf-newsletter Diabetes und Corona: Studie 1: onlinelibrary.wiley.com/doi/10.1155/2023/7660985 Diabetes und Corona: Studie 2: jamanetwork.com/journals/jama/fullarticle/2809621 Diabetes und Corona: Studie 3: diabetesjournals.org/care/article/45/8/1762/139385/Incidence-of-Type-1-Diabetes-in-Children-and Mehr zum Wissenschaftsmagazin und Links zu Studien: srf.ch/wissenschaftsmagazin.

Host Dr. Davide Soldato and his guests Dr. Ann Wu and Dr. Alexa White discuss the article "Air Pollution and Breast Cancer Incidence in the Multiethnic Cohort Study" and the editorial "Growing Evidence for the Role of Air Pollution in Breast Cancer Development"  TRANSCRIPT The guests on this podcast episode have no disclosures to declare.  Dr. Davide Soldato: Hello and welcome to JCO After Hours, the podcast where we sit down with authors from some of the latest articles published in the Journal of Clinical Oncology. I am your host, Dr. Davide Soldato, Medical Oncologist at Ospedale San Martino in Genoa, Italy.  Today, we are joined by JCO authors Dr. Anna Wu and Dr. Alexander White. Dr. Wu is a professor of Population and Public Health Sciences at the Keck School of Medicine of UCS, while Dr. White is an investigator in the Epidemiology branch of the Environment and Cancer Epidemiology Group at the National Institute of Health.  Today, we will be discussing the article titled, “Air Pollution and Breast Cancer Incidence in the Multiethnic Cohort Study,” and the accompanying editorial.  So, thank you for speaking with us, Dr. Wu, Dr. White. Dr. Anna Wu: Thank you for having us. Dr. Alexandra White: Yes, thank you so much for the invitation to be here. Dr. Davide Soldato: So before going in depth about the results of the study that was published in the JCO, I was wondering if you could give us like a brief introduction and a little bit of background about what was known about air pollution as a risk factor for breast cancer and what was the evidence before this study was conducted. Dr. Alexandra White: Okay. I can start with that question. So, there's been research for decades looking at the relationship between air pollution and breast cancer. And it's been a really challenging question to address for a number of reasons. One being that it can be really difficult to assess exposure to air pollution and many previous studies have had really limited information on people's residences over time. But in general, what we thought leading up to this study was that evidence was most consistent that exposure to traffic related pollutants such as nitrogen dioxide was more consistently related to a higher risk of breast cancer. The evidence for fine particulate matter or PM2.5 was less consistent. More recently, there have been a few large, well conducted studies that have supported a positive association. This new study in the multiethnic cohort led by Dr. Wu is really important because it really demonstrated that, in this large study of over 50,000 women in California, that they also do see an association with PM2.5.  Dr. Davide Soldato: Thank you very much for the introduction. So, Dr. Wu, we just want to hear a little bit more about the results. So, what was the association that was observed for PM2.5? And specifically, the study that you ran was focused on a very diverse population, a multiethnic cohort, and so I was wondering if you observed any type of differences when you consider the different populations that were included in your study. And if you could also give us a little bit of what was the composition of the women that were enrolled in this cohort. Dr. Anna Wu: Thank you for the question. So, the multiethnic cohort study is a cohort of over 200,000 individuals who were enrolled when they lived in Hawaii or California. For the air pollution studies that we've been conducting, we have focused on primarily the California participants. And in this instance for the breast cancer study, it was based on roughly 56,000 individuals out of- there were about 100,000 because half of them were men and they were not included. Of the California participants, 75% of them were African Americans or Latinos and they were self-identified as these racial ethnic groups when they enrolled in the study. And this was a particularly important consideration for us because in most of the studies that have been published so far on-air pollution and breast cancer, as well as other cancer sites, most of those studies were conducted among whites in the US or whites in Europe. And even if they included non-white populations, the numbers tend to be small so that they were not able to conduct racial ethnic specific analysis. So, we were particularly interested in examining these other racial ethnic groups because we know from other studies that racial ethnic minority groups tend to live in communities of low socioeconomic status and those communities also tend to have higher levels of various types of environmental pollutants. And so, it was important for us to actually try to tease apart these various interrelated factors.  So, what we found was that per 10 micrograms per cubic meter, we had a 28% increased risk overall in all participants combined that meet across the racial ethnic groups. We actually did not see any differences or significant differences in the hazard ratios by race ethnicity and they were in general quite compatible with each other. But we did see a stronger finding among the white participants in our study. Dr. Davide Soldato: Thank you, a lot, Dr. Wu. So, I think it's very interesting the fact that in the end you observed that air pollution is a significant risk factor across all the ethnicities that were included in the study. But I think that one very strong point of the manuscript and one very strong point of the analysis was that in the end you also corrected for a series of different factors because we know that the incidence of breast cancer can be modified, for example, by familial history or BMI or smoking habits or also alcohol consumption. And a lot of these risk factors were included in your analysis. And so, I was wondering if you could tell us a little bit whether you observed any significant differences when you observed or included also these risk factors in your analysis, or whether the association for air pollution as a risk factor stands even when we consider all of these other elements. Dr. Anna Wu: Yes. So, we considered all the well-established breast cancer risk factors. And in this situation, we were particularly interested in considering smoking, alcohol intake, use of menopausal hormones, history of diabetes, body mass index, family history, as well as physical activity, because many of these risk factors, such as, for example, diabetes and body mass index, they are risk factors for breast cancer, and air pollution, have also been found to increase risk of these factors.  So, in our analysis, we first adjusted for all of these potential confounders in a mutually adjusted manner, so all of them were considered. In addition, we also conducted stratify analysis. So as an example, we stratified the analysis to examine whether the hazard ratio associated with PM2.5 provided comparable risk estimate or hazard ratio estimates for never smokers, former smokers, and current smokers. Although we did not see significant heterogeneity by these various subgroups, we did see a significantly stronger effect of PM2.5 among individuals who did not have a family history of breast cancer.  Interestingly, our finding was also stronger among individuals who were never smokers and light alcohol drinkers, even though the results were not significantly different. So, we surmised that maybe individuals who already had a high risk because of other established risk factors for breast cancer, we were less likely to be able to observe the effect of air pollution. But it's important to note that other studies, such as the ones that Dr. White has conducted, have also looked at various subgroups, and I think part of the limitation that all of us have is that once you subdivide the study population, even if you start out with a large sample size, often the sample size gets cut in half or a third. And so, we still lack the statistical power to be able to observe significant differences. But I think it is important to note that, in fact, the hazard ratio estimates are actually quite comparable, but we did see a hint of stronger effects among never smokers, and people who were light alcohol drinkers. So, I think this is an area that we certainly need to continue to investigate since there are other subgroups, such as menopausal status, such as hormone receptor status of breast cancer, that we need to consider in future studies. There's still a lot of work we need to do to sort this out, to actually figure out who are the women who are the most susceptible to the exposures. Dr. Davide Soldato: Dr. White, I would really love a comment from you on this specific area and specifically on what still needs to be done. And related to this, a question actually, for both of you, because I think that from a methodological point of view, there is a lot of work that goes into deciding how we are going to assess the exposure to air pollution. So which type of data are we going to use? Which type of data are we currently using in the epidemiological studies that have been conducted and in the one that we are discussing right now in JCO? And what are the caveats for this data that we are using? Meaning, I think that we use mostly residential addresses, which means that we are looking at the exposure where people actually live, which might not be the place where they spend most of their time. For example, if someone is working, maybe they could be more exposed and have higher exposure when they are at work compared to when they are at home. So, I was wondering if you could give us a little bit of an overview as to what is the methodological standard of care right now in terms of this analysis and what can we do better to refine and understand this specific factor as Dr. Wu was mentioning? Dr. Alexandra White: Yeah, so I'm happy to take a first stab at that question. So, I think it's important to note just how far we've come. I think even a few years ago, air pollution was really not considered a risk factor for breast cancer. And a lot of the work that we've been doing and others have really moved this forward in terms of understanding this as a risk factor. And as I mentioned earlier, there have been a lot of challenges in exposure assessment. And to get to your question, I think that our studies in general are doing better at looking at exposure over more years, residences, more time. We know that cancer takes time to develop, and we can't rely on just a single snapshot of exposure. But as you mentioned, almost all of the studies published have really exclusively focused on residential estimates of exposure. And so, there's a real need to understand the exposures that people are experiencing in other aspects of their life, from their commute to their jobs, to really capture that totality of exposure.  And then I think one of the points that Dr. Wu was alluding to as well as we know that breast cancer is a very heterogeneous disease, so risk factors for breast cancer vary by tumor subtypes, by menopausal status at diagnosis. And a lot of studies have really focused on considering breast cancer as a combined outcome, and that might be missing some really important signals where we might have a stronger effect for certain subtypes due to the fact that there's different biologic pathways that are underlying these subtypes or by menopausal status. And so having large study populations where, as we discussed earlier, would really give us the power to look among these smaller groups of women who might be more susceptible and those with younger women, we know that incidence of cancer is rising in young people, and we need to understand the risk factors for that. And most of our studies are really focused on older individuals, so I think that's one important gap, as well as having the power to really look at different differences by tumor subtypes. Dr. Davide Soldato: I think it's very interesting, and I think one point both of you made in the original article and in the accompanying editorial is also the fact that we tend to look at these risk factors in people who are actually aged, while we maybe should be looking at this in an earlier phase of development and potentially during puberty. Do you think that we should design studies that are more focused on this population even though I think that they will take a lot of time to produce significant results?  Dr. Alexandra White: Yeah. I think that it is really important to consider how exposure during early life is related to breast cancer risk. We know that exposures during pregnancy or even as early as during puberty might be particularly relevant for breast cancer. And I think a lot of our studies have really been up against the challenge of the fact that exposure monitoring for air pollution really didn't start until the 1990s. And so, it's challenging, especially for these older cohorts, to get back at that time period that might be relevant. But I think that's something that definitely newer cohorts are going to be able to address, and I think it's going to be really important, and also will give us some clues to better understand the important windows of exposure, but also that might provide clues for the biologic pathways as well that are relevant. Dr. Davide Soldato: And just a related question, because I'm not aware of this, but are there right now cohorts that are specifically looking at this in the US or in other parts of the world? If you are aware of that, of course.  Dr. Alexandra White: There have been some cohorts that have focused on exposure during these hypothesized windows of susceptibility, but I don't think they've been able to follow those women long enough to develop breast cancer. One of the things that we're working on in the sister study is trying to expand our assessment of air pollution exposure back in time to try to get at these earlier windows of exposure. So, I'm hoping that it's something we'll be able to comment on and at least for some of the women in our cohort who are younger. But I don't know, Dr. Wu, if you're familiar with any other populations that are doing this now?  Dr. Anna Wu: Well, NCI funded several new cohorts in the last couple years that are really focused on trying to get a much more refined exposure assessment. So, I know colleagues at University of Michigan that are peers and also Dr. Wei Zheng at Vanderbilt, they are putting together newer cohorts that are younger and also trying to include a range of exposure, not just air pollution, but really environmental exposures. Those cohorts I think have the potential in the future to try to address some of these questions, but again, it will take at least another number of years before there are a sufficient number of endpoints so that they can actually do these types of studies.  Another possibility is that there are a number of big cohort studies in Asia. The age of diagnosis tends to be earlier in Asia. I know that investigators in China are very interested and concerned with the air pollution effects in China. I think there are potentials that in other countries where the age of breast cancer diagnosis is actually younger than in the US and if they establish in a manner that allows them to assess air pollution that they may have opportunities.  And I think the other way to try to address this question, whether there are studies where you can actually tap into either biomarkers or pathology samples so you won't be actually studying air pollution in a large population, but you're actually narrowing it down to try to see if you see any signals in a way that would give you some additional clues and insights as to the mechanism. So I think we're going to have to piece together various types of study to try to answer the questions because one type of study like these observational air pollution studies, will allow us to address one slice of the questions that we have and then we need to put together other studies so that we can address other aspects that we're interested in to put it together. Dr. Davide Soldato: Thank you very much both of you. That was very interesting.  Coming back to the results of the manuscript, we really focused up until now on PM2.5. But it's true that inside of the study you evaluated different pollutants. So, I was wondering whether you saw a similar association for other pollutants that were included in the study or whether the association for higher risk was observed only for PM2.5. Dr. Anna Wu: The results for NO2, NOx, PM10, and carbon monoxide were actually very compatible with the risk estimates that other studies have published as well as from the meta-analysis. So, I would say that our results from the other pollutants are actually very consistent with other results. I think one difference is that our PM2.5 estimates were based on the satellite-based PM2.5 estimates, whereas all the other pollutants were based on monitoring station estimates from EPA sponsored air monitoring stations. So, they are not measured in the same way. And I think different studies over time have used either monitoring station type measures for other pollutants. And I think we were particularly interested in PM2.5 because the measurement of PM2.5 in the monitoring world didn't start until around 2000. So, studies up until that time were less able to actually provide the assessment of PM2.5 as good as we can for air pollution. There's always misclassification. So, I think it's a matter of how much misclassification in the assessment. But, again, we are really limited in really just having exposure over one part of adult life.  Dr. Davide Soldato: Thank you very much. And one potentially related question. We are speaking in general about air pollution, but I think that since we are considering residential addresses, probably we are capturing more either traffic pollution or pollution that comes from probably industries or stuff like that, which is mostly related to residential areas or the place where people live. But I think that in the end we also think about air pollution as something that can come from different forms. And one very interesting point, Dr. White, that you made in your editorial is also that there is a global change also in the way we are faced with air pollution. For example, you made the example of wildfires in your editorial and how this might potentially change exposure to air pollution, maybe for limited times, but with concentrations that are fairly higher compared to what we generally observed. So, I was wondering if you could comment a little bit on that and also, if there is potentially a way to also consider this in future epidemiological studies. Dr. Alexandra White: Yeah, so when we talk about exposure to fine particulate matter, PM2.5, we're assessing exposure to particles that are based on the size of the particle, and we're really not evaluating the types of particles that people are experiencing exposure to. And we know that, in general, that PM2.5 composition really varies geographically due to differing sources of exposure. So, like you were saying, there might be a stronger contribution to industry or from agriculture or from traffic. And so that could really change the PM2.5 exposure profile that individuals experience. And so it could be that this is another really important area that this research needs to consider, which could really help us identify what sources of exposure are most relevant.   Wildfires are a really important growing concern. We know that wildfires are increasing in both intensity and duration and frequency, and we really don't understand the long-term health impacts of wildfires. But we know that wildfire associated PM2.5 might be one of the most dominant contributors to PM2.5 moving forward. And although we've seen historic declines in PM2.5 in the US after the Clean Air Act, those declines have really stalled. PM2.5 itself is projected to increase over the next few decades, so understanding different PM2.5 composition profiles and the sources that drive them can really help us identify the most important targets for any potential interventions. And wildfire PM2.5 in particular may be of concern because it's a combustion byproduct, and so it's thought to have more of the components that might, we hypothesize, are most relevant for breast cancer, such as PAHs or polycyclic aromatic hydrocarbons or metals. And so, these components are thought to act as endocrine disruptors, which may be particularly relevant for breast cancer. So, I think understanding this changing landscape of PM2.5 moving forward is going to be really important in understanding how PM2.5 contributes to cancers beyond just breast, but as well as other female hormone driven cancers and all of the cancers really.  Dr. Davide Soldato: Thank you very much. So, one closing remark, because I think that in general, we have been really in a field of primary prevention for breast cancer where we were focusing on individual behaviors, for example, smoking cessation, reduction in alcohol intake, reduction of BMI, increase of physical activity. But I think that the evidence that is accumulating in the last three years or so is telling us more and more that we also need to shift the perspective on prevention going not only on individuals, but also as including environmental risk. So, I was wondering, how can we include this new evidence in the policies that we implement and how policymakers should act on the data that we have available right now? Dr. Anna Wu: I think it's really important that this new information is communicated to all the stakeholders, including our policymakers, so that they are, first of all, really aware that any changes and not actually adhering to current guidelines can have long lasting consequences, deleterious consequences. And I think it's important to also note that over 90% of the world actually live in areas where PM2.5 exceeds the limit. We have observed increases in breast cancer in many middle- and low-income countries, so I think it's particularly important to emphasize that this is really not just a western country issue, it is really a global issue. Dr. Alexandra White: I agree. And I would just add to that that air pollution is not something that an individual can really change on their own. There are things you can do, you can monitor air quality, you can try to live in a home that's far away from traffic. But really these are large scale problems that really require large scale solutions. And we know that policy changes can be effective here and that this is something that, in my opinion, is not something that we leave to the individual to change. This is something that we as a society should encourage change for the health of everyone. Dr. Davide Soldato: So, thank you very much again, Dr. Wu, Dr. White, for joining us today on the podcast. Dr. Anna Wu: Thank you. Dr. Alexandra White: Thank you so much for having us.  Dr. Davide Soldato: So we appreciate you sharing more on your JCO article and accompanying editorial titled, “Air Pollution and Breast Cancer Incidents in the Multiethnic Cohort Study.”  If you enjoy our show, please leave us a rating and review and be sure to come back for another episode. You can find all ASCO shows at asco.org/podcasts.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.      

Guest: Dr. Christian de Virgilio is the Chair of the Department of Surgery at Harbor-UCLA Medical Center. He is also Co-Chair of the College of Applied Anatomy and a Professor of Surgery at UCLA's David Geffen School of Medicine. He completed his undergraduate degree in Biology at Loyola Marymount University and earned his medical degree from UCLA. He then completed his residency in General Surgery at UCLA-Harbor Medical Center followed by a fellowship in Vascular Surgery at the Mayo Clinic.   Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Outline: Steal Syndrome Definition & Etiology Steal syndrome is an important complication of AV access creation, since access creation diverts arterial blood flow from the hand. Steal can be caused by multiple factors—arterial occlusive disease proximal or distal to the AV anastomosis, high flow through the fistula at the expense of distal arterial perfusion, and failure of the distal arterial networks to adapt to this decreased blood flow.  Incidence and Risk Factors The frequency of steal syndrome is 1.6-9%1,2, depending on the vessels and conduit choice Steal syndrome is more common with brachial and axillary artery-based accesses and nonautogenous conduits. Other risk factors for steal syndrome are peripheral vascular disease, coronary artery disease, diabetes, advanced age, female sex, larger outflow conduit, multiple prior permanent access procedures, and prior episodes of steal.3,4  Long-standing insulin-dependent diabetes causes both medial calcinosis and peripheral neuropathy, which limits arteries' ability to vasodilate and adjust to decreased blood flow. Patient Presentation, Symptoms, Grading Steal syndrome is diagnosed clinically.  Symptoms after AVG creation occurs within the first few days, since flow in prosthetic grafts tend to reach a maximum value very early after creation. Native AVFs take time to mature and flow will slowly increase overtime, leading to more insidious onset of symptoms that can take months or years. The patient should have a unilateral complaint in the extremity with the AV access. Symptoms of steal syndrome, in order of increasing severity, include nail changes, occasional tingling, extremity coolness, numbness in fingertips and hands, muscle weakness, rest pain, sensory and motor deficits, fingertip ulcerations, and tissue loss.  There could be a weakened radial pulse or weak Doppler signal on the affected side, and these will become stronger after compression of the AV outflow. Symptoms are graded on a scale specified by Society of Vascular Surgery (SVS) reporting standards:5  Workup Duplex ultrasound can be used to analyze flow volumes. A high flow volume (in autogenous accesses greater than 800 mL/min, in nonautogenous accesses greater than 1200 mL/min) signifies an outflow issue. The vein or graft is acting as a pressure sink and stealing blood from the distal artery. A low flow volume signifies an inflow issue, meaning that there is a proximal arterial lesion preventing blood from reaching the distal artery. Upper extremity angiogram can identify proximal arterial lesions. Prevention Create the AV access as distal as possible, in order to preserve arterial inflow to the hand and reduce the anastomosis size and outflow diameter.  SVS guidelines recommend a 4-6mm arteriotomy diameter to balance the need for sufficient access flow with the risk of steal. If a graft is necessary, tapered prosthetic grafts are sometimes used in patients with steal risk factors, using the smaller end of the graft placed at the arterial anastomosis, although this has not yet been proven to reduce the incidence of steal.  Indications for Treatment Intervention is recommended in lifestyle-limiting cases of Grade II and all Grade III steal cases. If left untreated, the natural history of steal syndrome can result in chronic limb ischemia, causing gangrene with loss of digits or limbs. Treatment Options Conservative management relies on observation and monitoring, as mild cases of steal syndrome may resolve spontaneously. Inflow stenosis can be treated with endovascular intervention (angioplasty with or without stent) Ligation is the simplest surgical treatment, and it results in loss of the AV access. This is preferred in patients with repetitive failed salvage attempts, venous hypertension, and poor prognoses. Flow limiting procedures can address high volumes through the AV access. Banding can be performed with surgical cutdown and placement of polypropylene sutures or a Dacron patch around the vein or graft. The Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique employs a percutaneous endoluminal balloon inflated at the AVF to ensure consistency in diameter while banding Plication is when a side-biting running stitch is used to narrow lumen of the vein near the anastomosis. A downside of flow-limiting procedures is that it is often difficult to determine how much to narrow the AV access, as these procedures carry a risk of outflow thrombosis. There are also surgical treatments focused on reroute arterial inflow. The distal revascularization and interval ligation (DRIL) procedure involves creation of a new bypass connecting arterial segments proximal and distal to the AV anastomosis, with ligation of the native artery between the AV anastomosis and the distal anastomosis of the bypass. Reversed saphenous vein with a diameter greater than 3mm is the preferred conduit. Arm vein or prosthetic grafts can be used if needed, but prosthetic material carries higher risk of thrombosis. The new arterial bypass creates a low resistance pathway that increases flow to distal arterial beds, and interval arterial ligation eliminates retrograde flow through the distal artery.  The major risk of this procedure is bypass thrombosis, which results in loss of native arterial flow and hand ischemia. Other drawbacks of DRIL include procedural difficulty with smaller arterial anastomoses, sacrifice of saphenous or arm veins, and decreased fistula flow. Another possible revision surgery is revision using distal inflow (RUDI). This procedure involves ligation of the fistula at the anastomosis and use of a conduit to connect the outflow vein to a distal artery. The selected distal artery can be the proximal radial or ulnar artery, depending on the preoperative duplex. The more dominant vessel should be spared, allowing for distal arterial beds to have uninterrupted antegrade perfusion. The nondominant vessel is used as distal inflow for the AV access. RUDI increases access length and decreases access diameter, resulting in increased resistance and lower flow volume through the fistula. Unlike DRIL, RUDI preserves native arterial flow.  Thrombosis of the conduit would put the fistula at risk, rather than the native artery.  The last surgical revision procedure for steal is proximalization of arterial inflow (PAI). In this procedure, the vein is ligated distal to the original anastomosis site and flow is re-established through the fistula with a PTFE interposition graft anastomosed end-to-side with the more proximal axillary artery and end-to-end with the distal vein. Similar to RUDI, PAI increases the length and decreases the diameter of the outflow conduit. Since the axillary artery has a larger diameter than the brachial artery, there is a less significant pressure drop across the arterial anastomosis site and less steal. PAI allows for preservation of native artery's continuity and does not require vein harvest.  Difficulties with PAI arise when deciding the length of the interposition graft to balance AV flow with distal arterial flow. 2. Ischemic Monomelic Neuropathy Definition Ischemic monomelic neuropathy (IMN) is a rare but serious form of steal that involves nerve ischemia. Severe sensorimotor dysfunction is experienced immediately after AV access creation. Etiology IMN affects blood flow to the nerves, but not the skin or muscles because peripheral nerve fibers are more vulnerable to ischemia. Incidence and Risk Factors IMN is very rare; it has an estimated incidence of 0.1-0.5% of AV access creations.6 IMN has only been reported in brachial artery-based accesses, since the brachial artery is the sole arterial inflow for distal arteries feeding all forearm nerves. IMN is associated with diabetes, peripheral vascular disease, and preexisting peripheral neuropathy that is associated with either of the conditions. Patient Presentation Symptoms usually present rapidly, within minutes to hours after AV access creation. The most common presenting symptom is severe, constant, and deep burning pain of the distal forearm and hand. Patients also report impairment of all sensation, weakness, and hand paralysis. Diagnosis of IMN can be delayed due to misattribution of symptoms to anesthetic blockade, postoperative pain, preexisting neuropathy, a heavily bandaged arm precluding neurologic examination. Treatment Treatment is immediate ligation of the AV access. Delay in treatment will quickly result in permanent sensorimotor loss.   3. Perigraft Seroma Definition A perigraft seroma is a sterile fluid collection surrounding a vascular prosthesis and is enclosed within a pseudomembrane. Etiology and Incidence Possible etiologies include: transudative movement of fluid through the graft material, serous fluid collection from traumatized connective tissues (especially the from higher adipose tissue content in the upper arm), inhibition of fibroblast growth with associated failure of the tissue to incorporate the graft, graft “wetting” or kinking during initial operation, increased flow rates, decreased hematocrit causing oncotic pressure difference, or allergy to graft material. Seromas most commonly form at anastomosis sites in the early postoperative period. Overall seroma incidence rates after AV graft placement range from 1.7–4% and are more common in grafts placed in the upper arm (compared to the forearm) and Dacron grafts (compared to PTFE grafts).7-9 Patient Presentation and Workup Physical exam can show a subcutaneous raised palpable fluid mass Seromas can be seen with ultrasound, but it is difficult to differentiate between the types of fluid around the graft (seroma vs. hematoma vs. abscess) Indications for Treatment Seromas can lead to wound dehiscence, pressure necrosis and erosion through skin, and loss of available puncture area for hemodialysis Persistent seromas can also serve as a nidus for infection. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines10 recommend a tailored approach to seroma management, with more aggressive surgical interventions being necessary for persistent, infected-appearing, or late-developing seromas.   Treatment The majority of early postoperative seromas are self-limited and tend to resolve on their own Persistent seromas have been treated using a variety of  methods-- incision and evacuation of seroma, complete excision and replacement of the entire graft, and primary bypass of the involved graft segment only. Graft replacement with new material and rerouting through a different tissue plane has a higher reported cure rate and lower rate of infection than aspiration alone.9     4. Infection Incidence and Etiology The reported incidence of infection ranges 4-20% in AVG, which is significantly higher than the rate of infection of 0.56-5% in AVF.11  Infection can occur at the time of access creation (earliest presentation), after cannulation for dialysis (later infection), or secondary to another infectious source. Infection can also further complicate a pre-existing access site issue such as infection of a hematoma, thrombosed pseudoaneurysm, or seroma. Skin flora from frequent dialysis cannulations result in common pathogens being Staphylococcus, Pseudomonas, or polymicrobial species. Staphylococcus and Pseudomonas are highly virulent and likely to cause anastomotic disruption. Patient Presentation and Workup Physical exam will reveal warmth, pain, swelling, erythema, induration, drainage, or pus. Occasionally, patients have nonspecific manifestations of fever or leukocytosis. Ultrasound can be used to screen for and determine the extent of graft involvement by the infection.   Treatments In AV fistulas: Localized infection can usually be managed with broad spectrum antibiotics.  If there are bleeding concerns or infection is seen near the anastomosis site, the fistula should be ligated and re-created in a clean field. In AV grafts: If infection is localized, partial graft excision is acceptable. Total graft excision is recommended if the infection is present throughout the entire graft, involves the anastomoses, occludes the access, or contains particularly virulent organisms Total graft excision may also be indicated if a patient develops recurrent bacteremia with no other infectious source identified. For graft excision, the venous end of the graft is removed and the vein is oversewn or ligated. If the arterial anastomosis is intact, a small cuff of the graft can be left behind and oversewn. If the arterial anastomosis is involved, the arterial wall must be debrided and ligation, reconstruction with autogenous patch angioplasty, or arterial bypass can be pursued. References   1. Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and Characteristics of Patients with Hand Ischemia after a Hemodialysis Access Procedure. J Surg Res. 1998;74(1):8-10. doi:10.1006/jsre.1997.5206 2. Ballard JL, Bunt TJ, Malone JM. Major complications of angioaccess surgery. Am J Surg. 1992;164(3):229-232. doi:10.1016/S0002-9610(05)81076-1 3. Valentine RJ, Bouch CW, Scott DJ, et al. Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis. J Vasc Surg. 2002;36(2):351-356. doi:10.1067/mva.2002.125848 4. Malik J, Tuka V, Kasalova Z, et al. Understanding the Dialysis access Steal Syndrome. A Review of the Etiologies, Diagnosis, Prevention and Treatment Strategies. J Vasc Access. 2008;9(3):155-166. doi:10.1177/112972980800900301 5. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603-610. doi:10.1067/mva.2002.122025 6. Thermann F, Kornhuber M. Ischemic Monomelic Neuropathy: A Rare but Important Complication after Hemodialysis Access Placement - a Review. J Vasc Access. 2011;12(2):113-119. doi:10.5301/JVA.2011.6365 7. Dauria DM, Dyk P, Garvin P. Incidence and Management of Seroma after Arteriovenous Graft Placement. J Am Coll Surg. 2006;203(4):506-511. doi:10.1016/j.jamcollsurg.2006.06.002 8. Gargiulo NJ, Veith FJ, Scher LA, Lipsitz EC, Suggs WD, Benros RM. Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas. J Vasc Surg. 2008;48(1):216-217. doi:10.1016/j.jvs.2008.01.046 9. Blumenberg RM, Gelfand ML, Dale WA. Perigraft seromas complicating arterial grafts. Surgery. 1985;97(2):194-204. 10. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4):S1-S164. doi:10.1053/j.ajkd.2019.12.001 11. Padberg FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: Recognition and management. J Vasc Surg. 2008;48(5):S55-S80. doi:10.1016/j.jvs.2008.08.067

Dr. David L. Katz makes a compelling case for considering diet as a vital sign. Learn about the evidence supporting the impact of dietary choices on overall health and how to make informed decisions for a healthier life. #DietAsVitalSign #NutritionScience #HealthyLiving

Join us as we discuss the alarming rise of pediatric pneumonia and pertussis cases, unpacking the latest clinical insights and prevention strategies essential for today's pharmacists. In this episode, we'll explore the factors driving these trends, discuss how pharmacists can play a crucial role in patient education, and review updates to vaccine recommendations. Don't miss this opportunity to stay at the forefront of patient care—tune in and be a proactive advocate in safeguarding children's health! HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTMona Ligvani, PharmD, APhClinical PharmacistChildren's Health Initiative for Medication Education (CHIME)Pharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE INFORMATION Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the recent trends in pediatric pneumonia and pertussis incidence and their contributing factors.2. Identify key vaccination recommendations and prevention strategies for pediatric pneumonia and pertussis.0.05 CEU/0.5 HrUAN: 0107-0000-24-315-H06-PInitial release date: 12/16/2024Expiration date: 12/16/2025Additional CPE details can be found here.

Join us as we discuss the alarming rise of pediatric pneumonia and pertussis cases, unpacking the latest clinical insights and prevention strategies essential for today's pharmacists. In this episode, we'll explore the factors driving these trends, discuss how pharmacists can play a crucial role in patient education, and review updates to vaccine recommendations. Don't miss this opportunity to stay at the forefront of patient care—tune in and be a proactive advocate in safeguarding children's health!HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTMona Ligvani, PharmD, APhClinical PharmacistChildren's Health Initiative for Medication Education (CHIME)Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE INFORMATIONLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the recent trends in pediatric pneumonia and pertussis incidence and their contributing factors.2. Identify key vaccination recommendations and prevention strategies for pediatric pneumonia and pertussis.0.05 CEU/0.5 HrUAN: 0107-0000-24-315-H06-P Initial release date: 12/16/2024Expiration date: 12/16/2025Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

Dr. Matthew Clarke is an emergency physician at QEII Cobequid. He stopped by the studio today to talk about why an increased incidence of bacterial pneumonia this fall is sounds a lot scarier than it is.

Does ejaculatory abstinence really affect embryo mosaicism? Today on Fertility Forward, Fellow at RMA New York, Dr. Atoosa Ghofranian joins us to discuss her study titled: ‘Evaluating the Relationship Between Ejaculatory Abstinence and the Incidence of Embryo Mosaicism.' Tuning in, you'll hear about her inspiration behind the study, what mosaicism is, what her findings of the study were, why she thinks another study is needed, and more! We even discuss what we can learn from the concrete evidence this provided us. Finally, Atoosa tells us what she is grateful for today. Thanks for listening in! 

Listen in as Sharon G. Humiston, MD, MPH, discusses current trends in HPV, including:Incidence and prevalence trends in the USSex-related features of HPV-attributable cancersHow HPV vaccination uptake can prevent certain types of cancerCurrent guidelines and recommendations for HPV vaccinationPresenter:Sharon G. Humiston, MD, MPHDirector for ResearchAssociate Editor of IZ-ExpressImmunize.orgRochester, New YorkTo access all of our new podcast episodes, subscribe to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify. Follow along with the slides: https://bit.ly/4flDxYbLink to full program: https://bit.ly/4f06tW4

Welcome to a very special episode of The Sports Docs Podcast. In celebration of our 100th episode, we are honoring Dr. Mark Price who passed away on August 16, 2024 following his battle with leiomyosarcoma. We wanted to pay tribute to Dr. Price, who mentored us both through our residency at Harvard. His death is an immeasurable loss to his family and the community. Dr. Price was the Head Team Physician and Medical Director of the New England Patriots since 2016 and a team physician for the Boston Red Sox since 2009. He was a Captain in the U.S. Navy Reserves and served in combat operations in Afghanistan, where he was awarded the Bronze Star Medal. Most importantly, he was a bright example of a physician who cared deeply for his friends and family, including his wife Stephanie and their children, Henry, Julia and Sarah. The words shared by family and friends at his memorial service in Wellesley last month demonstrated a life rooted in purpose and accomplishments aligned with his values.Mark was one of our first guests, coming onto the show for Episode #3 and #4 in March of 2021. Consistent with who he was, he was willing to take the time out of his busy schedule to help two of his mentees build something new. So, with that, we thank Mark Price for all that he taught us and the mentorship he provided to not only us, but our community.--We have 5 great articles which we discuss over two episodes that really contribute well this conversation on how to best manage shoulder instability in athletes both in-season and post-season. We're very honored to have Dr. Mark Price join our discussion today. Dr. Price specializes in sports medicine, knee and shoulder surgery. He is an attending surgeon at Massachusetts General Hospital and Assistant Professor of Orthopaedic Surgery at Harvard Medical School. Dr. Price earned his MD from Harvard Medical School and PhD in Medical Physics from MIT. He completed the Harvard Combined Orthopaedic Residency Program, where Catherine and I both attended as well, and then went on to complete a fellowship in sports medicine and shoulder reconstructive surgery at Mass General. Dr. Price is Head Team Physician and Medical Director for the New England Patriots and a Team Physician for the Boston Red Sox. He is a Captain in the US Navy Reserves and has served in combat operations in Afghanistan, where he was awarded the Bronze Star Medal for meritorious service. The first paper is from the February issue of AJSM, titled Incidence of Posterior Shoulder Instability in the United States Military. It is a descriptive epidemiology study by Brett Owen and his team which found the incidence is higher than previously reported. Then, from the January issue of Sports Health, we feature the publication Does Functional Bracing of the Unstable Shoulder Improve Return to Play in Scholastic Athletes? Tokish and colleagues found functional bracing did not result in increased success rates when compared to no bracing in adolescent athletes.

You're the new intern on your first night of night float. First page, right off the bat – AFib with rates into the 150s. What's your next move?! Dr. Nathan Anderson takes the anxiety out of approaching Atrial Fibrillation in the post-operative patient. Join him and Dr. Elizabeth Maginot as they discuss this very common post-operative you're guaranteed to see on the wards.  Hosts:  - Dr. Nathan Anderson, Internal Medicine Associate Professor and Hospitalist, University of Nebraska  - Dr. Elizabeth Maginot, General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95 Learning Objectives:  - Discuss the underlying pathophysiological mechanisms that contribute to the development of atrial fibrillation in the postoperative setting.  - Critically approach the different management options for atrial fibrillation in the post-cardiac and non-cardiac surgery settings, including rate versus rhythm control, indications for cardioversion, and the role of anticoagulation.  - Identify common risk factors for atrial fibrillation in the post-operative setting.  - Discuss long-term management and follow-up strategies for patients who develop atrial fibrillation after surgery. References:  1. Bhave PD, Goldman LE, Vittinghoff E, Maselli J, Auerbach A. Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. AmericanHeart Journal. 2012;164(6):918-924. doi:10.1016/j.ahj.2012.09.004 https://pubmed.ncbi.nlm.nih.gov/23194493/ 2. Gialdini G, Nearing K, Bhave PD, et al.. Perioperative Atrial Fibrillation and the Long-term Risk ofIschemic Stroke. JAMA. 2014;312(6):616. doi:10.1001/jama.2014.9143 https://pubmed.ncbi.nlm.nih.gov/25117130/ 3. Snow V, Weiss KB, LeFevre M, McNamara R, Bass E, Green LA, Michl K, Owens DK, Susman J, Allen DI, Mottur-Pilson C; AAFP Panel on Atrial Fibrillation; ACP Panel on Atrial Fibrillation.Management of newly detected atrial fibrillation: a clinical practice guideline from the AmericanAcademy of Family Physicians and the American College of Physicians. Ann Intern Med. 2003 Dec16;139(12):1009-17. doi: 10.7326/0003-4819-139-12-200312160-00011. PMID: 14678921. https://pubmed.ncbi.nlm.nih.gov/14678921/ 4. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NewEngland Journal of Medicine. 2002;347(23):1825-1833. doi:10.1056/nejmoa021328 https://pubmed.ncbi.nlm.nih.gov/12466506/ Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  DOMINATE THE DAY 

Like nerd-ing out with us? Join us for our 5-day Lab Workshop In September 2024! Get registered by clicking here. In this episode, the hosts delve into the fascinating connections between exercise, glucose consumption, and the reduced incidence of cancer. They highlight recent peer-reviewed studies showing how high intensity aerobic exercise can act as a 'metabolic shield' in distant organs, blocking cancer progression and metastatic dissemination. The discussion includes a comparison of human and animal data, demonstrating that physical activity significantly reduces metastatic tumor growth. The episode also touches on Alzheimer's disease and various contributing factors, proposing that metabolic health is key in preventing both neurodegenerative diseases and cancer. The hosts emphasize the importance of holistic lifestyle changes, including diet, exercise, and stress management, to achieve long-term health benefits.

Did you know that supplementation can improve depression and anxiety? A surprising new study has found that supplements can also enhance the effectiveness of popular antidepressant medications!  Learn more, watch now.  

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