Podcasts about inhibitors

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Best podcasts about inhibitors

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Latest podcast episodes about inhibitors

This Week in Cardiology
Jan 27 2023 This Week in Cardiology

This Week in Cardiology

Play Episode Listen Later Jan 27, 2023 24:53


Exercise for AF, drugs have more than one effect, AI bots and the future of medicine, and the good and bad news about prognosis in HF are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. AF and Exercise Aerobic Exercise Can Reduce AF Frequency, Severity: ACTIVE-AF https://www.medscape.com/viewarticle/957322 An Exercise and Physical Activity Program in Patients With Atrial Fibrillation: The ACTIVE-AF Randomized Controlled Trial https://www.jacc.org/doi/full/10.1016/j.jacep.2022.12.002 Early Rhythm-Control Therapy in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 II. GLP-1 Inhibitors and Retinopathy Eye Check Important Before Starting Semaglutide for Diabetes https://www.medscape.com/viewarticle/987418 Glucagon-like peptide 1-receptor agonists and A1c: Good for the heart but less so for the eyes? https://doi.org/10.1016/j.dsx.2022.102696 III. AI Bot Passes USMLEs AI Bot ChatGPT Passes US Medical Licensing Exams Without Cramming – Unlike Students https://www.medscape.com/viewarticle/987549 Performance of ChatGPT on USMLE: Potential for AI-Assisted Medical 2 Education Using Large Language Models https://www.medrxiv.org/content/10.1101/2022.12.19.22283643v2.full.pdf Tyler Cowen Comments -- GPT and my own career trajectory https://marginalrevolution.com/marginalrevolution/2023/01/gpt-and-my-own-career-trajectory.html IV. HF Prognosis Temporal trends in the incidence of malignancy in heart failure: a nationwide Danish study https://doi.org/10.1093/eurheartj/ehac797 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Diabetes Core Update
Diabetes Core Update – February 2023

Diabetes Core Update

Play Episode Listen Later Jan 25, 2023 28:48


Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. This issue will review: Dietary factors and all-cause mortality in individuals with type 2 diabetes Prevalence and Predictors of Household Food Insecurity and Supplemental Nutrition Assistance Program Use in Youth and Young Adults With Diabetes Association of Sodium–Glucose Cotransporter-2 Inhibitors with Time to Dementia Concomitant Use of Sulfonylureas and beta-Blockers with the Risk of Severe Hypoglycemia Among Patients With Type 2 Diabetes A novel triple GIP, GLP-1, and glucagon receptor agonist in people with type 2 diabetes: A Phase 1b Trial Different Types of Industry- Produced and Ruminant Trans Fatty Acid Intake and Risk of Type 2 Diabetes For more information about each of ADA's science and medical journals, please visitwww.diabetesjournals.org. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

WolverHeme Happy Hour
Episode 11: "Olu the Drunk Snowman" - IDH inhibitors in R/R AML with Dr. Jill Lykon

WolverHeme Happy Hour

Play Episode Listen Later Jan 21, 2023 52:30


In this episode, we are joined by Dr. Jill Lykon, Clinical Pharmacist Specialist in Hematology at the University of Miami, to discuss the use of IDH inhibitors in relapsed/refractory AML. How do we choose between IDH inhibitors? Is "Olu" the new standard IDH inhibitor in R/R AML, or just the name of a drunk snowman? What about ivosidenib? Olutasidenib Phase I - Watts, et al. Lancet. 2023: https://pubmed.ncbi.nlm.nih.gov/36370742/ Olutasidenib Phase II ASH Abstract: https://ash.confex.com/ash/2022/webprogram/Paper167330.html Ivosidenib Phase I escalation/expansion - Dinardo, et al. NEJM. 2018: https://pubmed.ncbi.nlm.nih.gov/29860938/ Design of olutasidenib and other IDH inhibitors: https://pubmed.ncbi.nlm.nih.gov/31971798/ and https://pubmed.ncbi.nlm.nih.gov/36091829/ Episode 5 of WolverHeme Happy Hour (for background on IDH Inhibitors and frontline data): https://open.spotify.com/episode/4eNXjuGEFFRWTFJF0zsuMw?si=9bd0ae0a488e44ba

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Jay B. Wish, MD - Novel Strategies for Managing Patients With CKD-Associated Anemia: What Do Health-System Pharmacists Need to Know About HIF-PH Inhibitors?

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Jan 11, 2023 26:49


Go online to PeerView.com/HFV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, based on a recent live symposium, an interprofessional panel of experts examines the efficacy and safety data for HIF-PH inhibitors in the treatment of CKD-associated anemia and discusses best practices for working collaboratively with other members of the healthcare team to identify patients with CKD who are at risk for anemia The panel also considers current and emerging treatment strategies that pharmacists can use to improve the clinical management of CKD-associated anemia. Upon completion of this activity, participants should be better able to: Describe the rationale for involving clinical pharmacists in the management of anemia associated with CKD; Differentiate the mechanisms of action of HIF-PH inhibitors from other treatments for anemia associated with CKD; Evaluate the clinical potential of HIF-PH inhibitors as an emerging treatment approach for anemia in patients with DD-CKD or NDD-CKD; ad Apply evidence-based strategies within the context of health-system pharmacy to identify patients with CKD-associated anemia who would likely benefit from treatment with a HIF-PH inhibitor.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Jay B. Wish, MD - Novel Strategies for Managing Patients With CKD-Associated Anemia: What Do Health-System Pharmacists Need to Know About HIF-PH Inhibitors?

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Jan 11, 2023 73:05


Go online to PeerView.com/HFV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, based on a recent live symposium, an interprofessional panel of experts examines the efficacy and safety data for HIF-PH inhibitors in the treatment of CKD-associated anemia and discusses best practices for working collaboratively with other members of the healthcare team to identify patients with CKD who are at risk for anemia The panel also considers current and emerging treatment strategies that pharmacists can use to improve the clinical management of CKD-associated anemia. Upon completion of this activity, participants should be better able to: Describe the rationale for involving clinical pharmacists in the management of anemia associated with CKD; Differentiate the mechanisms of action of HIF-PH inhibitors from other treatments for anemia associated with CKD; Evaluate the clinical potential of HIF-PH inhibitors as an emerging treatment approach for anemia in patients with DD-CKD or NDD-CKD; ad Apply evidence-based strategies within the context of health-system pharmacy to identify patients with CKD-associated anemia who would likely benefit from treatment with a HIF-PH inhibitor.

AcademicCME Podcast
Applying Poly (ADP-ribose) Polymerase (PARP) Inhibitors to Maintenance Treatment Plans to Improve Outcomes for Patients with Advanced Ovarian Cancer

AcademicCME Podcast

Play Episode Listen Later Jan 9, 2023 61:02


Please go to academiccme.com/ovariancancer/ and complete the evaluation to receive your CE/CME Credit.

Keeping Current
Where Are We Now in the Use of Interleukin-17 Inhibitors for Psoriatic Disease?

Keeping Current

Play Episode Listen Later Jan 4, 2023 39:17


Can you navigate the increasingly complex treatment landscape for psoriasis and psoriatic arthritis (PsA)? Earn Credit / Learning Objectives & Disclosures:  https://www.medscape.org/viewarticle/985565?ecd=bdc_podcast_libsyn_mscpedu

Keeping Current
Spotlight on Chronic Lymphocytic Leukemia: Exploring the Continued Evolution of Bruton Tyrosine Kinase Inhibitors for Our Patients

Keeping Current

Play Episode Listen Later Jan 4, 2023 28:56


Did you know there are 3 Bruton tyrosine kinase (BTK) inhibitors approved to treat chronic lymphocytic leukemia (CLL) in Europe? Credit available for this activity expires: 1/4/2024 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/986280?ecd=bdc_podcast_libsyn_mscpedu

Research To Practice | Oncology Videos
Chronic Lymphocytic Leukemia | Addressing Current Questions and Controversies in the Management of Chronic Lymphocytic Leukemia — What Clinicians Want to Know

Research To Practice | Oncology Videos

Play Episode Listen Later Dec 28, 2022 121:10


Featuring perspectives from Drs Alexey Danilov, Matthew Davids, Lindsey Roeker, Philip Thompson and Prof Dr Arnon Kater, including the following topics: Front-Line Treatment of Chronic Lymphocytic Leukemia (CLL)   Introduction (0:00) Cases: A man in his early 90s with Rai Stage 0 CLL who underwent surveillance x 5 years and now develops cytopenias and transfusion-dependent anemia, and a woman in her late 60s with IGHV-unmutated CLL who develops night sweats, rapid doubling time of ALC — Bhavana (Tina) Bhatnagar, DO and Jennifer L Dallas, MD (3:18) Case: A man in his mid 50s with relapsed CLL after ibrutinib x 5 years now with disease progression — Amany R Keruakous, MD, MS (9:11) Dr Danilov presentation (16:47) Novel Strategies Combining Bruton Tyrosine Kinase (BTK) and Bcl-2 Inhibitors for CLL   Case: A man in his late 70s with IGHV-unmutated CLL under observation for many years who develops B symptoms, cytopenias and lymphadenopathy — Henna Malik, MD (32:15) Prof Kater presentation (37:18) Optimal Management of Adverse Events with BTK and Bcl-2 Inhibitors; Considerations for Special Patient Populations  Case: A man in his early 70s with multiple musculoskeletal comorbidities and transportation limitations develops symptomatic IGHV-mutated CLL with cytopenias — Syed F Zafar, MD (51:08) Cases: A man in his mid 50s with del(17p) CLL and significant lymphadenopathy and B symptoms who receives acalabrutinib and a woman in her early 70s with IGHV-mutated CLL and a complex karyotype — Dr Keruakous and Spencer H Bachow, MD (55:10) Dr Davids presentation (1:03:01) Selection and Sequencing of Available Therapies for Relapsed/Refractory Disease   Case: A man in his mid 70s with relapsed del(17p) CLL after ibrutinib with multiple chronic low-grade toxicities — Dr Bhatnagar (1:16:23) Dr Thompson presentation (1:20:56) Promising Investigational Agents and Strategies  Case: A woman in her late 70s with CLL (p53, 11q, 13q mutations), disease progression on ibrutinib and a BTK C481S mutation detected on repeat testing — Dr Bachow (1:39:09) Case: A man in his late 70s who develops Richter's transformation while receiving obinutuzumab/venetoclax for CLL — Justin Peter Favaro, MD, PhD (1:43:12) Dr Roeker presentation (1:48:29) CME information and select publications

AUAUniversity
PARP Inhibitors in Advanced Prostate Cancer Care

AUAUniversity

Play Episode Listen Later Dec 28, 2022 40:20


PARP Inhibitors in Advanced Prostate Cancer Care Podcast CME Available: https://auau.auanet.org/node/37321 Host: Jay D. Raman, MD, FACS Guests: Maha Hussain, MD and Ganesh Raj, MD, PhD LEARNING OBJECTIVES At the conclusion of this activity, participants will be able to: 1. Identify approved PARP Inhibitors for prostate cancer and patients who may benefit from PARP Inhibitor‐based therapy. 2. Evaluate available clinical safety and efficacy data for PARP Inhibitors. 3. Describe indications and contraindications for PARP Inhibitors in patients with advanced prostate cancer. 4. Identify how to manage adverse events that patients may experience while taking a PARP Inhibitors. ACKNOWLEDGEMENTS: This series is supported by independent educational grants from: Astellas AstraZeneca Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC Lantheus Medical Imaging Merck & Co., Inc. Pfizer, Inc. Sanofi Genzyme

VetFolio - Veterinary Practice Management and Continuing Education Podcasts
The Future of Feline Diabetes Mellitus – SGLT2 Inhibitors

VetFolio - Veterinary Practice Management and Continuing Education Podcasts

Play Episode Listen Later Dec 21, 2022 31:21


In this podcast, Dr. Cassi is joined by Dr. Jocelyn Mott to discuss the use of SGLT2 inhibitors, an exciting new option in the world of feline diabetes mellitus. Their discussion includes mechanism of action of these drugs, practical applications and potential complications, and appropriate monitoring for patients managed with SGLT2 inhibitors. Elanco's new SGLT2 inhibitor for the management of feline diabetes mellitus, Bexacat™ (bexagliflozin tablets), will also be discussed.

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Javed Butler, MD, MPH, MBA - How I Think, How I Treat: Cardiology-Focused Perspectives on Using SGLT2 Inhibitors to Optimize Outcomes in Patients With Heart Failure

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Dec 19, 2022 81:48


Go online to PeerView.com/EYZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. SGLT2 inhibitors have a newly established role in the foundation of guideline-directed medical therapy for patients with heart failure (HF). As more data has been collected, these agents have evolved beyond their use in diabetes care, with SGLT2 inhibitors now earning a place as vital pharmacotherapy in optimizing the management of patients with HF. Landmark clinical trials of SGLT2 inhibitors have shown clinically relevant and statistically significant reductions in hospitalization for HF events, major adverse cardiovascular events, and kidney events. In this activity based on a recent live symposium, experts review the evidence for using SGLT2 inhibitors in patients with HFrEF, HfpEF, or acute HF, and provide guidance for integrating these multifaceted therapies into cardiology practice using a patient-centered approach. Upon completion of this activity, participants should be better able to: Identify patients with HF who are most likely to benefit from the use of SGLT2 inhibitors; Apply evidence for the use of SGLT2 inhibitors to optimize the management of patients with HF with or without comorbid conditions; and Integrate SGLT2 inhibitors for the treatment of patients with HF, considering indications, dosage, and other clinically relevant characteristics.

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast
Javed Butler, MD, MPH, MBA - How I Think, How I Treat: Cardiology-Focused Perspectives on Using SGLT2 Inhibitors to Optimize Outcomes in Patients With Heart Failure

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast

Play Episode Listen Later Dec 19, 2022 81:58


Go online to PeerView.com/EYZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. SGLT2 inhibitors have a newly established role in the foundation of guideline-directed medical therapy for patients with heart failure (HF). As more data has been collected, these agents have evolved beyond their use in diabetes care, with SGLT2 inhibitors now earning a place as vital pharmacotherapy in optimizing the management of patients with HF. Landmark clinical trials of SGLT2 inhibitors have shown clinically relevant and statistically significant reductions in hospitalization for HF events, major adverse cardiovascular events, and kidney events. In this activity based on a recent live symposium, experts review the evidence for using SGLT2 inhibitors in patients with HFrEF, HfpEF, or acute HF, and provide guidance for integrating these multifaceted therapies into cardiology practice using a patient-centered approach. Upon completion of this activity, participants should be better able to: Identify patients with HF who are most likely to benefit from the use of SGLT2 inhibitors; Apply evidence for the use of SGLT2 inhibitors to optimize the management of patients with HF with or without comorbid conditions; and Integrate SGLT2 inhibitors for the treatment of patients with HF, considering indications, dosage, and other clinically relevant characteristics.

PeerView Clinical Pharmacology CME/CNE/CPE Video
Javed Butler, MD, MPH, MBA - How I Think, How I Treat: Cardiology-Focused Perspectives on Using SGLT2 Inhibitors to Optimize Outcomes in Patients With Heart Failure

PeerView Clinical Pharmacology CME/CNE/CPE Video

Play Episode Listen Later Dec 19, 2022 81:48


Go online to PeerView.com/EYZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. SGLT2 inhibitors have a newly established role in the foundation of guideline-directed medical therapy for patients with heart failure (HF). As more data has been collected, these agents have evolved beyond their use in diabetes care, with SGLT2 inhibitors now earning a place as vital pharmacotherapy in optimizing the management of patients with HF. Landmark clinical trials of SGLT2 inhibitors have shown clinically relevant and statistically significant reductions in hospitalization for HF events, major adverse cardiovascular events, and kidney events. In this activity based on a recent live symposium, experts review the evidence for using SGLT2 inhibitors in patients with HFrEF, HfpEF, or acute HF, and provide guidance for integrating these multifaceted therapies into cardiology practice using a patient-centered approach. Upon completion of this activity, participants should be better able to: Identify patients with HF who are most likely to benefit from the use of SGLT2 inhibitors; Apply evidence for the use of SGLT2 inhibitors to optimize the management of patients with HF with or without comorbid conditions; and Integrate SGLT2 inhibitors for the treatment of patients with HF, considering indications, dosage, and other clinically relevant characteristics.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Javed Butler, MD, MPH, MBA - How I Think, How I Treat: Cardiology-Focused Perspectives on Using SGLT2 Inhibitors to Optimize Outcomes in Patients With Heart Failure

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Dec 19, 2022 81:58


Go online to PeerView.com/EYZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. SGLT2 inhibitors have a newly established role in the foundation of guideline-directed medical therapy for patients with heart failure (HF). As more data has been collected, these agents have evolved beyond their use in diabetes care, with SGLT2 inhibitors now earning a place as vital pharmacotherapy in optimizing the management of patients with HF. Landmark clinical trials of SGLT2 inhibitors have shown clinically relevant and statistically significant reductions in hospitalization for HF events, major adverse cardiovascular events, and kidney events. In this activity based on a recent live symposium, experts review the evidence for using SGLT2 inhibitors in patients with HFrEF, HfpEF, or acute HF, and provide guidance for integrating these multifaceted therapies into cardiology practice using a patient-centered approach. Upon completion of this activity, participants should be better able to: Identify patients with HF who are most likely to benefit from the use of SGLT2 inhibitors; Apply evidence for the use of SGLT2 inhibitors to optimize the management of patients with HF with or without comorbid conditions; and Integrate SGLT2 inhibitors for the treatment of patients with HF, considering indications, dosage, and other clinically relevant characteristics.

Immunotherapy for Advanced Endometrial Cancer
S13:E1 – Oncology Morning Commute: Patient Selection for Treatment With PARP Inhibitors in Ovarian Cancer

Immunotherapy for Advanced Endometrial Cancer

Play Episode Listen Later Dec 16, 2022 29:36


What is the history behind the development of PARP inhibitors for the treatment of ovarian cancer and how have they influenced recent guideline changes regarding their use? Our faculty discuss this and more in the first podcast of the three-part series on PARP inhibitors and ovarian cancer.   Visit http://www.MorningCommutePodcast.com/OvarianCancer1 to view the activity and CME/CE information, download the transcript, and complete the post-test and evaluation to earn CME/CE credit

Hematology / Oncology @Point of Care Podcasts
S13:E3 – Oncology Morning Commute: What's Next in Using PARP Inhibitors for Patients With Ovarian Cancer?

Hematology / Oncology @Point of Care Podcasts

Play Episode Listen Later Dec 16, 2022 29:22


In this final podcast of our three-part series, our faculty look at some of the latest findings on PARP inhibitors as well as what is on the horizon. They also tackle the topic of disparities in care for patients with ovarian cancer and how clinical trials can address this. Visit http://www.MorningCommutePodcast.com/OvarianCancer3 to view the activity and CME/CE information, download the transcript, and complete the post-test and evaluation to earn CME/CE credit

Hematology / Oncology @Point of Care Podcasts
S13:E1 – Oncology Morning Commute: Patient Selection for Treatment With PARP Inhibitors in Ovarian Cancer

Hematology / Oncology @Point of Care Podcasts

Play Episode Listen Later Dec 16, 2022 29:36


What is the history behind the development of PARP inhibitors for the treatment of ovarian cancer and how have they influenced recent guideline changes regarding their use? Our faculty discuss this and more in the first podcast of the three-part series on PARP inhibitors and ovarian cancer.   Visit http://www.MorningCommutePodcast.com/OvarianCancer1 to view the activity and CME/CE information, download the transcript, and complete the post-test and evaluation to earn CME/CE credit

Immunotherapy for Advanced Endometrial Cancer
S13:E3 – Oncology Morning Commute: What's Next in Using PARP Inhibitors for Patients With Ovarian Cancer?

Immunotherapy for Advanced Endometrial Cancer

Play Episode Listen Later Dec 16, 2022 29:22


In this final podcast of our three-part series, our faculty look at some of the latest findings on PARP inhibitors as well as what is on the horizon. They also tackle the topic of disparities in care for patients with ovarian cancer and how clinical trials can address this. Visit http://www.MorningCommutePodcast.com/OvarianCancer3 to view the activity and CME/CE information, download the transcript, and complete the post-test and evaluation to earn CME/CE credit

Prevmed
How to Manage Lp(a) Part 2 - Niacin, PCSK9 Inhibitors, Lifestyle - FORD BREWER MD MPH

Prevmed

Play Episode Listen Later Dec 15, 2022 12:09


For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources: ·Newsletter Sign Up·Purchase an Appointmen Today!·PrevMed's Locals·PrevMed's Rumble·PrevMed's website·PrevMed's YouTube channel·PrevMed's Facebook page·PrevMed's Instagram·PrevMed's LinkedIn·PrevMed's Twitter ·PrevMed's Pinterest

Psound Bytes
Ep. 182 "The Ins and Outs of JAK Inhibitors for Psoriatic Disease"

Psound Bytes

Play Episode Listen Later Dec 6, 2022 20:28


Have questions about JAK inhibitors? Not sure how they work, what they treat, risks and how effective they are compared to other treatments? Listen as rheumatologist and NPF Medical Board member, Dr. Sergio Schwartzman from Weill Cornell Medical Center in NY, addresses such questions and more about the JAK STAT pathway. This Psound Bytes episode is provided with support from AbbVie, Amgen, Bristol Myers Squibb and Janssen. 

Alopecia Connection
AC 8: Tommy H., JAK Inhibitors

Alopecia Connection

Play Episode Play 29 sec Highlight Listen Later Dec 6, 2022 54:47


Episode 8- Tommy H., JAK InhibitorsOn this episode of Alopecia Connection we speak with Tommy (IG: @travelingputtputt), an American from Maine, who's been living and working in London for several years now.  Tommy developed alopecia universalis less than a year ago, and has recently starting using JAK inhibitors, with some success already!  Tommy's Metro UK Article: https://metro.co.uk/2022/09/25/i-lost-100-of-my-body-hair-in-the-space-of-6-months-17433809/Enjoy the episode! Remember to rate, review, subscribe and share!Linktree Alopecia Connection Website*Discussions on Alopecia Connection are from the personal perspectives and experiences of its host and guests, and should be considered that. Any personal medical decisions should only be made after consultation with one's health care provider.

ESC Cardio Talk
Journal Editorial - SGLT2 inhibitors in heart failure: insights from plasma proteomics

ESC Cardio Talk

Play Episode Listen Later Dec 5, 2022 9:44


Psychopharmacology and Psychiatry Updates
Antipsychotics and Cholinesterase Inhibitors for BPSD

Psychopharmacology and Psychiatry Updates

Play Episode Listen Later Dec 3, 2022 9:19


Antipsychotics or cholinesterase inhibitors for BPSD? This episode discusses the evidence of antipsychotics and cholinesterase inhibitors for BPSD, including the risks of using antipsychotics in elderly patients. We also provide recommendations for treating patients with Parkinson's disease and Lewy body dementia. Faculty: Lauren Gerlach, D.O. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: Management of Behavioral and Psychological Symptoms of Dementia Antipsychotics and Cholinesterase Inhibitors for BPSD

Aging-US
Glutaminase Inhibitors Rejuvenate Human Skin via Clearance of Senescent Cells

Aging-US

Play Episode Listen Later Dec 1, 2022 4:16


A new research paper was published on the cover of Aging (Aging-US) Volume 14, Issue 22, entitled, “Glutaminase inhibitors rejuvenate human skin via clearance of senescent cells: a study using a mouse/human chimeric model.” Skin aging caused by various endogenous and exogenous factors results in structural and functional changes to skin components. However, the role of senescent cells in skin aging has not been clarified. In this new study, researchers Kento Takaya, Tatsuyuki Ishii, Toru Asou, and Kazuo Kishi, from the Department of Plastic and Reconstructive Surgery at the Keio University School of Medicine, evaluated the effects of the glutaminase inhibitor BPTES (bis-2-(5-phenylacetamido-1, 3, 4-thiadiazol-2-yl)ethyl sulfide) on human senescent dermal fibroblasts and aged human skin to elucidate the function of senescent cells in skin aging. “[...] we utilized plastic surgery to create an experimental mouse/human chimeric model in which intraoperatively obtained human whole skin layers were transplanted into nude mice using previously described methods [25] and evaluated the anti-aging effects of BPTES on real human skin.” Primary human dermal fibroblasts (HDFs) were induced to senescence by long-term passaging, ionizing radiation, and treatment with doxorubicin, an anticancer drug. Cell viability of HDFs was assessed after BPTES treatment. A mouse/human chimeric model was created by subcutaneously transplanting whole skin grafts from aged humans into nude mice. The model was treated intraperitoneally with BPTES or vehicle for 30 days. Skin samples were collected and subjected to reverse transcription-quantitative polymerase chain reaction (RT-qPCR), western blotting, and histological analysis. BPTES selectively eliminated senescent dermal fibroblasts regardless of the method used to induce senescence; aged human skin grafts treated with BPTES exhibited increased collagen density, increased cell proliferation in the dermis, and decreased aging-related secretory phenotypes, such as matrix metalloprotease and interleukin. These effects were maintained in the grafts 1 month after termination of the treatment. In conclusion, selective removal of senescent dermal fibroblasts can improve the skin aging phenotype, indicating that BPTES may be an effective novel therapeutic agent for skin aging. “In summary, our results indicate that selective clearance of aging dermal fibroblasts by BPTES ameliorates skin senescence-related changes and that aging dermal fibroblasts may play an important role in the skin aging process. Therefore, senescent cell eliminators for aging skin cells may be an effective option for treating skin aging.” DOI: https://doi.org/10.18632/aging.204391 Corresponding Author: Kento Takaya - kento-takaya312@keio.jp Sign up for free Altmetric alerts about this article: https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.204391 About Aging-US Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at https://www.Aging-US.com​​ and connect with us: SoundCloud - https://soundcloud.com/Aging-Us Facebook - https://www.facebook.com/AgingUS/ Twitter - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/agingus​ LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ For media inquiries, please contact media@impactjournals.com

The Drug Chat with Dr. Wambui
Angiotensin Converting Enzyme Inhibitors.

The Drug Chat with Dr. Wambui

Play Episode Listen Later Nov 25, 2022 14:00


Here we are with the ACE Inhibitors!! Yet another versatile class of drugs and oh how smart those scientists were to discover them. Listen up.

Keeping Current
RET Inhibitors for RET-Altered Non-Small Cell Lung Cancer: Identification, Treatment, and Practicalities

Keeping Current

Play Episode Listen Later Nov 22, 2022 33:15


Did you know that RET fusions have been detected in 1% to 2% of all lung cancers and can be treated with available targeted therapies? Credit available for this activity expires: 10/21/2023 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/982531?src=mkm_podcast_addon_982531

The Medbullets Step 1 Podcast
Psychiatry | Monoamine Oxidase (MAO) Inhibitors

The Medbullets Step 1 Podcast

Play Episode Listen Later Nov 20, 2022 10:04


In this episode, we review the high-yield topic of Monoamine Oxidase (MAO) Inhibitors from the Psychiatry section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The Pleasure Zone ~ Milica Jelenic
“What Are My Sexual Inhibitors & Sexual Excitors?” ~ Milica Jelenic

The Pleasure Zone ~ Milica Jelenic

Play Episode Listen Later Nov 15, 2022


The Pleasure Zone with Milica Jelenic - Diamond Host Have you ever thought that maybe you just have no sex drive, and figure "it must be the hormones"? Hormones do have a role as sexual inhibitors and sexual excitors so does your nervous system. Have you ever wondered what your sexual inhibitors and sexual excitors are? In this episode we will explore: Some of the research around sexual inhibitors and sexual excitors What creates a sexual inhibitor and sexual excitor reaction in the body How to identify what your sexual inhibitors and sexual exitors are Knowing what your sexual inhbitors and sexual excitors are, what can you do with that and how to communicate it to your lover Join Milica Jelenic on this episode of The Pleasure Zone to learn more about "What Are My Sexual Inhibitors & Sexual Excitors?" Sexy Coupons: https://www.milicajelenic.com/online-store/Sexy-Times-Coupons-p291754882 “Pleasure Do's, Don'ts & Maybe's, List.” https://mailchi.mp/4fbc5b0c3587/dos-donts-maybe-list *Listen now on the Inspired Choices Network app!  https://www.inspiredchoicesnetwork.com/links/ ~ More About The Pleasure Zone ~ Milica Jelenic is a Sex & Intimacy Coach. What is pleasure? Have you ever noticed that what is pleasing to one body is not necessarily pleasing to all bodies? What if our bodies like to be pleasing and to gift pleasure to others and to receive pleasure? In this show we will explore the world of pleasure. If your body was sensing pleasure more often would your life have more ease? We start out with magical little bodies that turn on everybody. Babies are always having people come up to them and compliment them on their beauty and get really excited to be in their presence. What would the world be like if we stopped judging ourselves, our bodies and others? How much more fun, joy and pleasure is possible on this planet if we choose to be explorers? Whose ready for an adventure??? Milica Jelenic is an advocate for pleasure. In her private practice she invites clients to create life and lifestyle that offers more pleasure and vitality. Milica's intuitive ability to sense where change is possible and to question what is stuck in the target area creates a very dynamic session that promotes choice, possibility and change. Milica has impacted the lives and health of individuals both in Canada and abroad with her humor, kindness, gentleness, potency and intensity. Milica's approach is playful, fun and direct. Milica is willing to be whatever energy and space is required for the change you desire.   If you are interested in receiving Milica' monthly newsletter about events, classes and information on booking private sessions send and e-mail through her website.  www.milicajelenic.com/ To get more of The Pleasure Zone with Milica Jelenic, be sure to visit the podcast page for replays of all her shows here: https://www.inspiredchoicesnetwork.com/podcast/the-pleasure-zone-milica-jelenic/

Psychiatric Nurse Practitioner Podcasts
SSRI - Selective serotonin reuptake inhibitors

Psychiatric Nurse Practitioner Podcasts

Play Episode Listen Later Nov 14, 2022 13:57


SSRI's are you first line antidepressants that are used because of its tolerability, efficacy and safety. SSRI's are also indicated for anxiety, eating disorders, PTSD, OCD, premature ejaculation, premenstrual dysphoric disorder's and other somatic disorders.

Rheumnow Podcast
ACR2022 - Day 3.1

Rheumnow Podcast

Play Episode Listen Later Nov 14, 2022 23:29


Comorbidities in Axial Spondyloarthritis Dr. Antoni Chan discusses Abstract 1609 at ACR22 Convergence. Diffuse alveolar hemorrhage in antiphospholipid syndrome Dr. Eric Dein discusses Abstract 0675 at ACR22 Convergence. Abstract 0675: Clinical Characteristics and Factors Associated with Relapse and Mortality in Diffuse Alveolar Hemorrhage Among Patients with Antiphospholipid Syndrome: A Multi-Center Retrospective Cohort Eosinophilia in systemic JIA patients after exposure to biologics Dr. Bella Mehta discusses Abstract 0872 at ACR22 Convergence. Abstract 0872: Incidence, Risk Factors, and Outcomes of Eosinophilia on IL-1 and IL-6 Inhibitors in Systemic and Non-Systemic Juvenile Idiopathic Arthritis Gender differences in Axial Spondyloarthritis Dr. Antoni Chan covered abstracts 0497 and 1614 at ACR22 Convergence in Philadelphia, PA. Inadequate Dosing of Hydroxychloroquine Leads to Hospitalizations in SLE Dr. Sheila Reyes discusses abstract 1654 at ACR22 Convergence.  Abstract 1654: Hydroxychloroquine Dosing Less Than 5 Mg/kg/day Leads to Increased Hospitalizations for Systemic Lupus Erythematosus Flares Oligoarticular PsA: FOREMOST Study Dr. Peter Nash discusses abstract 1018 at ACR22 Convergence.  Abstract 1018: Characterization of Joint Distribution and Disease Burden in Patients with Early Oligoarticular Psoriatic Arthritis: Results from the Ongoing FOREMOST Study Sensor-engineered glove evaluates hand function in RA Dr. David Liew discusses abstract 0904 at ACR22 Convergence.  Abstract 0904: Testing the Hand Function with a Sensor-engineered Glove in Patients with Rheumatoid Arthritis

OncoPharm
Metastatic NSCLC Updates: Role of CTLA-4 inhibitors?

OncoPharm

Play Episode Listen Later Nov 10, 2022 14:05


We review the 5-year update of CheckMate 227 and the POSEIDON to generate the hypothesis that CLTA-4 inhibition has a role in PD-L1 negative metastatic NSCLC. CM 227 update: https://pubmed.ncbi.nlm.nih.gov/?term=36223558 POSEIDON: https://pubmed.ncbi.nlm.nih.gov/?term=36327426 Editorial: https://pubmed.ncbi.nlm.nih.gov/?term=36331243

CCO Oncology Podcast
Evolving Role of BTK Inhibitors in CLL: Experts Answer Your Questions

CCO Oncology Podcast

Play Episode Listen Later Nov 9, 2022 10:33


In this episode, Farrukh T. Awan, MD, and Nicole Lamanna, MD, answer questions from an audience of healthcare professionals on topics related to the use of BTK inhibitors for the management of chronic lymphocytic leukemia (CLL). The topics covered include:Whether it is justifiable to use chlorambucil plus obinutuzumab as a control arm in a registrational trial todayRelevance of overall response rate vs progression-free survival for BTK inhibitor therapyApproval of ibrutinib/venetoclax combination therapy for patients with CLLKey differences between zanubrutinib and acalabrutinib in the treatment of patients with CLLHow to transition/overlap next therapy in patients with CLL with progression while receiving a BTK inhibitorFaculty:Farrukh T. Awan, MDAssociate Professor of Internal MedicineDirector of Lymphoid Malignancies ProgramHarold C. Simmons Comprehensive Cancer CenterUniversity of Texas Southwestern Medical CenterDallas, TexasNicole Lamanna, MDAssociate ProfessorLeukemia ServiceDirector of CLL ProgramHematologic Malignancies SectionDepartment of MedicineNew York-Presbyterian/Columbia University Medical CenterNew York, New YorkLink to the complete program, including downloadable slidesets and an on-demand webcast:https://bit.ly/3EjvSKm

PeerView Family Medicine & General Practice CME/CNE/CPE Audio Podcast
Milind Desai, MD, MBA - Pushing Back Against HCM: Can Cardiac Myosin Inhibitors Alter the Disease Progression and Management Trajectory for Patients With Hypertrophic Cardiomyopathy?

PeerView Family Medicine & General Practice CME/CNE/CPE Audio Podcast

Play Episode Listen Later Nov 8, 2022 61:14


Go online to PeerView.com/KST860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How are you pushing back against HCM in your practice? In PeerView's latest CME/MOC/NCPD/CPE-certified activity, a panel of experts will present a MasterClass and Practicum on integrating cardiac myosin inhibitors into clinical practice. Learn how to apply the latest guidelines and sharpen your diagnostic skills to identify patients with HCM while hearing the latest recommendations for the individualized management of patients with obstructive HCM, including team-based collaboration. This activity also looks to the future and reviews the latest evidence for using cardiac myosin inhibitors in nonobstructive disease. Upon completion of this activity, participants should be better able to: Identify the mechanism of action of cardiac myosin inhibitors in the treatment of patients with HCM; Apply the latest recommendations and evidence-based guidance to diagnose and manage patients with HCM in a collaborative, team-based manner; Describe the efficacy and safety of cardiac myosin inhibitors, including the ability to reduce eligibility for septal reduction therapy, to address unmet needs among patients with obstructive and non-obstructive HCM; and Collaborate with patients and clinical colleagues to better identify patients with HCM and achieve their personal goals and desired outcomes pertaining to HCM management.

PeerView Internal Medicine CME/CNE/CPE Video Podcast
Milind Desai, MD, MBA - Pushing Back Against HCM: Can Cardiac Myosin Inhibitors Alter the Disease Progression and Management Trajectory for Patients With Hypertrophic Cardiomyopathy?

PeerView Internal Medicine CME/CNE/CPE Video Podcast

Play Episode Listen Later Nov 8, 2022 61:14


Go online to PeerView.com/KST860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How are you pushing back against HCM in your practice? In PeerView's latest CME/MOC/NCPD/CPE-certified activity, a panel of experts will present a MasterClass and Practicum on integrating cardiac myosin inhibitors into clinical practice. Learn how to apply the latest guidelines and sharpen your diagnostic skills to identify patients with HCM while hearing the latest recommendations for the individualized management of patients with obstructive HCM, including team-based collaboration. This activity also looks to the future and reviews the latest evidence for using cardiac myosin inhibitors in nonobstructive disease. Upon completion of this activity, participants should be better able to: Identify the mechanism of action of cardiac myosin inhibitors in the treatment of patients with HCM; Apply the latest recommendations and evidence-based guidance to diagnose and manage patients with HCM in a collaborative, team-based manner; Describe the efficacy and safety of cardiac myosin inhibitors, including the ability to reduce eligibility for septal reduction therapy, to address unmet needs among patients with obstructive and non-obstructive HCM; and Collaborate with patients and clinical colleagues to better identify patients with HCM and achieve their personal goals and desired outcomes pertaining to HCM management.

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast
Milind Desai, MD, MBA - Pushing Back Against HCM: Can Cardiac Myosin Inhibitors Alter the Disease Progression and Management Trajectory for Patients With Hypertrophic Cardiomyopathy?

PeerView Clinical Pharmacology CME/CNE/CPE Audio Podcast

Play Episode Listen Later Nov 8, 2022 61:14


Go online to PeerView.com/KST860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How are you pushing back against HCM in your practice? In PeerView's latest CME/MOC/NCPD/CPE-certified activity, a panel of experts will present a MasterClass and Practicum on integrating cardiac myosin inhibitors into clinical practice. Learn how to apply the latest guidelines and sharpen your diagnostic skills to identify patients with HCM while hearing the latest recommendations for the individualized management of patients with obstructive HCM, including team-based collaboration. This activity also looks to the future and reviews the latest evidence for using cardiac myosin inhibitors in nonobstructive disease. Upon completion of this activity, participants should be better able to: Identify the mechanism of action of cardiac myosin inhibitors in the treatment of patients with HCM; Apply the latest recommendations and evidence-based guidance to diagnose and manage patients with HCM in a collaborative, team-based manner; Describe the efficacy and safety of cardiac myosin inhibitors, including the ability to reduce eligibility for septal reduction therapy, to address unmet needs among patients with obstructive and non-obstructive HCM; and Collaborate with patients and clinical colleagues to better identify patients with HCM and achieve their personal goals and desired outcomes pertaining to HCM management.

PeerView Family Medicine & General Practice CME/CNE/CPE Video Podcast
Milind Desai, MD, MBA - Pushing Back Against HCM: Can Cardiac Myosin Inhibitors Alter the Disease Progression and Management Trajectory for Patients With Hypertrophic Cardiomyopathy?

PeerView Family Medicine & General Practice CME/CNE/CPE Video Podcast

Play Episode Listen Later Nov 8, 2022 61:14


Go online to PeerView.com/KST860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How are you pushing back against HCM in your practice? In PeerView's latest CME/MOC/NCPD/CPE-certified activity, a panel of experts will present a MasterClass and Practicum on integrating cardiac myosin inhibitors into clinical practice. Learn how to apply the latest guidelines and sharpen your diagnostic skills to identify patients with HCM while hearing the latest recommendations for the individualized management of patients with obstructive HCM, including team-based collaboration. This activity also looks to the future and reviews the latest evidence for using cardiac myosin inhibitors in nonobstructive disease. Upon completion of this activity, participants should be better able to: Identify the mechanism of action of cardiac myosin inhibitors in the treatment of patients with HCM; Apply the latest recommendations and evidence-based guidance to diagnose and manage patients with HCM in a collaborative, team-based manner; Describe the efficacy and safety of cardiac myosin inhibitors, including the ability to reduce eligibility for septal reduction therapy, to address unmet needs among patients with obstructive and non-obstructive HCM; and Collaborate with patients and clinical colleagues to better identify patients with HCM and achieve their personal goals and desired outcomes pertaining to HCM management.

Ask Stago
S3E11 - What is Factor parallelism for?

Ask Stago

Play Episode Listen Later Nov 8, 2022 11:04


Welcome to Ask Stago, the Podcast dedicated to provide expert answers to your expert questions in coagulation. In today's episode, our guest Tom Childs will help us to understand the goal and clinical benefits of the Factor parallelism method.   Link to previous podcasts: S1E11 – How to be more productive (part 1): implementation of a rules engine  S2E8 - World Hemophilia Day  S2E4 - How to determine factor levels in hemophilia?  Literature sources: Ma AD, Carrizosa D. Acquired factor VIII inhibitors: pathophysiology and treatment. Hematology Am Soc Hematol Educ Program 2006: 432–7 (https://ashpublications.org/hematology/article/2006/1/432/19703/Acquired-Factor-VIII-Inhibitors-Pathophysiology). Morfini M. Articular status of haemophilia patients with inhibitors. Haemophilia 2008; 14 (Suppl 6): 20–2. Gringeri A, Mantovani LG, Scalone L, Mannucci PM; COCIS Study Group. Cost of care and quality of life for patients with hemophilia complicated by inhibitors: the COCIS Study Group. Blood 2003; 102 (7): 2358–63 Monahan PE, Baker JR, Riske B, Soucie JM. Physical functioning in boys with hemophilia in the U.S. Am J Prev Med 2011; 41 (6 Suppl 4): S360–8. Collins PW, Chalmers E, Hart D et al.; United Kingdom Haemophilia Centre Doctors' Organization. Diagnosis and management of acquired coagulation inhibitors: a guideline from UKHCDO. Br J Haematol 2013; 162 (6): 758–73 (https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.12463). Riley PW, Gallea B, Valcour A. Development and implementation of a coagulation factor testing method utilizing autoverification in a high‑volume clinical reference laboratory environment. J Pathol Inform 2017; 8: 25. Witmer C, Young G. Factor VIII inhibitors in hemophilia A: rationale and latest evidence. Ther Adv Hematol 2013; 4 (1): 59–72 Oldenburg J, Mahlangu JN, Kim B et al. Emicizumab prophylaxis in hemophilia A with inhibitors. N Engl J Med 2017; 377 (9): 809–18. Florin L, Desloovere M, Devreese KML. Validation of an automated algorithm for interpretation of lupus anticoagulant testing on the Stago STA R Max (Poster). International Society on Thrombosis and Haemostasis, 2017.   Content is scientific and technical in nature. It is intended as an educational tool for laboratory professionals and topics discussed are not intended as recommendations or as commentary on appropriate clinical practice.

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast
Milind Desai, MD, MBA - Pushing Back Against HCM: Can Cardiac Myosin Inhibitors Alter the Disease Progression and Management Trajectory for Patients With Hypertrophic Cardiomyopathy?

PeerView Heart, Lung & Blood CME/CNE/CPE Video Podcast

Play Episode Listen Later Nov 8, 2022 61:14


Go online to PeerView.com/KST860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How are you pushing back against HCM in your practice? In PeerView's latest CME/MOC/NCPD/CPE-certified activity, a panel of experts will present a MasterClass and Practicum on integrating cardiac myosin inhibitors into clinical practice. Learn how to apply the latest guidelines and sharpen your diagnostic skills to identify patients with HCM while hearing the latest recommendations for the individualized management of patients with obstructive HCM, including team-based collaboration. This activity also looks to the future and reviews the latest evidence for using cardiac myosin inhibitors in nonobstructive disease. Upon completion of this activity, participants should be better able to: Identify the mechanism of action of cardiac myosin inhibitors in the treatment of patients with HCM; Apply the latest recommendations and evidence-based guidance to diagnose and manage patients with HCM in a collaborative, team-based manner; Describe the efficacy and safety of cardiac myosin inhibitors, including the ability to reduce eligibility for septal reduction therapy, to address unmet needs among patients with obstructive and non-obstructive HCM; and Collaborate with patients and clinical colleagues to better identify patients with HCM and achieve their personal goals and desired outcomes pertaining to HCM management.

PeerView Internal Medicine CME/CNE/CPE Audio Podcast
Milind Desai, MD, MBA - Pushing Back Against HCM: Can Cardiac Myosin Inhibitors Alter the Disease Progression and Management Trajectory for Patients With Hypertrophic Cardiomyopathy?

PeerView Internal Medicine CME/CNE/CPE Audio Podcast

Play Episode Listen Later Nov 8, 2022 61:14


Go online to PeerView.com/KST860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How are you pushing back against HCM in your practice? In PeerView's latest CME/MOC/NCPD/CPE-certified activity, a panel of experts will present a MasterClass and Practicum on integrating cardiac myosin inhibitors into clinical practice. Learn how to apply the latest guidelines and sharpen your diagnostic skills to identify patients with HCM while hearing the latest recommendations for the individualized management of patients with obstructive HCM, including team-based collaboration. This activity also looks to the future and reviews the latest evidence for using cardiac myosin inhibitors in nonobstructive disease. Upon completion of this activity, participants should be better able to: Identify the mechanism of action of cardiac myosin inhibitors in the treatment of patients with HCM; Apply the latest recommendations and evidence-based guidance to diagnose and manage patients with HCM in a collaborative, team-based manner; Describe the efficacy and safety of cardiac myosin inhibitors, including the ability to reduce eligibility for septal reduction therapy, to address unmet needs among patients with obstructive and non-obstructive HCM; and Collaborate with patients and clinical colleagues to better identify patients with HCM and achieve their personal goals and desired outcomes pertaining to HCM management.

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast
Milind Desai, MD, MBA - Pushing Back Against HCM: Can Cardiac Myosin Inhibitors Alter the Disease Progression and Management Trajectory for Patients With Hypertrophic Cardiomyopathy?

PeerView Heart, Lung & Blood CME/CNE/CPE Audio Podcast

Play Episode Listen Later Nov 8, 2022 61:14


Go online to PeerView.com/KST860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How are you pushing back against HCM in your practice? In PeerView's latest CME/MOC/NCPD/CPE-certified activity, a panel of experts will present a MasterClass and Practicum on integrating cardiac myosin inhibitors into clinical practice. Learn how to apply the latest guidelines and sharpen your diagnostic skills to identify patients with HCM while hearing the latest recommendations for the individualized management of patients with obstructive HCM, including team-based collaboration. This activity also looks to the future and reviews the latest evidence for using cardiac myosin inhibitors in nonobstructive disease. Upon completion of this activity, participants should be better able to: Identify the mechanism of action of cardiac myosin inhibitors in the treatment of patients with HCM; Apply the latest recommendations and evidence-based guidance to diagnose and manage patients with HCM in a collaborative, team-based manner; Describe the efficacy and safety of cardiac myosin inhibitors, including the ability to reduce eligibility for septal reduction therapy, to address unmet needs among patients with obstructive and non-obstructive HCM; and Collaborate with patients and clinical colleagues to better identify patients with HCM and achieve their personal goals and desired outcomes pertaining to HCM management.

Keeping Current
Solving the Puzzles for B-Cell Malignancies: Navigating the Place of BTK Inhibitors Today and Tomorrow

Keeping Current

Play Episode Listen Later Nov 8, 2022 92:13


Did you know that using Bruton tyrosine kinase (BTK) inhibitors can lead to chemotherapy-free regimens for treating certain B-cell malignancies? Credit available for this activity expires: 11/7/2023 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/983523?src=mkm_podcast_addon_983523

The Medbullets Step 2 & 3 Podcast
Psychiatry | Selective Serotonin Reuptake Inhibitors (SSRIs)

The Medbullets Step 2 & 3 Podcast

Play Episode Listen Later Oct 31, 2022 9:39


In this episode, we review the high-yield topic of Selective Serotonin Reuptake Inhibitors (SSRIs) from the Psychiatry section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

The Medbullets Step 2 & 3 Podcast
Psychiatry | Monoamine Oxidase (MAO) Inhibitors

The Medbullets Step 2 & 3 Podcast

Play Episode Listen Later Oct 27, 2022 8:28


In this episode, we review the high-yield topic of Monoamine Oxidase (MAO) Inhibitors from the Psychiatry section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

CEConversations
Clinical Advances in Ovarian Cancer: Exploring the Expanding Role of PARP Inhibitors in the Treatment Paradigm

CEConversations

Play Episode Listen Later Oct 26, 2022 40:56


To receive up to 1.0 CME/CE credit please complete the evaluation and request form here: https://www.ceconcepts.com/ovarian-gr-podcast Learning ObjectivesReview recent updates to national guideline recommendations in ovarian cancer treatment and testing and discuss health equity issues that may hinder ovarian cancer patients from receiving the current standard of care.Appraise landmark and emerging safety and efficacy data with PARP inhibitors in the treatment of ovarian cancer, with a focus on most recent recommendations and rationale for the use of PARP inhibitors in the first-line maintenance setting.Analyze the unique toxicity profiles among PARP inhibitor therapies and important considerations for both monitoring and managing adverse events.Use an interactive, multi-disciplinary approach to discuss challenging cases regarding the appropriate selection of treatment based on clinical data and guidelines, the use of predictive biomarkers, the management of adverse events, and strategies to mitigate modifiable healthcare disparities in ovarian cancer patients.Presented by Creative Educational Concepts, LLC.Supported through an independent educational grant from GSK.

Your Fertility Pharmacist
Taking Tadalafil to Improve Embryo Implantation

Your Fertility Pharmacist

Play Episode Listen Later Oct 21, 2022 8:30


This is the first study to test the use of vaginal tadalafil on endometrial thickness and pregnancies in women using IVF to conceive. ResourcesBalduyck J, Ameye A, Decleer W. Effect of vaginal/oral tadalafil on endometrial thickness in IVF patients: a double-blind, placebo controlled RCT: a pilot study. Facts Views Vis Obgyn. 2022;14(2):155-161. doi:10.52054/FVVO.14.2.026Belapurkar P, Jaiswal A, Madaan S. Comparison of Efficacy Between Vaginal Sildenafil and Granulocyte-Colony Stimulating Factor (G-CSF) in Improving Endometrial Thickness (ET) in Infertile Women. Cureus. 2022;14(6):e26415. Published 2022 Jun 29. doi:10.7759/cureus.26415Cialis. Package Insert. Eli Lilly and Company; 2011.Heger A, Sator M, Walch K, Pietrowski D. Smoking Decreases Endometrial Thickness in IVF/ICSI Patients. Geburtshilfe Frauenheilkd. 2018;78(1):78-82. doi:10.1055/s-0043-123762Mostafa T. Useful Implications of Low-dose Long-term Use of PDE-5 Inhibitors. Sex Med Rev. 2016;4(3):270-284. doi:10.1016/j.sxmr.2015.12.005

Rio Bravo qWeek
Episode 114: Diabetes Care Update

Rio Bravo qWeek

Play Episode Listen Later Oct 14, 2022 14:32


Episode 114: Diabetes care updateYvette presents updates from ADA on diabetes care regarding SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone. Written by Yvette Singh, MSIV, American University of the Caribbean. Comments and text edition by Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.The American Diabetes Association (ADA) released revisions in May 2022; specifically regarding sodium-glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RA), and finerenone for cardiovascular and renal comorbidities. What are SGLT2 inhibitors and GLP-1 receptor agonists?SGLT2 inhibitor class of oral antidiabetic drugs, including empagliflozin, canagliflozin, dapagliflozin, and more. They increase the excretion of glucose and sodium in the urine by inhibiting SGLT2 in the kidney, thus lowering blood glucose levels. In other words, it has a glucoretic effect. GLP-1 receptor agonists are a class of non-insulin drugs, including exenatide, liraglutide, semaglutide, and more. They mimic the intestinal hormone incretin and bind to its receptor, which slows the rate at which foods leave the stomach, controls appetite, and regulates insulin and glucagon secretion.What is the NEW use of SGLT-2 Inhibitors and GLP-1 RA in treatment?Traditional glucocentric approaches recommend initial medications such as metformin for most adults with type 2 diabetes, leaving SGLT-2 inhibitors and GLP-1 receptor agonists as alternative options mainly for patients with high risk for atherosclerotic cardiovascular disease in whom additional glucose lowering was needed after metformin treatment. Current guidelines now recommend these agents (SGLT-2 inhibitors and GLP-1 RA) for any T2DM patient with current or high-risk for ASCVD, chronic kidney disease (CKD), or heart failure (HF). This guideline stands regardless of the need for additional glucose lowering and/or metformin use. This has now changed through trials, demonstrating that cardiovascular disease and chronic kidney disease benefits independent of a medication's glucose-lowering potential.HbA1c has long been used to guide clinical decision-making about type 2 diabetes. However, systematic reviews have revealed minimal benefits in the normalization of HbA1c.Moreover, the cardiovascular and kidney protection of SGLT-2 inhibitors and GLP-1 receptor agonists are unrelated to their impact on HbA1c. Double-blinded randomized clinical trials showed that SGLT-2 inhibitors reduced the risk of cardiovascular death and hospitalization for heart failure in patients with or without diabetes. Therefore, cardiovascular and kidney risk, rather than HbA1c, constitutes a possible indication for the two medication classes. If patients with ASCVD remain above goal A1C despite the addition of an SGLT-2 inhibitor or GLP-1 RA, then adding the agent the patient is not currently on out of the two is recommended before dipeptidyl peptidase-4 aka (DPP-4) inhibitors, basal insulin, or sulfonylureas because the combined use of an SGLT-2 inhibitor and GLP-1 RA can produce an additive risk reduction for cardiovascular and renal adverse events.What is Finerenone, and how does it help with diabetes? Finerenone (Kerendia®) selectively blocks sodium reabsorption and overactivation of mineralocorticoid receptors within epithelial and non-epithelial tissues. This, in turn, reduces fibrosis and inflammation of both the kidneys and blood vasculature.Finerenone use for patients with advanced CKD, i.e., moderately elevated albuminuria, eGFR of 25- 60 mL/min, and diabetic retinopathy, is encouraged for nephroprotection. However, Patients with less-advanced CKD, i.e., stages 1-2, do not receive any benefit. Regardless of the severity of CKD, SGLT-2 inhibitors remain first-line therapy.Although Finerenone improves cardiovascular outcomes and reduces CKD progression for patients, it is still unknown if there are any additive cardioprotective effects if used with SGLT2 inhibitors and/or GLP-1 receptor agonists.Some Closing Pearls: The use of SGLT2 inhibitors in patients with eGFR > 25 decreased from 30 previously.If the A1c goal is not being met, combination therapy of insulin with a GLP receptor agonist can be considered, as this combination treatment has been shown to increase the efficacy and duration of insulin.Overall, this new change could be very beneficial if accepted internationally. Though understandably, there could be some limitations to this guideline given the availability and cost of these medications, as well as their contraindication of use in specific populations such as pregnancy, ages >65 with concurrent risk factors for hypoglycemia or dehydration, and those with history of acute pancreatitis. ____________________________Conclusion: Now we conclude our episode number 114 “Diabetes care update.” Yvette explained that the ADA now recommends the use of SGLT2 inhibitors and GLP-1 agonists in any patient with type 2 diabetes with current or at high risk for cardiovascular disease, chronic kidney disease, or heart failure. Primary care physicians should become familiar with the dosing, cautions, side effects, and contraindications of these meds. Also, a newer medication for CKD in diabetes was mentioned: Finerenone. Diabetes treatment continues to evolve, and we hope this information is useful for you. This week we thank Hector Arreaza, Yvette Singh, and Fiona Axelsson. Audio edition by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________________Lacanlale, Jana K et al. “Notable Revisions in Diabetes Treatment According to ADA Guidelines.” Pharmacy Times, 26 Mar. 2021, https://www.pharmacytimes.com/view/notable-revisions-in-diabetes-treatment-according-to-ada-guidelines.Li, Sheyu, et al. “SGLT-2 inhibitors or GLP-1 receptor agonists for adults with type 2 diabetes: a clinical practice guideline.” British Medical Journal 2021; 373:n1091. doi:10.1136/BMJ.n1091Royalty-free music used for this episode: BUrn Flow by Gushito, downloaded on September 22, 2022, from https://www.videvo.net/royalty-free-music-track/burn-flow/1008877/ 

Global Hemophilia Report
Hemophilia B & the story of Tsarevich Alexei - Part 1

Global Hemophilia Report

Play Episode Listen Later Oct 13, 2022 57:48


Hemophilia B is a rare inherited X-linked disorder characterized by a congenital anomaly in the factor IX gene leading to a variable deficiency in clotting factor IX. In this episode, we explore the known differences between Hemophilia B and Hemophilia A and discuss priority areas for further research into Hemophilia B. The episode also guides listeners on an entertaining journey through 19th and 20th century European monarchy and the unlikely role that hemophilia played in forever shaping Europe's governance!    Contributors: Bethany Samuelson Bannow, MD Brian O'Mahony Kathaleen M. Schnur, MSW, LCSW   Senior Advisor: Donna DiMichele, MD   Episode Advisors (also contributors): Dr. Amy Shapiro Professor Jan Astermark   Hosted by: Laurence Woollard   Links to learn more:   Brown A. "The Royal Disease and The Royal Collapse: Political Effects of Hemophilia in the Royal Houses of Europe." Honor Scholar Theses. 2017;63. [Online]. Available at: https://scholarship.depauw.edu/cgi/viewcontent.cgi?article=1063&context=studentresearch [Accessed 10 October 2022]   Hoffman TA. "Bad Blood: Hemophilia and Its Detriment to the Russian Imperial Family." Young Historians Conference. 2022;8. [Online]. Available at: https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?article=1244&context=younghistorians [Accessed 10 October 2022]   Lannoy N, Hermans C. The ‘royal disease' – haemophilia A or B? A haematological mystery is finally solved. Haemophilia 2010;16:843-47. Doi: 10.1111/j.1365-2516.2010.02327.x   Potts WTW. Royal haemophilia. J Biol Educ 1996;30(3):207-17. DOI: 10.1080/00219266.1996.9655504   Price KD. "Diary of Nicholas II, 1917-1918, an annotated translation." Graduate Student Theses, Dissertations, & Professional Papers. 1966;2065. [Online]. Available at: https://scholarworks.umt.edu/cgi/viewcontent.cgi?article=3084&context=etd [Accessed 10 October 2022]   Radcliffe J. “Rasputin and the Fragmentation of Imperial Russia.” Young Historians Conference. 2017;14. [Online]. Available at: https://pdxscholar.library.pdx.edu/younghistorians/2017/oralpres/14/ [Accessed 10 October 2022]   Funnell APW, Crossley M. Hemophilia B Leyden and once mysterious cis-regulatory mutations. Trends Genet 2014;30(1):18-23. Doi: 10.1016/j.tig.2013.09.007   Simioni P, et al. X-linked thrombophilia with a mutant factor IX (factor IX Padua). N Engl J Med 2009;361(17):1671-5. Doi: 10.1056/NEJMoa0904377   Nogami K, et al. Clinical conditions and risk factors for inhibitor-development in patients with haemophilia: A decade-long prospective cohort study in Japan, J-HIS2 (Japan Hemophilia Inhibitor Study 2). Haemophilia 2022;28(5):745-59. Doi: 10.1111/hae.14602   Thorland EC, et al. Anaphylactic response to FIX replacement therapy in haemophilia B patients: complete gene deletions confer the highest risk. Haemophilia 1999;5(2):101-5.    Chitlur M, et al. Inhibitors in factor IX deficiency a report of the ISTH-SSC international FIX inhibitor registry (1997-2006). Haemophilia 2009;15(5):1027-31. Doi: 10.1111/j.1365-2516.2009.02039.x   DiMichele D. The North American Immune Tolerance Registry: contributions to the thirty-year experience with immune tolerance therapy. Haemophilia 2009;15(1):320-8. Doi: 10.1111/j.1365-2516.2008.01880.x   Astermark J, et al. The B-Natural Study – The outcome of immune tolerance induction therapy in patients with severe haemophilia B. Haemophilia 2021;27(5):802-13. Doi: 10.1111/hae.14357   Iorio A, et al. Establishing the prevalence and prevalence at birth of hemophilia in males: a meta-analytic approach using national registries. Ann Intern Med 2009;171(8):540-46. Doi: 10.7326/M19-1208   Soucie JM, et al. Occurance rates of haemophilia among males in the United States based on surveillance conducted in specialized haemophilia treatment centres. Haemophilia 2020;26(3):487-93. Doi: 10.1111/hae.13998   Berntorp E, et al. Quality of life in a large multinational haemophilia B cohort (The B-Natural Study – Unmet needs remain. Haemophilia 2022;28(3):453-61. Doi: 10.1111/hae.14525   Kihlberg K, et al. Treatment outcomes in persons with severe haemophilia B in the Nordic region: The B-NORD study. Haemophilia 2021;27(3):366-74. Doi: 10.1111/hae.14299   Feng D, et al. Evidence of clinically significant extravascular stores of factor IX. Thromb Haemost 2013;11(12):2176-2178. Doi: 10.1111/jth.12421   DiMichele DM, et al. Severe and moderate haemophilia A and B in US females. Haemophilia 2014;20(2):e136-43. Doi: 10.1111/hae.12364   Buckner TW, et al. Management of US men, women, and children with hemophilia and methods and demographics of the Bridging Hemophilia B Experiences, Results and Opportunities into Solutions (B-HERO-S) study. Eur J Haematol 2017;98:5-17. Doi: 10.1111/ejh.12854     Show Notes: Presenting Sponsor: Sanofi Subscribe to the Global Hemophilia Report   Connect with the Global Hemophilia Report Global Hemophilia Report on LinkedIn Global Hemophilia Report on Twitter Global Hemophilia Report on Facebook   Connect with BloodStream Media: BloodStreamMedia.com BloodStream on Facebook  BloodStream on Twitter 

CorConsult Rx: Evidence-Based Medicine and Pharmacy
SGLT-2 Inhibitors in Heart Failure *ACPE-Accredited*

CorConsult Rx: Evidence-Based Medicine and Pharmacy

Play Episode Listen Later Oct 3, 2022 51:48 Very Popular


On this episode, we review the data that lead to some SGLT-2 inhibitors being used routinely in heart failure. We discuss the initial cardiovascular safety studies that initially showed heart failure benefit in this class. Then we look as some of the newer studies that have looked at empagliflozin and dapagliflozin in heart failure patients (with and without diabetes as a comorbidity). Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. To earn credit for this episode, visit the following link below to reach the post-activity test for this episode: SGLT-2 Inhibitors in HF For existing Unlimited freeCE members, this CE option is included in your membership benefits at no additional cost! Members can simply follow the link above to take the post-test and evaluation for this activity. Use the password NEWHF (all caps) to unlock the post-test for this episode. But if you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. CorConsult Rx listeners can save 15% off the purchase of an unlimited membership by entering the discount code “PODCAST2022” at checkout, or by clicking the following link in the description https://hubs.ly/Q012N0H60 Thanks for listening! We want to give a big thanks to our main sponsor Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. You can find our account at the website below:  www.patreon.com/corconsultrx If you have any questions for Cole or me, reach out to us on any of the following: Text - 415-943-6116 Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com Instagram and other social media platforms - @corconsultrx This podcast reviews current evidence-based medicine and pharmacy treatment options. This podcast is intended to be used for educational purposes only and is intended for healthcare professionals and students. This podcast is not for patients and not intended as advice or treatment.

The Oncology Nursing Podcast
Episode 227: Biomarker Testing, PARP Inhibitors, and Oral Adherence During Ovarian Cancer Maintenance Therapy

The Oncology Nursing Podcast

Play Episode Listen Later Sep 30, 2022 43:36 Very Popular


“We found that nurses still needed clarity of terminology and the rationale for germline, somatic, and homologous recombination deficiency testing,” ONS member Paula Anastasia, MN, RN, AOCN®, clinical nurse specialist for UCLA Health in Los Angeles, CA, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS. Anastasia discussed the findings of a July 2022 ONS focus group that she facilitated on PARP inhibitor therapy, biomarker testing and terminology, and oral medication adherence for patients with ovarian cancer. This podcast episode is supported by a sponsorship from AstraZeneca. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes NCPD contact hours are not available for this episode. Clinical Update: PARP Inhibitors Survey: 2022 Member Feedback on Ovarian Cancer Treatment Focus Group Outcomes ONS Biomarker Database ONS Genomics and Precision Oncology Learning Library ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications Oncology Nursing Podcast episodes: Episode 215: Navigate Updates in Oral Adherence to Cancer Therapies ONS Voice articles: Oncology Nurses' Role in Translating Biomarker Testing Results Maintain Oral Adherence With ONS Guidelines™ Help Patients Understand Biomarker Test Results and Clinical Trials Options Genetic Counselors Help Patients and Providers Understand Biomarker Testing Goals and Results Nursing Considerations for Ovarian Cancer Survivorship Care An Oncology Nurse's Primer on Genomics and Biomarker Terminology Ovarian Cancer: Prevention, Screening, Treatment, and Survivorship Recommendations Clinical Journal of Oncology Nursing article: Shifting to a Biomarker Paradigm Across Cancer Care ONS video: Cancer Treatment Therapies Overview Oral Chemo Patient Education Sheets National Society of Genetic Counselors To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “We found in this focus group that nurses still needed clarity of terminology and the rationale for germline and somatic/homologous recombination deficiency (HRD) testing. They all shared that those who worked in the infusion center in general medical oncology offices as opposed to the specific gynecologic clinics, that they weren't as familiar with somatic and HRD terminology as you would suspect.” Timestamp (TS) 06:31 “As cancer care is evolving and patients are living longer and better, I think it's we nurses who are actually the ones that are doing these behind the scenes. The most common barriers that were consistently discussed across the board were cost and insurance approvals. . . . Other issues were access to the results. Results are not always being uploaded into the patient's medical record.” TS 09:51 “The nurses discussed wanting more knowledge of the mechanism of action with PARP inhibitors and how that alteration benefits patients with germline or somatic mutations. And most nurses did agree that their patients were offered germline testing at the time of diagnosis, but they were unclear as to when somatic or HRD testing was being done. . . . It was very inconsistent, so not all nurses knew where to find these results or to even know if it was done.” TS 16:54 “Education was key, and the nurses all agreed that it was important to identify who the appropriate patient would be that would most likely receive a clinical benefit, and who also would be following through or maintaining oral adherence. It was recommended to reinforce the side effects with the patients. . . . It was determined that patients should be informed that the goal of treatment of maintenance therapy was to prevent or decrease risk of recurrence.” TS 18:17 “It was recommended to assess patient adherence by asking open-ended questions. . . . The nurses agreed that the most common question to ask a patient would be: ‘How many doses did you miss this week? Or this month?' Recognizing that people miss doses, and it's not necessarily intentional, but it does happen, so we are validating and giving them permission to be honest with us.” TS 21:26 “I think having tools or resources—quick handouts—that they can give their patients that's like an easy guide, and they can review it with the patient, but the patient if they have questions can follow up. I think it's important to find out the patient's needs and how they learn best, on a video or paper, that sort of thing. . . . But the nurses also wanted quick-references guides, just an overview of what the indication is, what needs to be done prior to ordering this, and the mechanism of action.” TS 30:32