Podcasts about Intermountain Medical Center

Three Intermountain Health hospitals recently ranked among the Top 50 heart hospitals in the nation for 2025, according to a new national study of heart hospitals in America by Premier Inc. Intermountain Medical Center in Murray, Intermountain McKay-Dee Hospital in Ogden, and Intermountain St. George Regional Hospital, all made the list due to their quality of care, outcomes, and patient experience, among other criteria. According to the study, if hospitals around the country had similar marks to those making the Top 50 list, it could mean 14,000 fewer deaths, 28,600 fewer bypass and angioplasty patients suffering complications, and save more than 1.5 billion dollars for inpatient costs in 2025. To learn more, visit the Intermountain Health website. The Salt Lake Chamber. We Stand as the Voice of Business. Originally aired: 3/11/25

Receiving a cancer diagnosis is a frightening experience, but in the last few decades there has been real progress in cancer research and treatments. In this week's edition of Utah Weekly Forum, FM100.3 Host and cancer survivor Rebecca Cressman is joined by Dr. Margaret Van Meter, Associate Medical Director Oncology Services for Intermountain Health. Dr Van Meter shares the details on current cancer care at Intermountain Health's integrated Cancer Centers and why LDS Hospital in Salt Lake City, Utah Valley Hospital in Provo, and Intermountain Medical Center in Murray were recently ranked among the best cancer hospitals in the country by Newsweek. For more information on cancer care, call “Cancer Answers” at 833-321-3332.

Please join Guest Host Maryjane Farr, authors Sarah Franklin and Stavros G. Drakos, as well as Associate Editor Hesham Sadek as they discuss the article "Distinct Transcriptomic and Proteomic Profile Specifies Heart Failure Patients With Potential of Myocardial Recovery on Mechanical Unloading and Circulatory Support." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your cohosts. I'm Dr. Carolyn Lam, associate editor from the National Heart Center in Duke National University of Singapore. Dr. Peder Myhre: And I'm Dr. Peder Myhre, social media editor from Akershus University Hospital and University of Oslo. Dr. Carolyn Lam: Peder, today's featured paper is very, very important in the heart failure world. It is such a deep dive into the transcriptomic and proteomic profile that specifies heart failure and the potential of myocardial recovery with mechanical unloading and circulatory support. Dr. Peder Myhre: Can't wait for that feature discussion today, Carolyn. Dr. Carolyn Lam: But you have to wait because I insist on telling you about yet another really important paper, of course in my favorite subject, heart failure with preserved ejection fraction or HFpEF. Now you know that exercise intolerance is a defining characteristic of HFpEF and a marked rise in pulmonary capillary wedge pressure during exertion is pethepneumonic for HFpEF and it's thought to be a key cause of the exercise intolerance. Now if that is true, acutely lowering the wedge pressure should improve exercise capacity, right? Well, don't assume this because to test this hypothesis, authors led by corresponding author Dr. Ben Levine from UT Southwestern evaluated peak exercise capacity with and without nitroglycerin, which was used to acutely lower pulmonary capillary wedge pressure during exercise in patients with HFpEF. Dr. Peder Myhre: Oh, that's so cool. What an amazing research question and Carolyn, you're the best to summarize this. Please tell us what did they find? Dr. Carolyn Lam: Well, they studied 30 patients with HFpEF and get this. They underwent two bouts of upright seated cycle exercise dosed with sublingual nitroglycerin or a placebo every 15 minutes in a single blind randomized crossover design. So really well done. Wedge pressure, VO2 and cardiac output were assessed at rest with 20 watts exercise and at peak exercise during both the placebo and nitroglycerin conditions and the principle finding of the study (singing) acutely lowering pulmonary capillary wedge pressure during upright exercise with nitroglycerin in HFpEF did not improve peak exercise performance. So peak VO2 was practically identical with a 1% difference despite a 17% drop in peak wedge pressure. Peak cardiac output and peak peripheral oxygen extraction were unchanged, again, despite the drop in peak wedge pressure suggesting that oxygen delivery and utilization were unaffected. Exercise performance variables including peak wattage, peak ventilation and peak RER were unchanged, suggesting that again, reductions in peak wedge were insufficient to improve exercise tolerance. All these results suggest acute reductions in wedge pressure are insufficient to improve exercise capacity and provide convincing evidence that a high wedge during exercise by itself is an epiphenomenon perhaps rather than a primary limiting factor for exercise performance in patients with HFpEF. Now of course this is incredibly interesting contrary to hypothesis and so please read the paper. The discussion is very rich. Dr. Peder Myhre: Oh wow, Carolyn. That is such a great paper. I can't wait to pick it up and read it from start to finish and now Carolyn, we're going to look into research within cardiovascular disease from COVID-19 and we have learned so much and so quickly about COVID-19 and its effects on the heart and we have really come a long way from the first case reports reported in the beginning of the pandemic and this paper, which comes to us from corresponding author Professor JP Greenwood, really adds important knowledge to this field. The COVID heart study was a prospective longitudinal multi-center observational cohort study of patients hospitalized with COVID-19 and at elevated serum troponin levels across 25 hospitals in the UK and these investigators aim to characterize myocardial injury, its association and sequela in convalescent patients following hospitalization with COVID-19 utilizing appropriately matched contemporary controls. Dr. Carolyn Lam: Ooh, important stuff. So what did they find? Dr. Peder Myhre: So these authors included in total 519 patients comprising 342 patients with COVID-19 and an elevated troponin, 64 patients with COVID-19 and a normal troponin and 113 age and comorbidity matched controls without COVID-19 and the frequency of any heart abnormality defined as left or right ventricular impairment, scar or pericardial disease was two full greater in patients with COVID positive and troponin positive, so 61% compared to the control groups and that is 36% for COVID positive and troponin negative and 31% for COVID negative and comorbidity positive and the myocardial injury pattern was different for these patients with COVID and an elevated troponin more likely than controls to have infarction and micro infarction. But there was no difference in non-ischemic scar and using the late MRI criteria, the prevalence of probable recent myocarditis was almost 7% for those with COVID and elevated troponin compared to only 2% for the controls without COVID-19 and myocardial scar is but not prior COVID-19 infection or troponin was an independent predictor of MACE. So Carolyn, these authors discussed their findings in light of previously reported studies and these authors identified a lower prevalence of probable recent myocarditis than previously described and a higher proportion of myocardial infarction and this newly described pattern of micro infarction following COVID-19 and Carolyn, there is a brilliant editorial really summarizing this by Dr. Stuber and Baggish entitled "Acute Myocardial Injury in the COVID Heart Study Emphasizing Scars While Reassuring Scarce." I really recommend everyone to pick this up and read the editorial as well. Dr. Carolyn Lam: Very clever title. Thank you. For the last original paper in today's issue, it focuses on the crosstalk between sterile metabolism and inflammatory pathways, which have been demonstrated to significantly impact the development of atherosclerosis. Authors today are featuring and focusing on 25 hydroxy cholesterol, which is produced as an oxidation product of cholesterol and belongs to a family of bioactive cholesterol derivatives produced by cells in response to fluctuating cholesterol levels and immune activation. So these authors with co-corresponding authors, Dr. Suárez and Fernández-Hernando from Yale University School of Medicine, they showed beautifully that first, 25 hydroxy cholesterol accumulates in human coronary atherosclerosis. Next, that 25 hydroxy cholesterol produced by macrophages accelerated atherosclerosis progression and promoted plaque instability by promoting the inflammatory response in macrophages and also via paracrine actions on smooth muscle cell migratory responses. Dr. Peder Myhre: Wow, that is so interesting, Carolyn. What are the therapeutic implications of these findings? Dr. Carolyn Lam: Yes, I'm glad you asked because it was summarizing a lot of work in those findings with the very important implications that inhibition of 25 hydroxy cholesterol production might therefore delay atherosclerosis progression and promote plaque stability. So this study actually opens a door to explore the role of 25 hydroxy cholesterol as a target to control inflammation and plaque stability in human atherosclerosis. Dr. Peder Myhre: Oh, that is so important. Thank you so much and there is more in this issue as well, Carolyn. We have another issue of Circulation Global Rounds and this time we're going to France in a paper written by Dr. Danchin and Bouleti. We also have an exchange of letters by Dr. Yang and Dr. Schultze regarding the article, "Deep Lipidomics in Human Plasma: Cardiometabolic Disease Risk and Effect of Dietary Fat Modulation" and an ECG Challenge by Drs. Manickavasagam, Dar and Jacob entitled "Syncope After Transcatheter Aortic Valve Implantation: Pace or Not." Dr. Carolyn Lam: Interesting. There's a Frontiers paper also by Dr. Dimopoulos on “Cardiovascular Complications of Down Syndrome: Scoping Review and Expert Consensus,” a Research Letter by Dr. Kimenai on the impact of patient selection on performance of an early rule out pathway for myocardial infarction from research to the real world. Nice. Well let's carry on to that feature discussion on heart failure, transcriptomics and proteomic, shall we? Dr. Peder Myhre: Can't wait. Dr. Maryjane Farr: Welcome everybody to Circulation on the Run. We are so pleased to be talking with Dr. Stavros Drakos and Dr. Sarah Franklin from the University of Utah. My name is Maryjane Farr and I am the heart failure section chief at UT Southwestern and Digital Strategies editor for circulation. Myself and Hesham Sadek will be talking with them about their new paper and circulation called "Distinct Transcriptomic and Proteomic Profile Specifies Heart Failure Patients with Potential of Myocardial Recovery Upon Mechanical Unloading and Circulatory Support." Just briefly, Dr. Stavros Drakos is the director of cardiovascular research for the division of cardiology at Utah and co-director of the Heart Failure Mechanical Circulatory Support and Heart Transplant Program. Dr. Sarah Franklin is associate professor of medicine at the University of Utah whose lab has a specific expertise in the applications of proteomics to heart disease. Welcome, Stavros and Sarah. Dr. Sarah Franklin: Thank you. Dr. Stavros Drakos: Thank you. Thank you for having us. Dr. Maryjane Farr: This paper is exciting for clinicians. It's exciting for translational scientists. Hesham, why don't you start digging into this paper and tell us one or then the other of you tell us what this paper is about, what's the background and let's get into the science. Let's go there and then we'll pull back and look at some of the big picture stuff. Hesham. Hesham Sadek: Well, thank you. So I've been fascinated by the field of cardiac recovery for some time now and obviously Stavros is as an expert and one of the leaders of that field and what struck me about this is that we are starting to see some distinct molecular signature of patients that can experience recovery as opposed to patients undergoing the same procedures with the same profile that do not manifest evidence of myocardial recovery and specifically, the study was conducted very rigorously and the signature was very clear in that they saw primarily interest for someone like me who's interested in cardiac regeneration, a signature of cell cycle in the patients that experience recovery as well as ECM signature which could suggest reverse remodeling and also there's some evidence that ECM might impact cardiomyocyte and myocardial regeneration. So my interest in this for selfish reasons is primarily that this supports the hypothesis that perhaps there is a molecular signature of regeneration that occurs in patients that experience myocardial recovery with LVAD. Dr. Maryjane Farr: So Stavros, let's start with you. Give us the reason why to do this study. You mentioned some of the background. It'd be great to sort of talk for a moment about re-stage heart failure and then how it brought you to this study. Dr. Stavros Drakos: Thank you, Jane. So again, thank you for the opportunity to talk about the findings and the implications of this study. I like the way you are asking us to look a little bit at what led to this study and as you mentioned, the re-stage is a multi-center study that was performed in six US sites which showed in a reproducible fashion now given that we had single center studies from all over the world suggesting that, advanced heart failure is not an irreversible process that has to lead to end stage, an irreversible disease and what a re-stage demonstrated was that there is a subset of patients which if you select them based on clinical characteristics that we derived from other studies that were performed previously, you can achieve reverse remodeling, essentially a bad heart looking much better by every clinical, functional, structural characteristic in up to 50% of the selected patients. That's what re-stage showed. So having this finding now in a multicenter study, what made this study very timely was to be able to understand what drives this remarkable response. What are some of the mechanisms, as Hesham said, that we can if uncover take advantage of and expand this paradigm and enhance it and achieve reverse remodeling and recovery of even more patients and even go earlier in the disease process. So that's kind of how I would link the clinical findings that preceded this study with the motivation to perform the study and the implications of these findings for the ongoing translational and basic science research. Hesham Sadek: I'd like to ask a question here. So Stavros, do you think it's too early to sort of redefine the term reverse remodeling in this context to include perhaps some evidence of regeneration? Is there evidence of regeneration in this field or that's too premature to say? Dr. Stavros Drakos: I think the data are directing us towards the direction you just mentioned. I think that we can begin talking about it and planting the seed. We do have other evidence from work that you and others have performed indicating that this indeed is one of the mechanisms that drives this phenomenon and I think that the findings, especially in the cell cycle that we identified add to and contribute even more to that body of work that you and others have done. At this point, I will turn it to Sarah who can talk a little bit more about the findings related to the cell cycle that we identified in our study and I think that these may complete the answer to you, Hesham. Dr. Sarah Franklin: Yeah, I would love to comment. I think it's a really interesting phenomenon and really in these patient samples we were trying to understand molecularly what the difference is between individuals that respond positively to therapy and individuals that receive the same exact therapy and do not respond positively. So these are termed responders and non-responders and in our analysis we combined two platforms where we could molecularly interrogate what's different in these two tissues and try to see what is differentiating these populations. So what's consistent and reproducible different in responders and non-responders on a molecular level and in both the transcriptomic data and the phospho proteomic data, we saw clear patterns with cell cycle regulation and extracellular matrix or focal adhesion molecules and the interesting thing about cell cycle is cardiomyocytes have typically been thought to exit the cell cycle not long after birth and we see some interesting phenomenon either in humans or mice where we can have nuclei that have either multiple sets of chromosomes or multiple nuclei and there's some differences that have been observed in the nucleus with regards to disease, so hypertrophy, heart failure. So the molecules that we've identified, we saw a large difference in proteins involved in cell cycle regulation. Now the interesting thing is not all of those molecules are increasing or decreasing. We see a combination of molecules that are increasing or decreasing. But I think the other thing that's interesting is that these molecules, even though we are seeing changes in expression or changes in phosphorylation, exactly how that contributes to either cell cycle or cell cycle reentry or just nuclear function and transcription of proteins or genes or DNA regions is still what we need to continue to study. So exactly how these changes in proteins or transcripts related to the cell cycle, how they are exactly contributing to the physiological improvements that we're seeing is something that still needs to be investigated but is really important that that is a highlight of this study and as Stavros mentioned of previous work. Dr. Maryjane Farr: Stavros, tell us the design of the study. Dr. Stavros Drakos: Okay. So this study was performed in 93 patients that were prospectively enrolled in the Utah transplant affiliated hospitals here in Salt Lake City between the University of Utah, Intermountain Medical Center and the VA and these people came from all over the mountain west, the surrounding states of Utah and through our VA, through the state, from all over the west and south, from Alaska and Hawaii to Texas and we think it's a very representative population of our country's patient population and then we followed prospectively these people with serial echocardiograms so we can tell who will respond as Sarah said before, which essentially means which hearts are going to get better by echocardiographic criteria functionally and structurally, the dimensions of the heart shrinking and the ejection fraction improving to more than 40% and the dimension shrinking to normal range and then we compare these people, the subset of patients that have responded to the majority of patients actually that they have not responded. As we know these are advanced end stage patients and there is only a subset of those that they will favor respondents. As we said earlier, these subset can increase if you go selectively and pick these patients based on baseline characteristics. So then we analyze the tissue we got from these people when the LVAD went in, which is the core of the apex of the heart and compare that to the tissue we receive when the patients got transplanted and we got the whole heart. So in the meantime, as we just discussed, we phenotyped these people so we knew who were responders and non-responders and then we went back in the lab and tried to marry two basic processes, analyzing the transcriptome and the proteome and by doing that we were able to see some overlapping changes between the transcriptome and the proteome and we felt that by doing this overlapping analysis, we will increase the likelihood that what we are seeing, exponential mechanistic drivers will be the real mechanism and not just associations that you can frequently find when you do studies in humans and that's kind of a rough, brief summary of the design. Sarah, would you add something to that? Dr. Sarah Franklin: No, I think that's a great overview of it. I think what excites me about it is that this was first clinically observed that these patients were recovering and so I think the exciting part is the hypothesis was that there was some molecular underpinnings that could molecularly define these patients that were responding or not responding and so with that hypothesis we then carried out these analyses hoping that we would see a difference and we're very excited. It's very successful in that we found very clear, molecular differences that are reproducible between these patient populations. Dr. Maryjane Farr: So obviously there's lots of implications. Let me start with one very simple clinical one and that is, so based on some of the differences in the signatures and pathways that you saw for the next patient who needs LVAD therapy and you're trying to predict in some way whether they may be a responder or a non-responder, could you look at a biopsy sample and try to make some sort of prediction based on some of your findings so that they can choose a VAD over a transplant? That's a very clinical question and then I guess the second question is would it have to be a left ventricular myocardial sample? So are the differences? What do you think about that question? Or it's just too much too, far beyond? This is obviously a mechanistic study. But I'm just asking. Dr. Stavros Drakos: No, that's a great question and I'll start and Sarah can add later. So obviously it will be great if we can have a practical way to predict before the intervention who are the people that they will respond and that's one of the motivations for this study. It was not just to find the mechanism so we can make this phenomenon better and enhance it and find the mechanism, create new therapies. It was also the practical approach that you suggested, Jane, and I think that yes, this adds to the clinical predictors that we have already identified from other studies and yes, we could theoretically take the tissue and do this analysis. Is this the most practical thing we can say to the patient to biopsy the heart, right? It would've been better to be able to identify a biomarker in the plaque and we've done that. We started in other studies, identifying what's going on in the tissue and then going targeted in the blood and that's how we identified two cytokines and a two cytokines model, interferon gamma and TNF alpha being predictive as circulating biome. In this study we identify changes that can also inform future studies of biomarkers in the blood. But if we had a way to easily get the tissue and analyze the genes, yes, we could have done that as a predictor as well. The practical issue is that asking a patient for a biopsy just to predict the response to therapy may be something that most patients and most clinicians will consider way too advanced and complicated, right?that's why more work should and could be done to identify circulating biomarkers or other modalities that can help us interrogate what's going on in the heart related with these findings. But not that we cannot also do what you said. It's just more complicated. I don't know if Sarah would like to add to this. Dr. Sarah Franklin: I'd love to. I think that's a great overview. I think the only thing that I would add is that there are a number of conditions whether in the heart or otherwise in the body that you can use a single biomarker and it can be very predictive of conditions. Heart failure is so complex that often individual biomarkers are not sufficient enough to cover an entire population and all the nuances that can go into heart failure symptoms or syndromes and I think the exciting part about this study is it is one of the largest cohorts of patients that have been examined in this manner, which is exciting, but also that we have a multi-factor panel that is made up of multiple biomarkers that with the number of individuals that we examined is completely predictive of all of these patients. So these biomarkers are consistent and reproducible across all of these patients between responders and non-responders regardless of some of the nuances in the heart failure that they have and so it's very exciting because it's possible that a multifactorial panel could be much more applicable and last the test of time more so than an individual biomarker. I think the one other thing that is exciting like Stavros mentioned is that we did initially identify these in the left ventricle and it will be really exciting to see how far these biomarkers can be used if they can be used in potentially other aspects of the heart or blood, which obviously is less invasive and so that's not something that we've applied this panel to yet, but I think is a really wonderful extension of now saying, can we also identify some of these biomarkers in the blood which would be less invasive even if it's a fraction of them. That would still be wonderful. Dr. Maryjane Farr: I have so many clinical questions. But Hesham, what questions do you have? Hesham Sadek: Yeah, so the elephant in the room here obviously is that the variable is that these patients have an unloaded heart and there is evidence that unloading can reverse some of the changes that occur after birth with increasing ventricular load and initiate cascade of molecular events that may allow myocytes to proliferate. So this begs the question, is there a difference in how these ventricles of patients that recover versus those that do not recover see load? Are we able to measure load appropriately and is there a difference in load between these patients and if so, can this be improved or detection or measuring unloading or the degree of unloading clinically, can this be improved? Dr. Stavros Drakos: No, that's a great question and it provides the opportunity to talk about some of the things we can do on the clinical arena to further enhance this phenomenon. Yes, there are ways that we can use to tailor the mechanical unloading that we can provide in order to enhance this phenomenon. One way, and that's a study that we are proposing, is to use sensors, pressure sensors that can guide the way you function the machines, the devices, right? The way you remove part of the load and these sensors, some of them are clinically approved like cardioments and then without doing invasive procedures you can follow chronically how these patients are being unloaded and how the heart is responding to this unloading. We know that a lot of LVAD patients, despite doing clinically well, we know this from snapshot evaluations in right-heart cath studies, they are not optimally unloaded. They are feeling pressures left and right are not always optimized and so by doing this kind of prospective assessment of the mechanical unloading, you can tailor what you offer and the hypothesis generated is that by doing that you may be able to recover even more people. You can do this as we said, with approved sensors like cardioments or with other sensors that they are under investigation. You can also do more invasive stuff like PV loops. Of course these will require cathing these patients, which is a little bit more complicated. But it will provide more accurate assessment and it will also interrogate how the heart is improving and provide to you in-depth investigation and in-depth insights on also how the recovery process and the reverse remodeling process is being, I would say, digested by the heart and translated to functional response instead of just looking at it with an echocardiogram or the findings of a right-heart cath and these are studies that others have performed and have published and we know that they can give you a real good look into the systolic and diastolic function of the heart and how this is changing and improving down the road. So yes, that's the short answer. We can do that and we can tailor the unloading and potentially that's the hypothesis, maximize the effect that we saw here. Hesham Sadek: So this begs the question, maybe two questions here. One, is there evidence that patients who recover not from this study only but from other studies, is there evidence that patients who recover are more unloaded than patients that do not recover and the second question is: is it time to standardize assessment of mechanical load in patients with LVAD, especially those that will undergo or would be considered for recovery? Dr. Stavros Drakos: Yes. So that's a great opportunity to share with our audience what we know and what we don't know in this field in relation to your question about whether we know what is the optimum degree of unloading and the answer I think is that we need to know and understand more. What do I mean by that? There's this idea that the heart as every other organ after being unloaded and not working for some time may it lazy, may get atrophic and may need some rehab like the skeletal muscle when we put it in the cast and get atrophic and we need to rehab it when we remove the cast. So you can imagine that the LVAD and the unloading that provides, which in many cases may take over a significant part of the function of the heart may need gradual reloading as a second phase after the first phase of unloading and that's something that we've done. We have an ongoing study on this and also others have published that it may be beneficial. Of course, it needs to be validated and investigated further and to discuss about the degree of unloading in the first phase and what is the optimum degree of unloading, I would say even there, there is room for us to understand better what's going on and I think that we can investigate with ongoing studies right now whether full unloading versus partial unloading and measure the pressures using these sensors can translate to better changes functionally and structurally. I think that's something that is very doable and it would be very beneficial. What was the second part of your question, Hesham? Hesham Sadek: I was asking whether it's time to start standardizing some measure of unloading if these patients are planned for recovery? Dr. Stavros Drakos: Yes, and that's what we are doing. In all of these people, we report from the get-go what is their recovery score based on the intermixed ICARS derived score and when we have patients that they have high likelihood of recovery, we monitor them very closely and clinically what we do is just looking at the echo and whenever we do a right heart cath for clinical reasons. But in a prospective research study we could do more than just looking at the echo and occasional right heart cath and using the sensors we just discussed previously, you can tailor the unloading and begin prospectively unloading them in a more I would say well monitored wave. Yes. Hesham Sadek: So this is unloading or device specific parameters. Now are there patient specific parameters with regards to type of heart failure? So we talked initially about whether there's an element of regeneration specifically when it comes to cell cycle. But many patients with non-ischemic cardiomyopathy for example, don't have large scars and don't have lot of myocytes as the underlying cause of cardiomyopathy. Would you foresee that there is different mechanisms, for example, in these patients that don't have myocyte loss, that perhaps maybe it's not cardio myocyte proliferation and not regeneration? Dr. Stavros Drakos: Yes. So I think that the differential responses we get based on the heart failure theology warrant further investigation. Sarah and I have discussed that and actually we are following on our findings with larger number of patients so we can tease out these and I'll let Sarah talk a little bit more about it in a minute. But to answer the clinical part of this question, we don't know yet whether different parts of heart failure should be prescribed different modes of unloading. But the way you described it of course invites the hypothesis that of course different substrates, different injuries of the heart, as you said, it's a completely different failing heart if you have a big scar there versus a patient who has a mode of heart failure, another type of injury and would this be treated better and more effectively in terms of reverse remodeling by applying a different mode of unloading? That's things that we need to investigate further. But Sarah, would you like to comment on the potential on the effect of the different heart failure theologies on some of the findings we saw? Dr. Sarah Franklin: Yeah, definitely. So I think it's a really interesting question and in this analysis we included ischemic and non-ischemic samples in the patient populations and really we're just stratifying them based on responders and non-responders. When we start layering additional levels onto that, then we're effectively kind of reducing the potential numbers. So if we have 25 responders and we start breaking that down into ischemic and non-ischemic to see if there's another layer of biomarkers there, we actually did that we did not include it in this study. It's something that we're working on to add that. But we do reduce the number overall of patients in those two populations. So it would be fine to share that we were seeing stratification between ischemic and non-ischemic. But we did not feel like the numbers might be high enough within the responder and non-responder categories that warrant including that in this manuscript. So it's very intriguing that just responders and non-responders alone stratify as well as they do. They separate based on these biomarkers and it looks like it will also be possible in the future for us to even separate these samples further based on similar or additional biomarkers based on more specific factors in the etiology. So I think that will be another really exciting next step for future research. Hesham Sadek: My final question would be maybe a little bit broader than LVAD population, but definitely informed by this study. The term non-ischemic cardiomyopathy, do you think it's too broad and too vague for us to use in this setting because this encompasses many different types of cardiomyopathy that really are not nuanced enough by this definition. Dr. Stavros Drakos: Well, Jane was smiling while you were asking this question because we all as heart failure clinicians need to accept that it was not a good idea to name all of these different diseases non-ischemic cardiomyopathy when we did it or when this happened many moons ago. As you said, Hesham, and I couldn't agree more, these are completely different diseases. We need to understand them better and I think that the way we treat nowadays, chronic heart failure, many years down the road when people will look back, they will consider it a little bit, I would say, surprising that we were treating all of these the same way. We need more studies like the one we just did, that they will have enough numbers and that's when the issue becomes that you need enough numbers to be able to tell the differences between all of these non-ischemic cardiomyopathy types, theologies and if you go upstream, motivated and inspired by findings like this, we hope that we will be able to identify how to go and do a root cause analysis and treat these diseases, not down, down, downstream the same way, but going upstream, finding what really went wrong and treating them earlier in the molecular or other pathophysiological mechanism pathway that led to the heart failure and so yes, it was a bad idea to do that. But of course sometimes we do things because we don't understand it better, right? As one of our keynote speakers here in the recovery symposium said a few years ago, Jay Khan, the founder of Heart Failure Strata of America, some things look complicated until you understand them. Then when you understand them, they look simple. So here we don't really understand non-ischemic cardiomyopathy and how all these theologies lead there and I think studies like these can help us really inform the field better. But we will need, as Sarah said, more numbers. Dr. Maryjane Farr: So that was a great conversation. I wanted to just raise one last thing and that is what's so interesting about this cohort relative to re-stage heart failure is these were older patients and for re-stage heart failure, I think the average age was 35. So you would imagine there might have been one etiology for cardiomyopathy, uncontrolled hypertension or peripartum. But for cohorts in their fifties, there's probably an accumulation of different insults over many years time and so I thought that was particularly interesting from the point of view of that you were probably dealing with, again, a mixed bag of pressure overload, volume overload, maybe a genetic underpinning, whatever the life trajectory of some of these patients were and then lastly, the decision to try to go to recovery rather than to transplant, which would be the real world experience of why this wet pathway than the other. These are people truly in their fifties where they may have one or two surgeries in their lifetime left and so it's the relevant population that you're studying and so I'll leave it at that. That's a comment rather than a question, I think. But I think for heart failure clinicians, this is why the bench to bedside piece is so relevant to understanding this because it actually does change clinical practice, even if the mechanistic pathways may take still many more years to truly understand. It helps understand what's possible from an accrued clinical decision-making level. Dr. Sarah Franklin: Jane, if I might just comment on that, I actually think that's one of the most exciting parts about this dataset is that, as you mentioned, these patients have complex diseases. They are older. But yet we are still able to see consistent and reproducible differences between the patient populations that respond and don't respond and to me that suggests that at the end of the day there are consistent differences or reproducible or consistent molecular changes in cardiac tissue and in response to stress and I think that that gives us hope that we could potentially not only predict who would respond or not respond, but that as we get better at understanding the differences, that there could be potential therapeutic targets or therapies that would still be beneficial regardless of the complexity of the heart failure. Dr. Maryjane Farr: Okay. So Sarah, Stavros, thank you so much for spending time with Hesham and myself and look forward to EUCORS--I'm allowed to say that. Dr. Stavros Drakos: Of course. Dr. Maryjane Farr: Thanks so much. Bye. Dr. Greg Hundley: This program is copyright of the American Heart Association 2023. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Jenna works at Alta as a part time ski patroller, at Powderbird Heli Skiing as a tailguide, and as an instructor for the American Avalanche Institute. She also works as a PA in Neurosurgery, Trauma, and Critical Care at Intermountain Medical Center. She is a council member for the newly incorporated Town of Brighton in Big Cottonwood Canyon, and has spent multiple seasons on Denali as a medical provider for Denali Rescue Volunteers. She's presented at Snow and Avalanche Workshops in Utah, Wyoming, Oregon, and New Hampshire, and has contributed to The Avalanche Review and Ascent Backcountry Snow Journal. Here's a link to the podcast on Apple: https://podcasts.apple.com/us/podcast/utah-avalanche-center-podcast/id1327581604?i=1000459555748 And here's a link to the podcast on the UAC podcast site https://utavy.libsyn.com/why-forecasting-is-poker-and-not-chess-a-conversation-with-jenna-malone And here's a link to Jenna's WYSAW Talk: https://vimeo.com/475545319?embedded=true&source=vimeo_logo&owner=4475613 And here's a link to Heather Thamm's WYSAW Talk: Forecasting for a scary low: https://vimeo.com/475482344?embedded=true&source=vimeo_logo&owner=4475613a Utah Avalanche Center Drew Hardesty blog post on Expert Intuition: https://utahavalanchecenter.org/blog/26871 Margaret Wheeler's podcast with Utah Avalanche Center on “Does Culture Eat Training for Breakfast?” Wheeler Podcast

Welcome to "Dear Cancer," a takeover episode of Out of Patients with special guest hosts Dr. Mark Lewis, an oncologist from Intermountain Medical Center, and Stephanie Elsea, a volunteer patient advocate from The Lustgarten Foundation. Together with Matthew Zachary, Mark and Stephanie break down the latest cancer research medical jargon into human terms, especially with the help of another special guest, Matt's daughter, Hannah. With grace, humor, and passion, the three share personal stories that connect them deeply to this cause. They wish only to help patients strike that balancing act between hope and hope by banishing pessimism and embracing reality about their prognoses. Throughout the episode, the team covers everything from understanding different types of tumors, what biomarkers are (and their importance), and clinical trials can sound less, um.. "clinical." They also discuss the latest findings and some extremely positive results from the Crestone Research Study.See if biomarker testing is right for you, and sign up today at http://dearcancer.health/findout.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is a previously released episode that I thought would be of great interest to our listeners. As we move forward post 24 months of COVID-19 reconnecting with our purpose and core values is more important than ever. In this episode, we discuss the practice of respect in the intensive care unit. Our guest is Samuel M. Brown, MD, MS, a practicing intensivist and Director of the Center for Humanizing Critical Care, at Intermountain Medical Center in Murray, Utah. Dr. Brown holds an academic appointment as Associate Professor of Medicine at the University Of Utah School Of Medicine, Murray UT. He is a prolific investigator and author with a wide range of interests including complexity in critical illness, echocardiography, and ethics. Our conversation covers topics such as dignity, respect, compassion, and burnout. Join us in a fascinating discussion with a thought leader in bringing humanism to critical care. Additional Resources: Recent article co-authored by Dr. Brown and colleagues reviewing important aspects of the practice of respect in critical care medicine: https://bit.ly/3uFLou8 The Center for Humanizing Critical Care works with researchers and clinicians with the goal of helping patients and family members make it through critical illness with their humanity intact: https://bit.ly/3JTxfjp Speak, Memory: An autobiography revisited. By Vladimir Nabokov: https://amzn.to/3iKaXVc

Welcome to “Is It Serious?,” a conversational podcast where two top doctors pull back the curtain on the American healthcare system and answer all of your health concerns, one question at a time. Hosted by Jean Luc Neptune, MD and Mark Lewis, MD, both highly accomplished physicians and health experts from Suntra Modern Recovery and Intermountain Medical Center, respectively. This show will discuss a wide range of topics including complex health issues, insider insurance tips, healthcare hacks, mean tweets and the absurdity of drug commercials.Tweet us your questions @jeanlucneptune or @marklewismd or email us at isitserious@offscrip.com or call us at 855-283-4666See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

HEALTH NEWS   Adding herbs and spices to meals may help lower blood pressure Texas Tech University, November 8, 2021 In a controlled-feeding study, the researchers found that seasoning foods with 6.5 grams, or about 1.3 teaspoons, of herbs and spices a day was linked with lower blood pressure after four weeks. The findings offer people a simple way to help improve their heart health. For the study, the researchers recruited 71 people with risk factors for heart disease. Every participant consumed every spice diet—one low, one moderate, and one high in herbs and spices—in a random order for four weeks each, with a two-week break between each diet period. Blood samples were drawn from each participant at the beginning of the study as well as after each diet period. The doses included a blend of 24 different herbs and spices, ranging from basil and thyme to cinnamon and turmeric, designed to simulate the way people use different herbs and spices throughout the day while cooking. The researchers found that after consuming the diet including a high dose of herbs and spices, participants had lower systolic blood pressure than after the diet with the medium dose. Participants also had lower diastolic blood pressure after the diet with a high dose of herbs and spices than after the diet with a low dose.   Bitter melon can lower blood sugar levels and even prevent cancer University of Colorado Cancer Center, November 11, 2021 Bitter melon (Momordica charantia), also known as bitter gourd and balsam pear in other parts of the world, is one of those foods that meet more than your senses of sight and taste.  A study conducted by researchers from the University of Colorado Cancer Center demonstrated the vegetable's ability to fight pancreatic cancer, one of the hardest cancers to treat. It found that treating pancreatic cancer tumors in mice with 5 milligrams of freeze-dried bitter melon juice every day reduces the tumors' size and makes them 64 percent smaller than those in untreated mice. What more, bitter melon proved more effective than a common chemotherapy drug used in a similar study, which reduced the tumor size by only 52 percent. The researchers noted that the dosage used in the study caused no adverse effects on the mice and may be adapted for human consumption. In another study, bitter melon caused apoptosis – cellular death – in four pancreatic cancer cell lines, reducing the viability of two lines by 90 percent and the other two by an impressive 98 percent. It also halted the metastasis and re-growth of the cancer cells. Further research has shown the vegetable's activity against other types of cancer as well, including blood, colon, liver, stomach, and breast cancers. If you really don't think you can take the vegetable's flavor, you can take it in capsule form. Do note that some studies showing its benefits for blood sugar control used dosages as high as 2,000 mg a day. To ensure that bitter melon supplements are the best for your condition, it would be best to consult with your healthcare provider before taking them.   Flame retardants linked to autistic-like behavior University of California at Riverside, November 7, 2021 Polybrominated diphenyl ethers, or PBDEs, are a class of fire-retardant chemicals that are ubiquitous. They are found on upholstery, carpets, curtains, electronics, and even infant products. Flame retardants migrate out of products into dust that humans contact and can ingest.  Considered to be global environmental pollutants, they have been detected in water, soil, air, food products, animals, and human tissues. They are found, too, in breast milk of women all over the world. A research team has found that when female mice exposed to PBDEs pass on these neuroendocrine-disrupting chemicals to their developing offspring, the female offspring show traits relevant to autism spectrum disorders, or ASD. Their short-term social-recognition ability and long-term social memory is reduced significantly and the offspring show exaggerated “marble burying” behavior — repetitive behavior reminiscent of human compulsive behavior, a core symptom of ASD.  “Humans mostly rely on faces to recognize people and most autistics show deficits in face-identity processing,” Curras-Collazo explained. “Mice, on the other hand, rely on smell for social recognition. The female offspring of mother mice exposed to PBDEs showed olfactory deficits that dampened their ability to recognize other mice. In effect, these offspring do not distinguish new mice from familiar ones. Humans with ASD also show abnormal olfactory ability.”  To the authors' knowledge, their study is the first to show autistic-relevant behavior and brain changes in female offspring from maternal transfer of environmental pollutants. The behaviors were also tested in exposed mothers, but they were largely unaffected. ype and social neuropeptide alterations in female mice offspring induced by maternal transfer of PBDE congeners in the commercial mixture DE‑71.”   Two omega-3s in fish oil may boost brain function in people with heart disease   Harvard Medical School , November 8, 2021 Two omega-3 fatty acids found in fish oil may help improve brain function in older adults who have a type of heart disease known to put people at risk for cognitive decline. A new study found that DHA and EPA, given in a combined supplement at prescription levels, improved cognitive function in older adults with coronary artery disease, or CAD. It is a common type of heart disease that occurs when plaque builds up in the arteries and hinders proper blood flow. Studies have shown people with CAD have a 45% increased risk for cognitive decline. The largest improvements in brain function were seen when higher levels of both types of omega-3 fatty acids were present in the bloodstream. When analyzed individually, DHA levels were a better predictor for cognitive improvement than EPA, suggesting the presence of one type of omega-3 fatty acid was more important than the other, the authors concluded. "The study showed EPA adds additional benefit when DHA levels are already high," said study researcher Dr. Francine Welty, an associate professor of medicine at Harvard Medical School in Boston. "But EPA levels alone had no predictive ability for cognitive improvement."   Despite understanding the concept of mindfulness, people are applying it incorrectly, research finds University of Waterloo (Canada), November 8, 2021 Mindful awareness is about both accepting and engaging with life's challenges, and that's what popularized concepts of mindfulness tend to miss, new research has found. Studying popular concepts of mindfulness, the researchers found most laypeople are confusing the practice with passive acceptance of problem—a misconception scientists say ignores the important work of engaging with them. Originating in Buddhist religious practice, much of the mindfulness movement's popularity grew from clinical research affirming its potential for reducing stress and related health disorders.  It is, in fact, the engagement with stressors that ultimately results in stress relief. More specifically, mindfulness includes two main dimensions: awareness and acceptance. "While we found that people seem to conceptually understand that mindfulness involves engagement, the general public is not walking the talk. Our results suggest that laypeople may understand what awareness is, but the next step of acceptance may not be well understood—limiting potential for engaging with problems," said Ellen Choi, lead author on the paper.   Bacterial pneumonia far more dangerous to the heart than viral pneumonia, study finds   Intermountain Medical Center (Utah), November 11, 2021   Heart complications in patients diagnosed with bacterial pneumonia are more serious than in patients diagnosed with viral pneumonia, according to new research. In the study of nearly 5,000 patients, researchers found that patients diagnosed with bacterial pneumonia had a 60 percent greater risk of a heart attack, stroke, or death than patients who had been diagnosed with viral pneumonia. "We've always known pneumonia was a risk factor for a major adverse cardiac event, like a heart attack, within the first 90 days of being diagnosed," said J. Brent Muhlestein, MD, a cardiovascular researcher with the Intermountain Heart Institute at Intermountain Medical Center. "What we didn't know was which type of pneumonia was more dangerous. The results of this study provided a clear answer, which will allow physicians to better monitor patients and focus on reducing their risk of a major adverse cardiac event." Nearly 80 percent of the patients were diagnosed with bacterial pneumonia, and 34 percent (1,270 patients) of them had a major cardiovascular event within 90 days. At the same time, 21 percent of the patients were diagnosed with viral pneumonia, and 26 percent (258 patients) had a major adverse event within the 90-day window. "The likely underlying cause is that bacterial pneumonia causes greater inflammation of the arteries compared to viral pneumonia," said Dr. Muhlestein.   Researchers find exposure to microplastics may alter cellular function Florida State University, November 11, 2021 Pollution from miniscule pieces of plastic, or microplastics, have been a growing concern for scientists, public health advocates and environmentalists as these nondegradable items have increasingly made their way into waterways and even the air we breathe.  Now, a team researchers found that exposure to microplastics for only a few days caused human lung cells to slow down their metabolism and growth, change shapes, and decluster so that gaps exist in what is typically a solid sheet of cells. The findings raise questions about the long-term effects of microplastics on human health, particularly for those who already have respiratory conditions.   The team exposed lung cells in a petri dish to small amounts of polystyrene at levels that are commonly found in the environment and found that though the plastic didn't cause cell death, it caused some interesting changes. After only a few days, they found that the cell's metabolic processes had slowed down, cell proliferation was inhibited, the shape of the cell morphed and the delustering had occurred. Additionally, the team found that the microplastic particles were uptaken by the cells and had formed a ring around the nucleus in the cell.  

The 4 Best Reasons Why Intermittent Fasting May Prevent AFib Fasting has been shown to slow aging and help most chronic medical conditions but can intermittent fasting also prevent atrial fibrillation? In this article, I'll share everything you need to know about intermittent fasting's role in atrial fibrillation prevention. Why Did I Write this Article? My long-term readers know I've always been impressed by the strong data supporting intermittent fasting for longevity and cardiovascular health. Indeed, both of our books, The Longevity Plan and The AFib Cure, had a section on intermittent fasting. The reason why I chose to cover this topic again came from a recent podcast interview I heard with Dr. David Sinclair. For those not familiar with Dr. David Sinclair, he is a Harvard University longevity researcher. And interestingly, the person who helped him write his New York Times best-seller, Lifespan, was the same person who helped me write The Longevity Plan and The AFib Cure. In this podcast, Dr. David Sinclair reported that he doesn't snack and only eats one meal a day. As someone who has always struggled with fasting, my goal is that writing again on the topic of intermittent fasting will help me to redouble my efforts to fast regularly. And to help you redouble your efforts, below are my 4 best reasons why intermittent fasting may prevent AFib. 1. Fasting May Slow Aging Researchers have long known that caloric restriction, or eating the absolute minimum number of calories to keep the body functioning, makes animals of all types live longer. Indeed, if you're a rat you'll live 80% longer with caloric restriction. But while caloric restriction works great for animals in a controlled experiment, it is almost impossible for humans to maintain caloric restriction long-term. The beautiful thing is that humans may not need to calorically restrict themselves to achieve this longevity boost. Indeed, intermittent fasting activates the same genes that caloric restriction does. How does this happen? Studies show that periodic fasting activates an energy-sensing protein called AMP-activated protein kinase (AMPK), which then keeps the energy center of the cell, the mitochondria, in a “youthful” state. With regards to AFib, as age-related fibrosis (or scarring) of the left atrium is a significant driver of AFib, anything that slows the aging process would be expected to also slow the development of AFib. Indeed, based on a study we were involved with at Intermountain Medical Center, shorter telomeres, which is a marker of premature aging, was associated with atrial fibrillation. 2. Fasting May Lower Blood Pressure 10 mmHg When we fast, blood sugar levels are less likely to spike high. The research is pretty clear, the more time we can give our bodies a break from food the better our insulin sensitivity, the slower our body "rusts" with aging, and the lower our blood pressure runs. And when it comes to AFib, lower is usually better. Indeed, studies show that high blood pressure doubles the risk of AFib. So if you suffer from AFib, the goal is to keep your blood pressure always below 130/80 mmHg. But if your goal is to maximize longevity, then the research suggests a blood pressure in the range of 110/70 mmHg, without the help of blood pressure medications, is where you probably need to be. 3. Fasting is Good for a 9 Pound Weight Loss If you're looking for a quick 9-pound weight loss, then the science suggests you may want to try intermittent fasting. For example, I have found that when I skip dinner I eat approximately 500 fewer calories for the day. And these 500 fewer calories are maintained even after accounting for any "make-up" calories I may consume on the following days. While most people practice intermittent fasting by skipping breakfast, medical science argues the opposite. Studies show that if you're going to skip a meal, skipping dinner is best. To optimize health and longevity,

The delta variant of COVID-19 is surging across the country, with nearly half of all Americans still not fully vaccinated. As the enduring pandemic once again grows dire, Utah hospitals have been overwhelmed with mostly unvaccinated patients battling the disease. The new emergency prompted the top leaders of The Church of Jesus Christ of Latter-day Saints to issue yet another, even more forceful, message last week to members to wear masks and get vaccinated. Dr. Samuel Brown is witnessing the pandemic's devastating toll up close, and all too personally, as an intensive care unit physician-scientist at Intermountain Medical Center in Murray. Brown, who doubles as a religious historian, is also the author of a new book, “Where the Soul Hungers: One Doctor's Journey From Atheism to Faith.” On this week's show, he talks about his experiences treating COVID-19, his thoughts about fellow Latter-day Saints who choose not to wear masks or be vaccinated, and how the pandemic has affected his faith.

Guest Bio:Reid Robison is the co-founder and medical director of Cedar Psychiatry. He is also a founding board member at the Utah-based non-profit Psychedelic Institute. Dr. Robison serves as Coordinating Investigator of the MAPS (Multidisciplinary Association for Psychedelic Studies) MDMA-Assisted Psychotherapy study of Eating Disorders, supervising the training and clinical research of all of the MDMA therapy sites. Additionally, he works in a medical and therapeutic capacity at psychedelic medicine retreats abroad, and often consults on medical safety issues and plant medicine use.Reid was born in Chicago, but grew up in Toronto, Canada. He completed undergraduate studies in Neuroscience at Brigham Young University, and went on to medical school at the University of Utah where he earned both his MD and MBA degrees. After residency training in Psychiatry at the University of Utah, Dr. Robison completed fellowship training in Neurodevelopmental Genetics, followed by a postdoc in Bioinformatics. He currently serves as adjunct faculty at both the University of Utah and Brigham Young University.Dr. Robison has extensive experience with ketamine in both research and clinic settings. In 2011 he conducted his first research study with ketamine, then went on to create a ketamine program for treatment-resistant depression at Intermountain's IV Therapy Center at IMC. Dr. Robison was selected as Principal Investigator for Utah by J&J/Janssen to run a site for a pivotal IV-ketamine treatment-depression study, leading to the company's FDA approval of Spravato (esketamine) via breakthrough therapy designation earlier this year. In 2013, the Intermountain Research & Medical Foundation awarded an investigator-initiated grant to Dr. Robison to continue studying ketamine for depressive disorders. Dr. Robison also conducted an IRB-approved study of ketamine for depression and severe eating disorders at Center for Change. He continues to supervise the ketamine therapy practice at Cedar Psychiatry, and believes in careful but prudent use of ketamine as a tool for transformation in severe depression, PTSD, OCD and other mental health conditions.Dr. Robison joined the tenure-track faculty at the University of Utah, conducting industry sponsored and investigator initiated trials of new neuropsychiatric medicines and co-directed a genetics lab. He went on to co-found three healthcare startups that were all acquired. First came Clinical Methods, a phase I-IV CNS clinical trials site, where Dr. Robison led over $15 million in industry-sponsored studies as Principal Investigator, which was acquired by CRI-Lifetree (and later PRA Healthsciences, NASDAQ: PRAH). Next Dr. Robison co-founded Anolix, a healthcare data analytics firm dedicated to answering questions for big pharma using machine learning and big data. He then co-founded Tute Genomics, a personalized medicine software company that raised over $10 million in venture capital from various investment partners including Tencent, Intermountain Healthcare, Peak Ventures and more. As CEO of Tute, Dr. Robison was selected to participate in numerous startup incubators and accelerators such as BoomStartup, Healthbox and StartupHealth.Reid shares his vision for personalized medicine whenever he gets the chance, like in his TEDx talk on the Genome Revolution.Dr. Robison is active in humanitarian pursuits, and was part of the University of Utah's Global Health Initiative, where he made medical trips to post-quake Haiti, refugee camps along the Thai-Burma border and rural Ghana. He also founded the Polizzi Clinic, a free mental health clinic based in Salt Lake City, Utah, and served as Psychiatrist for Utah Health & Human Rights, helping refugees and human trafficking subjects.Dr. Robison set up the Consult-Liaison Service at Intermountain Medical Center, Intermountain's flagship hospital, providing psych consults to the ER and medical floors. He currently serves as Medical Director at Center for Change, one of the top Eating Disorder treatment centers worldwide.Dr. Robison is a firm believer that inside every person, no matter where they are in their journey, is an inextinguishable light with the capability for a full human life. Dr. Robison says, “Not all wounds are visible, and everyone has their unique struggle. Pain is real…but so is hope.”

When you're in the business of saving lives, particularly during the pandemic, you better know what you're doing, both medically and operationally.  Albert Marinez recently took over Intermountain Medical Center's highly developed data and analytics capability, and faced his first real test this year during the pandemic.  He'll share how one of the country's leading hospitals is also a standout high-performer when it comes to analytics.

Brandon Sulser graduated with his master’s degree in social work from the University of Utah. As a licensed clinical social worker at Salt Lake City’s Intermountain Medical Center’s neuro- rehabilitation unit, his work focused on counseling individuals experiencing traumatic injuries and diagnoses. Currently, Brandon enjoys public speaking and sharing his extraordinary story of survival and lessons learned. He hopes to be able to show others how not only to survive but to live successfully through their own paralyzing challenges, while placing an emphasis on becoming better not bitter through them. Website Link:https://www.brandonsulser.com/00:01 Brandon Sulser Opening Statement01:24 Introduction Dr. James Perdue02:36 Brandon’s Story at 12 Years Old13:51 at 18 Years Old28:34 at 28 Years Old38:09 at 34 Years Old42:41 Support System47:43 Brandon’s Closing MessageTo learn more about James, visit Professor of Perseverance. You may also contact him through email, James@professorofperseverance.com or call 615 – 336 – 2181

#plugintodevin Show - Devin Thorpe for Congress Guest: Suzanne harrison Office Held: State rep Office Sought: State rep Issue: Feeling heard and prioritized. Bio: I grew up in Provo where my parents both spent their careers working at BYU. I went to Timpview High School and then attended Stanford University where I met my husband, John, who was raised in Centerville, Utah. After Stanford I graduated from medical school at the University of Utah, and completed my residency in anesthesiology at Harvard University. We’ve lived in District 32 for over a decade. Our children attend local public schools. John works as a Senior Director of Engineering at Lucid Software. I am a board-certified anesthesiologist at Riverton Hospital and Intermountain Medical Center. I also volunteer at our children’s schools and sports leagues and in our church. Website: Votesuz.com Twitter: @votesuz Facebook: @votesuz Instagram: @votesuz #plugintodevin #UtahValues #BoldSolutions #UTpol

Deep vein thrombosis (DVT) is the development of a blood clot in a major deep vein in the leg, thigh, pelvis, or abdomen, which may result in impaired venous blood flow and consequent leg swelling and pain. Scott C. Woller, Director, Thrombosis Clinic, Intermountain Medical Center, Murray and Professor of Medicine, University of Utah, gives us an overview of the condition. For more on DVT, visit BMJ Best Practice: https://bestpractice.bmj.com/topics/en-gb/70 - The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

This week on Fully Involved with Unified Fire, PIO Matthew McFarland is joined in the studio with UFA Health & Safety Officer Captain Mike Greensides and Assistant Chief Riley Pilgrim. Dr. Eddie Stenehjem, an infectious diseases physician and medical director of Intermountain Medical Center’s Antibiotic Stewardship Program, calls in to discuss COVID-19 antibody testing. We talk about the test, it's importance and relevance, and how we use this information to move forward as an organization during this pandemic.Follow us on social media:Instagram - @unifiedfireTwitter - @fireauthorityFacebook - @unifiedfireauthority

Intermountain Healthcare is joining the federal effort to see if donated plasma from people who already recovered from the coronavirus can be used to treat current patients.  As part of the effort a team conducted Utah’s first plasma transfusion of a COVID-19 patient at Intermountain Medical Center in Murray.  See omnystudio.com/listener for privacy information.

Ways to lead teams to help them excel and embrace change is the topic of a recent discussion between Annie Luke, RN, nurse manager of the Post-anesthesia Care Unit and Same-day Surgery at Intermountain Medical Center, and CEO Marc Harrison, MD. Annie also shared how she responds as a leader when a member of her team struggles to embrace change.

In this episode, we discuss the practice of respect in the intensive care unit. Our guest is Samuel M. Brown, MD, MS, a practicing intensivist and Director of the Center for Humanizing Critical Care at Intermountain Medical Center in Murray, Utah. Dr. Brown holds an academic appointment as Associate Professor of Medicine at the University Of Utah School Of Medicine, Murray UT. He is a prolific investigator and author with a wide range of interests, including complexity in critical illness, echocardiography, and ethics. Our conversation covers topics such as dignity, respect, compassion and burnout. Join us in a fascinating discussion with a thought leader in bringing humanism to critical care. Additional Resources: - Recent article co-authored by Dr. Brown and colleagues reviewing important aspects of the practice of respect in critical care medicine. Click here to read. - The Center for Humanizing Critical Care works with researchers and clinicians with the goal of helping patients and family members make it through critical illness with their humanity intact. Learn more here. - Speak, Memory: An Autobiography Revisited by Vladimir Nabokov. Additional Resources: Recent article co-authored by Dr. Brown and colleagues reviewing important aspects of the practice of respect in critical care medicine. Click here to read. The Center for Humanizing Critical Care works with researchers and clinicians with the goal of helping patients and family members make it through critical illness with their humanity intact. Learn more here. Speak, Memory: An Autobiography Revisited by Vladimir Nabokov. Click here to learn more.

Episode 140 Healing Body and Mind: Interview Amanda Grow – Part 2 Welcome to the rest of Amanda Grow’s story. Did you know that the United States has the highest maternal mortality rate in the developed world? Because severe childbirth complications have become very rare, it is easy to forget that childbirth can be life threatening. Amanda Grow, a wife and mother of 4 children – 1 daughter and 3 sons, experienced an extremely rare complication of childbirth known as Amniotic Fluid Embolism which has a mortality rate of 80%. Last week you heard about her rapid blood transfusion that nearly drained the hospitals blood supply and left her in a medically induced coma for a week. This week we’ll get more of her story and talk about the importance of healing. Amanda’s story today isn’t just about a miracle and the healing of her body. It’s also about the toll such an event takes on us mentally as well as physically, and today we’re looking at the total process of finding meaning in brokenness and the process of rebuilding. Amanda is the owner of Strategic ACT Prep, a business she built over 10 years that helps high school students prepare for standardized tests. At the time of her medical crisis, she had 12 employees and three locations. The crisis necessitate major life changes as it took many months to regain mental and physical functioning. She and her business partner summoned the courage to shut down all 3 locations and let all the employees go. In the aftermath of the crisi, Amanda has also experienced mental health challenges characterisctic to Post Intensive Care Syndrome, situational drpession, and post traumatic stress. She has also struggled through a deep identity crisis as she no longer has the energy to the “do it all” mo, business owner and community member she once was Amanda has a bachelors degree from Brigham Young University and a Master’s degree from the Univesity of Utah. She and her husband now serve on the Patient and Family Advisory Council for Intermountain Medical Center. In this two-part series we are talking about recovering from accidents, loss, death. Sometimes we may gloss over the real process of climbing out of those dark holes that take us to the brink of strength. Mental and emotional recovery can be significantly harder than a physical recovery. It can be a long road to becoming whole and even then we will most certainly not be the same. Sometimes what must be grieved is the loss of who we were before. This is all a normal part of growth and life. It’s worth the two episodes to get the whole story and to learn about giving ourselves space to heal. Tune into the audio program for the rest of the interview with Amanda. To follow Amanda and her story on Facebook: Miracles for Amanda Grow Your challenge for this week – the same as last week (while we’re on the topic)  is to think about your own journey. Is there a space where you have expected yourself to bounce back more quickly, or expected someone else to bounce back and get back to normal without a sensitivity to the length and depth of the process. Consider what this looks like in your circles and see if there isn’t a place where you need to check in, allow, and nurture, yourself or another. Remember the website – You can go there to get your copy of my new book: LIFE – Living Intentional and Fearless Everyday. The 21 Life Connection Challenges. Or hop on Amazon. On the website you can also buy t-shirts, listen to all the past episodes, and reach out if you would like to contact me. See you next week.

Episode 139 Healing Body and Mind: Interview Amanda Grow – Part 1 Did you know that the United States has the highest maternal mortality rate in the developed world? Because severe childbirth complications have become very rare, it is easy to forget that childbirth can be life-threatening. Amanda Grow, a wife, and mother of 4 children – 1 daughter and 3 sons, experienced an extremely rare complication of childbirth known as Amniotic Fluid Embolism which has a mortality rate of 80%. Amandas story today isn’t just about a miracle and the healing of her body. It’s also about the toll such an event takes on us mentally as well as physically and today we’re looking at the total process of finding meaning in brokenness and the process of rebuilding. Amanda is the owner of Strategic ACT Prep, a business she built over 10 years that helps high school students prepare for standardized tests. At the time of her medical crisis, she had 12 employees and three locations. The crisis necessitate major life changes as it took many months to regain mental and physical functioning. She and her business partner summoned the courage to shut down all 3 locations and let all the employees go. In the aftermath of the crisi, Amanda has also experienced mental health challenges characterisctic to Post Intensive Care Syndrome, situational drpession, and post traumatic stress. She has also struggled through a deep identity crisis as she no longer has the energy to the “do it all” mo, business owner and community member she once was Amanda has a bachelors degree from Brigham Young University and a Master’s degree from the Univesity of Utah. She and her husband now serve on the Patient and Family Advisory Council for Intermountain Medical Center. Tune into the audio program to hear about her rapid blood transfusion that nearly drained the hospital’s blood supply and left her in a medically induced coma for a week. We’ll discuss questions like: You said, “A crisis or trauma is not just one chapter in your life…it is a deep canyon that affects everything going forward from that point.” Tell me a little about that. What do you feel is the most important part of your story? What was your biggest struggle? What has been your most important growth or insight gained? How are you doing now? To follow Amanda on Facebook look for: Miracles for Amanda Grow So often we are talking about recovering from accidents, loss, death….the stories we tell here are always about the victors who find their way out of the dark, and they shine a light for us so that if we are having similar experiences we can learn from their stories. Sometimes is hindsight I think we may gloss over the real process of climbing out of those dark holes that take us to the brink of strength. Mental and emotional recovery is significantly harder than physical recovery. It can be a long road to becoming whole and even then we will most certainly not be the same. Sometimes what must be grieved is the loss of who we were before. This is all a normal part of growth and life. Amanda’s story and feelings about her story focus on these concepts of acknowledging the real journey. Your challenge for this week is to think about your own journey. Is there a space where you have expected yourself to bounce back more quickly, or expected someone else to bounce back and get back to normal without a sensitivity to the length and depth of the process. Consider what this looks like in your circles and see if there isn’t a place where you need to check in, allow, and nurture, yourself or another. Remember the website – You can go there to get your copy of my new book: LIFE – Living Intentional and Fearless Everyday. The 21 Life Connection Challenges. Or hop on Amazon. On the website you can also buy t-shirts, listen to all the past episodes, and reach out if you would like to contact me. See you next week.

How does Intermountain Healthcare support and reward innovative caregivers? That was the subject of a podcast discussion with Mark Briesacher, MD, Intermountain’s chief physician officer, Caleb Frischknecht, Intermountain’s intellectual property director, and Mark Ott, MD, medical director of Intermountain Medical Center.

Stein Rosqvist, a Life Flight nurse medic, was the lone survivor of a Life Flight crash on January 10, 2003. At that time, Michele worked at LDS Hospital in the emergency room, and was on duty when Stein was brought into the ER. Stein began walking again 7 months after the accident. Today, Michele is a critical care nurse at Intermountain Medical Center in Murray, Utah.

Learn about the importance of laboratory testing in the identification of a C. difficile Infection (CDI). with guests: Jeanine Thomas, President and Founder of the MRSA Survivors Network who is a survivor of both MRSA and C. diff. infections. Dr. Nathan A. Ledeboer, PhD, D(ABMM), Medical Director of Microbiology and Molecular Diagnostics for Wisconsin Diagnostic Laboratories and Froedtert Health. Dr. Whitney R. Buckel, PharmD, BCPS who is the Infectious Diseases and Antimicrobial Stewardship Clinical Pharmacist at Intermountain Medical Center, and Dr. Steven Cagas, who will give us a brief overview of Roche Diagnostics as well as their new cobas® Cdiff Test.

Learn about the importance of laboratory testing in the identification of a C. difficile Infection (CDI). with guests: Jeanine Thomas, President and Founder of the MRSA Survivors Network who is a survivor of both MRSA and C. diff. infections. Dr. Nathan A. Ledeboer, PhD, D(ABMM), Medical Director of Microbiology and Molecular Diagnostics for Wisconsin Diagnostic Laboratories and Froedtert Health. Dr. Whitney R. Buckel, PharmD, BCPS who is the Infectious Diseases and Antimicrobial Stewardship Clinical Pharmacist at Intermountain Medical Center, and Dr. Steven Cagas, who will give us a brief overview of Roche Diagnostics as well as their new cobas® Cdiff Test.

As a charge nurse in the Emergency Department at Intermountain Medical Center, Josh Lane, RN, has both witnessed and been a victim of violence from patients and their family members. He’s always concerned about the safety of himself and his team, which is why he asked CEO Marc Harrison, MD, what can be done to better keep Intermountain caregivers safe from workplace violence.

Mark Briesacher, MD, President of the Intermountain Medical Group, speaks with Dean Mayer, MD, Medical Director of Riverton Hospital, Eddie Stenehjem, MD, Infectious Disease specialist and Medical Director of Antibiotic Stewardship, and Michael Coudreaut, MD, Psychiatrist and Consultation Liaison at Intermountain Medical Center, about the team they have created to help improve the lives and health of Intermountain patients addicted to opioids.

What will Intermountain Healthcare look like in 25 to 30 years? That’s what Brenden O’Neal from the Compliance team at Intermountain Medical Center asked CEO Marc Harrison, MD. Brenden also asked: Will our vision of what Intermountain is and what we do change in the future? How will the way we operate hospitals change? Has there been any thought to expanding into new markets or neighboring states?

Knock the wind out of asthma with tips from Dr Denitza Blagev, a pulmonologist and intensivist who currently serves as Director for the Schmidt Chest Clinic at Intermountain Medical Center in Murray, Utah. We simplify the approach to diagnosis, spirometry, patient counseling, choice of agent, stepwise therapy, and de-escalation...plus, a little myth busting. Special thanks to Dr Cyrus Askin for writing and producing this episode and to Dr Bryan Brown for his wonderful infographics. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps 00:00 Disclaimer 00:32 Intro 01:44 Picks of the week 04:38 Guest bio 06:20 Getting to know our guest 11:50 Clinical case and approach to the patient with dyspnea 16:38 How to explain asthma to a patient 17:22 Are PFTs needed for diagnosis and management of asthma? 18:44 Methacholine challenge and who needs one 21:15 Is imaging needed? 22:09 Typical PFT patterns in asthma 24:23 Utility and use of peak expiratory flows 25:45 Cough variant asthma 26:34 Physical exam in patient with asthma 27:45 Lab workup 29:07 Initial treatment and inhaler teaching 33:10 Stepwise therapy for asthma 37:27 De-escalation of therapy 39:18 Levalbuterol versus albuterol 40:20 Asthma action plans 43:06 Who needs a sputum sample 45:25 How to treat asthma exacerbations 48:05 Asthma therapy for hospitalized patients 51:10 Azithromycin and asthma 53:40 Who needs a referral 55:24 Are beta blockers safe in asthma? 56:08 Anticholinergic therapy and asthma 57:26 Take home points 58:58 Paul tells a story about asthma 59:55 Outro  Tags: asthma, inhaler, teaching, eosinophilia, albuterol, cough, variant, methacholine, spirometry, xray, pft, peak, flow, fev1, sputum, step, laba, lama, beta, agonist, azithromycin, symptoms, steroids, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Lincoln Bloomfield of the Stimson Center claims Harvey is a big test for Trump. Dr. Colin Grissom of Intermountain Medical Center warns about altitude sickness. Claire Berryman of USARIEM discovered almonds help cholesterol levels. Shoshanah Inwood of Ohio State Univ on why health insurance is a challenge for farmers. Northwestern's Nicola Bianchi says STEM degrees don't equal more innovation. Abe Streep of Outside Mag on why tech companies are coming to a rural Oregon town.

Learn about the importance of laboratory testing in the identification of a C. difficile Infection (CDI). with guests: Jeanine Thomas, President and Founder of the MRSA Survivors Network who is a survivor of both MRSA and C. diff. infections. Dr. Nathan A. Ledeboer, PhD, D(ABMM), Medical Director of Microbiology and Molecular Diagnostics for Wisconsin Diagnostic Laboratories and Froedtert Health. Dr. Whitney R. Buckel, PharmD, BCPS who is the Infectious Diseases and Antimicrobial Stewardship Clinical Pharmacist at Intermountain Medical Center, and Dr. Steven Cagas, who will give us a brief overview of Roche Diagnostics as well as their new cobas® Cdiff Test.

In this podcast, I sit down with Dr. Samuel M. Brown, a medical doctor at the Intermountain Medical Center and a brilliant historian of death theology in Mormonism, focusing particularly on his book, In Heaven as it is on Earth: Joseph Smith and the Early Mormon Conquest of Death. We discuss the distinctive contributions Mormonism made to […] The post Podcast #14: Transcending Death: Dr. Samuel M. Brown on Mormon Death Theology appeared first on Mormon History Guy.

SAMUEL M. BROWN is Assistant Professor of Pulmonary and Critical Care Medicine and Medical Ethics and Humanities at the University of Utah and an intensive care physician in the Shock Trauma ICU at Intermountain Medical Center. His award-winning book In Heaven as It Is on Earth: Joseph Smith and the Early  Mormon Conquest of Death […] The post Articles of Faith: Samuel M. Brown – First Principles and Ordinances (Book) appeared first on FairMormon.

SAMUEL M. BROWN is Assistant Professor of Pulmonary and Critical Care Medicine and Medical Ethics and Humanities at the University of Utah and an intensive care physician in the Shock Trauma ICU at Intermountain Medical Center. His award-winning book In Heaven as It Is on Earth: Joseph Smith and the Early  Mormon Conquest of Death […] The post Articles of Faith: Samuel M. Brown – First Principles and Ordinances (Book) appeared first on FairMormon.

Host: Janet Wright, MD Guest: Jeffrey Anderson, MD Vitamin D insufficiency and deficiency are common because of a number of factors, not the least of which is a lack of exposure to sunlight. What role does vitamin D play in ensuring cardiovascular health, and should clinicians routinely test patients for such deficiency? Dr. Jeffrey Anderson, vice-chair of research in the department of medicine and associate chief of cardiology and director of cardiovascular research at Intermountain Medical Center, discusses current evidence about vitamin D and the heart, but says more prospective studies are needed to determine whether vitamin D plays an associated or causal role related to cardiovascular health. Is routine vitamin D supplementation useful for protecting cardiovascular health, or should clinicians wait for more evidence? Dr. Janet Wright hosts. Produced in Cooperation with

Host: Janet Wright, MD Guest: Jeffrey Anderson, MD Vitamin D insufficiency and deficiency are common because of a number of factors, not the least of which is a lack of exposure to sunlight. What role does vitamin D play in ensuring cardiovascular health, and should clinicians routinely test patients for such deficiency? Dr. Jeffrey Anderson, vice-chair of research in the department of medicine and associate chief of cardiology and director of cardiovascular research at Intermountain Medical Center, discusses current evidence about vitamin D and the heart, but says more prospective studies are needed to determine whether vitamin D plays an associated or causal role related to cardiovascular health. Is routine vitamin D supplementation useful for protecting cardiovascular health, or should clinicians wait for more evidence? Dr. Janet Wright hosts. Produced in Cooperation with

Guest: Benjamin Horne, PhD Host: Shira Johnson, MD Guest: Brent Muhlestein, MD Dr Shira Johnson interviews Dr Benjamin Horne and Dr Brent Muhlestein from Intermountain Medical Center in Utah to discuss the practical implications of fasting on CV disease as studied in the Mormon population.

Guest: Benjamin Horne, PhD Host: Shira Johnson, MD Guest: Brent Muhlestein, MD Dr Benjamin Horne and Dr Brent Muhlestein from the Intermountain Medical Center in Utah discuss their recent research into the beneficial effects of fasting on cardiovascular risk.