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Improving patient access requires more than new processes. It also requires clinicians, administrators, and healthcare leaders to work toward a shared goal. In Part 2 of our conversation, Victor Hassid, MD, Associate Vice President of Access Strategic Operations at MD Anderson Cancer Center, discusses how organizations can align teams, overcome operational challenges and begin putting a patient safety approach to access into practice. You can listen to the first half of the conversation here. You can find Dr. Hassid's article in JAMA here. (paywall) Hosted on Acast. See acast.com/privacy for more information.
Mi primer pensamiento es para Ti. Oraciones para iniciar el día basadas en el salmo de la liturgia dirigidas por Tais Gea.
Editor's Summary by Linda Brubaker, MD, and Christopher C. Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from July 25-31, 2026.
In this School of Doza episode, we break down the loop between stubborn belly fat and low testosterone: fat tissue raises aromatase activity, converts testosterone into estradiol, and releases inflammatory signals that can suppress the brain-to-testes axis. He then walks through five everyday factors pushing testosterone the wrong direction—alcohol, fast food, sugar, sitting, and poor sleep—and what to change first when energy, motivation, and workouts have all quietly flattened out. FEATURED PARTNER Zen by MSW Nutrition is the adrenal and adaptogen formula Nurse Doza reaches for when stress is the thing driving the loop. Every one of the five factors in this episode—alcohol, processed food, blood sugar swings, sedentary days, broken sleep—lands on the same stress-response system that sits upstream of hormone signaling. Zen pairs bovine adrenal concentrate with Asian ginseng, eleuthero, schisandra, and rhodiola, plus 150 mg of pantothenic acid, P-5-P (activated B6), and vitamin C, to support the body's adaptogenic response and normal adrenal function—without caffeine.
The ingredient people complain about the most is the single one that'll make the biggest difference in your skin — and no, it's not a retinoid or a fancy peptide. It's your sunscreen.This week we're getting into why SPF is the highest-leverage thing you can do for your skin (prevention is cheaper and easier than reversal), the difference between UVB and the UVA rays nobody talks about, chemical vs. mineral without the fear-mongering, what those "sunscreen in your bloodstream" studies actually found, and the new filter the FDA finally approved in June — what it is, and when you'll actually see it on shelves.No demonizing, no overclaiming. Just the nuance, from a friend who did the research so you don't have to.
Lenkijos pareigūnai aiškinasi įvykį, kai šįryt netoli sienos su Ukraina esančiame Targowiskos miestelyje nugriaudėjus galingam sprogimui, laukuose rastas išmuštas didelis krateris ir neatpažinto objekto nuolaužos. Kiek anksčiau Lenkija dėl Rusijos smūgių Ukrainoje buvo pakėlusi naikintuvus.Vyriausioji rinkimų komisija sprendžia, ar pripažinti, jog „Nemuno aušra“ ir jos pirmininkas Remigijus Žemaitaitis šiurkščiai pažeidė Rinkimų kodeksą dėl 2024 metų Seimo ir prezidento rinkimų kampanijų finansavimo. Tai būtų antras šiurkštus „Nemuno aušros“ finansinis pažeidimas.Daugiavaikės šeimos iš Ukmergės istorija: sekmadienį mirė dviejų mėnesių mergaitė, o netrukus po to vaiko teisių tarnyba pranešė, kad iš šeimos paima visus vaikus, taip pat ir mirusį kūdikį. Mama Smiltėja Žlabienė teigia, kad net neturi laiko gedėti mirusios dukros. Tuo metu Valstybės vaiko teisių ir apsaugos tarnybos atstovė teigia, kad įvyko nesusipratimas, nes tarnyba siųsdama pranešimą nežinojo apie vaiko mirtį, o kiti šeši vaikai paimami, nes rasta kitų pažeidimų.Dėl ilgai trunkančių karštų ir itin sausų orų Britanijoje įvesti papildomi vandens naudojimo ribojimai.Ved. Madona Lučkaitė
Hawk makes a factual point often lost in the coverage: as director of the National Institute of Allergy and Infectious Diseases, Fauci had no authority to order anyone to do anything. The office advises the president and offers recommendations to states, and during the first year of the pandemic Fauci served under Donald Trump. The heart of the video is the mortality data. Hawk walks through peer-reviewed research, including a University of California Irvine study finding that heavily Republican counties saw roughly 73 more deaths per 100,000 than Democratic-leaning ones, and a JAMA Internal Medicine study finding excess death rates about 15 percent higher among registered Republicans. He connects the gap to vaccination rates, mitigation measures, and trust in public health, and asks why the hearing is happening now given that Fauci was already pardoned. SUPPORT & CONNECT WITH HAWK- Support on Patreon: https://www.patreon.com/mdg650hawk - Hawk's Merch Store: https://hawkmerchstore.com - Connect on TikTok: https://www.tiktok.com/@mdg650hawk7thacct - Connect on TikTok: https://www.tiktok.com/@hawkeyewhackamole - Connect on BlueSky: https://bsky.app/profile/mdg650hawk.bsky.social - Connect on Substack: https://mdg650hawk.substack.com - Connect on Facebook: https://www.facebook.com/hawkpodcasts - Connect on Instagram: https://www.instagram.com/mdg650hawk - Connect on Twitch: https://www.twitch.tv/mdg650hawk ALL HAWK PODCASTS INFO- Additional Content Available Here: https://www.hawkpodcasts.comhttps://www.youtube.com/@hawkpodcasts- Listen to Hawk Podcasts On Your Favorite Platform:Spotify: https://spoti.fi/3RWeJfyApple Podcasts: https://apple.co/422GDuLYouTube: https://youtube.com/@hawkpodcastsiHeartRadio: https://ihr.fm/47vVBdPPandora: https://bit.ly/48COaTB
Political conflicts related to immigration are thorny enough on their own. The issues and challenges intensify once we add to the mix our warming planet and its relationship to migration, immigration, and human displacement. Two 2024-25 CASBS fellows – Maureen Eger, a sociologist of immigration, and Alice Farmer, a refugee lawyer specializing in climate change and displacement – discuss scholarly and policy dimensions of the climate migration landscape in conversation with Pulitzer Prize-winning journalist John Markoff (CASBS fellow, 2017-18). Maureen Eger: USC faculty page | personal website | Google Scholar page | Alice Farmer: LinkedIn page | Read John Markoff's latest book, Whole Earth: The Many Lives of Stewart Brand (Penguin Random House, 2022). John's next book, expected in 2027, will be published by MIT Press. Referenced in the episode or related works L. Yang, M. Eger, and Link, eds. Migration Stigma: Understanding Prejudice, Discrimination, and Exclusion (MIT Press, 2024) M. Eger and S Valdez, "From Radical Right to Neo-nationalist," European Political Scientist (2019) M. Eger, M. Hjerm, and P. Velasquez, "What is the Liberalizing Potential of Higher Education? An Analysis of Academic Fields and Anti-Immigrant Sentiment Across 32 Countries," The British Journal of Sociology (2025) M. O'Brien and M. Eger, "Suppression, Spikes, and Stigma: How COVID-19 Will Shape International Migration and Hostilities toward It," International Migration Review (2020) L. Yang, M. Eger, and B. Link, "The Human Cost of Politicizing Immigration: Migration Stigma, US Politics, and Health," JAMA (2024) A. Farmer and K. Linos, "Tools to Finance Climate Mobility: An Introduction to the Symposium," American Journal of International Law (2025) A. Farmer, "Disasters in Slow Motion: Why Climate Displacement Tests International Legal Frameworks, and What to Do about it," University of Pennsylvania Journal of International Law (2026) J. Bittle, The Great Displacement: Climate Change and the Next American Migration (Simon & Schuster, 2024) G. Vince, Nomad Century: How Climate Migration will Reshape our World (Macmillan, 2022) A. Lustgarten, On the Move: The Overheating Earth and the Uprooting of America (Macmillan, 2024) T. Hale, Long Problems: Climate Change and the Challenge of Governing Across Time (Princeton Univ. Press, 2024) Center for Advanced Study in the Behavioral Sciences (CASBS) at Stanford UniversityExplore CASBS: website | Bluesky | X | YouTube |LinkedIn | podcast | latest newsletter | signup | outreachHuman CenteredProducer: Mike Gaetani | Audio engineer & co-producer: Joe Monzel
We got intellectually swole on creatine and astrology before this great episode! The main science topic was a study connecting carb oxidation to hydration status. We explain how hydration is the gateway to fueling.We also provided details of the first week of David's creatine experiment. There is some very strange heart rate data that we're tracking. Correlation or causation? We'll find out!And this one was full of fun topics! Other topics: bailing on workouts on bicarb days, how runners should think about improving bike power, tons of thoughts from the Tour de France including the massive power numbers and a follow-up on overnight drug testing, AI in mathematics, a fantastic article in JAMA on tendon healing, and questions on dealing with an identity crisis in athletics, stairmill v. biking, a listener passionate about oysters, a grooming tip, Malcolm Gladwell, stoppage time in runs, and low iron levels.You'll never look at Cheez-Its the same. We're sorry and/or thank you. We love you all! HUZZAH!-David and MeganClick "Get 40% Off" button for 40% off at The Feed here: thefeed.com/swapBuy Janji's amazing gear: https://janji.com (code "SWAP")Get a deal on the best treadmill on the market from Wahoo: https://www.wahoofitness.com/devices/running/treadmills/kickr-run-buy (code “SWAP”)For training plans, weekly bonus podcasts, heart rate zones, articles, and videos: patreon.com/swap
Send us Fan MailThis episode unpacks what "probable CTE" actually means — where the term comes from, what the science can and can't currently tell us, and why a single case (former Socceroos captain Paul Wade) has reignited debate about diagnosing a disease that's only ever been confirmed after death. It walks through the genuine case for and against using this label in living patients, and why the language we use around it matters.Note: This episode is for educational purposes only and is not medical advice or a diagnostic tool. While I've done my best to accurately interpret the cited journal articles, please read the original sources yourself for full context before drawing conclusions. 06:00 - Segment One: What Chronic Traumatic Encephalopathy Actually Is 09:45 - Segment Two: Why You Can't Diagnose It in the Living — Yet 12:00 - Segment Three: "Probable CTE" — Where the Term Actually Comes From 17:09 - Segment Four: Why This Topic Divides Even the Experts — The Dose-Response Problem 21:30 - Segment Five: The Case For Diagnosing Probable CTE in Living Patients 24:00 - Segment Six: The Case Against — Or At Least, the Case for Caution 29:27 - Segment Seven: Why the Words We Use Actually Matter 32:50 - Segment Eight: Where This Leaves Us Episode — Reference List1. Martland, H.S. Punch drunk. Journal of the American Medical Association. 1928;91(15):1103–1107.2. McKee, A.C., Cairns, N.J., Dickson, D.W., et al. The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Acta Neuropathologica. 2016;131(1):75–86.3. Bieniek, K.F., Cairns, N.J., Crary, J.F., et al. The second NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Journal of Neuropathology & Experimental Neurology. 2021;80(3):210–219.4. Mez, J., Daneshvar, D.H., Kiernan, P.T., et al. Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA. 2017;318(4):360–370.5. Montenigro, P.H., Baugh, C.M., Daneshvar, D.H., et al. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome. Alzheimer's Research & Therapy. 2014;6(5):68.6. Cantu, R.C., Budson, A.E. Management of chronic traumatic encephalopathy. Expert Review of Neurotherapeutics. 2019;19(10):1015–1023.7. Katz, D.I., Bernick, C., Dodick, D.W., et al. National Institute of Neurological Disorders and Stroke consensus diagnostic criteria for traumatic encephalopathy syndrome. Neurology. 2021;96(18):848–863.8. Dickstein, D.L., Pullman, M.Y., Fernandez, C., et al. Cerebral [18F]T807/AV1451 retention pattern in clinically probable CTE resembles pathognomonic distribution of CTE tauopathy. Translational Psychiatry. 2016;6(9):e900.9. Arena, J.D., Stewart, W., Schneider, A.L.C., et al. Performance of traumatic encephalopathy syndrome criteria in identifying individuals with chronic traumatic encephalopathy. Nature Medicine. 2026;32:2037–2046.10. Iverson, G.L., Gardner, A.J. Risk for misdiagnosing chronic traumatic encephalopathy in men with anger control problems. Frontiers in Neurology. 2020;11:739.11. Iverson, G.L., Gardner, A.J. Risk of misdiagnosing chronic traumatic encephalopathy in men with depression. Journal of Neuropsychiatry and Clinical Neurosciences. 2020;32(2):139–146.12. Iverson, G.L., Gardner, A.J. Symptoms of traumatic encephalopathy syndrome are common in the United States general population. Brain Communications. 2021;3(1):fcab001.13. Grashow, R., Weisskopf, M.G., Baggish, A., et al. Premortem chronic traumatic encephalopathy diagnoses in professional football. Annals of Neurology. 2020;88(1):106–112.14. Eagle, S.R., et al. Interaction of medical conditions and football exposures associated with premortem chronic traumatic encephalopathy diagnosis in former professional American football players. Sports Medicine. 2024;54:743–752.15. Stewart, W., Buckland, M.E., McInnes, K., et al. Primum non nocere: a call for balance when reporting on CTE. Lancet Neurology. 2019;18(3):231–233.16. Hazrati, L-N., Schwab, N. Embracing the unknown in the diagnosis of traumatic encephalopathy syndrome. Neurology. 2021;96(18):835–836.17. McKee, A.C., et al. Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts. Acta Neuropathologica. 2023;145(4):371–394.18. Atherton, K., Han, X., Chung, J., et al. Association of APOE genotypes and chronic traumatic encephalopathy. JAMA Neurology. 2022;79(8):787–796.19. SBS News. Former Socceroo becomes first Australian footballer to share probable CTE diagnosis. July 2026.20. beIN SPORTS. Former Socceroos captain reveals probable CTE diagnosis. July 22, 2026.21. The Washington Post. Ex-Socceroos captain Paul Wade says he has probable CTE, urges no heading for junior players. July 22, 2026.
Claim your complimentary gift of my exclusive mini weight care guide today!Link: Weight Care Guide — Dr. Francavilla Show (thedrfrancavillashow.com)Have You Ever Wondered If Your Telehealth Weight Loss Clinic Is Actually Giving You Real Medical Care, or Just a Prescription?This episode dives into a JAMA study that's been generating serious buzz throughout the obesity medicine community, and once you hear what it uncovered, you'll understand exactly why. Researchers conducted a "secret shopper" investigation, sending someone posing as a patient to 49 different telehealth clinics offering obesity management medications, simply to see what kind of care they'd actually receive. The findings shed light on where the gaps really are in this rapidly expanding area of healthcare, and they back up what a lot of obesity medicine providers have suspected for quite some time.We're unpacking what comprehensive obesity care is truly supposed to look like, and how you can figure out whether the care you're getting, or the care you're offering, actually holds up. And there are two calls to action woven throughout: if you're someone taking these medications or considering starting them, we'll walk through how to find a provider who's doing this the right way. And if you're a clinician providing this kind of care already, consider this your reminder to put yourself out there more, because there are patients who genuinely need access to someone doing it well.Topics Discussed:The JAMA Study Raising Questions About Obesity TelehealthThe Missing Piece in Many Telehealth Weight Loss ProgramsConvenience Shouldn't Replace Comprehensive Medical CareThe Importance of Clinical Oversight in Telehealth PrescribingWhat Comprehensive Obesity Care Should Look LikeWhere to Start If You're Considering Weight-Loss MedicationHow to Find High-Quality Obesity CareThis episode covers a lot of ground, from the specific numbers behind the study to what a truly thorough evaluation should include, and what red flags to watch for if you're navigating this kind of care yourself. Whether you're a patient trying to figure out if your provider is doing right by you, or a clinician who wants to understand where the industry is falling short, this conversation breaks it all down in a way that's genuinely worth your time. Press play to catch the full episode and get every detail we covered.Want to see the data for yourself? You can check out the full JAMA study here: https://www.sciencedirect.com/science/article/pii/S2667368123000165Connect with me:Instagram: doctorfrancavillaFacebook: Help Your Patients Lose Weight with Dr. FrancavillaWebsite: Dr. Francavilla ShowYoutube: The Doctor Francavilla ShowGLP Strong: glpstrong.com
Fitness mit M.A.R.K. — Dein Nackt Gut Aussehen Podcast übers Abnehmen, Muskelaufbau und Motivation
Mit 34 ließ ich meinen Testosteronwert messen – mein damals 69-jähriger Vater gleich mit. Sein Ergebnis: dreimal so hoch wie meins. Ich: 16 Jahre Krafttraining, 17 Marathons. Er: Rentner ohne Leistungssport. Acht Wochen später hatte sich mein Wert fast versechsfacht – ohne Medikamente, ohne Wundermittel. Der Hebel, den ich jahrelang ignoriert hatte: Schlaf. Gemerkt habe ich davon lange nichts – mein „Passt schon“ war ein mieser Ratgeber.In der neuen Folge erfährst Du die ganze Geschichte. Ungeschönt, und inklusive der Einordnung, warum mein Fall kein Naturgesetz ist. Du bekommst außerdem sechs Fragen an die Hand, mit denen Du Deinen Schlaf innerhalb von 14 Tagen verbesserst, ohne dass Du Geräte oder sonstigen Hokuspokus anschaffen musst.____________*WERBUNG: Infos zum Werbepartner dieser Folge und allen weiteren Werbepartnern findest Du hier.____________ERWÄHNT IN DIESER FOLGE (Werbung)
Sau da dama, masu burin shiga harkokin noma a Nigeria kan canza tunaninsu, sakamakon rashin samun gonakin da za su noma kusa da gari, lamarin da kan tilasta su jingine aniyarsu ta yin noma. Gwamnatin Nigeria dai, ta sha kira ga ‘yan kasar da su koma gona, la'akari da yadda Allah ya albarkaci kasar da wadatattun filayen noma da kuma yanayi mai kyau da za a iya noma kowane irin nau'in kayan abinci.
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from July 18-24, 2026.
The Podcasts of the Royal New Zealand College of Urgent Care
A recent large study in JAMA showed amoxicillin is as effective as augmentin for treating sinusitis. Which tallies with our national antibiotic guideline advice. It is important to recognise, sinusitis does not usually require antibiotic therapy. Check out the paper mentioned Savage TJ, Butler AM, Kronman MP, Durkin MJ, Sreedhara SK, Kabbani S, Hicks LA, Huybrechts KF. Amoxicillin-Clavulanate vs Amoxicillin for Acute Sinusitis in Adults. JAMA. 2026 May 19;335(19):1694-1705. doi: 10.1001/jama.2025.26902. PMID: 41999289; PMCID: PMC13092118. Check out the national antibiotic guidelines - Te Whata Kura Check out the RNZCUC Research Network Check out the Bootcamp conference, incorporating the research network meeting Check out the Research Review www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice, always consult your usual doctor
CardioNerds (Drs. Apoorva Gangavelli, Jenna Skowronski, and Hannah Every) discuss the continuum of prevention and heart failure with Drs. Anu Lala and Martha Gulati. Grounded in a clinical case of a 55-year-old woman with uncontrolled hypertension, type 2 diabetes, and obesity who is on the trajectory toward heart failure, this episode unpacks a paradigm-shifting framework from a joint HFSA/ASPC Scientific Statement. The discussion explores how prevention should not be siloed from heart failure management but rather integrated across a patient’s lifespan—from primary prevention in at-risk individuals, to secondary prevention in those with established heart failure, to tertiary prevention in patients with advanced therapies such as LVADs and heart transplantation. The experts highlight the importance of aggressive risk factor management, biomarker-guided screening, the AHA’s Life’s Essential 8, and the need for multidisciplinary collaboration and systems-level change to shift heart failure care from reactive to proactive. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Systemic inflammatory diseases are associated with an elevated CVD risk that has significant implications for early detection, risk Heart failure prevention is a continuum, not a checkpoint. Prevention applies at every stage—from at-risk (Stage A) through advanced/post-transplant care—and every clinical encounter is an opportunity to intervene. The AHA’s Life’s Essential 8 (diet, physical activity, nicotine exposure, sleep, BMI, blood lipids, blood glucose, blood pressure) forms the foundation at every stage. Hypertension carries the highest population-attributable risk for heart failure of any modifiable risk factor. In the Framingham Heart Study, 91% of patients with newly diagnosed HF had pre-existing hypertension. The SPRINT trial demonstrated a 38% reduction in HF incidence with intensive blood pressure targets (30 ng/L or NT-proBNP >125 ng/L) identify individuals at heightened risk for progression to symptomatic HF. The ACC/AHA/HFSA guidelines give a Class IIa recommendation for natriuretic peptide screening in at-risk patients. Urine albumin-to-creatinine ratio (UACR) is an underutilized screening tool that provides additional insight into CKM risk. The heart failure label does not close the prevention window—it accentuates it. Secondary prevention through GDMT optimization (quadruple therapy in HFrEF) and continued risk factor management remains critical. Tertiary prevention extends to post-LVAD and post-transplant patients, where hypertension, diabetes, obesity, and CKD management remain essential to long-term outcomes. Show notes For a comprehensive review, please review the full HFSA/ASPC Joint Scientific Statement: Lala A, Beavers C, Blumer V, et al. The Continuum of Prevention and Heart Failure in Cardiovascular Medicine. J Card Fail. 2026;32:75-105. doi:10.1016/j.cardfail.2025.06.013 1. What is the “continuum of prevention” framework, and how does it differ from traditional approaches to heart failure prevention? Historically, prevention and heart failure management have been treated as separate disciplines—primary prevention handled by preventive cardiologists and treatment managed by heart failure specialists. This joint HFSA/ASPC Scientific Statement reframes prevention as a dynamic, continuous process that spans a patient’s entire lifespan, regardless of HF stage or ejection fraction. The framework maps onto the ACC/AHA HF staging system: Primary prevention targets Stage A (“at risk”) and Stage B (“pre-HF”) patients to reduce the burden of incident HF. Secondary prevention targets Stage C (symptomatic) and Stage D (advanced) patients to reduce the impact of established HF through GDMT optimization and ongoing risk factor management. Tertiary prevention encompasses risk factor management in patients with LVADs or heart transplants—populations where hypertension, diabetes, and obesity still drive outcomes. The Central Figure of the statement illustrates that Life’s Essential 8 (blood pressure and lipid control, diabetes management, exercise, sleep, smoking cessation, weight management, and diet/nutrition counseling) forms the foundation at every stage, with pharmacologic and device-based therapies layered on top as disease progresses (Figure) 2. How do traditional risk factors drive heart failure, and what should clinicians prioritize? Hypertension carries the greatest population-attributable risk for HF. In the Framingham Heart Study (N=5,143), HTN was associated with a 2- to 3-fold increased risk of HF, with a population-attributable risk of 39% in men and 59% in women. The SPRINT trial showed a 38% reduction in HF incidence and 25% reduction in the primary composite outcome with intensive BP targets (30 ng/L or NT-proBNP >125 ng/L) are associated with heightened risk for progression to symptomatic HF. In the ARIC study, incorporating NT-proBNP reclassified 20% of older adults without HF into Stage B. Factors that affect interpretation include age, sex, obesity (lower values), and CKD (higher values). High-sensitivity cardiac troponin (hs-cTn): Concentrations above the 99th percentile are now included in the definition of Stage B HF. Troponin testing may complement natriuretic peptides, particularly when BNP/NT-proBNP values are ambiguous. Risk scores: The PCP-HF equation predicts 10-year HF risk using traditional risk factors plus QRS duration. The AHA PREVENT score incorporates HF risk calculation and includes markers of kidney function (albuminuria, eGFR), though it may underestimate risk in men and Black adults. The CKM syndrome staging framework (Stages 0–4) provides a holistic approach to assessing systemic cardiovascular-kidney-metabolic risk. 4. What are the key nontraditional risk factors and cross-cutting themes in heart failure prevention? Genetics: Pathogenic cardiomyopathy variants exist in ~1 in 200 individuals in the general population. The HFSA and ACMG recommend cascade testing to identify at-risk family members. Polygenic risk scores for dilated cardiomyopathy show a 3.8-fold risk for DCM in the top 10th percentile compared with the median. Sex-specific considerations: Women have 2.8 times the odds of developing HFpEF, while men have similarly increased odds of HFrEF. A complete obstetric/gynecologic history is essential—preeclampsia is associated with a 4-fold increased risk of HF. Peripartum cardiomyopathy requires intentional screening in high-risk populations. Cardiotoxic exposures: Clinicians should be aware of medications that cause direct myocardial toxicity (e.g., anthracyclines, trastuzumab, tyrosine kinase inhibitors). A team-based approach with pharmacists can help optimize medication selection and risk factor modification. Social determinants of health: Environmental exposures (air pollution, arsenic, lead, cadmium), food insecurity, financial instability, and limited healthcare access contribute to HF risk and progression. Equity-focused, risk-based prevention strategies are needed. Psychological health: Depression is common in HF and independently associated with worse outcomes. Screening with brief questionnaires (e.g., PHQ-2) is recommended. Meditation, spirituality, and holistic wellness approaches remain underutilized. 5. What systems-level and policy changes are needed to move the needle on heart failure prevention? Multidisciplinary HF prevention clinics that bring together preventive cardiologists, HF specialists, endocrinologists, nephrologists, dietitians, pharmacists, exercise physiologists, and genetic counselors are advocated by the statement. EHR-embedded risk stratification could proactively flag patients on a trajectory toward HF—analogous to sepsis alerts or fall risk flags—enabling earlier intervention, particularly for patients who may not reach a cardiologist. Cardiac rehabilitation remains underutilized, particularly in HFrEF (Class 2b recommendation) and HFpEF (not yet covered by Medicare). The HF-ACTION trial showed quality-of-life benefits, and the REHAB-HF trial showed particular benefit in older patients with HFpEF. Policy priorities include expanding insurance coverage for preventive screening and novel therapies (SGLT2i, GLP-1 RAs, nsMRAs), reducing clinical inertia through team-based care models with closer follow-up intervals, and ensuring equitable access to evidence-based therapies across diverse populations. Digital health and AI hold promise for personalized risk prediction, remote monitoring (e.g., wearable devices, implantable PA pressure monitors), and virtual cardiac rehabilitation to overcome access barriers. Figure Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013) References Key references are bolded. Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013 Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. 2022;146(5):e18-e43. doi:10.1161/CIR.0000000000001078 SPRINT Research Group, Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103-2116. doi:10.1056/NEJMoa1511939 Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996;275(20):1557-1562. doi:10.1001/jama.1996.03530440037034 Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981-2997. doi:10.1001/jama.288.23.2981 Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342(3):145-153. doi:10.1056/NEJM200001203420301 Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373(22):2117-2128. doi:10.1056/NEJMoa1504720 Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038 Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022;387(12):1089-1098. doi:10.1056/NEJMoa2206286 Filippatos G, Anker SD, Agarwal R, et al. Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial. Circulation. 2022;145(6):437-447. doi:10.1161/CIRCULATIONAHA.121.057983 Solomon SD, McMurray JJV, Vaduganathan M, et al. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2024;391(16):1475-1485. doi:10.1056/NEJMoa2407107 Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563 Deanfield J, Verma S, Scirica BM, et al. Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial. Lancet. 2024;404(10454):773-786. doi:10.1016/S0140-6736(24)01498-3 Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069-1084. doi:10.1056/NEJMoa2306963 Ndumele CE, Neeland IJ, Tuttle KR, et al. A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American Heart Association. Circulation. 2023;148(20):1636-1664. doi:10.1161/CIR.0000000000001175 Khan SS, Matsushita K, Sang Y, et al. Development and validation of the American Heart Association’s PREVENT equations. Circulation. 2024;149(6):430-449. doi:10.1161/CIRCULATIONAHA.123.067626 Khan SS, Ning H, Shah SJ, et al. 10-year risk equations for incident heart failure in the general population. J Am Coll Cardiol. 2019;73(19):2388-2397. doi:10.1016/j.jacc.2019.02.057 Bozkurt B, Fonarow GC, Goldberg LR, et al. Cardiac rehabilitation for patients with heart failure: JACC expert panel. J Am Coll Cardiol. 2021;77(11):1454-1469. doi:10.1016/j.jacc.2021.01.030 Packer M. Leptin-aldosterone-neprilysin axis: identification of its distinctive role in the pathogenesis of the three phenotypes of heart failure in people with obesity. Circulation. 2018;137(15):1614-1631. doi:10.1161/CIRCULATIONAHA.117.032474 Lala A, Tayal U, Hamo CE, et al. Sex differences in heart failure. J Card Fail. 2022;28(3):477-498. doi:10.1016/j.cardfail.2021.10.006 Bozkurt B, Coats AJS, Tsutsui H, et al. Universal definition and classification of heart failure. Eur J Heart Fail. 2021;23(3):352-380. doi:10.1002/ejhf.2115 Hershberger RE, Givertz MM, Ho CY, et al. Genetic evaluation of cardiomyopathy—a Heart Failure Society of America practice guideline. J Card Fail. 2018;24(5):281-302. doi:10.1016/j.cardfail.2018.03.004 Levine GN, Cohen BE, Commodore-Mensah Y, et al. Psychological health, well-being, and the mind-heart-body connection: a scientific statement from the American Heart Association. Circulation. 2021;143(10):e763-e783. doi:10.1161/CIR.0000000000000947 Ezekowitz JA, Colin-Ramirez E, Ross H, et al. Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial. Lancet. 2022;399(10333):1391-1400. doi:10.1016/S0140-6736(22)00369-5
Ingrid, Jørgen og Nikolai oppsummerer etter beste evne årets ESCMID (en av verdens største infeksjonsmedisinske konferanser) og vårmøtet (kanskje en av verdens minste infeksjonskonferanser) i denne reporasje-baserte episoden av Pestpodden.Referanser:1. White NM, et al. Effectiveness of oral care for the prevention of non-ventilator hospital-acquired pneumonia (HAPPEN): a multicentre, stepped-wedge, cluster-randomised trial in Australia. Lancet Infect Dis. 2026.2. Israelsen SB, et al. Short-course antibiotic therapy of 5 days in community-acquired pneumonia (CAP5): study protocol for a randomised controlled trial. BMJ Open. 2023;13:e069013. doi: 10.1136/bmjopen-2022-069013. 3. Chanderraj R, et al. Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime. JAMA Intern Med. 2024;184(7):769-77.4. Azevedo LCP, et al. Using the 2026 Surviving Sepsis Campaign Guidelines in Practice. Crit Care Sci. 2026;38:e20260036.5. Doumat G, et al. Short Versus Longer Antibiotic Duration for Community-Acquired Pneumonia : A Multicenter Target Trial Emulation. Ann Intern Med. 2026;179(5):629-36.6. Overdevest AG, et al. Antibiotic treatment for 1 day versus 4–7 days in patients with acute cholangitis after adequate endoscopic biliary drainage (COBRA): study protocol for a randomized controlled trial. Trials. 2026. doi: 10.1186/s13063-026-09524-7. PubMed: PMID 41689066. 7. Turner NA, et al. Dalbavancin for Treatment of Staphylococcus aureus Bacteremia: The DOTS Randomized Clinical Trial. JAMA. 2025.8. Kristensen LH, et al. Diagnostic accuracy of dipsticks for urinary tract infections in acutely hospitalised patients: a prospective population-based observational cohort study. BMJ Evid Based Med. 2025;30(1):36-44.9. Giamarellos-Bourboulis EJ, et al. Precision Immunotherapy to Improve Sepsis Outcomes: The ImmunoSep Randomized Clinical Trial. JAMA. 2026;335(9):775-86. Hosted on Acast. See acast.com/privacy for more information.
Broadcast from KSQD, Santa Cruz on 7-16-2026: Dr. Dawn dissects a June 2026 JAMA Internal Medicine paper that claimed simultaneous flu and COVID vaccination in veterans reduced cardiac events, arguing the retrospective natural-experiment design cannot support causal conclusions. The 20% versus 2% dropout rates between groups signal fundamentally non-comparable populations, and the divergence in cardiac events starting within a month of vaccination is clinically implausible—suggesting an X-factor other than vaccine effect is driving the numbers. Dr. Dawn delivers a pointed critique of a major chain pharmacy—part of a vertical healthcare monopoly—for creating deliberate friction around controlled-substance prescriptions through claims of stock shortages, unnecessary prior authorizations, and phantom "clarification" requests. She acknowledges the real paperwork burden of DEA compliance (quarterly reporting, six-month inspections, legitimate-need documentation) but argues chains are pushing pain patients away rather than doing due diligence, while independent pharmacies are closing at alarming rates in California. Following up on last week's Kampo medicine caller, Dr. Dawn reports research on Goshajinkigan showing it suppresses voltage-gated sodium channels at the motor end plate, functioning as a muscle relaxant used clinically in Japan for low back pain, extremity numbness, and chemotherapy- and diabetic-induced neuropathy. An emailer asks about a case report of an 80-year-old woman with 10-year Alzheimer's whose function dramatically improved after 5g oral psilocybin (Enigma strain), regaining conversation, continence, and autonomous dressing. Dr. Dawn notes plausible mechanisms (neuroplasticity, anti-inflammatory action, elevated BDNF) but cautions the diagnosis was clinical rather than confirmed with imaging or CSF markers, and recommends the emailer pursue exercise and sleep optimization for word-finding difficulties instead. An emailer asks how to reassure her chemically-hypersensitive adult son that their remediated apartment is safe. Dr. Dawn recommends commercial ERMI (Environmental Relative Moldiness Index) testing along baseboards where spores concentrate, plus urine mycotoxin testing on the parents themselves to demonstrate objectively low exposure levels. Drosophila fruit-fly males produce sperm longer than their own 2mm bodies—40 times longer than human sperm—with thousands packed inside. Fluorescent-dye imaging shows the sperm remain unusually still and coordinated, moving in synchronized slow waves like flocking birds or kelp in tides, preventing tangling. A Washington University study of 154,000 UK and 10,000 US participants used nine blood biomarkers to calculate biological age, finding people born in the 1990s show accelerated biological aging compared to those born three decades earlier. The gap between biological and chronological age correlated with increased risk of lung, colon, and uterine cancers—all rising in younger populations. A University of Pennsylvania study of 493 mouse litters found germ-free mice had shorter reproductive lifespans, more ovarian scarring, and accelerated loss of primordial follicles. Introducing gut bacteria at birth or weaning reversed these effects, as did supplementation with short-chain fatty acids alone (butyrate, isobutyrate, acetate). Dr. Dawn suggests ghee as a readily available butyrate source for those interested in the theoretical fertility-preservation benefit.
Is the "Make America Healthy Again" movement beginning to unravel? Jonathan Howard, MD, and Wendy Orent examine a wave of recent public health stories that they argue reveal growing dysfunction within the Department of Health and Human Services under Secretary Robert F. Kennedy Jr. From staffing shortages and agency leadership vacancies to vaccine policy changes and expanding infectious disease outbreaks, they discuss what they believe are the real-world consequences of current federal health leadership. The conversation also explores new measles outbreaks, cyclospora foodborne illness, influenza vaccine effectiveness, updated COVID vaccine research, child labor debates, NIH funding, scientific independence, and the continuing influence of prominent pandemic-era commentators. Whether you agree or disagree, this episode tackles some of the most consequential public health debates unfolding today. In This Episode The latest reporting on RFK Jr.'s leadership at HHS Why MAHA and MAGA may be increasingly at odds The growing measles outbreaks across the United States Cyclospora infections and concerns over weakened food safety oversight New research on influenza vaccine effectiveness in preventing pediatric deaths Updated COVID vaccine effectiveness data against hospitalization and severe illness The role of herd immunity and population immunity in today's COVID landscape The future of CDC leadership and federal public health agencies NIH funding, political oversight, and concerns about scientific independence Scott Atlas and calls to abolish the NIH Continued debate over COVID lockdowns and pandemic policy David Zweig, Jeffrey Tucker, Brownstone Institute, and education debates Child labor laws and their intersection with pandemic-era rhetoric Why physician-scientists continue debating the legacy of COVID policy Scientific misinformation and public trust Current public health threats beyond COVID Key Topics Discussed RFK Jr. Department of Health and Human Services MAHA MAGA Measles resurgence Cyclospora outbreak Vaccine effectiveness Influenza vaccination COVID-19 boosters CDC leadership NIH funding Scientific research Public health policy Pandemic response School closures Medical misinformation Health policy Memorable Discussion Points "Public health leadership isn't judged by rhetoric—it's judged by outcomes." "Preventable diseases don't care about political ideology." "Science requires evidence, not personalities." Resources Mentioned Recent New York Times reporting on HHS leadership JAMA studies on COVID-19 vaccine effectiveness CIDRAP influenza vaccine research Scientific American reporting on NIH funding changes Washington Post reporting on federal science policy About We Want Them Infected We Want Them Infected examines public health, infectious disease, vaccine policy, misinformation, and science through evidence-based discussion featuring neurologist Dr. Jonathan Howard and science journalist Wendy Orent. Follow the Show Subscribe wherever you get your podcasts and leave a review to help more listeners discover the show.
What if our obsession with “dangerous” sun is killing us?If you (recklessly) leave your urban office for lunch, you are told to yank your hat down low. If you (again, recklessly) let your kids dash into the backyard, you are told to slather them in sunscreen—or learn to live with the guilt.And yes, sun avoidance undoubtedly prevents some skin cancers, including the deadliest type, melanomaBut a recent study suggests sunlight contributes to hundreds of thousands of deaths every year in the United States alone—orders of magnitude more than the estimated 8400 annual US melanoma deaths.In this episode, we discuss evidence linking sun avoidance toalmost a million annual deaths in the US and Europe alone, exceeding the number caused by global military conflictsbreast, pancreatic, colon, and lung cancers, as well as heart disease, high blood pressure, and stroketo INCREASED risk of death in those diagnosed with sun-induced melanoma.Yes, you read that right; some melanoma deaths may be related to too little sunlight. (But do understand that this is complex--sunlight DOES cause melanoma. Well, some melanomas....)We also discuss why supplementing with vitamin D pills fails to remedy these terrible conditions, and what a thoughtful person can do instead, while staying safe.We hope you enjoy this episode, and that it helps you enjoy the sun again--thoughtfully, of course. References and further reading: Sunlight: Time for a Rethink?Benefits of oral Polypodium leucotomas extract in MM high risk patients (This is an ingredient in Life Extension's Shade Factor, mentioned in this episode by Dr. Gordon). Uses of Polypodium leucotomos Extract in Oncodermatology Calzari et alInsufficient Sun Exposure Has Become a Real Public Health Problem. Alfredsson L, Armstrong BK, Butterfield DA, et al. International Journal of Environmental Research and Public Health. 2020;17(14):E5014. doi:10.3390/ijerph17145014.Prospective Study of Ultraviolet Radiation Exposure and Risk of Cancer in the United States. Lin SW, Wheeler DC, Park Y, et al. International Journal of Cancer. 2012;131(6):E1015-23. doi:10.1002/ijc.27619.An Estimate of Premature Cancer Mortality in the U.S. Due to Inadequate Doses of Solar Ultraviolet-B Radiation. Grant WB. Cancer. 2002;94(6):1867-75. doi:10.1002/cncr.10427.Solar Ultraviolet-B Exposure and Cancer Incidence and Mortality in the United States, 1993-2002. Boscoe FP, Schymura MJ. BMC Cancer. 2006;6:264. doi:10.1186/1471-2407-6-264.Ecological Studies of the UVB-vitamin D-Cancer Hypothesis. Grant WB. Anticancer Research. 2012;32(1):223-36.Sunlight Exposure in Association With Risk of Lymphoid Malignancy: A Meta-Analysis of Observational Studies. Kim HB, Kim JH. Cancer Causes & Control : CCC. 2021;32(5):441-457. doi:10.1007/s10552-021-01404-6.Adulthood Residential Ultraviolet Radiation, Sun Sensitivity, Dietary Vitamin D, and Risk of Lymphoid Malignancies in the California Teachers Study. Chang ET, Canchola AJ, Cockburn M, et al. Blood. 2011;118(6):1591-9. doi:10.1182/blood-2011-02-336065.Is Prevention of Cancer by Sun Exposure More Than Just the Effect of Vitamin D? A Systematic Review of Epidemiological Studies. van der Rhee H, Coebergh JW, de Vries E. European Journal of Cancer (Oxford, England : 1990). 2013;49(6):1422-36. doi:10.1016/j.ejca.2012.11.001.An Ecologic Study of Cancer Mortality Rates in Spain With Respect to Indices of Solar UVB Irradiance and Smoking. Grant WB. International Journal of Cancer. 2007;120(5):1123-8. doi:10.1002/ijc.22386.Does Sunlight Prevent Cancer? A Systematic Review. van der Rhee HJ, de Vries E, Coebergh JW. European Journal of Cancer (Oxford, England : 1990). 2006;42(14):2222-32. doi:10.1016/j.ejca.2006.02.024.Heliovaccination: Solar mediated immunity against cancer. Uzoigwe CE. Experimental Dermatology. 2020;29(5):477-480. doi:10.1111/exd.14087.Beneficial Health Effects of Ultraviolet Radiation: Expert Review and Conference Report. Riedmann U, Dibben C, de Gruijl FR, et al. Photochemical & Photobiological Sciences : Official Journal of the European Photochemistry Association and the European Society for Photobiology. 2025;24(6):867-893. doi:10.1007/s43630-025-00743-6.A Blueprint for the Primary Prevention of Cancer: Targeting Established, Modifiable Risk Factors. Gapstur SM, Drope JM, Jacobs EJ, et al. CA: A Cancer Journal for Clinicians. 2018;68(6):446-470. doi:10.3322/caac.21496.Proportion and Number of Cancer Cases and Deaths Attributable to Potentially Modifiable Risk Factors in the United States, 2019. Islami F, Marlow EC, Thomson B, et al. CA: A Cancer Journal for Clinicians. 2024 Sep-Oct;74(5):405-432. doi:10.3322/caac.21858.Cutaneous Melanoma. Joshi UM, Kashani-Sabet M, Kirkwood JM. JAMA. 2025;334(23):2113-2125. doi:10.1001/jama.2025.13074.Sunlight, Vitamin D and the Prevention of Cancer: A Systematic Review of Epidemiological Studies. van der Rhee H, Coebergh JW, de Vries E. European Journal of Cancer Prevention : The Official Journal of the European Cancer Prevention Organisation (ECP). 2009;18(6):458-75. doi:10.1097/CEJ.0b013e32832f9bb1.Lessons Learned From Paleolithic Models and Evolution for Human Health: A Snap Shot on Beneficial Effects and Risks of Solar Radiation. Reichrath J. Advances in Experimental Medicine and Biology. 2020;1268:3-15. doi:10.1007/978-3-030-46227-7_1.PS-Vitamin D. American Academy of Dermatology (2022).American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer With Healthy Food Choices and Physical Activity. Kushi LH, Byers T, Doyle C, et al. CA: A Cancer Journal for Clinicians. 2006;56(5):254-81; quiz 313-4. doi:10.3322/canjclin.56.5.254.Vitamin D, Sunlight and Cancer Connection. Holick MF. Anti-Cancer Agents in Medicinal Chemistry. 2013;13(1):70-82.Survivorship. National Comprehensive Cancer Network. Updated 2026-04-08.Keratinocyte Carcinoma. Wehner MR. JAMA. 2025;:2840731. doi:10.1001/jama.2025.18749.Public Awareness and Behaviour in Great Britain in the Context of Sunlight Exposure and Vitamin D: Results From the First Large-Scale and Representative Survey. Burchell K, Rhodes LE, Webb AR. International Journal of Environmental Research and Public Health. 2020;17(18):E6924. doi:10.3390/ijerph17186924.Behavioral Counseling to Prevent Skin Cancer: US Preventive Services Task Force Recommendation Statement. US Preventive Services Task Force, Grossman DC, Curry SJ, et al. JAMA. 2018;319(11):1134-1142. doi:10.1001/jama.2018.1623.Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women. Lergenmuller S, Rueegg CS, Perrier F, et al. JAMA Dermatology. 2022;158(12):1367-1377. doi:10.1001/jamadermatol.2022.4053.Cancer Prevention and Early Detection Facts & Figures. Rick Alteri, Deana Baptiste, Emily Butler Bell, et al. American Cancer Society (2025). Skin Cancer, Irradiation, and Sunspots: The Solar Cycle Effect. Valachovic E, Zurbenko I. BioMed Research International. 2014;2014:538574. doi:10.1155/2014/538574.Intense Solar Activity Reduces UrinarDawn Lemanne, MD Oregon Integrative OncologyLeave no stone unturned.Deborah Gordon, MDNorthwest Wellness and Memory CenterBuilding Healthy Brains
Send us Fan MailVitamin K refusal has crossed 5%. That's one in twenty babies, and the curve is bending the wrong way. Ben and Eli work through a new Pediatrics case review that opens with a warning shot, that hemorrhagic presentation in an infant should no longer be a diagnostic mystery, alongside a JAMA letter tracking refusal from 2.9% in 2017 to 5.2% in 2024. Eighty-one times the risk. Intracranial hemorrhage in most late-onset cases. Twenty percent mortality. They talk about the halo effect on other refusals, the ICD code you should be using, and why this conversation belongs in the obstetrics office, not the nursery.----Vitamin K Deficiency Bleeding After Refusal: A Sentinel Event in a Misinformation Era. Jacobs JW, Booth GS, Wheeler AP, Adkins BD.Pediatrics. 2026 May 1;157(5):e2026075994. doi: 10.1542/peds.2026-075994.PMID: 41916583 No abstract available.Trends in Vitamin K Administration Among Infants. Scott K, Miller E, Culhane JF, Greenspan J, Handley SC, Lo JY, Knake LA, McKenney KM, Burris HH, Dysart K.JAMA. 2026 Jan 20;335(3):272-274. doi: 10.1001/jama.2025.21460.PMID: 41359326 Free PMC article.Babies Are Bleeding to Death as Parents Reject a Vitamin Shot Given at Birth https://www.propublica.org/article/more-parents-decline-vitamin-k-shot-newbornsSupport the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from July 11-17, 2026.
In this episode, Dr. Stuart Slavin is joined by Dr. Daniel Saddawi‑Konefka, associate professor of anesthesia, and Dr. Matthew Tung, instructor in anesthesia, both at Harvard Medical School. They discuss their JAMA viewpoint, Meaning and Comfort in Physician Well‑Being: An Integrated Framework, and explore how two complementary dimensions of well‑being—meaning and comfort—can help physicians thrive throughout their careers. Drawing on concepts rooted in ancient Greek philosophy, Drs. Saddawi‑Konefka and Tung examine the relationship between eudaimonia (the sense of purpose and fulfillment that comes from service, growth, and connection) and hedonia (the well‑being associated with comfort, safety, and the reduction of unnecessary burdens). They discuss why these concepts are often framed as competing priorities in medicine and argue instead that both are essential components of sustainable physician well‑being. The conversation also explores practical applications within graduate medical education, including fostering intrinsic motivation, promoting autonomy, competence, and relatedness, and creating opportunities for learners to connect with the meaning inherent in patient care. Throughout the discussion, the speakers highlight how organizational efforts to reduce administrative burdens and improve working conditions can create the space needed for physicians to engage more deeply with purpose, connection, and professional fulfillment. Listeners will gain valuable insights into how an integrated approach to meaning and comfort can support well‑being for learners, educators, and practicing physicians alike. Podcast Chapters (00:00) – Intro and Guest Introduction (01:15) – Origins of the Meaning and Comfort Framework (03:00) – Rethinking Physician Well-Being (04:30) – Understanding Meaning and Comfort (06:03) – Hedonia, Eudaimonia, and Well-Being (08:10) – Finding Life and Meaning in Work (10:06) – Balancing Purpose and Comfort (11:20) – Intrinsic Motivation and Medical Training (12:56) – Self-Determination Theory in Practice (14:47) – Autonomy, Competence, and Relatedness (16:39) – Creating Cultures of Meaning and Connection (18:18) – Gratitude, Recognition, and Daily Purpose (19:45) – Rediscovering Meaning in Everyday Clinical Work (21:20) – When Loss of Meaning Signals a Need for Support (22:27) – Hedonic Adaptation and Sustainable Well-Being (23:11) – Integrating Meaning and Comfort (24:48) – Closing and Resources
Um paciente jovem, sem fator de risco clássico, chega com infarto. Ele não fumou, não tem colesterol alto, não é diabético. Mas relata uso frequente de maconha e bebidas alcoólicas.Neste episódio do DozeCast, Diandro e Thaysa mergulham em duas substâncias que acompanham a humanidade há milênios e que colocam o cardiologista moderno diante de decisões clínicas que exigem evidência, não moralismo. Da cerveja de 13 mil anos encontrada em rituais funerários à cannabis usada em cerimônias no Pamir há 2.500 anos, o episódio começa pela história para depois destrinchar, bloco a bloco, o que a ciência cardiovascular mais recente realmente mostra.
Dr. Matthew Robbins discusses the assessment and diagnosis of headache in emergency settings, emphasizing red and green flags to differentiate primary from secondary headaches. This episode provides practical tips for trainees and clinicians to improve headache management. Show citation: Robbins MS. Diagnosis and Management of Headache: A Review. JAMA. 2021;325(18):1874-1885. doi:10.1001/jama.2021.1640
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from July 3-10, 2026.
Neurologist Dr. David Perlmutter Explains Brain Inflammation and Alzheimer's Risk Your brain has its own immune system, and when it turns against you, it becomes the hidden driver behind Alzheimer's, Parkinson's, depression, and even long COVID. This episode hands you the science to recognize it early and reverse it. Get Dr. Perlmutter's new book Brain Defenders: https://drperlmutter.com/books/brain-defenders/ Host Dave Asprey sits down with Dr. David Perlmutter, a board-certified neurologist and six-time New York Times bestselling author whose work sits at the intersection of neurology, nutrition, and brain health. He is a Fellow of the American College of Nutrition, serves on its Board of Directors, and sits on the Editorial Board of the Journal of Alzheimer's Disease. His books, including the number one bestseller Grain Brain, span 32 languages and have sold over a million copies, and his upcoming release, Brain Defenders, explores the pivotal role of microglia, the brain's immune cells, in protecting, repairing, and reprogramming the brain for lifelong resilience. Dave and Dr. Perlmutter break down how microglia, the brain's resident immune cells, shift from a supportive state into a destructive one called M1, and why this shift, not amyloid plaque, may be the real driver of Alzheimer's, Parkinson's, and other neurodegenerative conditions. They dig into why the leading amyloid-clearing drugs fail to improve cognition, what a landmark JAMA study revealed about reversing cognitive decline through lifestyle intervention alone, and why a single daily serving of ultra-processed food raised Alzheimer's risk by 13 percent in a 12.7 year study. They also cover new research on GLP-1 drugs and brain inflammation, the surprising role of gum disease and oral bacteria in dementia risk, and why 40 hertz light therapy is emerging as a low-cost tool for clearing brain plaque and calming neuroinflammation. You'll Learn: Why the shift from supportive to destructive brain immune cells may be the true root cause of Alzheimer's and Parkinson's Why leading Alzheimer's drugs fail to improve cognition, and what the original research behind the amyloid hypothesis actually showed How one daily serving of ultra-processed food raises Alzheimer's risk, and what a landmark lifestyle intervention study found instead Whether GLP-1 drugs help or harm brain inflammation, based on new Parkinson's and Alzheimer's trial data How gum disease and oral bacteria are linked to dementia, and simple daily habits that reduce that risk Why 40 hertz light therapy is emerging as a tool to clear brain plaque and calm neuroinflammation How ketones, DHA, and metabolic health protect the brain after head injury Thank you to our sponsors! - Beyond Wonderland Conference | Oct 13 - 14, 2026. Get your ticket now at wonderlandconference.com. - ZenBud | Dave's Nervous System Biohack. Visit zenbud.health and use code DAVE15 at checkout for a discount. - Pique | Head over to Piquelife.com/Dave to get 20% off your order. That's P-I-Q-U-E life dot com slash DAVE - PredictiveMind™ | Get your Brain Pattern Mapping report at predictivemind.io/dave and use code DAVE for 10% off. Dave Asprey is a four-time New York Times bestselling author, founder of Bulletproof Coffee, and the father of biohacking. With over 1,000 interviews and 1 million monthly listeners, The Human Upgrade brings you the knowledge to take control of your biology, extend your longevity, and optimize every system in your body and mind. Each episode delivers cutting-edge insights inhealth, performance, neuroscience, supplements, nutrition, biohacking, emotional intelligence, and conscious living. New episodes are released every Tuesday, Thursday, Friday, and Sunday (BONUS). Dave asks the questions no one else will and gives you real tools to become stronger, smarter, and more resilient. Keywords: microglia, brain inflammation, Alzheimer's prevention, Parkinson's disease, amyloid hypothesis, neurodegeneration, GLP-1 drugs, semaglutide, ultra-processed food, gum disease and dementia, oral microbiome, 40 hertz light therapy, ketones, DHA, mitochondria, brain fog, long COVID, David Perlmutter, Brain Defenders, Grain Brain, functional medicine, biohacking, longevity, neuroplasticity Resources: • Get Dr. Perlmutter's New Book Brain Defenders: https://drperlmutter.com/books/brain-defenders/ • Learn More About Dr. Perlmutter's Work At: https://drperlmutter.com/ • Get My 2026 Clean Nicotine Roadmap | Enroll for free at https://daveasprey.com/2026-clean-nicotine-roadmap/ • Dave Asprey's Latest News | Go to https://daveasprey.com/ to join Inside Track today. • Danger Coffee: https://dangercoffee.com/discount/dave15? • My Daily Supplements: SuppGrade Labs (15% Off) • Favorite Blue Light Blocking Glasses: TrueDark (15% Off) • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Join My Substack (Live Access To Podcast Recordings): https://substack.daveasprey.com/ • Upgrade Labs: https://upgradelabs.com Timestamps: 00:00 – Trailer 00:40 – Intro 02:38 – Ultra-Processed Foods 06:34 – Are Carbs Bad? 08:48 – Alcohol & Brain Health 12:28 – Microglia & Inflammation 24:37 – Head Injury & Recovery 29:27 – Oral Bacteria & Dementia 34:08 – GLP-1s & Brain Inflammation 40:20 – 40 Hertz Light Therapy 48:35 – Air Pollution vs. Lead 50:27 – David's Closing Truth See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In our first summer series episode, we review a topic that keeps coming back. Hormone therapy for menopause. It was a thing, then it stopped being a thing, now it's a thing again. Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE Email us your questions at thebodyofevidence@gmail.com. Editor: Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information. References: Geographic variability of menopausal symptoms 1) Nappi RE et al. Global cross-sectional survey of women with vasomotor symptoms associated with menopause: prevalence and quality of life burden. Menopause. 2021 May 24;28(8):875-882. doi: 10.1097/GME.0000000000001793. 2) Nappi RE, et al. Prevalence and quality-of-life burden of vasomotor symptoms associated with menopause: A European cross-sectional survey. Maturitas. 2023 Jan;167:66-74. doi: 10.1016/j.maturitas.2022.09.006. What's the normal duration of symptoms 3) Avis NE, et al. Study of Women's Health Across the Nation. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015 Apr;175(4):531-9. doi: 10.1001/jamainternmed.2014.8063. The Women's Health Initiative (WHI) studies Rossouw JE et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-33. doi: 10.1001/jama.288.3.321. Anderson GL et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. JAMA. 2004 Apr 14;291(14):1701-12. doi: 10.1001/jama.291.14.1701. Decline in HRT after WHI studies Sprague BL, Trentham-Dietz A, Cronin KA. A sustained decline in postmenopausal hormone use: results from the National Health and Nutrition Examination Survey, 1999-2010. Obstet Gynecol. 2012 Sep;120(3):595-603. doi: 10.1097/AOG.0b013e318265df42. Danish Osteoporosis Prevention Study Schierbeck LL metal. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial. BMJ. 2012 Oct 9;345:e6409. doi: 10.1136/bmj.e6409. Kronos Early Estrogen Prevention Study (KEEPS) Harman SM, et al. Arterial imaging outcomes and cardiovascular risk factors in recently menopausal women: a randomized trial. Ann Intern Med. 2014 Aug 19;161(4):249-60. doi: 10.7326/M14-0353. Kronos Early Estrogen Prevention Study (KEEPS) Hodis HN et al. Vascular Effects of Early versus Late Postmenopausal Treatment with Estradiol. N Engl J Med. 2016 Mar 31;374(13):1221-31. doi: 10.1056/NEJMoa1505241. Stopping hormonal therapy Berman RS et al. Risk factors associated with women's compliance with estrogen replacement therapy. J Womens Health. 1997 Apr;6(2):219-26. doi: 10.1089/jwh.1997.6.219. Grady D, Sawaya GF. Discontinuation of postmenopausal hormone therapy. Am J Med. 2005 Dec 19;118 Suppl 12B:163-5. doi: 10.1016/j.amjmed.2005.09.051. Tapering vs. abrupt stop or hormonal therapy Haimov-Kochman R et al. Gradual discontinuation of hormone therapy does not prevent the reappearance of climacteric symptoms: a randomized prospective study. Menopause. 2006 May-Jun;13(3):370-6. doi: 10.1097/01.gme.0000186663.36211.c0. PMID: 16735933.
Interview with Philip A. Weissbrod, MD, Joshua R. Bedwell, MD, MS, and David O. Francis, MD, MS, authors of Uncoded Tracheostomy Care—Impacting Care, Quality, and Research? Hosted by Paul C. Bryson, MD, MBA. Related Content: Uncoded Tracheostomy Care—Impacting Care, Quality, and Research?
Traveling for the boys.Senate races across country are interesting:MaineMichiganOhioAlaskaTexasIowaMinnesotaGeorgiaNew HampshireNorth CarolinaWhat no one is talking about - Oregon.State Governor Races:Toss ups:NevadaArizonaGeorgiaWisconsinIowaMichiganLeans R:KansasOhioNew HampshireLean D:New MexicoMaineNew YorkPennsylvaniaMinnesotaOregonOregon Caucus Money:House R - Elmer 145k/175k evergreen = $320kHouse D - Future 1.1/$66k Fahey/$100k Bowman = $1.3Senate D - Leadership $720/Wagner $120/ Jama $50k = $900Senate R - Leadership $6k/Starr $150k = $150kBring Balance $4.5 millionIPO nominations are out:US CongressChris Beck — OR 02Andrea Salinas — OR 06Oregon SenateClay Bearnson — SD 03James I. Manning, Jr. — SD 07Melisa (Lisa) Finkle — SD 16Dawn Regier — SD 21Oregon HousePam Marsh — HD 5David Gomberg — HD 10Ivan Maluski — HD 11Joanna Robinson — HD 15Roy Kaufmann — HD 18Tom Andersen — HD 19Lesly Munoz — HD 22Sue Rieke Smith — HD 26Brian Schimmel — HD 29Cyrus Javadi — HD 32Jules Walters — HD 37April Dobson — HD 39Pat Hubbell — HD 40Thuy Tran — HD 45Ricki Ruiz — HD 50Emerson Levy — HD 53 This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.crosstabs.studio
Kirsten Bibbins-Domingo, MD, PhD, has a front-row seat to the tension at the heart of health innovation. As Editor in Chief of JAMA and the JAMA Network, she oversees 13 journals that sit at the intersection of clinical medicine, public health, and eme...
Send us Fan MailDescription: An immersive reading of Echo by Wendy Wisner with reflection on hearts, love, and architecture. Website:https://anauscultation.wordpress.comReferences:Wisner W. Echo. JAMA. 2026;335(17):1538. doi:10.1001/jama.2026.1502 Website: https://www.wendywisner.com/Book: https://www.amazon.com/New-Life-Poems-Wendy-Wisner/dp/1960329553
Alcohol-related liver disease is the leading cause of liver-related morbidity and mortality and the most common indication for liver transplant in Europe and the US. Author Aleksander Krag, MD, PhD, of the University of Southern Denmark joins JAMA Deputy Editor Kristin Walter, MD, MS, to discuss a recent review on this topic published in JAMA. Related Content: Alcohol-Related Liver Disease
She's been told to have a glass of wine. To just relax. That the pain is in her head. And she is still in pain — every time she has sex, every time she uses a tampon, sometimes just sitting at her desk. What she may have is a hypertonic pelvic floor: muscles stuck in a state of tension they cannot release on their own. In this episode, Dr. Carolyn Moyers sits down with Dr. Chailee Moss, board-certified OB/GYN at the Centers for Vulvovaginal Disorders in Washington, DC, and one of the country's leading experts in sexual pain — to talk about a treatment most women have never been offered: vaginal Botox.In this episode:• What a hypertonic pelvic floor actually is — and why it is so often missed• Why painful sex in midlife is not always "just hormones"• Who is a candidate for vaginal Botox, and what has to be tried first• What the procedure is really like: units, timeline, results, and side effects• Whether pelvic floor physical therapy is still necessary alongside Botox• Dr. Moss's current clinical study on incobotulinumtoxinA for pelvic floor dysfunction• Her published JAMA research on medical gaslighting in vulvovaginal careIf sex hurts, tampons hurt, or exams hurt — and no one has been able to tell you why — this episode is for you.
In this must-listen episode, Dr. Ryan Moenster is joined by Dr. Monica Mahoney and Dr. Mark Gilchrist to dive deep into the evolving landscape of outpatient parenteral antimicrobial therapy (OPAT) and complex outpatient antimicrobial therapy (CoPAT), highlighting real-world challenges, patient selection, and emerging treatment strategies. Navigating outpatient antimicrobial management can be complex, but this episode breaks down key insights and practical applications to help clinicians optimize care beyond the hospital. References: 1. Noble AL, Patel S, Birnie E, et al. 2026 updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC Antimicrob Resist. 2026;8(2). 2. British Society for Antimicrobial Chemotherapy (BSAC). OPAT Global Summit 2027. 3. Naicker S, Roberts JA, Cheng V, et al. A review of antimicrobial stability testing guidance for outpatient parenteral antimicrobial therapy programmes: Is it time for global harmonization of testing frameworks? JAC Antimicrob Resist. 2024;6(6). 4. Gilchrist M, Jamieson C, Drummond F, et al. Assessment of ceftolozane/tazobactam degradation profile and toxicity data in elastomeric devices for continuous infusion via outpatient parenteral antimicrobial therapy (OPAT). JAC Antimicrob Resist. 2023;5(2). 5. Naicker S, Roberts JA, Won H, et al. Evaluation of the stability of ceftazidime/avibactam in elastomeric infusion devices used for outpatient parenteral antimicrobial therapy utilizing a national stability protocol framework. JAC Antimicrob Resist. 2024;6(2). 6. Wolie ZT, Unwin S, Burke A, et al. Evaluation of the stability of tigecycline in elastomeric infusion devices used for outpatient parenteral antimicrobial therapy. JAC Antimicrob Resist. 2025;7(3). 7. Solomon DA, Beieler AM, Levy S, et al. Perspectives on the use of outpatient parenteral antibiotic therapy for people who inject drugs: Results from an online survey of infectious diseases clinicians. Open Forum Infect Dis. 2023;10(7):ofad372. doi:10.1093/ofid/ofad372. 8. Yagnik KJ, Brown LS, Saad HA, et al. Implementation of IV push antibiotics for outpatients during a national fluid shortage following Hurricane Maria. Open Forum Infect Dis. 2022;9(5):ofac117. doi:10.1093/ofid/ofac117. 9. Boettcher SR, Kenney RM, Everson NA, et al. Discharge delays and costs associated with outpatient parenteral antimicrobial therapy for multidrug-resistant organisms: A retrospective cohort study. Open Forum Infect Dis. 2025;13(1):ofaf770. 10. Rivera CG, Mara KC, Mahoney MV, Ryan KL. Survey of pharmacists on their roles and perceptions of outpatient parenteral antimicrobial therapy in the United States. Antimicrob Steward Healthc Epidemiol. 2022;2(1):e69. 11. Rapoport AB, Fischer LS, Santibanez S, et al. Infectious diseases physicians' perspectives regarding injection drug use and related infections—United States, 2017. Open Forum Infect Dis. 2018;5(7):ofy132. doi:10.1093/ofid/ofy132. 12. Turner NA, Hamasaki T, Doernberg SB, et al.; Antibacterial Resistance Leadership Group. Dalbavancin for treatment of Staphylococcus aureus bacteremia: The DOTS randomized clinical trial. JAMA. 2025;334(10):866–877. doi:10.1001/jama.2025.12543. 13. Volk CF, Hutson PR, Rose WE. Simulated target attainment of multidose regimens of dalbavancin for prolonged durations of therapy. Open Forum Infect Dis. 2024;11(6):ofae315. doi:10.1093/ofid/ofae315. Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Instagram: @SIDPharm ( https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/) https://www.instagram.com/breakpointspodcast_sidp/?hl=en Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from June 27-July 2, 2026.
Ep. #812 | One of the most critical habits for improving erections, and a simple mental approach to help you get it done.Inquiries: contact@holisticalpha.comStudiesKhera M, Bhattacharyya S, Miller LE. (2023). Effect of aerobic exercise on erectile function: Systematic review and meta-analysis of randomized controlled trials. Journal of Sexual Medicine.https://academic.oup.com/jsm/article/20/12/1369/7301709https://pubmed.ncbi.nlm.nih.gov/37814532/Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. (2018). Physical activity to improve erectile function: A systematic review of intervention studies. Sexual Medicine.https://pmc.ncbi.nlm.nih.gov/articles/PMC5960035/Silva AB, Sousa N, Azevedo LF, et al. (2017). Physical activity and exercise for erectile dysfunction: Systematic review and meta-analysis. British Journal of Sports Medicine.https://pubmed.ncbi.nlm.nih.gov/27707739/Esposito K, Giugliano F, Di Palo C, et al. (2004). Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. JAMA.https://jamanetwork.com/journals/jama/fullarticle/198993Begot I, Peixoto TC, Gonzaga LR, et al. (2015). A home-based walking program improves erectile dysfunction in men with an acute myocardial infarction. American Journal of Cardiology.https://pubmed.ncbi.nlm.nih.gov/25727080/Maio G, Saraeb S, Marchiori A. (2010). Physical activity combined with PDE5 inhibitor therapy improves erectile function more than medication alone.https://pubmed.ncbi.nlm.nih.gov/20367777/Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. (2006). A prospective study of risk factors for erectile dysfunction. Journal of Urology.https://pubmed.ncbi.nlm.nih.gov/16753404/Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. (2000). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology.https://pubmed.ncbi.nlm.nih.gov/10731462/Dorey G, Speakman M, Feneley R, Swinkels A, Dunn C. (2004). Randomized controlled trial of pelvic floor muscle exercises and biofeedback for erectile dysfunction. BJU International.https://pubmed.ncbi.nlm.nih.gov/15527607/Chen Z, et al. (2024). Effect of different physical activities on erectile dysfunction: A systematic review and network meta-analysis. Andrology.https://onlinelibrary.wiley.com/doi/full/10.1111/andr.13682
Roderick Little, PhD, University of Michigan School of Public Health Departments of Epidemiology & Biostatistics discusses Pattern-Mixture Models for Missing Data with Roger J. Lewis, MD, PhD, statistical editor for JAMA. Related Content: Pattern-Mixture Models for Missing Data
Welcome to the latest episode (July 2026) of DOC Updates, where every month Neil Skolnik, MD and John Russell, MD review the most important articles on diabetes, obesity, and cardiometabolic disease. This month on DOC Updates: Aroda V, Buzzetti R, Dalskov S et al. "Efficacy and safety of once-weekly cagrilintide–semaglutide (CagriSema) in adults with type 2 diabetes inadequately controlled on diet and exercise (REIMAGINE 1): a randomised, double-blind, placebo-controlled, phase 3a study." The Lancet Diabetes & Endocrinology, 2026; 0 doi: 10.1016/S2213-8587(26)00126-9 Bajaj H, Welch M, Shah P et al. "Efficacy and safety of retatrutide, a GIP, GLP-1, and glucagon receptor agonist, in people with type 2 diabetes and inadequate glycaemic control with diet and exercise (TRANSCEND-T2D-1): a double-blind, randomised, phase 3 trial." The Lancet, 2026; 407, 2402-2413 doi: 10.1016/S0140-6736(26)00967-0 Melville, N. "CGM Monitoring Benefits Extend to Non-Insulin-Using T2D." Medscape, June 07, 2026 Aronne, L.J., Horn, D.B., le Roux, C.W. et al. "Orforglipron for maintenance of body weight reduction: the double-blind, randomized phase 3b ATTAIN-MAINTAIN trial." Nat Med(2026) doi: 10.1038/s41591-026-04386-7 Salive ME, Tjaden AH, Ames JR, et al. "Lifestyle and Metformin Interventions and Risk of Multimorbidity in Adults With Prediabetes." JAMA. Published online June 15, 2026. doi:10.1001/jama.2026.8492 Presented by: Neil Skolnik, MD, 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, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health For information about the American Diabetes Association's scholarly journals, visit diabetesjournals.org. For more about this podcast, visit About Diabetes Core Update.
Propofol remains a cornerstone sedative for mechanically ventilated critically ill patients and is supported by PADIS guidelines and favored for its rapid onset, titratability, and limited side effects. However, its use in hemodynamically unstable patients remains a persistent clinical dilemma. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle Enfield, MD, is joined by Scott Benken, PharmD, MHPE, BCCCP, and Nathan Smischney, MD, MS, to explore the risks, benefits, and evolving evidence surrounding propofol use in this high-risk population. The discussion examines the physiologic basis of propofol-associated hypotension and how that can manifest in different patients, such as those with sepsis and septic shock. Patient selection and real-time assessment of hemodynamic trends are essential. Additional considerations include the recognition of and monitoring for propofol infusion syndrome, a rare but life-threatening complication. The episode also explores alternative drugs such as dexmedetomidine and ketamine, highlighting the benefits and risks of each. Emerging strategies are discussed, including a ketamine-propofol combination called ketafol and its utility in balancing sedation and hemodynamic stability. Listeners will gain expert insights into propofol use in the ICU and a deeper understanding of patient-centered approaches to sedation. Resources referenced in this episode: Lewis K, Balas MC, Stollings JL, et al. A focused update to the clinical practice guidelines for the prevention and management of pain, anxiety, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2025;53(3):e711-e727. Russotto V, Myatra SN, Laffey JG, et al. Intubation practices and adverse peri-intubation events in critically ill patients from 29 countries. JAMA. 2021;325(12):1164-1172. Boncyk C, Devlin JW, Faisal H, et al. INhaled Sedation versus Propofol in REspiratory failure in the Intensive Care Unit (INSPiRE-ICU1): protocol for a randomised, controlled trial. BMJ Open. 2024;14(10):e086946. O'Gara B, Serra AL, Englert JA, et al. Inhaled sedation versus propofol in respiratory failure in the ICU (INSPiRE-ICU2): study protocol for a multicenter randomized controlled trial. Trials. 2025;26(1):114.
Contributor: Travis Barlock, MD Educational Pearls: First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma. Complication rate for patients intubated on the first pass is 14% Complication rates increase to 47% after two attempts, 64% after three, and 71% after the fourth attempt How to improve likelihood of first-pass success: Use Video laryngoscopy (VL). VL increases chance of first-pass success to 85% from 71% Use a bougie, especially in patients with anatomically difficult or otherwise obstructed airways. The BEAM study cites a success rate in these patients of 96% with a bougie, compared to 82% without Use a Checklist mnemonic (SOAPME) Suction – On, ready, and within reach Oxygen – Patient is preoxygenated Adjuncts – Oral/nasal adjuncts and BVM ready Positioning - Patient positioned properly; consider obesity, using semi-Fowler/head-up positioning Medications – Rapid sequence intubation (RSI), sedation, vasopressor, and other medications prepared as necessary Equipment – Laryngoscope (blade), tube, bougie/stylet, syringe, scalpel/cric kit, others ready as necessary References Sakles, J.C., Chiu, S., Mosier, J., Walker, C. and Stolz, U. (2013), The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. Acad Emerg Med, 20: 71-78. https://doi.org/10.1111/acem.12055 Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. New England Journal of Medicine. 2023;389(5). doi:https://doi.org/10.1056/nejmoa2301601 Driver BE, Prekker ME, Klein LR, et al. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial. JAMA. 2018;319(21):2179–2189. doi:10.1001/jama.2018.6496 Turner JS, Bucca AW, Propst SL, et al. Association of Checklist Use in Endotracheal Intubation With Clinically Important Outcomes: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(7):e209278. doi:10.1001/jamanetworkopen.2020.9278 Turner, Joseph S et al. "Feasibility of upright patient positioning and intubation success rates At two academic EDs." The American journal of emergency medicine vol. 35,7 (2017): 986-992. doi:10.1016/j.ajem.2017.02.011 Summarized by Sam Pahl | Edited by Sam Pahl & Ahmed Abdel-Hafiz, NREMT-P Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf
Mamen Delgado, adicta a la cocaína en recuperación, divulgadora y creadora del Podcats “Albada, Un nuevo amanecer" nos cuenta su historia y cómo ha vivido su particular infierno para desengancharse de la droga y, lo más importante, afrontar sus miedos y vacíos aprendiendo a gestionar sus emociones. Para ello, como nos cuenta: "Hay que ser valiente, atravesar mucha oscuridad y mucho dolor. Jamás pensé que me iba a recuperar. Hay que pedir ayuda, pero se puede salir". Mamen pidió ayuda a Proyecto hombre y ellos le ayudaron a cambiar muchas cosas en su vida y aprender a quererse. Ahora está ayudando a otras personas con la asociación Albada. "Antes estaba vacía y ahora vivo con la mente en calma"
Editor's Summary by Linda Brubaker, MD and Christopher C. Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from June 20-26, 2026.
Are light runs (Zone 2 runs) better than heavier workouts? Sophie goes on a semi-manic tangent in her most enthusiastic episode yet to answer whether less intense exercise might actually help your fitness level, aerobic threshold and mitochondrial efficiency. Also, Chris tells a funny marathon story and a viewer question tries to fact-check to the fact checkers on whether walking and running burn the same amount of energy. Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE Email us your questions at thebodyofevidence@gmail.com. Hosts: Christopher Labos & Sophie Tseng Pellar Editor: Robyn Flynn Researcher: Auriane Journet Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information. References: 1. Storoschuk, K. L., Moran-MacDonald, A., Gibala, M. J., & Gurd, B. J. (2025). Much Ado About Zone 2: A Narrative Review Assessing the Efficacy of Zone 2 Training for Improving Mitochondrial Capacity and Cardiorespiratory Fitness in the General Population: KL Storoschuk et al. Sports Medicine, 55(7), 1611-1624. 2. Mølmen, K. S., Almquist, N. W., & Skattebo, Ø. (2025). Effects of exercise training on mitochondrial and capillary growth in human skeletal muscle: a systematic review and meta-regression. Sports Medicine, 55(1), 115-144. 3. Inglis, E. C., Iannetta, D., Rasica, L., Mackie, M. Z., Keir, D. A., Macinnis, M. J., & Murias, J. M. (2024). Heavy-, severe-, and extreme-, but not moderate-intensity exercise increase V̇o 2max and thresholds after 6 wk of training. Medicine & Science in Sports & Exercise, 56(7), 1307-1316. 4. McConell, G.K., Wadley, G.D., Le plastrier, K. and Linden, K.C. (2020), Skeletal muscle AMPK is not activated during 2 h of moderate intensity exercise at ∼65% in endurance trained men. J Physiol, 598: 3859-3870. https://doi.org/10.1113/JP277619 5. Meixner, B., Filipas, L., Holmberg, H. C., & Sperlich, B. (2025). Zone 2 Intensity: A Critical Comparison of Individual Variability in Different Submaximal Exercise Intensity Boundaries. Translational sports medicine, 2025, 2008291. https://doi.org/10.1155/tsm2/2008291 6. Harber MP, et al. Impact of Cardiorespiratory Fitness on All-Cause and Disease-Specific Mortality: Advances Since 2009. Progress in Cardiovascular Diseases 2017;60(1):11-20. PubMed 28286137 7. Kodama S, Saito K, Tanaka S, et al. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women: A Meta-analysis. JAMA 2009;301(19):2024-2035. PubMed 19454641
Chris Boyer and Reed Smith bring in two people who worked the problem from the inside. Chris Hemphill of Modular Feedback, who builds AI for a living, and Heather Nairn, a healthcare economist who reads this as an access problem first. The reflex across the industry is to point AI at the mess. Standardize the data, set some agents loose, let the model sort it out. Hemphill and Nairn tested that reflex against a plain deterministic workflow on exactly this job. The workflow won on accuracy, on speed and on cost. Their point is not that AI is useless here. It is that the most useful skill in this work is knowing when not to reach for it. The deeper problem is structural. Provider data is a commodity. Every payer and every health system chases the same handful of fields, guards its copy as proprietary, and rebuilds the same record in parallel. Every cycle spent on that is a cycle not spent on the access work that moves outcomes. Transportation, care coordination, the patient in crisis who just needs a number that connects. Mentions from the Show: U.S. Senate Finance Committee, Ghost Network Secret Shopper Study, May 2023: https://www.finance.senate.gov/imo/media/doc/050323%20Ghost%20Network%20Hearing%20-%20Secret%20Shopper%20Study%20Report.pdf HHS Office of Inspector General, behavioral health network issue brief, October 2025 (72% of listed clinicians non-participating) New York Attorney General, "Inaccurate and Inadequate: Health Plans' Mental Health Provider Directories" (EmblemHealth investigation) American Psychiatric Association class-action complaint against EmblemHealth, January 2026: https://psychiatryonline.org/doi/full/10.1176/appi.pn.2026.03.3.15 CMS Final Rule CMS-4208-F2, finalized September 2025 (MA directory data to Medicare Plan Finder by plan year 2027; 85% accuracy threshold) Ideon, CMS Provider Directory Requirements compliance guide, March 2026 (48.74% of MA provider locations carry at least one inaccuracy): https://ideonapi.com/resources/blog/cms-provider-directory-requirements-a-complete-compliance-guide-for-2026-2027/ JAMA, AI-assisted directory inconsistency study, University of Colorado researchers (81% of physicians show inconsistencies), via Healthcare Dive: https://www.healthcaredive.com/news/inconsistent-physician-directories-no-surprises-act/645307/ Modular Feedback (Chris Hemphill), deployment write-up: https://modularfeedback.com/blog Chris Hemphill on LinkedIn: https://www.linkedin.com/in/chrishemphill/ CONFIRM handle Heather Nairn on LinkedIn: CONFIRM URL Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices
CardioNerds (Amit and Dan), Billy Joe Mullinax, and Saahil Jumkhawala discuss the long term management of pulmonary embolism with Dr. Soophia Naydenov. The episode focuses on the approach to patients who struggle with persistent symptoms like dyspnea and fatigue even after completing the acute phase of anticoagulation. This spectrum of disease, ranging from mild post-PE impairment to chronic thromboembolic pulmonary hypertension (CTEPH), requires a structured follow-up. The discussion covers the critical importance of identifying CTEPH early, the necessary timelines for follow-up, and the appropriate objective screening tools and invasive testing to guide patient care toward full functional recovery. Audio editing by CardioNerds academy intern, Grace Qiu. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Acronyms PE: Pulmonary Embolism PERT: Pulmonary Embolism Response Team CTEPH: Chronic Thromboembolic Pulmonary Hypertension QL: Quality of Life VTE: Venous Thromboembolism DASH: D-dimer, Age, Sex, History of non-provoked PE (a risk score) CPET: Cardiopulmonary Exercise Testing PFTs: Pulmonary Function Tests VQ Scan: Ventilation-Perfusion Scan DOACs: Direct Oral Anticoagulants TPA: Tissue Plasminogen Activator (Thrombolytics) ECMO: Extracorporeal Membrane Oxygenation Pearls: Post-PE “Syndrome” is a Spectrum: It is more accurately a spectrum of disease (sequelae of PE) rather than a single syndrome, ranging from mild fatigue/dyspnea to the most severe form, CTEPH. Structured Follow-up is Mandatory: All PE survivors need a structured follow-up, typically with checkpoints at 3, 6, 12, and 16–24 months, with the primary goal being to detect CTEPH, the deadliest, yet potentially curable, disease on the spectrum. Screening Should Be Objective and Practical: When screening for persistent symptoms, use objective assessment tools like the Post-VTE Functional Status (PVFS) scale or the Modified Medical Research Council (MMR-C) scale, as highly comprehensive but cumbersome tools (like the PE Quality of Life questionnaire) may not be practical for routine clinical use. Recurrence Risk Scores Aid in Anticoagulation Duration: Simple scores like the DASH score or the HERDO2 score (for women) can provide guidance when considering the continuation versus discontinuation of anticoagulation after the initial treatment phase. Invasive Testing for Persistent Symptoms: If a patient remains symptomatic at the 6-month mark despite normal non-invasive testing (chest X-ray, ECG, PFTs, six-minute walk, echo, VQ scan, CPET), consider invasive testing such as Right Heart Catheterization (RHC) at rest or with exercise, or an invasive CPET. Notes: Notes drafted by Saahil Jumkhawala. 1. The Spectrum of Post-PE Disease The term “post-PE syndrome” should be used with caution, as it refers to a spectrum of disease rather than a single entity. This spectrum includes symptoms (sequelae) that exist in a patient’s life following an incidental PE event that they did not have before. On one extreme is Chronic Thromboembolic Pulmonary Hypertension (CTEPH): The definition is clear, but it is the most deadly type, though thankfully rare (2% to 4%). It involves a residual clot and pulmonary hypertension identifiable at rest. In the middle is Chronic Thromboembolic Disease (CTED): Patients may have residual defects seen on a VQ or CT scan, but they do not have pulmonary hypertension. On the other side is a milder disease, which can include fatigue, dyspnea, or a patient’s perceived impairment, where the definitions of CTEPH and CTED are not met, but the patient remains symptomatic. 2. Structured Follow-up and Screening for Post-PE Symptoms Structured follow-up is key for all PE survivors, though the structure may vary based on available resources (PCP, Cardiology, Pulmonary, or multidisciplinary clinic). Recommended Timeline for Follow-up: Data from studies like ELOPE and FOCUS suggest checkpoints at 3, 6, 12, and up to 16 to 24 months. This timeline is designed to identify patients who may develop CTEPH. 88% of patients who develop CTEPH will be identified within about a year. A structured follow-up can reduce the delay in CTEPH diagnosis from 10–12 months to 4–6 months. Personal Practice Note: A quick 2–3 week/30-day check-in is recommended for severely ill patients (e.g., those who had TPA, profound shock, or ECMO support) to ensure medication compliance, manage symptoms, and identify red flags. Screening Tools (Objective Assessment): The first step is an inventory of patient symptoms, leaning toward objective rather than subjective assessment. Recommended Simple Tools: Modified Medical Research Council (MMR-C) for dyspnea evaluation. Post-VTE Functional Status (PVFS) scale. The Pulmonary Embolism Quality of Life (QL) questionnaire is comprehensive but long, making it tedious and better suited for research. Future Utility: Technology (AI/electronic tools) may assist in administering these questionnaires before the clinic visit, presenting the information as a “dashboard” for the provider. 3. Management of Persistent Symptoms and Further Testing Initial Non-Invasive Tests (Often done at 3 months): Echocardiogram VQ Scan Full PFTs Six-minute walk CPET Further Evaluation for Persistent Symptoms (e.g., at 6 months): If non-invasive tests (Chest X-ray, ECG, CPET) are normal but symptoms persist, more invasive testing should be considered as the patient has not returned to baseline. Repeat VQ scan or echocardiogram if symptoms have changed. Right Heart Catheterization (RHC) at rest or with exercise. Invasive CPET. PA gram (Pulmonary Angiogram) to assess vasculature. 4. Recurrence Risk and Anticoagulation Duration The decision to continue or discontinue anticoagulation depends on the patient’s risk factors, the situation of the PE (provoked or unprovoked), presence of active cancer, and patient preference. Recurrence Risk Scores: Simple scores are preferred for practicality. DASH Score. HERDO2 Score (particularly for women). The Vienna Score can be considered if the question is whether to restart anticoagulation after a disruption. Role of D-dimer in Abbreviation: While D-dimer can be used to guide the decision to restart anticoagulation after a planned pause (if D-dimer is high, resume), patient symptoms are preferable to guide management decisions like early abbreviation. 5. Prevention of Post-PE Syndrome Currently, there is no clear tool known to prevent the post-PE syndrome/spectrum of disease. Best Current Advice for Prevention/Recovery: Anticoagulation compliance. Pulmonary rehabilitation, which aids in faster recovery. General precautions, such as smoking cessation and body weight management. Future Research: Ongoing trials are investigating whether acute management strategies (e.g., using thrombolytics in intermediate-risk PE) can prevent long-term sequelae. (The PYTHO trial did not show a reduced rate of CTEPH in intermediate-risk PE patients who received thrombolytics). References: Khan, F., Tritschler, T., Kahn, S. R., & Rodger, M. A. “Venous Thromboembolism.” The Lancet, vol. 398, no. 10294, 2021, pp. 64-77. doi:10.1016/S0140-6736(20)32658-1. Kearon, C., & Kahn, S. R. “Long-Term Treatment of Venous Thromboembolism.” Blood, vol. 135, no. 5, 2020, pp. 317-325. doi:10.1182/blood.2019002364. Kahn, S. R., & de Wit, K. “Pulmonary Embolism.” The New England Journal of Medicine, vol. 387, no. 1, 2022, pp. 45-57. doi:10.1056/NEJMcp2116489. Di Nisio, M., van Es, N., & Büller, H. R. “Deep Vein Thrombosis and Pulmonary Embolism.” The Lancet, vol. 388, no. 10063, 2016, pp. 3060-3073. doi:10.1016/S0140-6736(16)30514-1. Chopard, R., Albertsen, I. E., & Piazza, G. “Diagnosis and Treatment of Lower Extremity Venous Thromboembolism: A Review.” JAMA, vol. 324, no. 17, 2020, pp. 1765-1776. doi:10.1001/jama.2020.17272.
Cancer Caused by His Volunteer Work at a New York Attack: A 9/11 Volunteer's Fight Against Lung Cancer, Trauma, and Finding Hope. Those words summarize a journey that began with selfless service and evolved into a decades-long battle for survival. Twenty-five years after volunteering at Ground Zero following the September 11 terrorist attacks, Craig Sotkovsky continues fighting a different enemy, an aggressive form of lung cancer linked to toxic exposure at the World Trade Center. The Law Enforcement Talk Radio Show and Podcast social media like their Facebook , Instagram , LinkedIn , Medium and other social media platforms. His remarkable story is featured on the Law Enforcement Talk Radio Show and Podcast website, available on Apple Podcasts, Spotify, and shared across Facebook, Instagram, LinkedIn, X, and other major News and podcast platforms. The episode is available to listen to Free. The Podcast is available for free on the Law Enforcement Talk Radio Show and Podcast website, also on Apple Podcasts, Spotify, YouTube, iHeartradio and most major podcast platforms. #LawEnforcementTalk #Free #Podcast #Radio One Decision Changed Everything On September 11, 2001, Craig Sotkovsky watched history unfold from his home in Jersey City, New Jersey. Supporting articles about this and much more from Law Enforcement Talk Radio Show and Podcast in platforms like Medium , Blogspot and Linkedin. Like millions of Americans, he watched in disbelief as the Twin Towers collapsed after terrorists hijacked commercial airliners and carried out one of the deadliest attacks in U.S. history. But unlike most Americans, Craig didn't remain a spectator. A skilled carpenter and mason, he volunteered to help. He joined the bucket brigade at Ground Zero and spent two of the first five days working in the debris field following the collapse of the World Trade Center. Cancer Caused by His Volunteer Work at a New York Attack: A 9/11 Volunteer's Fight Against Lung Cancer, Trauma, and Finding Hope. The episode is available across major platforms including their website, Apple Podcasts, Spotify, YouTube, with highlights shared across their Facebook, Instagram, and LinkedIn profiles. At the time, he believed he was simply helping his country. He had no idea the toxic dust surrounding him would follow him for the rest of his life. "Twenty-five years ago, I answered a call for help." The Hidden Cost of Being a Volunteer Ground Zero contained a dangerous mixture of pulverized concrete, asbestos, glass fibers, lead, fuel residue, and countless other hazardous materials released when the towers collapsed. Available for free on the Law Enforcement Talk Radio Show and Podcast website, also on Apple Podcasts, Spotify, Youtube and most major Podcast networks. Years later, Craig received devastating news. He had developed a rare and aggressive lung cancer connected to his exposure at the World Trade Center. The diagnosis transformed every part of his life. He underwent multiple cancer surgeries. He endured physical pain, emotional trauma, and overwhelming financial hardship. The illness eventually cost him nearly everything. "Cancer changed everything." More Than a Medical Battle Craig explains that surviving cancer became more than simply recovering from surgery. It became a complete rebuilding of his identity. He describes losing financial security, emotional stability, and the life he once knew. The Podcast is available for free on the Law Enforcement Talk Radio Show and Podcast website, also on Apple Podcasts, Spotify, YouTube, iHeartradio and most major podcast platforms. Yet amid tremendous hardship, he discovered something unexpected. Purpose. "Growth can come from pain." That philosophy became the foundation for what Craig now calls "Gro-Win Through Pain," a message encouraging others to find strength through life's darkest moments. Cancer Caused by His Volunteer Work at a New York Attack: A 9/11 Volunteer's Fight Against Lung Cancer, Trauma, and Finding Hope. Trauma Doesn't Always End When the Crisis Is Over Many people associate September 11 with the horrific events of that single morning. Craig reminds listeners that for thousands of responders, recovery workers, and volunteers, the disaster never truly ended. For many, the effects emerged years later through chronic illness, cancer, respiratory disease, and lasting emotional trauma. The Law Enforcement Talk Radio Show and Podcast continues bringing listeners real conversations from the front lines of crime, policing, trauma, survival, and healing. His story highlights the reality that some of the greatest wounds are invisible for years. Research Continues to Show Elevated Cancer Risks Craig's experience reflects what researchers have documented for years. Studies examining World Trade Center responders have found elevated rates of several cancers among those exposed to Ground Zero dust. One study published in JAMA followed more than 12,000 World Trade Center responders. Researchers found that participants reporting heavier exposure experienced nearly three times the incidence of lung cancer compared with responders reporting minimal exposure, even after accounting for smoking history and other demographic factors. Cancer Caused by His Volunteer Work at a New York Attack: A 9/11 Volunteer's Fight Against Lung Cancer, Trauma, and Finding Hope. The complete interview is available as a Free Podcast on Facebook, Instagram, YouTube, Apple Podcasts, Spotify, LinkedIn, and major podcast platforms. While every individual's medical history is unique, Craig's diagnosis illustrates the very real health consequences many volunteers and first responders continue to face decades later. A Mission Across America As the 25th anniversary of September 11 approaches, Craig is preparing for another mission. He plans to travel across America in an RV to honor those who lost their lives, recognize responders and volunteers still living with the consequences of that day, and share stories of resilience, perseverance, and hope. His journey is no longer defined by cancer. It is defined by purpose. An Inspiring Conversation On the Law Enforcement Talk Radio Show and Podcast, Craig Sotkovsky shares the emotional details of witnessing the attacks, volunteering at Ground Zero, developing lung cancer, enduring repeated surgeries, and learning how to move forward despite overwhelming adversity. Cancer Caused by His Volunteer Work at a New York Attack: A 9/11 Volunteer's Fight Against Lung Cancer, Trauma, and Finding Hope. Listeners can hear the complete interview on Facebook, Instagram, YouTube, Apple Podcasts, Spotify, iHeartRadio, and other major Podcast, Radio, News, and Media platforms. His story serves as a reminder that true courage often continues long after the cameras disappear. Sometimes the greatest heroes are those who quietly keep fighting years after the world has moved on. Listen Free Today Hear Craig Sotkovsky's incredible story on the Law Enforcement Talk Radio Show and Podcast. The episode is available Free on the Law Enforcement Talk Radio Show and Podcast website, also on Apple Podcasts, Spotify, and is promoted across Facebook, Instagram, LinkedIn, X, and other major podcast and News platforms. Cancer Caused by His Volunteer Work at a New York Attack: A 9/11 Volunteer's Fight Against Lung Cancer, Trauma, and Finding Hope. This powerful conversation explores sacrifice, resilience, recovery, and the lasting impact of trauma from one of America's darkest days. The podcast is available on Facebook, Instagram, YouTube, Apple Podcasts, Spotify, LinkedIn, and other major podcast platforms. If Craig's story inspires you, please share this article so more people understand the sacrifices made not only on September 11, but for decades afterward. Listen to the full story on the Free Podcast, available on the Law Enforcement Talk Radio Show and Podcast Website, on Facebook, Instagram, YouTube, Apple, Spotify, and more. Be sure to follow us on X , Instagram , Facebook, Pinterest, Linkedin and other social media platforms for the latest episodes and news. Learn and get access to money saving tips and how to increase your net worth at www.LetSavings.com Listen to this powerful #Free Podcast episode featuring Marci Hopkins on Facebook, Instagram, Youtube, Apple Podcasts, Spotify, and major Podcast platforms nationwide. Download the Free Ebook about ways and tips to improve your health. You can get the ebook for free at www.LetHealthy.com Get the Free Clubhouse App, it is Drop In Social Audio. Think of it as your own talk radio show on your phone, and best of all it is free. Be sure to look for me and follow me, that's John J Wiley or @letradioshow you can do all that here. The Law Enforcement Talk Radio Show and Podcast social media like their Facebook , Instagram , LinkedIn , Medium and other social media platforms. You can contact John J. “Jay” Wiley by email at Jay@letradio.com , or learn more about him on their website . Find a wide variety of great podcasts online at The Podcast Zone Facebook Page , look for the one with the bright green logo. Be sure to check out our website . Cancer Caused by His Volunteer Work at a New York Attack: A 9/11 Volunteer's Fight Against Lung Cancer, Trauma, and Finding Hope. Attributions Craig Sotovsky JAMA Wikipedia Facebook Facebook Group Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
What if one of the most important health crises affecting men today wasn't being caused by aging, but by the environment we live in? In this eye-opening solo episode, Darin Olien investigates the alarming decline in testosterone levels, fertility, and reproductive health among men worldwide. Drawing on decades of research, epidemiological studies, environmental science, endocrinology, and public health data, Darin examines the growing evidence connecting endocrine-disrupting chemicals, microplastics, sleep deprivation, chronic stress, poor lifestyle habits, and environmental toxins to declining testosterone levels across generations. From BPA, phthalates, atrazine, PFAS, and microplastics to sleep quality, circadian rhythms, cholesterol metabolism, cortisol regulation, and natural testosterone-supporting strategies, this episode explores what may be one of the most underreported public health issues of our time—and what men can do to take control of their health today. What You'll Learn Why testosterone levels have been declining for decades The startling research on global sperm count decline How endocrine-disrupting chemicals interfere with hormone production Why BPA and phthalates may disrupt testosterone synthesis The role of atrazine, PFAS, and environmental toxins How chronic stress diverts resources away from testosterone production Why sleep may be the most important testosterone intervention The connection between cholesterol and hormone production How microplastics are being found throughout the human body The surprising relationship between statins and testosterone levels Natural lifestyle strategies that support healthy hormone production Practical steps to reduce environmental exposure and improve health Chapters 00:00:00 – Welcome to SuperLife 00:00:33 – Sponsor: Fatty15 and cellular health 00:04:17 – The testosterone collapse explained 00:04:51 – Testosterone levels have been declining for decades 00:06:03 – Global sperm count decline and accelerating trends 00:07:02 – Why treating symptoms misses the root cause 00:07:27 – The hidden public health crisis 00:08:03 – Why low testosterone isn't just about aging 00:09:12 – Why hormone health affects longevity 00:09:53 – Low testosterone and increased mortality risk 00:10:35 – Testosterone's role in metabolism and cardiovascular health 00:11:27 – Endocrine-disrupting chemicals and hormone disruption 00:12:44 – BPA and its effects on testosterone production 00:13:59 – Phthalates and their impact on hormone pathways 00:16:00 – Glyphosate, atrazine, and pesticide exposure 00:17:07 – PFAS and reproductive health concerns 00:17:55 – Environmental toxins and population-wide effects 00:18:11 – Sponsor: Shakeology 00:20:02 – Cholesterol and hormone production 00:20:53 – Chronic stress and cortisol dominance 00:21:45 – Actionable solutions begin 00:21:56 – Why sleep is essential for testosterone production 00:23:07 – How sleep deprivation rapidly lowers testosterone 00:23:21 – Light pollution and circadian disruption 00:23:41 – Foods and nutrients needed for hormone health 00:24:23 – Microplastics and testicular tissue 00:24:53 – Statins and unintended hormonal consequences 00:25:39 – A practical testosterone sovereignty protocol 00:25:48 – Water filtration and reducing toxic exposure 00:26:13 – Eliminating plastics and fragrance chemicals 00:26:35 – Why organic food matters 00:26:45 – Sunlight and vitamin D 00:27:05 – Magnesium, omega-3s, and iodine 00:27:26 – Pine pollen and natural androgen support 00:28:01 – Tongkat Ali and ashwagandha 00:28:48 – Strength training and lifestyle interventions 00:29:10 – Habits that naturally support testosterone 00:29:27 – Darin's approach to healthy aging 00:29:37 – Plants, herbs, and common sense 00:29:51 – Reclaiming your health and sovereignty 00:30:00 – Final thoughts and closing message Thank You to Our Sponsors Fatty15: Get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/DARIN and using code DARIN at checkout. Shakeology: Get 15% off with code DARINO1BODI at Shakeology.com. Join the SuperLife Patreon: This is where Darin now shares the deeper work: - weekly voice notes - ingredient trackers - wellness challenges - extended conversations - community accountability - sovereignty practices Join now for only $7.49/month at https://patreon.com/darinolien Find More from Darin Olien: Website: darinolien.com Instagram: @darinolien Book: Fatal Conveniences Platform & Products: superlife.com New Show: Roadmap to Happiness Key Takeaway "The testosterone crisis may be about far more than aging. It may be a reflection of the modern environment itself—one increasingly saturated with endocrine-disrupting chemicals, chronic stress, poor sleep, circadian disruption, and toxic exposures. While many of these forces feel outside our control, the encouraging reality is that many of the most powerful interventions remain accessible: improving sleep, reducing toxic load, eating whole foods, getting sunlight, managing stress, exercising regularly, and reclaiming responsibility for our health. The goal isn't fear. The goal is awareness—and action." Bibliography/Sources: The Decline — Primary Research Levine, H., Jørgensen, N., Martino-Andrade, A., et al. (2022). Temporal trends in sperm count: A systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries. Human Reproduction Update, 29(2), 157–176. https://doi.org/10.1093/humupd/dmac035 Lokeshwar, S. D., Patel, P., Fantus, R. J., et al. (2021). Decline in testosterone levels in men aged 15–40: Results from the National Health and Nutrition Examination Survey (NHANES), 1999–2016. World Journal of Urology, 39(2), 447–452. https://doi.org/10.1007/s00345-020-03227-1 Spital Clinic. (2026, March). Declining testosterone levels by generation. https://www.spitalclinic.com Travison, T. G., Araujo, A. B., O'Donnell, A. B., Kupelian, V., & McKinlay, J. B. (2007). A population-level decline in serum testosterone levels in American men. The Journal of Clinical Endocrinology & Metabolism, 92(1), 196–202. https://doi.org/10.1210/jc.2006-1375 Low Testosterone — Mortality & Disease Risk Muraleedharan, V., Marsh, H., Kapoor, D., Channer, K. S., & Jones, T. H. (2013). Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes. European Journal of Endocrinology, 169(6), 725–733. https://doi.org/10.1530/EJE-13-0321 Shores, M. M., et al. (2006). Low testosterone associated with increased all-cause and cardiovascular mortality. Archives of Internal Medicine, 166(15), 1660–1665. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/410754 Yeap, B. B., Marriott, R. J., Dwivedi, G., et al. (2024). Associations of testosterone and related hormones with all-cause and cardiovascular mortality and incident cardiovascular disease in men. Annals of Internal Medicine. https://doi.org/10.7326/M23-2781 Endocrine Disrupting Chemicals Associations between endocrine-disrupting chemical exposure and fertility outcomes: A decade of human epidemiological evidence. (2024). PubMed Central (PMC12299029). https://pmc.ncbi.nlm.nih.gov/articles/PMC12299029/ Hayes, T. B., Haston, K., Tsui, M., et al. (2002). Herbicides: Feminization of male frogs in the wild. Nature, 419, 895–896. https://doi.org/10.1038/419895a Mechanisms of testicular disruption from exposure to BPA and phthalates. (2020). Journal of Clinical Medicine, 9(2), 471. https://pmc.ncbi.nlm.nih.gov/articles/PMC7074154/ Meeker, J. D., Calafat, A. M., & Hauser, R. (2014). Urinary phthalate metabolites and their biotransformation products: Predictors and temporal variability among men and women. Journal of Exposure Science & Environmental Epidemiology. https://www.sciencedaily.com/releases/2014/08/140814124330.htm Zhao, Q., et al. (2023). Male reproductive toxicity of microplastics: Head and tail of the sperm. Science of the Total Environment, 872, 162181. https://doi.org/10.1016/j.scitotenv.2023.162181 Zhong, B., et al. (2024). Mixed EDC exposure associated with reductions in testosterone and free androgen index. Scientific Reports. https://doi.org/10.1038/s41598-024-76972-z Cortisol, Stress & the HPG Axis Bielohuby, M., et al. (2012). Swiss military cadets prolonged stress study. Psychoneuroendocrinology. Preprints.org. (2025). Sleep deprivation: A modifiable cause. https://doi.org/10.20944/preprints202505.0580.v1 SiPhox Health. (n.d.). Summary of Journal of Clinical Endocrinology & Metabolism data. https://www.siphoxhealth.com Viau, V. (2002). Functional cross-talk between the hypothalamic-pituitary-gonadal and -adrenal axes. Journal of Neuroendocrinology, 14(6), 506–513. https://doi.org/10.1046/j.1365-2826.2002.00798.x Sleep & Testosterone Leproult, R., & Van Cauter, E. (2011). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), 2173–2174. https://jamanetwork.com/journals/jama/fullarticle/1029127 Reiter, R. J., et al. (2021). Melatonin and male reproductive health: Relationship to oxidative stress, mitochondrial function, and Leydig cell protection. Endocrine. Tan, D. X., Hardeland, R., Manchester, L. C., et al. (2023). Melatonin as a pleiotropic antioxidant hormone. Journal of Pineal Research. Nutrition — Zinc, Vitamin D, Cholesterol Corona, G., et al. (2010). Statin therapy and testosterone levels in men: A systematic review. The Journal of Sexual Medicine. Daniell, H. W. (2002). Hypogonadism in men consuming sustained-action oral opioids. The Journal of Pain, 3(5), 377–384. https://doi.org/10.1054/jpai.2002.126790 Pilz, S., Frisch, S., Koertke, H., et al. (2011). Effect of vitamin D supplementation on testosterone levels in men. Hormone and Metabolic Research, 43(3), 223–225. https://doi.org/10.1055/s-0030-1269854 Prasad, A. S., Mantzoros, C. S., Beck, F. W., Hess, J. W., & Brewer, G. J. (1996). Zinc status and serum testosterone levels of healthy adults. Nutrition, 12(5), 344–348. https://doi.org/10.1016/S0899-9007(96)80058-X Natural Testosterone Support — Botanical Evidence Pine pollen impacts testosterone-related symptoms in men. (2024). ACMCR Case Reports, 14(5), 1–9. Chinnappan, S. M., George, A., et al. (2021). Effect of Eurycoma longifolia standardised extract Physta on testosterone levels in ageing males: A randomised, double-blind, placebo-controlled multicentre study. Food & Nutrition Research, 65. https://doi.org/10.29219/fnr.v65.5647 Lazarev, A., & Bezuglov, E. (2021). Testosterone boosters intake in athletes: Current evidence and further directions. Endocrines, 2(2), 109–120. https://doi.org/10.3390/endocrines2020011 Leisegang, K., et al. (2022). Eurycoma longifolia (Tongkat Ali) improves serum total testosterone in men. Food & Nutrition Research. https://pubmed.ncbi.nlm.nih.gov/36013514/ Leitão, A. E., et al. (2021). 6-month double-blind RCT: Eurycoma longifolia 200mg + concurrent training. Maturitas. https://doi.org/10.1016/j.maturitas.2020.10.005 Lopresti, A. L., Smith, S. J., et al. (2019). An investigation into the stress-relieving and pharmacological actions of an ashwagandha extract. Medicine, 98(37), e17186. https://doi.org/10.1097/MD.0000000000017186 Pandit, S., Biswas, S., Jana, U., De, R. K., Mukhopadhyay, S. C., & Biswas, T. K. (2016). Clinical evaluation of purified shilajit on testosterone levels in healthy volunteers. Andrologia, 48(5), 570–575. https://doi.org/10.1111/and.12482 Saden-Krehula, M., Tajic, M., & Kolbah, D. (1971). Testosterone, epitestosterone and androstenedione in the pollen of Scotch pine Pinus sylvestris L. Experientia, 27(1), 108–109. https://doi.org/10.1007/BF02137731 Wankhede, S., Langade, D., Joshi, K., et al. (2015). Examining the effect of Withania somnifera supplementation on muscle strength and recovery: A randomized controlled trial. Journal of the International Society of Sports Nutrition, 12, 43. https://doi.org/10.1186/s12970-015-0104-9
Dr. Spencer Nadolsky and Karl bring on Dr. Austin Baraki and Dr. Jordan Feigenbaum from the Barbell Medicine crew for a conversation that cuts through one of the most hyped and least understood topics in the health and fitness space right now: the research peptides that millions of people are injecting into themselves based on anecdotes, social media marketing, and the logic that short chain amino acids are natural so they must be fine. In this episode they cover what peptides actually are from a basic biochemistry standpoint and why calling something a short chain amino acids does not make it a food or a supplement it makes it a drug with all the same questions around safety efficacy dosing and long-term effects that any other drug requires, why the explosion of GLP-1 popularity essentially normalized both injectable medications and the idea that if semaglutide works this well what else is out there leading directly to the current peptide boom, why BPC-157 has no randomized controlled trial data in humans and the three human trials that were started were all terminated early with results never published which is a red flag that would make people furious if it were a vaccine but barely registers in the peptide space, why TB-500 has wound healing data when applied topically but nothing when injected despite being universally marketed as a muscle and tendon healer, why MOTS-C has never been tested in humans at all and yet enormous numbers of people are currently injecting it, why the argument that big pharma would sell these if they worked is actually the correct argument and why most of these compounds were abandoned precisely because they failed in trials or showed harm signals, why biological plausibility is a dangerous standard to rely on given that suppressing arrhythmias seemed biologically obvious until the CAST trial showed it killed people and beta blockers for heart failure seemed obviously wrong until trials showed they were life saving, what a randomized controlled trial actually does that anecdote cannot and why thousands of positive experiences are not equivalent to controlled data, why a JAMA study on SARMs sold as research chemicals found that only 18 of 44 products actually contained what was on the label meaning people may not even be getting the compound they think they are getting, why the doctors on this podcast could have made millions of dollars branding and selling their own peptide lines and have specifically chosen not to, and what standard of evidence they believe should be the minimum before recommending any compound to another human being. The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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