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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.
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
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
C'est la journée du Reggae ! Musique née en Jamaïque et très à la mode dans les années 80 . Quels sont vos tubes reggae préférés ?
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"
Fontes do episódio aqui:https://portal.afya.com.br/podcasts/afya-news/29-06-2026Nesta segunda-feira, analisamos o crescimento acentuado na busca por suporte emocional na infância, uma nova solução clínica na medicina intensiva e diretrizes globais para a longevidade funcional. Abordamos os dados da Inglaterra que mostram que o volume de crianças encaminhadas para cuidados de saúde mental ultrapassou a marca de um milhão, impulsionado por alterações severas de humor e investigações neurodesenvolvimentais. Detalhamos o estudo publicado no JAMA comprovando que o uso de EDTA tetrassódico a 4% como solução de lock em UTIs preserva a perviedade de cateteres venosos centrais e diminui intervenções por obstrução. Por fim, trazemos no Radar o posicionamento da OMS sobre o papel de práticas corporais integrativas na prevenção de quedas em idosos. Afya News. Informação médica confiável e atualizada no seu tempo.
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
In this World Shared Practice Forum Podcast, first authors Drs. Frances Balamuth and Chanu Rhee describe the objectives and methodology for their study “National Estimates of Pediatric Sepsis in US Hospitals Using Clinical Data” published in the March 2026 edition of JAMA. They discuss the process of modifying the Phoenix Sepsis Criteria to an electronic health record-based Pediatric Sepsis Event (PSE) definition and the methods for validating this definition. The authors share salient findings from their study, noting the limitations, and share their hopes for the future direction of sepsis surveillance research. LEARNING OBJECTIVES - Understand the derivation for the Pediatric Sepsis Event definition for electronic health record-based pediatric sepsis surveillance - Review the validation process for the Pediatric Sepsis Event definition - Compare the Pediatric Sepsis Event definition to the Phoenix Sepsis Criteria - Discuss the results and limitations of the electronic health record-based study design - Express the goals for the future direction of pediatric sepsis surveillance research AUTHORS Frances Balamuth, MD, PhD, MSCE Professor of Pediatrics, Chief of Pediatric Emergency Medicine University of Pennsylvania Perelman School of Medicine Children's Hospital of Philadelphia Chanu Rhee, MD, MPH Associate Professor of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Traci Wolbrink, MD, MPH Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Associate Professor of Anesthesia Harvard Medical School DATE Initial publication date: June 23, 2026. ARTICLES REFERENCED Rhee C, Balamuth F, Dysart K, et al. National Estimates of Pediatric Sepsis in US Hospitals Using Clinical Data. JAMA. 2026;335(15):1321-1331. https://pubmed.ncbi.nlm.nih.gov/41865411/ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/swj4kvkgg686b6p9whmbht/20260622_WSP_Rhee_and_Balamuth_Transcript Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Balamuth F, Rhee C, O'Hara JE, Wolbrink TA. National Estimates of Pediatric Sepsis. 06/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/new-national-estimates-of.
High performers are exceptional at supporting others. They are often much less exceptional at being supported themselves. In this episode, Dr Jo Braid unpacks why professional isolation is so common in healthcare — and what to actually do about it. You'll hear: Why medical culture trains us to see help-seeking as weakness - The neuroscience of social connection and what chronic isolation does to your decision-making - The difference between a mentor, a coach, and a peer — and why you need all three - The three-column support audit tool - The debrief walk and why movement + connection is a different thing to either alone Research referenced: - Dr Matthew Lieberman (UCLA) — the social brain and reward pathways - Dr Amy Edmondson (Harvard) — psychological safety and team performance - JAMA research — one trusted person and burnout outcomes in physicians Action step this week: Do the support audit. Three columns: Mentor / Coach / Peer. Five minutes. Honest answers. Pick the most depleted column and identify one name. This podcast is supported by MIGA: www.miga.com.au Connect with Jo:
durée : 00:02:32 - Debout la Terre - Les 1000 km de côtes jamaïcaines et les fonds marins appartiennent à l'État, héritage du colonialisme britannique, qui les cède à des promoteurs immobiliers. Mais des citoyens se mobilisent contre ce qu'ils qualifient "d'accaparement capitaliste" et de "tourisme de plantation". Vous aimez ce podcast ? Pour écouter tous les épisodes sans limite, rendez-vous sur Radio France
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.
Johnny Mac shares five good news stories: the USPS is reissuing the 2018 Mister Rogers Neighborhood stamp after it won an encore contest by over 40,000 votes, returning as a Forever stamp with souvenir sheets. In San Francisco Bay, an AI detection system called Whale Spotter uses thermal cameras to spot whales day and night and alert ships to slow down, addressing a rise in gray whale deaths, many from ship strikes. A JAMA study reports tofersen (Qalsody) slowed and sometimes reversed symptoms in a specific form of ALS, with over 20% showing improved strength and function after three years, including a patient who moved from wheelchair use to a cane. In Texas, volunteers set a world record by stacking 19,019 golf balls into a pyramid without adhesives. In Wisconsin, a driver ignored road-closed barricades and drove into wet concrete, prompting a safety reminder.00:00 Five Good News Intro00:10 Mister Rogers Stamp Returns01:28 Whale Spotter Saves Whales02:32 ALS Drug Breakthrough03:56 Golf Ball Pyramid Record04:25 Driver Sinks in Concrete 5 Good News Stories is a daily podcast with five positive, uplifting news stories to brighten your day. New episodes every day. Follow on Apple Podcasts, Spotify, or wherever you listen. Part of the Caloroga Shark Media networkJohn also hosts Daily Comedy NewsUnlock an ad-free podcast experience with Caloroga Shark Media! For Apple users, hit the banner which says Uninterrupted Listening on your Apple podcasts app. Subscribe now for exclusive shows like 'Palace Intrigue,' and get bonus content from Deep Crown (our exclusive Palace Insider!) Or get 'Daily Comedy News,' and '5 Good News Stories' with no commercials! Plans start at $4.99 per month, or save 20% with a yearly plan at $49.99. Join today and help support the show!Get more info from Caloroga Shark Media and if you have any comments, suggestions, or just want to get in touch our email is info@caloroga.com
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. 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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. 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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
In this episode of Keeping Abreast, Dr. Jenn Simmons responds to Peter Attia's breast cancer screening episode (#396). Attia asks the right question: why are 42,000 women still dying of breast cancer every year? But his answer, more mammograms and MRI on top, is exactly wrong. Dr. Jenn breaks down, study by study, why that 40-year approach has never moved the death toll.Forty-two thousand women a year. That number has not moved since mammography went mainstream in the 1980s. Detection rates are up, diagnoses are up, and the death toll has not changed. We have been finding more cancer, calling more women patients, and watching the same number of them die. If you have ever scheduled your annual mammogram believing it was the most protective thing you could do, this episode will reframe everything you thought you knew.What You'll LearnWhy the breast cancer death toll has not moved in 40 years, and why more screening is the reasonWhy DCIS is not cancer, why mammography invented it, and what happens to a woman the moment it gets labeled "stage zero"Why an aggressive tumor is aggressive from the day it forms, and why finding it earlier on a mammogram does not change what it does nextWhy mammography catches the cancers least likely to kill you, and routinely misses the ones that willWhat happened when researchers followed 89,835 women for 25 years and compared annual mammography to doing nothing, and why you have never heard about itWhat the Cochrane review found after analyzing every randomized mammography trial ever run, and why Peter Attia addressed it in one sentenceWhy the WISDOM trial, the most significant recent evidence in this space and the one study Attia never mentions, is an indictment of everything he arguedWhy there is no standard radiation dose for a mammogram, and why the woman next to you in the waiting room may have received ten times less than you didWhat the FDA has formally documented about gadolinium staying in the brain and bones for years, and why the women being told to get it every six months are the last women who shouldWhy insulin resistance, chronic inflammation, and toxic burden are among the most powerful drivers of breast cancer risk, and why Attia's episode contained zero mention of any of themResources MentionedPeter Attia, Episode 396 on breast cancer screening: peterattiamd.com/breastcancerscreeningDr. Robin Berzin, founder of Parsley HealthMiller AB, et al. Twenty five year follow-up of the Canadian National Breast Screening Study. BMJ. 2014;348:g366.Gøtzsche PC, Jørgensen KJ. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013;(6):CD001877.Zahl PH, et al. Results of the Two-County trial are not compatible with official Swedish breast cancer statistics. Danish Medical Bulletin. 2006;53(4):438–440.Nyström L, et al. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet. 2002;359:909–19.Esserman LJ, et al. Risk-Based vs Annual Breast Cancer Screening: The WISDOM Randomized Clinical Trial. JAMA. 2026;335(9):763–774.FDA gadolinium-based contrast agent safety communications (2015, 2017, 2018), summarized in Fotenos A, FDA Pediatric Advisory Committee, Sept 2018.Kanda T, et al. High signal intensity in the dentate nucleus and globus pallidus and cumulative gadolinium dose. Radiology. 2014;270(3):834–841.Veenhuizen SGA, et al. Supplemental breast MRI for women with extremely dense breasts: DENSE trial. Radiology. 2021;299(2):278–286.Tabar L, et al. Reduction in mortality from breast cancer after mass screening with mammography. Lancet. 1985;325:829–32.To talk to a member of Dr. Jenn's team and learn more about working privately with Dr. Jenn visit: https://calendly.com/stephanie-1031/clarity-callTo get your copy of Dr. Jenn's book, The Smart Woman's Guide to Breast Cancer, visit: https://tinyurl.com/SmartWomansBreastCancerGuideTo purchase the auria breast cancer screening test go here https://auria.care/ and use the code DRJENN20 for 20% Off.Connect with Dr. Jenn:Website: https://www.jennsimmonsmd.com/Facebook: https://www.facebook.com/DrJennSimmonsInstagram: https://www.instagram.com/drjennsimmons/YouTube: https://www.youtube.com/@dr.jennsimmons
At Euroanaesthesia in Rotterdam, TopMedTalk hosts Andy Cumpsty and Kate Leslie speak with Denise Veelo Professor of Anesthesiology at the Amsterdam University Medical Center and Bernd Saugel Professor of Anesthesiology and Vice Chair of the Department of Anesthesiology in the Center of Anesthesiology and Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, about two JAMA blood-pressure trials published on the same day. Veelo describes a 3,500-patient, two-center randomized trial comparing usual care (MAP 65) with more intensive, risk-stratified higher MAP thresholds (70/80/90) using a functional recovery primary outcome, stopped early for futility. Saugel outlines the 1,300-patient IMPROVE trial in 15 German centers, individualizing the lower intervention threshold to each patient's preoperative nighttime MAP versus routine MAP 65, with a 7-day composite outcome; no significant difference was found and event rates were ~30%. They conclude routine targeting substantially above MAP 65 is not supported for broad populations, note special circumstances may differ, and they discuss limitations, vasopressor-heavy practice, and future research including the ASPIRE 85 delirium-focused trial and work on autoregulation and physiology. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org
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 13-18, 2026.
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.
Today we have another Pulm PEEPs Pearls episode about a core critical care topic. Furf and Monty will be giving a high level overview of the use of steroids in sepsis including a review of the relevant literature and recent guidelines, and pragmatic bedside points. Contributors This episode was prepared with research by Pulm PEEPs Associate Editor George Doumat. Dustin Latimer, another Pulm PEEPs Associate Editor, assisted with audio and video editing. Key Learning Points Why Steroids in Sepsis? Steroids do not treat the infection — antimicrobials are always first and remain the cornerstone. The goal is addressing critical illness–related corticosteroid insufficiency (CIRCI), where cortisol production cannot keep up with the overwhelming inflammatory demand of septic shock. Hydrocortisone helps in two main ways: Blunts the dysregulated inflammatory response — tempers the excessive vasodilation and febrile response that drive harm beyond the infection itself. Restores vascular sensitivity to catecholamines — sepsis downregulates adrenergic receptors; steroids turn that responsiveness back on. Clinical takeaway: The first thing you notice is vasopressor weaning (or a bend in the escalation curve) — not a rapid improvement in fever or white count. Caveat: These trials predate modern sepsis phenotyping. None distinguish hyperinflammatory vs. hypoinflammatory responders — they treat all comers. The Evidence: Four Landmark Trials Every IM resident and critical care fellow will eventually journal-club these four. The most consistent signal across all of them is faster shock reversal and reduced vasopressor use; the mortality question remains unsettled. Trial (Year)NRegimenKey FindingAnnane (2002)~300Hydrocortisone + fludrocortisoneMortality benefit in ACTH non-responders; criticized methodology and messy cortisol-response testing; not cleanly replicated.CORTICUS (2008)~500Hydrocortisone aloneFaster shock reversal but no mortality benefit, regardless of cortisol responsiveness. Raised (later allayed) superinfection concern. Cornerstone for abandoning routine cort-stim testing.ADRENAL (2018)~3,800Hydrocortisone aloneFaster vasopressor weaning; no 90-day mortality benefit.APROCCHSS (2018)~1,200Hydrocortisone + fludrocortisoneMortality benefit at 90 days. Bottom line: Faster shock reversal is consistent. Mortality benefit appears in 2 of 4 trials (both used fludrocortisone) but not the others. A 2026 meta-analysis showed benefit for hydrocortisone + fludrocortisone vs. placebo, but not for hydrocortisone + fludrocortisone vs. hydrocortisone alone — suggesting hydrocortisone drives the main effect. Who Gets Steroids, and When? 2021 Surviving Sepsis: Consider steroids for norepinephrine or epinephrine ≥ 0.25 mcg/kg/min for ≥ 4 hours despite adequate resuscitation — a reasonable bedside trigger. Early 2026 update: Moved away from a specific numeric trigger — consider steroids when a septic patient is not responding well to vasopressors or has escalating requirements. Make a clinical decision. (Quality of evidence: low to moderate.) Go faster than the threshold when: Known/suspected adrenal insufficiency or home steroids, or florid pressor-requiring shock on arrival. A practical escalation sequence: escalating norepinephrine → add vasopressin (per VASST) → then add steroids if requirements keep climbing. Do NOT wait for an ACTH stimulation test. It does not reliably predict who responds and only delays treatment. Sepsis is an elevated-cortisol state but can dissociate ACTH and cortisol, and cortisol-binding globulin is depleted — the test is too messy to guide care. What to Give: The Regimen Standard dose: Hydrocortisone 200 mg/day, typically 50 mg IV Q6H. (Original trials often used continuous infusions, rarely used in the U.S.) Some start with a 100 mg bolus to gain control. Higher dose: If chronically on steroids / adrenally insufficient, consider ~300 mg/day (e.g., 100 mg Q8H). Fludrocortisone: Unsettled. The two mortality-benefit trials added it (50 mcg PO/NG/OG daily), but hydrocortisone already has mineralocorticoid activity and meta-analyses don't show added benefit over hydrocortisone alone. Most clinicians omit it — adding it is reasonable and safe, just be honest about the uncertainty. Duration & Tapering Typical course: ~7 days is most common. Trial practices varied (ADRENAL ~7 days; VANISH used a taper after 6 days; some continue until pressors are off). No taper needed. You do not need to taper for adrenal insufficiency after a short course — just stop. If pressors dramatically rebound, you can restart, but most patients have gained the benefit they'll get by day 7. Pitfalls & Safety Hyperglycemia: Expected and must be managed (monitor closely; insulin drip if needed). No signal for major DKA / severe complications in the trials. Superinfection / fungal infection: The most-quoted concern, but the overall literature does not show a convincing, statistically significant increase. Be disciplined about stopping on schedule. Muscle weakness: Steroids can worsen critical illness myopathy; a short 7-day course likely has limited effect, but be aware. Other: GI bleeding (follow general PPI prophylaxis guidance) and sodium disturbances (watch for hyper-/hyponatremia). Two things we know: (1) steroids shorten duration of vasopressor support, and (2) they are relatively safe in sepsis. Whether they improve mortality — and in whom — remains open. The Five Pulm PEEPs Pearls Mechanism: Steroids restore catecholamine vascular sensitivity and blunt dysregulated inflammation. The clinical target is vasopressor weaning, not infection treatment. Evidence: Faster shock reversal is the most consistent finding. Mortality benefit is seen in 2 of 4 trials but not the others — still controversial. Some patients likely benefit; we don't yet know who. Trigger: A practical 2021 threshold is levo/epi ≥ 0.25 mcg/kg/min for ≥ 4 hours. Newer guidance drops the strict number — make a clinical decision based on poor pressor response or escalation. Dose: Hydrocortisone 200 mg/day (e.g., 50 mg Q6H). Adding fludrocortisone mirrors two trials, but meta-analyses find no benefit over hydrocortisone alone. Safety: Steroids appear safe in sepsis. Monitor and treat hyperglycemia; no marked increase in superinfection. References and Further Reading Annane, Djillali et al. “Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock.” JAMA vol. 288,7 (2002): 862-71. doi:10.1001/jama.288.7.862 Sprung, Charles L et al. “Hydrocortisone therapy for patients with septic shock.” The New England journal of medicine vol. 358,2 (2008): 111-24. doi:10.1056/NEJMoa071366 Venkatesh, Balasubramanian et al. “Adjunctive Glucocorticoid Therapy in Patients with Septic Shock.” The New England journal of medicine vol. 378,9 (2018): 797-808. doi:10.1056/NEJMoa1705835 Annane, Djillali et al. “Hydrocortisone plus Fludrocortisone for Adults with Septic Shock.” The New England journal of medicine vol. 378,9 (2018): 809-818. doi:10.1056/NEJMoa1705716 Sun, Alin et al. “Correction: Hydrocortisone combined with fludrocortisone for treatment of adults with septic shock: an updated meta-analysis and systematic review.” Frontiers in medicine vol. 13 1811616. 2 Mar. 2026, doi:10.3389/fmed.2026.1811616 Prescott, Hallie C et al. “Executive Summary: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026.” Critical care medicine vol. 54,4 (2026): 715-724. doi:10.1097/CCM.0000000000007089
Are you a dermatologist curious about clinical research — or a seasoned trialist looking to reignite your passion? In this episode of the Science of Skin Podcast, Dr. Ted Lane (Austin, TX) sits down with Dr. Jason Hawkes, Chief Scientific Officer at Oregon Medical Research Center, to pull back the curtain on what it really means to build a career in dermatology clinical trials. From navigating the growing complexity of modern trial protocols to reframing the pharma-physician relationship, Ted and Jason share candid insights that only experienced clinical trialists can offer. They discuss how running trials makes you a sharper diagnostician, why medical dermatology remains one of the most rewarding specialties, and how industry partnerships open unexpected academic and commercial doors. You'll also hear their honest takes on mentorship — including the must-read JAMA article Mentorship Malpractice — and why thinking of your career as a lattice, not a ladder may be the most liberating shift you can make. Whether you're five years into practice or just starting out, this episode is packed with hard-won wisdom on building a meaningful, intellectually stimulating career in dermatology.
Patient safety is often associated with what happens inside the exam room, operating room, or hospital bedside. But what if one of the greatest threats to patient safety occurs long before a patient ever receives care?In this thought-provoking episode of All-Access Pass, Elizabeth Woodcock sits down with Dr. Victor Hassid, Associate Vice President of Access Services and Professor of Plastic Surgery at UT MD Anderson Cancer Center, to discuss his groundbreaking JAMA article, Patient Safety Begins with Access. Together, they explore the powerful argument that delays, barriers, and failures in patient access should be viewed not simply as operational challenges, but as patient safety events. Dr. Hassid shares how fragmented referral processes, scheduling barriers, authorization delays, and care coordination failures can directly impact diagnosis, treatment, and patient outcomes. The conversation also examines the concepts of visibility, accountability, high reliability organizations, and the critical role of data in identifying and preventing access-related harm.Tune in to hear discussions on patient safety, access-related harm, high reliability principles, referral and scheduling barriers, access performance metrics, patient advocacy, health equity, and the future of treating access as a core component of quality and safety in healthcare.
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, Linda Brubaker, MD, Deputy Editor, and Christopher W. Seymour, MD, MSc, Associate Editor of JAMA, the Journal of the American Medical Association, for articles published from June 6-12, 2026. Related Content: Audio Highlights
Interview with Amal Isaiah, MD, PhD, MBA, author of Deep Learning in Otolaryngology: A Narrative Review, and Matthew A. Shew, MD, MSCI, author of Shifting the AI Questions in Otolaryngology From “Can We Build a Model?” to “Will It Improve Patient Care?” Hosted by Paul C. Bryson, MD, MBA. Related Content: Deep Learning in Otolaryngology Shifting the AI Questions in Otolaryngology From “Can We Build a Model?” to “Will It Improve Patient Care?”
Interview with Joachim Hübner, MD, SJD, and Alexander Katalinic, MD, authors of Population Skin Cancer Screening and Melanoma Mortality Rates. Hosted by Adewole S. Adamson, MD, MPP. Related Content: Population Skin Cancer Screening and Melanoma Mortality Rates
A University of Kentucky epidemiologist convinced 678 Catholic nuns to donate their brains and their entire life records to science, and the autopsies he performed quietly rewrote everything modern medicine thought it knew about Alzheimer’s disease. The findings have been published in JAMA and the New England Journal of Medicine. Almost nobody outside the field… Continue reading The Power of Gratitude
Cyanotic congenital heart diseases occur in approximately 0.2% of live births in the US, but survival to adulthood is common with current surgical interventions. JAMA Associate Editor David Simel, MD, MHS, speaks with author Michael Landzberg, MD, who coauthored a recent review in JAMA on this topic. Related Content: Survivors of Cyanotic Congenital Heart Disease
Group A Streptococcal infections remain a global challenge, spanning common conditions like pharyngitis to severe invasive disease. Dr. Shiranee Sriskandan, Dr. Josh Osowicki, and Dr. Tom Parks join host Dr. Erin McCreary to explore the evolving landscape of Group A Strep. From unpacking vaccine development challenges and the ongoing burden of rheumatic fever, to rethinking durations of therapy for strep throat and the role of adjunctive treatments, we have you covered! Join us as we break down key controversies, share expert insights, and highlight practical pearls you can apply in your own practice. References: 1. https://www.lancefieldsociety.org/ 2. Osowicki J, Lamagni TL. Invasive Group A Streptococcal Disease in the US. JAMA. 2025;333(17):1493-1494. doi:10.1001/jama.2025.3257 3. Davis K, Abo YN, Steer AC, Osowicki J. Chains of misery: surging invasive group A streptococcal disease. Curr Opin Infect Dis. 2024;37(6):485-493. doi:10.1097/QCO.0000000000001064 4. Osowicki J, Azzopardi KI, Fabri L, et al. A controlled human infection model of Streptococcus pyogenes pharyngitis (CHIVAS-M75): an observational, dose-finding study. Lancet Microbe. 2021;2(7):e291-e299. doi:10.1016/S2666-5247(20)30240-8 5. Hla TK, Osowicki J, Marsh JA, et al. Establishing the lowest penicillin concentration to prevent pharyngitis due to Streptococcus pyogenes using a human challenge model (CHIPS): a randomised, double-blind, placebo-controlled trial. Lancet Microbe. 2025;6(5):101038. doi:10.1016/j.lanmic.2024.101038 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/
Send us a Text Message (please include your email so we can respond!)Episode 93! In this episode we go over TOWAR or "Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage" by Sperry et all published in NEJM and "Remote Multicomponent Rehabilitation in Intensive Care Unit Survivors" published by O'Neill et al in JAMA both in May 2026 and presented at the ATS International Conference! Then we talk a little bit about some current events with Hantavirus and sepsis that has hit the news cyclesTOWAR (NEJM): https://www.nejm.org/doi/full/10.1056/NEJMoa2602167iRehab (JAMA): https://jamanetwork.com/journals/jama/fullarticle/2849320If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
Send us Fan MailOpioid withdrawal dosing, intranasal breast milk, human milk fortification in Japan, neonatal dysphagia, and vaccine policy. A full week on the Incubator Journal Club.Ben opens with the Optimized NOW trial in JAMA: symptom-based dosing reduced time to medical readiness for discharge by nearly two and a half days in NOWS infants managed with Eat Sleep Console, and allowed 65% of pharmacologically treated infants to avoid scheduled opioids entirely.Daphna reviews a small RCT out of Turkey showing improved cerebral oxygenation and favorable vital sign trends after intranasal breast milk administration in preterm infants, adding to the growing tolerability data for this intervention.Ben then covers the JASMINE trial, a Phase 3 RCT in Japan showing significantly better weight gain velocity with an exclusive human milk diet in very low birth weight infants.Daphna closes with a retrospective cohort study on FEES-confirmed dysphagia in preterm infants. Of those who met criteria for evaluation, every single one had laryngeal penetration and 57% were aspirating.Ben and Eli close the week on the quiet dismantling of vaccine infrastructure in the US and what it means for the populations in your NICU.Support 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!
Zamzam Jama, for that is indeed her name, has been convicted in connection with the "Feeding Our Future" scheme. Visit the Howie Carr Radio Network website to access columns, podcasts, and other exclusive content.
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