Podcasts about Mayo Clinic

Dr Pat Murphy on his holistic approach to addiction treatment. James P. Murphy, MD, DFASAM is founder and CEO of Murphy Pain Center. He serves gratis as an Assistant Clinical Professor at the University of Louisville School of Medicine. He has earned a Master of Medical Management from the University of Southern California's Marshall School of Business. He has board certifications in Pain Medicine, Addiction Medicine, and Anesthesiology. His Pain Management fellowship was at Rochester, Minnesota's Mayo Clinic, where he also served on the faculty of the Mayo Medical School.

Published August 14, 2025 In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, and William Morice II, M.D., Ph.D., CEO and president of Mayo Clinic Laboratories, discuss recent news about the use of artificial intelligence (AI) tools in healthcare. Together, they explore:Applications of AI tools in clinical diagnostics to identify dementia, cardiovascular conditions, and parasites.Ethical considerations, including global disparities in access to AI tools and environmental impacts.ResourcesUse of artificial intelligence and digital slide scanning for detection of intestinal protozoa in trichrome-stained stool specimensMayo Clinic's AI tool identifies 9 dementia types, including Alzheimer's, with one scanAI computing power is splitting the world into haves and have-nots - The New York Times

Over 40 million Americans have been diagnosed with bipolar disorder, and many more go undiagnosed. This episode takes a deep dive into what we know (and don't know) about bipolar I and II, why science has lagged behind, and what a groundbreaking new initiative—BD²: Breakthrough Discoveries for Thriving with Bipolar Disorder—is doing to change that. Host Morra Aarons-Mele speaks with Dr. Mark Frye, psychiatrist and professor of psychiatry at Mayo Clinic in Rochester, Minnesota, Dr. Kate Burdick, Distinguished Chair in Psychiatry and the Vice Chair for Research in Psychiatry at Brigham and Women's Hospital in Boston, MA, and neuroscientist and BD² initiative lead Dr. Cara Altimus about the genetics, biology, and lived experience of bipolar disorder, and what it means to truly thrive with a complex mental illness. We discuss promising research directions, including GLP-1s, cognitive trajectories, and precision psychiatry. Key Quote: " It's not enough to reduce the bad. We're aiming to increase the good—to help people with bipolar disorder live the full lives they want to live." — Dr. Cara Altimus Breakthrough Discoveries for Thriving with Bipolar Disorder (BD²) is a collaborative initiative building the scientific foundation for better treatments and better lives for people with bipolar disorder. Learn more and get involved at https://www.bipolardiscoveries.org/. Listeners who live with bipolar disorder can learn more about BD2' and their ongoing study described in this episode by visiting bipolardiscoveries.org or sending an email to info@bipolardiscoveries.org.    The study is taking place in partnership with 11 medical institutions across 44 locations in the U.S. and Canada. The medical institutions are: Mass General Brigham (Massachusetts) McLean Hospital (Massachusetts) Johns Hopkins University (Maryland) Mayo Clinic (Minnesota and Arizona) University of California Los Angeles (California) University of California San Diego (California) University of Michigan (Michigan) The University of Texas Health Science Center at Houston (Texas) The Feinstein Institutes for Medical Research (New York) The University of Texas at Austin (Texas) University of Cincinnati/Lindner Center of HOPE (Ohio) Ottawa Hospital Research Institute (Canada)   Listeners can also sign up for the BD2' newsletter, Thrive Updates, at bipolardiscoveries.org and learn more by following on LinkedIn, BlueSky, and X at BD2Discoveries.  Timestamps: 05:31 Understanding Bipolar Disorder: Definitions and Types 14:48 The Role of Genetics in Bipolar Disorder 20:57 Research Funding and Its Impact on Bipolar Disorder 26:51 Stigma Surrounding Bipolar Disorder and Its Effects 32:07 Breaking the Stigma of Mental Illness 36:51 Thriving with Bipolar Disorder 42:12 The Integrated Network: A New Approach to Bipolar Research 47:39 Shifting Perspective From Symptom Reduction to Thriving 53:46 Understanding the Complexities of Bipolar Disorder

Longevity is exploding in popularity. On my recent trip to LA it's very apparent that bio hacking has morphed into a genuine branch of medicine that legitimate medical researchers and doctors are practicing. One of those people at the forefront is Dr Darshan Shah, a board certified surgeon who has performed over 20,000 surgical operations, including trauma and complex reconstructive procedures. As a Longevity Medicine specialist, he has advised thousands of patients on how to optimize their well-being and extend their healthspan and lifespan.Dr. Shah earned his medical degree at the age of 21, becoming one of the youngest doctors in the United States. He continued his training at the Mayo Clinic, has authored numerous papers and patented medical devices. Dr. Shah's belief in continual education and self-improvement has earned him alumni status at Harvard Business School, Singularity University, and other prestigious institutions.Today I sat down with Darshan at one of his Next Health Clinic branches in West Hollywood to discuss the 4 pillars of longevity, which are …Lifestyle Medicine - diet, sleep and exerciseFunctional Medicine - detoxification, emotional health, hormones, inflammationPreventative Medicine - screening for heart health, brain health and cancerLongevity medicine - peptides, supplements, IVs and more

Frontotemporal lobar degeneration (FTLD) is one of the most common causes of dementia in individuals under the age of 60, yet it remains lesser known and often misunderstood. From the early symptoms to the challenges of diagnosis and treatment, FTLD presents unique hurdles for clinicians, researchers and families alike. Joining the podcast to discuss this complex disease is Dr. Brad Boeve, principal investigator of the ALLFTD study, a major national research effort aimed at identifying biomarkers and clinical tools to improve early detection of FTLD and prepare for future treatment trials.  Guest: Brad Boeve, MD, neurologist, Department of Neurology and Center for Sleep Medicine, professor of neurology, Division of Behavioral Neurology, Mayo Clinic, co-director, Mayo Clinic Alzheimer's Disease Research Center, principal investigator, ARTFL-LEFFTDS Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) research study Show Notes Are you a clinician interested in receiving continuing education (CE) credits for listening to this episode? Find credit designation information, disclosures and evaluation information on our website and on the UW–Madison Interprofessional Continuing Education Partnership (ICEP) website. The accreditation for this course expires 8/12/2026. After this date, you will no longer be able to access the course or claim credit. Learn more about Dr. Boeve and his research at his profile on the Mayo Clinic website.  Listen to our episode with Dr. Wolk, “LATE, Explained,” mentioned by Dr. Chin at 10:12 on our website. Visit the Association for Frontotemporal Degeneration (AFTD) website, mentioned by Dr. Boeve at 21:59. Visit the CurePSP website mentioned by Dr. Boeve at 22:21. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Essential tremor is the most common movement disorder, although it is often misdiagnosed. A careful history and clinical examination for other neurologic findings, such as bradykinesia, dystonia, or evidence of peripheral neuropathy, can reveal potential alternative etiologies. Knowledge about epidemiology and associated health outcomes is important for counseling and monitoring for physical impairment and disability. In this episode, Lyell Jones, MD, FAAN, speaks with Ludy C. Shih, MD, MMSc, FAAN, author of the article “Essential Tremor” in the Continuum® August 2025 Movement Disorders issue. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Shih is clinical director of the Parkinson's Disease and Movement Disorders Center at Beth Israel Deaconess Medical Center in Boston, Massachusetts. Additional Resources Read the article: Essential Tremor Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Guest: @ludyshihmd Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr Ludy Shih, who recently authored an article on essential tremor for our latest issue of Continuum on movement disorders. Dr Shih is an associate professor of neurology at Harvard Medical School and the clinical director of the Parkinson's Disease and Movement Disorder Center at Beth Israel Deaconess Medical Center in Boston. Dr Shih, welcome, and thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Shih: Thank you, Dr Jones, for having me. It's a real pleasure to be here on the podcast with you. I'm a neurologist, I trained in movement disorders fellowship, and I currently see patients and conduct clinical research. We offer a variety of treatments and diagnostic tests for our patients with movement disorders. And I have developed this interest, a clinical research interest in essential tremor. Dr Jones: And so, as an expert in essential tremor, the perfect person to write such a really spectacular article. And I can't wait for our listeners to hear more about it and our subscribers to read it. And let's get right to it. If you had, Dr Shih, a single most important message for our listeners about caring for patients with essential tremor, what would that message be? Dr Shih: Yeah, I think the takeaway that I've learned over the years is that people with essential tremor do develop quite a few other symptoms. And although we propose that essential tremor is this pure tremor disorder, they can experience a lot of different comorbidities. Now, there is some debate as to whether that is expected for essential tremor or is this some part of another syndrome, which we may talk about later in the interview. But the fact of the matter is, it's not a benign condition and people do experience some disability from it. Dr Jones: And I think that speaks to how the name of this disorder has evolved over time. right? You point out in your article, it used to be called benign essential tremor or benign familial tremor. But it's really not so straightforward as it. And fairly frequently these symptoms, the patient's tremor, can be functionally limiting, correct? Dr Shih: That is correct. In fact, the reason I probably started getting interested in essential tremor was because our center had been doing a lot of deep brain stimulation for essential tremor, which is remarkably effective, especially for tremor that reaches an amplitude that really no oral medication is going to satisfyingly treat. And if you have enough upper limb disability from this very large-amplitude tremor, a surgical option may make a lot of sense for a lot of patients. And yet, how did they get to that point? Do they continue to progress? These were the sort of interesting questions that got raised in my mind as I started to treat these folks. Dr Jones: We'll come back to treatment in just a minute here, because there are many options, and it sounds like the options are expanding. To start with the diagnosis- I mean, this is an extraordinarily common disorder. As you point out, it is the most common movement disorder in the US and maybe the world, and yet it seems to be underrecognized and frequently misdiagnosed. Why do you think that is? Dr Shih: Great question. It's been pretty consistent, with several case series over the decades showing a fairly high rate of quote/unquote “misdiagnosis.” And I think it speaks to two things, probably. One is that once someone sees a postural and kinetic tremor of the arms, immediately they think of essential tremor because it is quite common. But there's a whole host of things that it could actually be. And the biggest one that we also have to factor in is also the heterogeneity of the presentation of Parkinson's disease. Many people, and I think increasingly now these days, can present with not a whole lot of the other symptoms, but may present with an atypical tremor. And it becomes actually a little hard to sort out, well, do they have enough of these other symptoms for me to suspect Parkinson's, or is the nature of their tremor suspicious enough that it would just be so unusual that this stays essential tremor and doesn't eventually develop into Parkinson's disease? And I think those are the questions that we all still grapple with from time to time in some of our clinics. Dr Jones: Probably some other things related to it with, you know, our understanding of the pathophysiology and the availability of tests. And I do want to come back to those questions here in just a minute, but, you know, just the nomenclature of this disorder… I think our clinical listeners are familiar with our tendency in medicine to use words like essential or idiopathic to describe disorders or phenomena where we don't understand the precise underlying mechanism. When I'm working with our trainees, I call these “job-security terms” because it sounds less humbling than “you have a tremor and we don't know what causes it,” right? So, your article does a really nice job outlining the absence of a clear monogenic or Mendelian mechanism for essential tremor. Do you think we'll ever have a eureka moment in neurology for this disorder and maybe give it a different name? Dr Shih: It's a great question. I think as we're learning with a lot of our neurologic diseases---and including, I would even say, Parkinson's disease, to which ET gets compared to a lot---there's already now so much more known complexity to something that has a very specific idea and concept in people's minds. So, I tend to think we'll still be in an area where we'll have a lot of different causes of tremor, but I'm hopeful that we'll uncover some new mechanisms for which treating or addressing that mechanism would take care of the tremor in a way that we haven't been able to make as much progress on in the last few decades as maybe we would have thought given all the advances in in technology. Dr Jones: That's very helpful, and we'll be hopeful for that series of discoveries that lead us to that point. I think many of our listeners will be familiar with the utility---and, I think, even for most insurance companies, approval---for DAT scans to discriminate between essential tremor and Parkinsonian disorders. What about lab work? Are there any other disorders that you commonly screen for in patients who you suspect may have essential tremor? Dr Shih: Yeah, it's a great question. And I think, you know, I'm always mindful that what I'm seeing in my clinic may not always be representative of what's seen in the community or out in practice. I'll give an example. You know, most of the time when people come to the academic Medical Center, they're thinking, gosh, I've tried this or that. I've been on these medicines for the last ten years. But I've had essential tremor for twenty years. We get to benefit a little bit from all that history that's been laid down. And so, it's not as likely you're going to misdiagnose it. But once in a while, you'll get someone with tremor that just started a month ago or just started, you know, 2 or 3 months ago. And you have to still be thinking, well, I've got to get out of the specialist clinic mindset, and think, well, what else really could this be? And so, while it's true for everybody, moreso in those cases, in those recent onset cases, you really got to be looking for things like medications, electrolyte abnormalities, and new-onset thyroid disorder, for example, thyroid toxicosis. Dr Jones: Very helpful. And your article has a wonderful list of the conditions to consider, including the medications that might be used for those conditions that might result or unmask a tremor of a different cause. And I think being open-minded and not anchoring on essential tremor just because it's common, I think is a is a key point here. And another feature in your article that I really enjoyed was your step-by-step approach to tremor. What are those steps? Dr Shih: Well, I think you know first of all, tremor is such common terminology that even lay people, patients, nonclinicians will use the word “tremor.” And so, it can be tempting when the notes on your schedule says referred for tremor to sort of immediately jump to that. I think the first step is, is it tremor? And that's really something that the clinician first has to decide. And I think that's a really important step. A lot of things can look superficially like tremor, and you shouldn't even assume that another clinician knows what tremor looks like as opposed to, say, myoclonus. Or for example a tremor of the mouth; well, it actually could be orolingual or orobuccal dyskinesia, as in tardive dyskinesia. And another one that tremor can look like is ataxia. And so, I think- while they sound obvious to most neurologists, perhaps, I think that---especially in the area of myoclonus, where it can be quite repetitive, quite small amplitude in some conditions---it can really resemble a tremor. And so, there are examples of these where making that first decision of whether it's a tremor or not can really be a good sort of time-out to make sure you're going down the right path to begin with. And I think what's helpful is to think about some of the clinical definitions of a tremor. And tremor is really rhythmic, it's oscillatory. You should see an agonist and antagonist muscle group moving back and forth, to and fro. And then it's involuntary. And so, I think these descriptors can really help; and to help isolate, if you can describe it in your note, you can probably be more convinced that you're dealing with the tremor. The second step that I would encourage people to really consider: you've established it's a tremor. The most important part exam now becomes, really, the nontremor part of the exam. And it should be really comprehensive to think of what else could be accompanying this, because that's really how we make diagnosis of other things besides essential tremor. There really should be a minimum of evidence of parkinsonism, dystonia, neuropathy, ataxia- and the ataxia could be either from a peripheral or central nervous system etiology. Those are the big four or five things that, you know, I'm very keen to look for and will look pretty much in the head, neck, the axial sort of musculature, as well as the limbs. And I think this is very helpful in terms of identifying cases which turn out to have either, say, well, Parkinson's or even a typical Parkinson disorder; or even a genetic disorder, maybe even something like a fragile X tremor ataxia syndrome; or even a spinal cerebellar ataxia. These cases are rare, but I think if you uncover just enough ataxia, for example, that really shouldn't be there in a person, let's say, who's younger and also doesn't have a long history of tremor; you should be more suspicious that this is not essential tremor that you're dealing with. And then the last thing is, once you've identified the tremor and you're trying to establish, well, what should be done about the tremor, you really have to say what kind of tremor it is so that you can follow it, so you can convey to other people really what the disability is coming from the tremor and how severe the tremor is. So, I think an example of this is, often in the clinic, people will have their patients extend their arms and hands and kind of say, oh, it's an essential tremor, and that's kind of the end of the exam. But it doesn't give you the flavor. Sometimes you'll have a patient come in and have a fairly minimal postural tremor, but then you go out, take those extra few seconds to go grab a cup of water or two cups of water and have them pour or drink. And now all of a sudden you see this tremor is quite large-amplitude and very disabling. Now you have a better appreciation of what you really need to do for this patient, and it might not be present with just these very simple maneuvers that you have at bedside without props and items. And then the severity of it; you know, we're so used to saying mild, moderate, severe. I think what we've done in the Tremor Research Group to use and develop the Essential Tremor Rating Assessment Scale is to get people used to trying to estimate what size the tremor is. And you can do that by taking a ruler or developing a sense of what 1 centimeter, 2 centimeters, 3 centimeters looks like. I think it'd be tremendously helpful too, it's very easy and quick to convey severity in a given patient. Dr Jones: I appreciate you, you know, having a patient-centered approach to the- how this is affecting them and being quantitative in the assessment of the tremor. And that's a great segue to a key question that I run into and I think others run into, which is when to initiate therapy? You know, if you see a patient who, let's say they have a mild tremor or, you know, something that quantitatively is on the mild end of the spectrum, and you have, you know, a series of options… from a medication perspective, you have to say, well, when does this across that threshold of being more likely to benefit the patient than to harm the patient? How do you approach that question? What's your threshold for starting medication? Dr Shih: Yeah. You know, sometimes I will ask, because---and I know this sounds like a strange question---because I feel like my patients will come for a couple of different reasons. Sometimes it's usually one over the other. I think people can get concerned about a symptom of a tremor. So, I actually will ask them, was your goal to just get a sense for what this tremor is caused by? I understand that many people who develop tremor might be concerned it might be something like Parkinson's disease. Or is this also a tremor that is bothering you in day-to-day life? And often you will hear the former. No, I just wanted to get checked out and make sure you don't think it's Parkinson's. It doesn't bother me enough that I want to take medication. They're quite happy with that. And then the second scenario is more the, yeah, no, it bothers me and it's embarrassing. And that's a very common answer you may hear, may be embarrassing, people are noticing. It's funny in that many people with essential tremor don't come to see a doctor or even the neurologist for many years. And they will put up with it for a very long time. And they've adopted all sorts of compensatory strategies, and they've just been able to handle themselves very admirably with this, in some cases, very severe tremor. So, for some of them, it'll take a lot to come to the doctor, and then it becomes clear. They said, I think I'm at the point where I need to do something about this tremor. And so, I think those three buckets are often sort of where my patients fall into. And I think asking them directly will give you a sense of that. But you know, it can be a nice time to try some as-needed doses of something like Propranolol, or if it's something that you know that they're going to need something on day-to-day to get control of the tremor over time, there are other options for that as well. Dr Jones: Seems like a perfect scenario for shared decision-making. Is it bothersome enough to the patient to try the therapy? And I like that suggestion. That's a nice pearl that you could start with an a- needed beta blocker, right, with Propranolol. And this is a question that I think many of us struggle with as well. If you've followed a patient with essential tremor for some time and you've tried different medications and they've either lost effectiveness or have intolerable adverse effects, what is your threshold for referring a patient for at least considering a surgical neurostimulator therapy for their essential tremor? Dr Shih: Yeah, so surgical therapies for tremor have been around for a long time now, since 1997, which was when it was approved by the FDA for essential tremor and Parkinson tremor. And then obviously since then, we have a couple more options in the focus ultrasound thalamotomy, which is a lesioning technique. When you have been on several tremor medications, the list gets smaller and smaller. It- and then chance of likely satisfying benefit from some of these medications can be small and small as you pass through the first and second line agents and these would be the Propranolol and the primidone. And as you say, quite a few patients- it's estimated between 30 to 50% of these patients end up not tolerating these first two medications and end up discontinuing them. Some portion of that might also be due to the fact that some of our patients who have been living with essential tremor for decades now, to the point that their tremor is getting worse, are also getting older. And so, polypharmacy and/or some of the potential side effects of beta blockers and anticonvulsants like primidone may be harder to bear in an older adult. And then as you talk about in the article, there's some level of evidence for topiramate, and then from there a number of anticonvulsants or benzos, which have even weaker evidence for them. It's a personal decision. As I tell folks, look, this is not going to likely extend your life or save your life, but it's a quality of life issue. And of course, if there are other things going on in life that need to be taken care of and they need that kind of care and attention, then, you know, you don't need to be adding this to your plate. But if you are in the position where those other things are actually okay, but quality of life is really affected by your being unable to use your upper limbs in the way that you would like to… A lot of people's hobbies and applications are upper limb-based, and enjoying those things is really important. Then I think that this is something- a conversation that we begin and we begin by talking about yes, there are some risks involved, but fortunately this is the data we have on it, which is a fairly extensive experience in terms of this is the risk of, you know, surgery-related side effects. This is the risk of if you're having stimulation from DBS stimulation-related side effects, which can be adjustable. It's interesting, I was talking with colleagues, you know, after focused ultrasound thalamotomy was approved. That really led more people to come to the clinic and start having these discussions, because that seemed like a very the different sort of approach where hardware wasn't needed, but it was still a surgery. And so, it began that conversation again for a bunch of people to say, you know, what could I do? What could I tolerate? What would I accept in terms of risk and potential benefit? Dr Jones: Well, I think that's a great overview of a disorder where, you know, I think the neurologist's role is really indispensable. Right? I mean, you have to have this conversation not just once, this is a conversation that you have over time. And again, I really want to refer our listeners to this article. It's just a fantastic overview of a common disorder, but one where I think there are probably gaps where we can improve care. And Dr Shih, I want to thank you for joining us, and thank you for such a great discussion on essential tremor. I learned a lot from your article, and I learned even more from the interview today. I suspect our readers and listeners will too. Dr Shih: Well, thank you again for the invitation and the opportunity to kind of spread the word on this really common condition. Dr Jones: Again, we've been speaking with Dr Ludy Shih, author of a fantastic article on essential tremor in Continuum's latest issue on movement disorders. Please check it out, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Send us a textWhat happens when your body declares war on multiple organs? Julie Davis knows this reality all too well. Her medical journey began with a celiac disease diagnosis at 18, followed by ulcerative colitis in college, but it was the sudden onset of autoimmune pancreatitis in 2011 that turned her world upside down.Julie's story is remarkable not just for the rare combination of conditions she manages, but for the extraordinary resilience she's shown throughout her journey. As a dietitian who became a physician's assistant while battling debilitating pancreatitis flares, Julie brings unique perspective from both sides of healthcare. She takes us through the harrowing experience of multiple hospitalizations, specialists puzzling over her case at Mayo Clinic, and ultimately, the life-altering decision to have her pancreas completely removed in 2023.The procedure—called total pancreatectomy with islet cell autotransplantation—is so rare that Julie couldn't find a single podcast about it. Her pancreatic cells were extracted and transplanted into her liver, turning her into what she describes as "essentially a type 1 diabetic" overnight. Despite this dramatic medical intervention and the insulin pump she now relies on, Julie's perspective remains incredibly positive.Perhaps most inspiring is how Julie has refused to let her health conditions define her limitations. She completed PA school despite having an endoscopy and nerve block the same morning as important exams. She had three children through IVF while managing multiple autoimmune conditions. And today, she's passing on her hard-won wisdom to her daughter, who has inherited celiac disease.Julie's message to fellow chronic illness warriors rings clear: "It doesn't define you. You can still do things that you love." Her extraordinary journey demonstrates that even the most complex medical challenges can't stand in the way of a determined spirit pursuing a fulfilling career, family life, and future.Links: The Juicebox PodcastMission Cure: Nonprofit working in improve quality of life and bring more treatments to chronic pancreatitis Let's get social!!Follow us on Instagram!Follow us on Facebook!Follow us on Twitter!

This week's episode of Tomorrow's Cure takes you inside the PlatforMed Conference 2025. With over 250 global leaders from healthcare, government, academia, and business, the event explored how platform thinking is transforming the future of clinical care. Get the latest health information from Mayo Clinic's experts, subscribe to Mayo Clinic's newsletter for free today:  https://mayocl.in/3EcNPNc

THE CANCER CONUNDROM-STOP DYING & START LIVING -RESET Todays, Take Your Power Back Show with Peak Performance Master Coach Kim Yeater, embarks on an inspiring journey to ignite your God-given potential, empower your leadership, and elevate your voice. Joining us is a remarkable guest, Rick Hill, author of The Cancer Conundrum: Stop Dying and Start Living-RESET.  Diagnosed with aggressive embryonal cell carcinoma at just 23, Rick defied the odds after a grim prognosis at the Mayo Clinic. His journey took him from the health food stores of the 1970s to a transformative experience at a nutritional clinic in Tijuana, where he embraced alternative therapies and humor to beat cancer without chemo or radiation. A former stand-up comic and radio talk-show host, Rick's story is a testament to resilience and faith—proving that laughter and determination can light the way to healing. This show is more than a broadcast—it's a movement! Bold local action creates powerful national impact, and together, we're reclaiming our power. Today, we'll dive into Rick's inspiring journey, share tools for personal growth, health, and faith. Let's rise up and take our power back—stay tuned!"Get Your detox and healing resources today:  https://RncStore.com/KIMPatriotsMade.com/KimConnect with Us: •             Website: TakeYourPowerBackShow.com •             Rumble: rumble.com/c/TakeYourPowerBackShow •             Live Stream: rumble.com/TakeYourPowerBackShow/live •             Social Media: o            X: @realkimyeatero            Facebook: kimberlyyeater o            Instagram: Takeyourpowerback_kimyeater o            TikTok: takeyourpowerbackshow•             Email: TYPBProducer@gmail.comRelated Movement: TakeOurCaliforniaBack.com TakeOurElectionsBack.com Take Our Border Back •             Website: TakeOurBorderBack.com •             Rumble: rumble.com/c/TakeOurBorderBack •             Live Stream: rumble.com/TakeOurBorderBack/live •             Social Media: o            X: @Tobbconvoymaino            X: @Tobbconvoycaliforniao            X: @Tobbconvoyarizonao            X: @TobbconvoytexasMedia Inquiries: Contact TYPBProducer@gmail.com Send us a textSupport the show

In this groundbreaking episode, Dr. Gabrielle Lyon sits down with Dr. Tobias Kohler, a professor of urology at the Mayo Clinic, to discuss a topic most people are afraid to talk about: men's sexual health.Dr. Kohler shares eye-opening insights, backed by over two decades of clinical experience and research, on the powerful link between foundational health habits and male sexual function. They reveal why erectile dysfunction is a critical "check engine light" for heart disease and how building muscle and exercising can improve not just your erections, but your overall longevity.This conversation goes beyond simple fixes, providing actionable, science-based information that every man needs to hear.This episode is brought to you by: Puori - Get 20% off sitewide with code DRLYON → https://puori.com/DRLYON Cozy Earth - Use code DRLYON for up to 40% off - https://cozyearth.comBONCHARGE - Use code DRLYON for 15% off your entire order - https://boncharge.com/DRLYONOneSkin - Get 15% off with the code DRLYON – https://www.oneskin.coChapters0:00 - Link between muscle mass & erections0:52 - Erectile function1:13 - The truth about penis size & penile implants2:32 - The foundational pillars of men's health8:48 - Erectile dysfunction is an early sign of heart disease16:14 - The role of anxiety, alcohol & cannabis on ED24:29 - The "use-it-or-lose-it" organ29:31 - The truth about PDE5 inhibitors (Viagra & Cialis)46:46 - The "C"s of urinary frequency54:43 - The connection between muscle, testosterone & sexual function1:02:07 - Is there a point of no return for penile health?Erections: A “Check Engine Light” for Your HealthOne of the most striking points from the discussion was Dr. Kohler's perspective on erectile dysfunction (ED). He described it not just as a sexual problem, but as one of the earliest "check engine lights" for heart disease. The blood vessels leading to the penis are much smaller than those in the heart. As we age, plaque can build up in these vessels. This process, known as atherosclerosis, affects the smaller vessels first.This means if you're experiencing persistent issues with erections, it's a strong indicator that you may have vascular problems that could soon affect your heart. As Dr. Kohler put it, "If the penis is failing, you should assume you're going to have problems with your heart soon until proven otherwise." The good news is that anything good for your heart—like exercise and a healthy diet—is also good for your penis.The "Use-It-or-Lose-It" OrganThe conversation also tackled the surprising phenomenon of penile shortening. When the penis goes into a "garage" for an extended period—meaning there is a consistent lack of erections—it can lose length. Dr. Kohler shared that a consistent lack of erections for just three months can lead to a loss of 1-2 centimeters in length due to the formation of scar tissue. This is why he calls the penis a "use-it-or-lose-it" organ. The key to maintaining penile health is to exercise the penis through erections, and tools like a vacuum erection device can be used for penile rehabilitation.Muscle Mass, Testosterone, and Sexual FunctionFor many men, this is where the conversation gets personal. Dr. Kohler highlighted the direct correlation between muscle mass and erectile quality. Studies show that men with more muscle mass have better erections and higher testosterone levels. The reverse is also...

This episode was recorded at the 2025 Western Dairy Management Conference in Reno, Nevada.Stan begins with an overview of the dairy checkoff since its inception in 1983. At that time, dairy farmers were producing 139 billion pounds of milk, but only 122 million pounds were being consumed. Dairy promotion has evolved to focus on research and education about nutrition, crisis management and even partnerships with Domino's, Taco Bell and McDonald's. (3:02)Stan and Marty detail some of the national and regional partnerships around dairy menu options. Walt notes that the grilled cheese burrito from Taco Bell is one of his son's favorite fast food meals. The panel discusses some of the strategy behind the Taco Bell partnership as well as marketing to Gen Z consumers about how dairy fits into mind and body wellness. (6:39)Walt comments the checkoff has done and is continuing to do a great job of being future-ready. He remembers a few years ago hearing about the gaming generation and partnerships with Mr. Beast and YouTube and embedding cows in Minecraft, and now his sons are playing Minecraft and gaming and are on YouTube. (13:43)Stan notes in 1995, exports were at 3%. That has now increased to 16-17%. Marty gives some examples of partnerships with the Dallas Cowboys and HEB stores in Mexico to promote dairy. (16:09)The panel discusses the US investments in processing, the “Dairy Renaissance”, research into dairy-as-medicine, and continued product innovations to meet consumer demands. (23:24)Marty and Stan detail the agreement between the Dairy Checkoff and Mayo Clinic investigating the role of whole milk foods in treating and preventing cardiovascular and metabolic disease. (34:04)Panelists share their take-home thoughts. (37:51)You can find more information about the dairy checkoff at https://www.dairycheckoff.com/Please subscribe and share with your industry friends to invite more people to join us at the Real Science Exchange virtual pub table.  If you want one of our Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll mail you a shirt.

Host: Darryl S. Chutka, M.D. Guest: Stacy D. D'Andre, M.D. When we diagnose a patient with cancer, we typically focus on finding the most effective treatment for that malignancy: surgery, radiotherapy, chemotherapy, or immunotherapy. However, to a patient, the diagnosis of cancer means much more. Patients commonly experience fear and anxiety just from receiving the diagnosis. Other symptoms may include insomnia, depression, pain, and symptomatic effects from the treatment including nausea, loss of appetite and fatigue to name just a few. The Mayo Clinic Comprehensive Cancer Center has developed an integrative approach to help patients manage the variety of symptoms associated with malignancy. It centers around a multi-disciplinary team which assesses each patient individually and incorporates a variety of complementary treatments as well as physical and emotional support. It also includes nutrition and dietary supplement counseling and recommendations regarding exercise and movement. In this podcast, we'll learn more about this fascinating approach to treating patients with cancer as we discuss “Integrative Oncology” with my guest, Stacy D. D'Andre, M.D., from the Department of Oncology at the Mayo Clinic. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts Are you a medical professional, ready to ignite your passion and fuel your success? Join us October 23rd-25th in beautiful Pasadena, California or via livestream for GRIT, where innovation meets inspiration. GRIT in Medicine: Growth, Resilience, Inspiration & Tenacity 2025 will empower healthcare professionals with skills and resources to excel through productivity, personal development, and professional community. Leaders in business and healthcare will present evidence-based strategies and practical tips and tools to promote professional and personal well-being, and you'll leave encouraged and energized for excellence. Visit ce.mayo.edu/GRIT2025 by September 1st with the discount code GRIT2025 to save $100 on registration. See you soon for GRIT!

Anticoagulation with AF and Cancer   Guest: Nicholas Tan, M.D., M.S. Host: Anthony H. Kashou, M.D.   In today's episode of ECG Making Waves, Dr. Anthony Kashou interviews Dr. Nicholas Tan on how to manage anticoagulation in patients with cancer. They discuss the importance of appreciating the challenging balance in managing stroke risk in patients with cancer and atrial fibrillation. After listening to this episode, listeners will understand alternative strategies for stroke prevention in addition to systemic anticoagulation.   Topics Discussed: What is the relationship between cancer and atrial fibrillation? Why is stroke prevention challenging in this situation? What is the role of left atrial appendage closure in cancer patients? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.

#224: As an award-winning keynote speaker, eleven-time New York Times bestselling author, host of the top-rated Corporate Competitor Podcast, executive leadership coach, and longtime Associate Editor for Sports Illustrated, Don Yaeger has built a career as one of America's most compelling and influential thought leaders.Widely sought-after for his powerful insights on achieving greatness, Don draws from first-hand experiences working alongside some of the most legendary figures in sports and business. He has been engaged by leading organizations to coach executives on cultivating a culture of excellence, leveraging his proven framework developed through an extensive study of “Great Teams” in both athletics and corporate life. Known as a world-class storyteller, he has earned high praise from leadership icons such as John Maxwell and Simon Sinek, who have called him the best storyteller they have ever worked with. His expertise and charisma have earned him invitations to every major talk show—from Oprah and Good Morning America to Fox Business News and CNN.In 2020, Don launched the Corporate Competitor Podcast, which Podcast Magazine named one of America's Top 50 Podcasts. By 2022, Spotify ranked it among the top 5% of the most followed and shared podcasts worldwide. His guest list reads like a who's who of leadership and innovation, including former Secretary of State Condoleezza Rice, along with CEOs from Disney, Delta Airlines, Bank of America, Hendrick Motorsports, KPMG, FanDuel, Chick-fil-A, Insight Enterprises, Topgolf, Mayo Clinic, BET Media, and The Ritz-Carlton.Don's newest book The New Science of Momentum shares how the best coaches and leaders build a fire from a single spark. You can find the book across all platforms where books are sold and also the Amazon link below. For more on Don check out social media as well as donyaeger.com Enjoy the show!Book:https://www.amazon.com/New-Science-Momentum-Coaches-Leaders/dp/1400247136/?_encoding=UTF8&pd_rd_w=ZjHup&content-id=amzn1.sym.0fb2cce1-1ca4-439a-844b-8ad0b1fb77f7&pf_rd_p=0fb2cce1-1ca4-439a-844b-8ad0b1fb77f7&pf_rd_r=147-1714889-6514833&pd_rd_wg=KNm2d&pd_rd_r=6bb490c6-f2ca-4cd2-9107-756b3e2e3e2f&ref_=aufs_ap_sc_dsk 

Blood Work Decoded: Understanding the "Why" Behind Heart Disease and PAD Saturday LIVE on "The Heart of Innovation," Global PAD Association CEO Kym McNicholas and Dr. John Phillips welcome vascular surgeon Dr. Lily Johnston from Scripps La Jolla in California to discuss the root causes of peripheral artery disease and heart conditions. Dr. Johnston brings her extensive background (Princeton, Mayo Clinic, Johns Hopkins) to explore how advanced blood work can reveal underlying issues that traditional approaches might miss. She'll decode: • What your lipid panel actually means for your vascular health • Key blood cell markers everyone should understand • Why anemia frequently accompanies cardiovascular conditions • Which specialized tests to discuss with your doctor As founder of the Vascular Health Institute, Dr. Johnston takes a metabolic approach to vascular disease, focusing on prevention and addressing underlying causes rather than just managing symptoms. Have questions about PAD diagnosis, treatment options, or prevention strategies? Drop them below or bring them to our live conversation. #peripheralarterydisease #vascularmedicine #preventivehealth #cardiovascularhealth #peripheralarterydisease #padsupport #heartdisease

In this episode of THE MENTORS RADIO, Host Dan Hesse talks with Ursula Burns, Chairwoman of Teneo and founding partner of private equity company Integrum Holdings. But Ursula is best known for serving as Chairwoman and CEO of Xerox during a 36-year-career there, where she became the first black female CEO of a Fortune 500 company. In addition, Ursula serves on several private company boards, while also providing leadership counsel to several community, educational and non-profit organizations including the Ford Foundation, the MIT Corporation, the Metropolitan Museum of Art and the Mayo Clinic, among others. President Obama appointed her to lead the White House national program on STEM and she served as Chair of the President's Export Council. Since February 2022, Ursula Burns has served as Vice Chair of the U.S. Department of Commerce's Advisory Council on Supply Chain Competitiveness. Ursula holds a master's degree in mechanical engineering from Columbia and a bachelor's degree in mechanical engineering from NYU.  She's a member of the National Academy of Engineering, the American Academy of Arts and Sciences and the Royal Academy of Engineering. Listen to this episode below, or on ANY PODCAST PLATFORM here. BE SURE TO LEAVE US A GREAT REVIEW on Apple Podcasts or Spotify, and share with friends and colleagues! SHOW NOTES: URSULA BURNS: BIO: Bio: Ursula Burns DEIC Power 100 BOOKS: Where You Are Is Not Who You Are: A Memoir, by Ursula Burns ARTICLES / NEWS: Pioneering CEO Ursula Burns Wants to Make Stories Like Hers Less Rare– WSJ Ursula M. Burns – The New York Times In Her New Memoir, Ursula M. Burns Recounts Blazing a Trail to the Top of Xerox – The New York Times “I'm Here Because I'm As Good As You” – The Harvard Review Former Xerox CEO Ursula Burns on becoming the 1st black female Fortune 500 chief exec– YouTube Expect to see a sizable uptick in M&A in 2024, says Teneo's Ursula Burns – CNBC

Kristen and Jolenta announce the beginning of a new era! This includes: –Jolenta's new show, Hot Mess-terpiece Theatre, available in this very feed! –Kristen's new show, Pillow Talk, available exclusively at https://www.hatch.co/pillow-talk ! –The continuation of Kristen's show, Health Matters from Mayo Clinic, available everywhere you get your favorite shows! –The continuation of Dean & Kristen Look Back - the official By The Book recap show, exclusively at Patreon.com/listentobythebook !  Be sure to keep up with Kristen and Jolenta's ongoing adventures at facebook.com/groups/kristenandjolenta, kristenmeinzer.com, and jolentagreenberg.com. You can also follow us on Instagram @k10meinzer and @jolenta_g Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode of Tomorrow's Cure, we explore brain-computer interfaces (BCIs) - technologies creating direct pathways between the human brain and external devices. These aren't just futuristic concepts. BCIs are already helping paralyzed individuals move prosthetic limbs and control computers with their minds. Join our host Cathy Wurzer in her conversation with Dr. Jonathan J. Parker, Neurosurgeon at Mayo Clinic and Dr. Allen Waziri, Neurosurgeon & Neuroscientist, CEO & co-founder if iCE Neurosystems.  Listen to the lively conversation as they explore how this revolutionary technology works, its current applications and future potential as we merge minds with machines.Get the latest health information from Mayo Clinic's experts, subscribe to Mayo Clinic's newsletter for free today:  https://mayocl.in/3EcNPNc

Host: Darryl S. Chutka, M.D. Guest: Melinda J. Hahm Bariatric surgery is very likely the most effective method for long-term weight loss. It's not unusual for patients to lose well over 50% of their excess body weight. As a result, a variety of chronic health risks are reduced including diabetes, cardiovascular disease, sleep apnea, hypertension to name just a few. Exercise, associated with bariatric surgery is important to help achieve and maintain long-term weight loss and help prevent regaining the weight lost. The topic for this podcast is “Exercise and Bariatric Surgery” and my guest is Melinda J. Hahm, an exercise physiologist from the Mayo Clinic. Some of the topics we'll discuss include the benefits of exercise associated with bariatric surgery, when patients should start an exercise program in relation to their surgery and what type of exercise is best to help maintain weight loss. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

The range of symptoms and affected body systems in Parkinson's disease is extensive. One area that is less frequently discussed is the vestibular system—the inner ear structure directly connected to the brain, responsible for balance and spatial orientation. When this system malfunctions, individuals may experience dizziness, balance problems and an increased risk of falls, highlighting its importance in your overall health. With aging, the inner ear naturally becomes less robust. Although current research has not yet identified a definitive cause for the higher incidence of vestibular dysfunction in people with Parkinson's disease, effective interventions are available. In this episode, Christopher Taylor, Occupational Therapist at Mayo Clinic, will provide insights into the diagnosis and treatment options—namely vestibular therapy—that can assist with symptoms such as dizziness, gait disturbances, freezing, and postural instability. This discussion aims to enhance our understanding of the crucial role played by the inner ear and its connections. Thank you to our sponsor – Boston Scientific, the maker of Vercise Genus, a Deep Brain Stimulation or DBS system. To learn more about the latest treatment options for Parkinson's disease at https://DBSandMe.com/17branches  https://vestibular.org/

In this episode of The No Normal Show, hosts Stephanie Wierwille and Chris Bevolo explore one of the most pressing challenges in healthcare: the decline of centralized medical authority and the growing complexity of health information. From “health-conscious” marketing claims to vaccine skepticism, they unpack the cultural and psychological factors contributing to shifting perceptions of trust. With insights from the Joe Public 2030 report, the discussion highlights how healthcare marketers must evolve—from relying on traditional messaging to designing experiences that meet consumers where they are. Tune in now. Subscribe to The No Normal Rewind, our newsletter featuring a mashup of the boldest ideas, sharpest takes, and most rewind-worthy moments from our podcast — right here.Join our upcoming webinar, The Future of the Health System Chief Marketing Officer, to learn how to measure marketing performance, align metrics with organizational goals, and present impactful data to the C-suite. Register here.Articles to read: AdventHealth employees surprise coworker with bridal showerMayo, Nvidia launch AI supercomputer to diagnose diseases more quicklyPoppi's $8.9M Settlement Sends a Warning to Wellness MarketersDoctors Have Lost Their Mount Olympus of Medicine

Ceramide Risk Score: How to Incorporate it Into Your CV Prevention Practice   Guest: Vlad Vasile, M.D., Ph.D. Host: Stephen L. Kopecky, M.D.   Ceramides score is a blood test used to assess the risk of heart attacks and stroke. Most patients evaluated for cardiovascular risk benefit from this test, particularly patients deemed at intermediate risk by other assessments. Score is reported as numbers: the higher the score, the higher the risk. Ceramides score is reproducible and modifiable with lifestyle interventions and medications that lower cholesterol; it also helps with tracking patient progress and motivation.   Topics Discussed: What is the ceramides score? How is ceramides score different than hs CRP? Who benefits from ceramides testing?    Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.

Nutritionist Leyla Muedin discusses the recently released 2025 report on the best overall diets. She critiques the methodology behind nutritional research, emphasizing issues such as recall bias and the reliability of food frequency questionnaires. Leyla then provides an in-depth review of the top ten diets listed in the report: Mediterranean, DASH, Flexitarian, MIND, Mayo Clinic, TLC, Menopause, Dr. Andrew Weil's Anti-inflammatory, Volumetrics, and Cleveland Clinic diets. She argues that many of these diets are misrepresented, particularly regarding their fat content and sustainability claims. Leyla also offers her insights on what constitutes a truly effective and sustainable diet.

In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, is joined by Elitza Theel, Ph.D., director of the Infectious Diseases Serology Laboratory at Mayo Clinic, for a timely discussion on tick-borne diseases. Topics covered include:Observations from this year's tick season as we approach the end of July — a peak month for tick-borne disease transmission — along with trends in reported tick-borne pathogens over the past two decades.Algorithms developed by Mayo Clinic to guide clinicians in selecting the right tests for tick-borne and mosquito-borne diseases. The emergence of rare and esoteric infections and the challenges posed by vectors that carry and transmit multiple pathogens in a single bite.Shotgun metagenomics' growing role in the diagnosis of vector-borne infections.More resources Read "Update on North American tick-borne diseases and how to diagnose them" in the Journal of Clinical Microbiology for more insights from Drs. Pritt and Theel. You can also explore tools and information from Mayo Clinic Laboratories, including region-specific details, algorithms, prevention tools, and more. 

In this episode we're introduced to Beatty Carmichael, author of 'The Prayer of Freedom,' who shares his journey of using prayer for healing various ailments. Beatty discusses his methods and experiences, including empirical results from his work at an addiction recovery center. The podcast emphasizes the importance of incorporating prayer alongside traditional medical treatments but advises listeners to consult their healthcare professionals before making any changes. Beatty's spiritual approach has reportedly yielded impressive results across various chronic conditions. 00:00 Sponsor Message: 7 5 3 Academy 00:48 Introduction to the Podcast 01:22 Creating a Sanctuary: A Place of Rest 02:11 Guest Introduction: Beatty Carmichael 05:45 Beatty's Background and Healing Journey 08:41 The Power of Prayer in Healing 12:29 Scientific Approach to Spiritual Healing 21:05 Conclusion and Next Episode Teaser 21:34 Closing Remarks and Contact Information Bio: Beatty Carmichael is a leading expert in spiritual laws and how they affect our health, emotions, and behaviors. After 25 years in business, he uncovered a radical truth: most pain, mental illness, sickness, and trauma aren't rooted in physical or emotional causes, but in the spiritual realm. By identifying and removing the specific spiritual roots behind these struggles, he's helped over1,000 people find freedom from things like chronic pain, anxiety, addiction, depression, suicidal thoughts, and even bipolar disorder—issues that medical science often can't resolve. Once the root is gone, the problem typically disappears in less than 24 hours—with a documented 90% success rate. Beatty outlines this simple, step-by-step method in his book, The Prayer of Freedom, available at www.ThePrayerOfFreedomBook.com. Today, he'll expose why so many people stay stuck—and how anyone can experience real, lasting healing by targeting the root issue most others overlook. To get freedom in your life, get a copy of The Prayer of Freedom today. It's available at every bookstore, but the best place to go is book's website at www.ThePrayerOfFreedomBook.com where you'll find additional information, discounts, and a free gift.   Beatty Carmichael Part One [00:00:00] I do have a sponsor 7 5 3 Academy. Our martial art program specialized in anti-bullying programs for kids to combat proven Filipino martial arts. Kali We take a holistic, fun, and innovative approach that simply works. Our fitness community is friendly and supportive without the over the top muscle gym atmosphere. Our coaching staff are professionally trained with over 30 years of experience. Get started by claiming your free class voucher. So go to the link in the show notes. This is in the Phoenix Metro area, so reach out to Coach David and coach Eric over at 7 5 3 Academy. Welcome to the Wounds of the Faithful Podcast, brought to you by DSW Ministries. Your host is singer songwriter, speaker and domestic [00:01:00] violence advocate, Diana . She is passionate about helping survivors in the church heal from domestic violence and abuse and trauma. This podcast is not a substitute for professional counseling or qualified medical help. Now here is Diana. Hello and welcome to the podcast. Come on in, take a deep breath, breathe out. It's pretty crazy out there right now. Hopefully this is a sanctuary for you, a place of rest. A place to come and take a load off, a peaceful place and try and make it that way. Say a prayer. I hope that you've been enjoying the guests that we've had on the show recently. We do have a great guest for you this week as well. We're gonna be talking about [00:02:00] prayer when it comes to wellness. We are certainly big on prayer here and trying to find ways to heal from domestic violence and abuse. And my guest today is Beatie Carmichael, and he's gonna tell us our prayer. Is instrumental in healing. Uh, I wanna tell you a little about his bio here. Beatty Carmichael is the author of the book, the Prayer of Freedom. He has developed a way of praying for healing. God actually answers those prayers around 87% of the time. With this process, he has seen God heal over 700 people. Everything from relationship [00:03:00] conflicts, all kinds of chronic pain, anxiety, glaucoma, and more. Some people think God doesn't answer prayers for healing because they've never seen him do it for them, but Beatty has found that with the right approach, God does it almost every time. So if you struggle with relationship conflicts, chronic pain, migraines, depression, anxiety, panic attacks, and more, you're in for a big treat. With today's guest as Beatty shares the root cause of most of these issues and a simple four step approach in prayer to get lasting freedom from them today. So I do want to say when we're talking about healthcare issues, 'cause I work in healthcare. Yes, prayer is definitely a part of [00:04:00] healing. The hospital that I belong to, that I work at definitely believes in faith and incorporating prayer as part of the treatment plan. And some of the stories and examples that he's going to give are pretty miraculous. Just want to make sure that you are following your medical professional's advice, whether it's a medical doctor or a psychiatrist, psychologist. Pharmacist. That you are following their professional advice. Don't stop taking your medication or don't stop taking your cancer treatment unless it is approved by your doctor who is in charge of you. I have to say that because, a lot of lawsuits happen, especially here in the United States, you know, the whole, this is not to diagnose, cure, treat any [00:05:00] disease. We all see that on things like vitamins and so forth. But at the same time, we are open-minded to other ways of healing, particularly. Spiritual ways of healing is a little bit of a different take on healing. So we wanna be open-minded to other options that may work for you that may supplement what you're doing now. We certainly need God's help when it comes to healing because he is the great physician. So I am, excited as to what he has for us today and what he has to show for us. So enjoy my conversation with Beatty Carmichael. I'm excited to welcome my guest today, Beatie Carmichael from Birmingham, Alabama. Welcome. Well, thank you, Diana. I'm glad to be here. We're gonna talk about your book, the [00:06:00] Prayer of Freedom and about prayer and healing. So I'm very excited to have you today. Now, are you a survivor yourself or any of your family members? No, but I teach at a place where I deal with survivors all day long. Yeah. You say you teach a class on spiritual warfare at a Women's Addiction Recovery center. Yeah. So tell us about that, your ladies that you help. So, it's the largest addiction recovery center in America. They house over 500 women, and they're all recovering from addiction. Usually with addiction, you have all kinds of trauma, childhood abuse, you have all kinds of parental, loved one abuse and just all this stuff that goes with it. And I teach, two or three classes and I've been doing it for three years and love to just grow and to love the ladies and really understand a lot of the challenges they go [00:07:00] through. And I, I do teach a class on spiritual warfare. And the subtitle is How to Get Free of These Torments that They that struggle with. And it's the number one class in this facility because most of my students, when they come in, they leave being freed of most of the junk that they've been carrying for most of their life. And they're able to let go and finally start to be on a platform where they can move forward in life. So it's been really cool. Wow. You come from a family of doctors, I understand? Yes. So I come from a line of seven generations of medical doctors and I'll have to brag on mayo Clinic. So my dad, when he was in surgery, he entered surgery when specialties were just coming out, and so he was a vascular surgeon. His specialty were the carotid arteries on the either side of the neck, and it's very critical because if any of, if one of those bursts, you got [00:08:00] minutes before the eyes. Right? And so my dad had the highest. The quickest route recovery quickest surgery, lowest complication, even higher, better numbers than the guys at the Mayo Clinic. So we always thought, Hey, that's pretty cool, wow. Mayo Clinic. But he retired, 15, 18 years ago. But seven generations consecutively of medical doctors. I didn't go into medicine, but I took the same approach. To work on healing, which is a scientific approach, and I help people get healed through more of a prayer approach than a medicine approach. And it's been really cool. So was there like an event that brought you into this prayer? Yeah. I'll tell you the story as it is, whether you believe it or not, or whether you, okay. So I end up going into business. I'm actually a small business owner by trade and vocation. I [00:09:00] helped real estate agents get listings. It's a little company called agent dominator.com and about nine years ago, the Lord started put this burden on my heart to want to bring healing into people's lives and looking backwards. I can kind of see now, sort of this healing mantle in my generations and it was always there, but had been suppressed for me. But he started to awaken it and he led me eight and a half years ago to simply go out and try to pray for people for healing. And so, with a little bit of anxiety, but kind of this urge to try it. I went out to a Walmart and I walk up to people that look like they're in pain. They're limping, they're riding one of those scooters because they can't walk. Things of that sort. And I just asked, Hey, I'm out praying for people. Can I pray for you on anything? Are you in pain? Right? And I saw a third of the people. Uh, now you have to understand my definition of healing may be a little bit different. I call [00:10:00] it heal. But since we're on a kind of a medical type show, I wanna be clear on this, it was a total cessation of symptoms. Okay? Okay. So, like, the, one of the first ladies, she was she had degenerative disc in her neck and degenerative disc in her lower back. She was racked in arthritis and she had lupus and she was riding one of these little electric scooters and she had an assistant with her to help her get things off the shelf because she couldn't even look up. Mm-hmm. So I prayed for her and I said, well, stand up and let's see if it works. Right. And she stands up, no pain. She can move her neck all the way around. She can li you know, I mean everything as if. There was nothing there anymore, so I would call that being healed. She didn't go to the doctor, so we don't have a medical diagnosis, but everything that she couldn't do, she could do now without pain. And I started to see a third of the people I prayed for what that type of stuff would happen. And then within about a year or so, I got it up to about 90%. [00:11:00] People like with glaucoma, their eyes would, they can now see people who couldn't hear would now hear. I mean, these things that we would say, uh, like one first ones was a lady with RSD. She had on this compression sleeve on her right arm. And I said, can I pray for you? She said, yes, but don't touch it. I said, what's going on? I have RSD. And I said, oh, okay. Like, I knew what it was. I had no idea what RSD is about, When I went back and told dad about this, and I told him about RSD, he said, RSD. Is a neuropathy type of a neurological issue. It's extremely painful and it's incurable. And if she no longer has pain, he said that's a miracle, right? But after I prayed for her, you could touch her arm and she, I mean, everything was just normal. So I started to go this direction and then what happened that led me into where we're going with the prayer freedom is after about seven years of this, and I would say about a hundred people a year. All these things disappear. I'd go out and I was seeing nine outta 10 people, [00:12:00] whatever, as I prayed for all the symptoms, completely disappear. And then in a period of two weeks, I went back out and I now only saw one outta 10. And it baffled me, you know, I, I'm a scientist. I say, you keep doing the same thing, you should get the same result, right? So I went in prayer and asked God, what's going on? And God said, I took that gift of healing away. I said, why? He said, because now I want you to do it based on authority. And I understood what he meant. This is one of the things I've been experimenting with along the way is some of these spiritual laws and how, to define for you and the audience. You have several types of sciences. One is a physical science, right? So in physical sciences, I like, I have a pen, and if I let go of the pen, it drops. And every time I let go of the pen, it drops. And if you were to pick up your pen and let go of it, it would drop. So we can conclude. There's a physical law, we call it gravity because mm-hmm. Every time you do the same result, [00:13:00] same activity always gets the same result. So we can say there's a law that we can't see, but it's empirically provable. I started to see the same thing in the spiritual realm. And I call it spiritual realm because it's just not the physical realm. I don't know what realm it is. I just call it spirit. And that spiritual realm is when we pray a certain process over here, the same result always occurs over on this other side. And that's where God was starting to send me. So I would go back out to Walmart in places and I would take them through a process rather than me praying for them, I would lead them in prayer and they started getting the same result of all kinds of things that. We would call a miracle be only because we can't explain how in the world could that happen. And then God told me to write this into a book and that's what came out with the prayer freedom. And as I'm teaching at this Addiction Recovery Center, these women have all kinds of [00:14:00] issues. If you're familiar with anyone with addiction, there's a lot of trauma that goes with it. Usually in early age, and then you have, as a result of that, you have all kinds of things like bipolar, you have anxiety and depression and panic attacks. You have sometimes voices in your head, all kinds of chronic pain. And for these ladies also lots of addiction. And I worked out a worksheet where you make a list of the things that are the spiritual roots I was able to identify. And I gave them a prayer of just how to pray to God and include these spiritual roots basically saying, I'm sorry about doing this, or I'm sorry about doing that. And so I gave it to my three classes. I first had to make a list of all the issues they were going through, so all this stuff that, the mental illnesses, the chronic pains, and the addiction urges and anything else, and rate those, illness, those levels on a scale of zero to [00:15:00] 10. 10 being worse, zero being, they don't have it. They don't feel it, they can't identify it. And then I had them go through this process on their own. 'cause I wanted to measure was does this really work or is it just something with me? So I came back a month later and they turned in their papers after praying through going through this process. And I found that of those who completed it, 87% of them. Saw pretty much everything on their list go to a zero, just like totally disappear out of their lives. The 13% of the people saw almost no movement. Okay? So I'm not sure what's going on with the 13%, but for almost nine outta 10, it just like almost everything left, which is interesting. I won't thing about that until just now. Those are the same numbers I saw praying for people, right? Nine outta 10. I see the same thing with this. Yet, this is now a systematic approach. And so [00:16:00] that's why I say it's a spiritual approach to on spiritual laws, because these ladies, they're, some are atheists, some may probably Buddhist or Hindu. Others are Christian. Others are just agnostic. It doesn't matter to their religion. It's just that the framework of there's probably a God that created us. If, have you ever heard Diana of Karma? Do you know what karma is? Yes. Okay. Mm-hmm. So a lot of people say, you know, karma, you do bad things, bad things are gonna happen to you, kind of this cause, right? Yeah. Well, the Bible actually talks about that as as a root of sickness. And I use the Bible because it's been really accurate spiritually from the spiritual laws. And one of the things it says is, it says, actually two things. Number one in the Old Testament, it says, if you sin against God, uh, this is in a book called Deuteronomy. It said, if you sin against God and don't obey him, then he'll send on you all these sicknesses and diseases. And then over in the New [00:17:00] Testament at the end of the Bible, in James five 16, it says, if you confess your sins, you'll be healed. So it shows both of these spiritual laws. You do something bad against God, sickness and diseases, and then if you confess your sin, which means to repent and be sorry for them, then he will heal you. And that's basically the premise of this, of the prayer freedom is identifying these things that we may have done that maybe is against what God wants us to do. And when we say we're sorry and ask him to heal it, then we find a lot of these things just kind of disappear. I do wanna be real, since we're on a medical call, let me get this claimer. Okay. If you're under the care of a doctor, don't stop anything until you get their doctor's for approval, right? Because Yes, thank you. Yeah, because some of this stuff, it may not be exactly what you're thinking, but more than anything else, there's a lot of stuff that we don't want to fill with, especially when you get into prescription type of drugs. Okay. And there's a lot of issues there. So, [00:18:00] if you're on any sort of prescriptions or any other therapies before you stop it, even if you think you can, go talk to the doctor first and get permission. Great. Thank you. Yeah, you're welcome. Now you're talking about prayer, but. Would you call yourself a prayer warrior? What is your spiritual background? Like, were you really good at praying or no? What was it like for you growing up? I went to a very liberal church initially that really didn't teach much, other than feel good is the way I would describe it. Then I moved to another church that was very legalistic. Very dogmatic. Mm-hmm. And there was like no love. Right? Right. And so this whole thing of prayer, what really happened to me is I was, you know, I claim, I'm a Christian as my chosen religion, but it wasn until God started to heal people, when I would pray for them. I got really [00:19:00] curious about what this thing is all about and really curious, is prayer really that effective? Right, because it's, I'd never seen that before. Oh, I pray, but I'm not sure I could really say because I prayed something happened. And a lot of times I just wouldn't pray about things because it is like you just kind of pray and goes up in this ether somewhere and we hope maybe something happens good from it. Taking vitamins. We take vitamins, but we can't really track anything specific. We just know it's probably good. Unless you have scurvy? Yeah. Unless you have scurvy or something. Vitamin That vitamin C. But once I started to see people starting to be healed, it really prompted a high level of curiosity to understand what's going on. And this is where I think I call it the scientific mind. Only because doctors are scientists, they're medical scientists and so while they are medical doctors, I call myself a prayer doctor, right? Because they use medicine to heal. I figured out a way to [00:20:00] use prayer to heal so that I wouldn't call myself a prayer warrior. If anything, I would say I'm a scientist, a spiritual scientist or a prayer doctor. I'm not sure. But yeah, so that's how I started. And then over the years I started to identify these spiritual laws that the Bible talked about. And then I would go out and test them and start to pick up a consistent pattern of, I'll call it empirical data that was just irrefutable. And I go, wow, this works. And it no longer works because of me. It works because someone else is following the process. So I know a couple atheists very well, and we've had some conversations, very spirited conversations about Yeah, that God doesn't exist. You mentioned that this would work for anyone, even atheist. So they would say prayer is communication and worship of a [00:21:00] deity. So. Why would an atheist go for that? Just curious. I think this is a great place to stop. I know that you're gonna wanna hear more stories and more about this healing with prayer as to how it works and how you can incorporate it into your treatment plan. He has a lot more to say, so I encourage you to be here next time on the Woods of the Faithful Podcast. Thanks for listening. God bless you. Have a great week. Bye for now. Thank you for listening to the Wounds of the Faithful Podcast. If this episode has been helpful to you, please hit the subscribe button and tell a friend. You could connect with us at DSW Ministries dot org where you'll find our blog, along with our Facebook, Twitter, and our YouTube channel links. Hope to see you next [00:22:00] week.

In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Michael S. Okun, MD, FAAN, who served as the guest editor of the August 2025 Movement Disorders issue. They provide a preview of the issue, which publishes on August 1, 2025. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Okun is the director at Norman Fixel Institute for Neurological Diseases and distinguished professor of neurology at University of Florida in Gainesville, Florida. Additional Resources Read the issue: continuum.aan.com Subscribe to Continuum®: shop.lww.com/Continuum Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Guest: @MichaelOkun Full episode transcript available here: Dr Jones: Our ability to move through the world is one of the essential functions of our nervous system. Gross movements like walking ranging down to fine movements with our eyes and our hands, our ability to create and coordinate movement is something many of us take for granted. So what do we do when those movements stop working as we intend? Today I have the opportunity to speak with one of the world's leading experts on movement disorders, Dr Michael Okun, about the latest issue of Continuum on Movement Disorders. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about subscribing to the journal, listening to verbatim recordings of the articles, and exclusive access to interviews not featured on the podcast. Dr Jones: This is Dr Lyle Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr Michael Okun, who is Continuum's guest editor for our latest issue on movement disorders. Dr Okun is the Adelaide Lackner Distinguished Professor of Neurology at the University of Florida in Gainesville, where he's also the director of the Norman Fixel Institute for Neurological Diseases. Dr Okun, welcome, and thank you for joining us today. Why don't you introduce yourselves to our listeners?  Dr Okun: It's great to be here today. And I'm a neurologist. Everybody who knows me knows I'm pretty simple. I believe the patient's the sun and we should always orbit around the person with disease, and so that's how I look at my practice. And I know we always participate in a lot of research, and I've got a research lab and all those things. But to me, it's always the patients and the families first. So, it'll be great to have that discussion today.  Dr Jones: Yeah, thank you for that, Dr Oaken. Obviously, movement disorders is a huge part of our field of neurology. There are many highly prevalent conditions that fit into this category that most of our listeners will be familiar with: idiopathic Parkinson's disease, essential tremor, tic disorders and so on. And having worked with trainees for a long time, it's one of the areas that I see a lot of trainees gravitate to movement disorders. And I think it's in part because of the prevalence; I think it's in part because of the diversity of the specialty with treatment options and DBS and Botox. But it's also the centrality of the neurologic exam, right? That's- the clinical examination of the patient is so fundamental. And we'll cover a lot of topics today with some questions that I have for you about biomarkers and new developments in the field. But is that your sense too, that people are drawn to just the old-fashioned, essential focus on the neurologic encounter and the neurologic exam? Dr Okun: I believe that is one of the draws to the field of movement. I think that you have neurologists from all over the world that are really interested and fascinated with what things look like. And when you see something that's a little bit, you know, off the normal road or off the normal beaten path… and we are always curious. And so, I got into movement disorders, I think, accidentally; I think even as a child, I was looking at people who had abnormal movements and tremors and I was very fascinated as to why those things happened and what's going on in the brain. And, you know, what are the symptoms and the signs. And then later on, even as my own career developed, that black bag was so great as a neurologist. I mean, it makes us so much more powerful than any of the other clinicians---at least in my biased opinion---out on the wards and out in the clinic. And, you know, knowing the signs and the symptoms, knowing how to do a neurological examination and really walking through the phenomenology, what people look like, you know, which is different than the geno- you know, the genotypes, what the genes are. What people look like is so much more important as clinicians. And so, I think that movement disorders is just the specialty for that, at least in my opinion. Dr Jones: And it helps bring it back to the patient. And that's something that I saw coming through the articles in this issue. And let's get right to it. You've had a chance to review all these articles on all these different topics across the entire field of movement disorders. As you look at that survey of the field, Dr Okun, what do you think is the most exciting recent development for patients with movement disorders?  Dr Okun: I think that when you look across all of the different specialties, what you're seeing is a shift. And the shift is that, you know, a lot of people used to talk in our generation about neurology being one of these “diagnose and adios” specialties. You make the diagnosis and there's nothing that you can do, you know, about these diseases. And boy, that has changed. I mean, we have really blown it out of the water. And when you look at the topics and what people are writing about now and the Continuum issue, and we compare that the last several Continuum issues on movement disorders, we just keep accumulating a knowledge base about what these things look like and how we can treat them. And when we start thinking about, you know, all of the emergence of the autoimmune disorders and identifying the right one and getting something that's quite treatable. Back in my day, and in your day, Lyle, we saw these things and we didn't know what they were. And now we have antibodies, now we can identify them, we can pin them down, and we can treat many of them and really change people's lives. And so, I'm really impressed at what I see in changes in identification of autoimmune disorders, of channelopathies and some of the more rare things, but I'm also impressed with just the fundamental principles of how we're teaching people to be better clinicians in diseases like Parkinson's, Huntington's, ataxia, and Tourette. And so, my enthusiasm for this issue of Continuum is both on, you know, the cutting edge of what we're seeing based on the identification on our exams, what we can do for these people, but also the emergence of how we're shifting and providing much better care across a continuum for folks with basal ganglia diseases. Dr Jones: Yeah, I appreciate that perspective, Dr Okun. One of the common themes that I saw in the issue was with these new developments, right, when you have new tools like new diagnostic biomarker tools, is the question of if and when and how to integrate those into daily clinical practice, right? So, we've had imaging biomarkers for a while, DAT scans, etc. For patients with idiopathic Parkinson disease, one of the things that I hear a lot of discussion and controversy about are the seed amplification assays as diagnostic biomarkers. What can you tell us about those? Are those ready for routine clinical use yet?  Dr Okun: I think the main bottom-line point for folks that are out there trying to practice neurology, either in general clinics or even in specialty clinics, is to know that there is this movement toward, can we biologically classify a disease? One of the things that has, you know, really accelerated that effort has been the development of these seed amplification assays, which---in short for people who are listening---are basically, we “shake and bake” these things. You know? We shake them for like 20 hours and we use these prionlike proteins, and we learn from diseases like prion disease how to kind of tag these things and then see, do they have degenerative properties? And in the case of Parkinson's disease, we're able to do this with synuclein. That is the idea of a seed amplification assay. We're able to use this to see, hey, is there synuclein present or not in this sample? And people are looking at things like cerebrospinal fluid, they're looking at things like blood and saliva, and they're finding it. The challenge here is that, remember- and one of the things that's great about this issue of Continuum is, remember, there are a whole bunch of different synucleinopathies. So, Dr Jones, it isn't just Parkinson's disease. So, you've got Parkinson's disease, you've got Lewy body, you know, and dementia with Lewy bodies. You've got, you know, multiple system atrophy is within that synucleinopathy, you know, group primary autonomic failure… so not just Parkinson's disease. And so, I think we have to tap the brakes as clinicians and just say, we are where we are. We are moving in that direction. And remember that a seed amplification assay gives you some information, but it doesn't give you all the information. It doesn't forgive you looking at a person over time, examining them in your clinic, seeing how they progress, seeing their response to dopamine- and by the way, several of these genes that are associated with Parkinson; and there's, you know, less than 20% of Parkinson is genetic, but several of these genes, in a solid third---and in some cases, in some series, even more---miss the synuclein assay, misses, you know, the presence of a disease like Parkinson's disease. And so, we have to be careful in how we interpret it. And I think we're more likely to see over time a gemish: we're going to smush together all this information. We're going to get better with MRIs. And so, we're actually doing much better with MRIs and AI-based intelligence. We've got DAT scans, we've got synuclein assays. But more than anything, everybody listening out there, you can still examine the person and examine them over time and see how they do over time and see how they do with dopamine. And that is still a really, really solid way to do this. The synuclein assays are probably going to be ready for prime time more in choosing and enriching clinical trials populations first. And you know, we're probably 5, 10 years behind where Alzheimer's is right now. So, we'll get there at some point, but it's not going to be a silver bullet. I think we're looking at these are going to be things that are going to be interpreted in the context for a clinician of our examination and in the context of where the field is and what you're trying to use the information for. Dr Jones: Thank you for that. And I think that's the general gestalt I got from the articles and what I hear from my colleagues. And I think we've seen this in other domains of neurology, right? We have the specificity and sensitivity issues with the biomarkers, but we also have the high prevalence of copathology, right? People can have multiple different neurodegenerative problems, and I think it gets back to that clinical context, like you said, following the patient longitudinally. That was a theme that came out in the idiopathic Parkinson disease article. And while we're on Parkinson disease, you know, the first description of that was what, more than two hundred years ago. And I think we're still thinking about the pathophysiology of that disorder. We understand risk factors, and I think many of our listeners would be familiar with those. But as far as the actual cause, you know, there's been discussion in recent years about, is there a role of the gut microbiome? Is this a prionopathic disorder? What's your take on all of that?  Dr Okun: Yeah, so it's a great question. It's a super-hot area right now of Parkinson. And I kind of take this, you know, apart in a couple of different ways. First of all, when we think about Parkinson disease, we have to think upstream. Like, what are the cause and causes? Okay? So, Parkinson is not one disease, okay? And even within the genes, there's a bunch of different genes that cause it. But then we have to look and say, well, if that's less than 20% depending on who's counting, then 80% don't have a single piece of DNA that's closely associated with this syndrome. And so, what are we missing with environment and other factors? We need to understand not what happens at the end of the process, not necessarily when synuclein is clumping- and by the way, there's a lot of synuclein in the brains normally, and there's a lot of Tau in people's brains who have Parkinson as well. We don't know what we don't know, Dr Jones. And so when we begin to think about this disease, we've got to look upstream. We've got to start to think, where do things really start? Okay? We've got to stop looking at it as probably a single disease or disorder, and it's a circuit disorder. And then as we begin to develop and follow people along that pathway and continuum, we're going to realize that it's not a one-size-fits-all equation when we're trying to look at Parkinson. By the way, for people listening, we only spend two to three cents out of every dollar on prevention. Wouldn't prevention be the best cure, right? Like, if we were thinking about this disease. And so that's something that we should be, you know, thinking about. And then the other is the Global Burden of Disease study. You know, when we wrote about this in a book called Ending Parkinson's Disease, it looked like Parkinson's was going to double by 2035. The new numbers tell us it's almost double to the level that we expected in 2035 in this last series of numbers. So, it's actually growing much faster. We have to ask why? Why is it growing faster? And then we have lots of folks, and even within these issues here within Continuum, people are beginning to talk about maybe these environmental things that might be blind spots. Is it starting in our nose? Is it starting in our gut? And then we get to the gut question. And the gut question is, if we look at the microbiomes of people with Parkinson, there does seem to be, in a group of folks with Parkinson, a Parkinson microbiome. Not in everyone, but if you look at it in composite, there seems to be some clues there. We see changes in Lactobacillus, we see some bacteria going up that are good, some bacteria going down, you know, that are bad. And we see flipping around, and that can change as we put people on probiotics and we try to do fecal microbiota transplantations- which, by the way, the data so far has not been positive in Parkinson's. Doesn't mean we might not get there at some point, but I think the main point here is that as we move into the AI generation, there are just millions and millions and millions of organisms within your gut. And it's going to take more than just our eyes and just our regular arithmetic. You and I probably know how to do arithmetic really well, but this is, like, going to be a much bigger problem for computers that are way smarter than our brains to start to look and say, well, we see the bacteria is up here. That's a good bacteria, that's a good thing or it's down with this bacteria or this phage or there's a relationship or proportion that's changing. And so, we're not quite there. And so, I always tell people---and you know, we talk about the sum in the issue---microbiomes aren't quite ready for prime time yet. And so be careful, because you could tweak the system and you might actually end up worse than before you started. So, we don't know what we don't know on this issue.  Dr Jones: And that's a great point. And one of the themes they're reading between the lines is, we will continue to work on understanding the bio-pathophysiology, but we can't wait until that day to start managing the risk factors and treating patients, which I think is a good point. And if we pivot to treatment here a little bit, you know, one of the exciting areas of movement disorders---and really neurology broadly, I think movement disorders has led the field in many ways---is bioelectronic therapy, or what one of my colleagues taught me is “electroceutical therapy”, which I think is a wonderful term. Dr Okun, when our listeners are hearing about the latest in deep brain stimulation in patients who have movement disorders, what should they know? What are the latest developments in that area with devices? Dr Okun: Yeah. So, they should know that things are moving rapidly in the field of putting electricity into the brain. And we're way past the era where we thought putting a little bit of electricity was snake oil. We know we can actually drive these circuits, and we know that many of these disorders---and actually, probably all of the disorders within this issue of Continuum---are all circuit disorders. And so, you can drive the circuit by modulating the circuit. And it's turned out to be quite robust with therapies like deep brain stimulation. Now, we're seeing uses of deep brain stimulation across multiple of these disorders now. So, for example, you may think of it in Parkinson's disease, but now we're also seeing people use it to help in cases where you need to palliate very severe and bothersome chorea and Huntington's disease, we're seeing it move along in Tourette syndrome. We of course have seen this for various hyperkinetic disorders and dystonias. And so, the main thing for clinicians to realize when dealing with neuromodulation is, take a deep breath because it can be overwhelming. We have a lot of different devices in the marketplace and no matter how many different devices we have in the marketplace, the most important thing is that we get the leads. You know, where we're stimulating into the right location. It's like real estate: location, location, location, whether you've got a lead that can steer left, right, up, down and do all of these things. Second, if you're feeling overwhelmed because there are so many devices and so many settings, especially as we put these leads in and they have all sorts of different, you know, nodes on them and you can steer this way and that way, you are not alone. Everybody is feeling that way now. And we're beginning to see AI solutions to that that are going to merge together with imaging, and then we're moving toward an era of, you know, should I say things like robotic programming, where it's going to be actually so complicated as we move forward that we're going to have to automate these systems. There's no way to get this and scale this for all of the locales within the United States, but within the entire world of people that need these types of devices and these therapies. And so, it's moving rapidly. It's overwhelming. The most important thing is choosing the right person. Okay? For this, with multidisciplinary teams, getting the lead in the right place. And then all these other little bells and whistles, they're like sculpting. So, if you think of a sculpture, you kind of get that sculpture almost there. You know, those little adds are helping to maybe make the eyes come out a little more or the facial expression a little bit better. There's little bits of sculpting. But if you're feeling overwhelmed by it, everybody is. And then also remember that we're starting to move towards some trials here that are in their early stages. And a lot of times when we start, we need more failures to get to our successes. So, we're seeing trials of people looking at, like, oligo therapies and protein therapies. We're seeing CRISPR gene therapies in the laboratory. And we should have a zero tolerance for errors with CRISPR, okay? we still have issues with CRISPR in the laboratory and which ones we apply it to and with animals. But it's still pretty exciting when we're starting to see some of these therapies move forward. We're going to see gene therapies, and then the other thing we're going to see are nano-therapies. And remember, smaller can be better. It can slip across the blood brain barrier, you have very good surface area-to-volume ratios, and we can uncage drugs by shining things like focused ultrasound beams or magnets or heat onto these particles to turn them on or off. And so, we're seeing a great change in the field there. And then also, I should mention: pumps are coming and they're here. We're getting pumps like we have for diabetes and neurology. It's very exciting. It's going to be overwhelming as everybody tries to learn how to do this. So again, if you're feeling overwhelmed, so am I. Okay? But you know, pumps underneath the skin for dopamine, pumps underneath the skin for apomorphine. And that may apply to other disorders and not just Parkinson as we move along, what we put into those therapies. So, we're seeing that age come forward. And then making lesions from outside the brain with focused ultrasound, we're starting to get better at that. Precision is less coming from outside the brain; complications are also less. And as we learn how to do that better, that also can provide more options for folks. So, a lot of things to read about in this issue of Continuum and a lot of really interesting and beyond, I would say, you know, the horizon as to where we're headed.  Dr Jones: Thank you for that. And it is a lot. It can be overwhelming, which I guess is maybe a good reason to read the issue, right? I think that's a great place to end and encourage our listeners to pick up the issue. And Dr Okun, I want to thank you for joining us today. Thank you for such a great discussion on movement disorders. I learned a lot. I'm sure our listeners will as well, given the importance of the topic, your leadership in the field over many years. I'm grateful that you have put this issue together. So, thank you. And you're a busy person. I don't know how we talked you into doing this, but I'm really glad that we did.  Dr Okun: Well, it's been my honor. And I just want to point out that the whole authorship panel that agreed to write these articles, they did all the work. I'm just a talking head here, you know, telling you what they did, but they're writing, and the people that are in the field are really, you know, leading and helping us to understand, and have really put it together in a way that's kind of helped us to be better clinicians and to impact more lives. So, I want to thank the group of authors, and thank you, Dr Jones. Dr Jones: Again, we've been speaking with Dr Michael Okun, guest editor of Continuum's most recent issue on movement disorders. Please check it out. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. Thank you for listening to Continuum Audio.

When the spine begins to curve during childhood or adolescence, it can lead to a condition known as scoliosis. While traditional treatments have remained largely unchanged for decades, new advancements are offering young patients and their families more choices and better outcomes. In this episode, our host Cathy Wurzer explores the evolving landscape of scoliosis care and what these innovations mean for the future of spinal health with Dr. A. Noelle Larson, Division Chair of Mayo Clinic Orthopedic Surgery and Michelle Marks, Executive Director at Setting Scoliosis Straight Foundation.The shared decision-making tool discussed in the episode can be found here: Surgical Options - Setting Scoliosis StraightGet the latest health information from Mayo Clinic's experts, subscribe to Mayo Clinic's newsletter for free today:  https://mayocl.in/3EcNPNc

In this episode of the Vital Health Podcast, host Duane Schulthess convenes three leading voices from the 2025 BIO International Convention - prominent physicians, innovators, and advocates shaping the future of drug development in the wake of the Inflation Reduction Act (IRA). Throughout this conversation, they examine policy impacts, clinical ramifications, and patient access challenges: Barbara McAneny: Former American Medical Association President; Co‑Chair, ONCare Alliance; CEO, New Mexico Oncology Hematology Consultants, Ltd. Rafael Fonseca: Chief Innovation Officer & Getz Family Professor of Cancer, Mayo Clinic in Arizona Steve Potts: Chair, Drug Development Council, ICAN (International Cancer Advocacy Network) Key Topics: Pipeline Modality Shifts: Early‑stage developers are retooling small molecule programs into biologics, or abandoning follow‑on indications altogether to sidestep the IRA’s nine‑year exclusivity pill penalty. Clinical Trial Ecosystem: Independent and academic centers alike are seeing fewer small molecule trials, threatening orphan drug expansions and revenue streams that underwrite care. Oncology Practice Economics: Cuts to drug margins will jeopardize community practices, forcing difficult choices between patient treatment and financial survival. Patient Affordability & Copays: The cap on out‑of‑pocket oral drug costs versus the hidden burden of high copays and co‑insurance - and why eliminating them could raise premiums only modestly. PBM & Insurer Vertical Integration: Payers acquiring manufacturers and ownership of formularies are steering patients toward the highest‑rebate products at the expense of clinical judgment. Broader Systemic Ripples: From congested ERs due to unmanaged side effects to rural access collapse, plus the missed opportunity to cut PBM take‑rates instead of hampering innovation. Policy Fix Imperatives: Proposals include recalibrating exclusivity durations (extend small molecule to 13 years), automating rebate flows to CMS, and overhauling PBM incentives. This discussion covers the interplay between drug-pricing reform and the future of care, highlighting unintended consequences and pragmatic solutions. It’s essential listening for policymakers, payers, industry leaders, patient advocates, and every stakeholder invested in sustaining medical innovation and ensuring equitable patient access. Opinions expressed are those of the speakers, not the companies listed. Recorded on June 16, 2025.See omnystudio.com/listener for privacy information.

Host: Darryl S. Chutka, M.D. Guest: Eric J. Moore, M.D. Salivary gland tumors can be benign or malignant, as well as primary or metastatic. Malignant salivary gland tumors usually present after the 6th decade, whereas benign lesions tend to occur a bit earlier, usually in the 4th to 5th decades. An interesting statistic is that the vast majority of salivary gland tumors occur in the parotid, only about 10% occur in the submandibular salivary gland and less than 4% in the minor salivary glands. Fortunately, most parotid tumors are benign. Previous radiation as well as occupational exposure to silica and nitrosamines have been linked to malignant parotid tumors. What should a primary care clinician do when we discover a mass in the parotid gland? What imaging studies are helpful? What treatment is available and what happens if the tumor recurs? These are all questions I'll be asking my guest, Eric J. Moore, M.D., Chair of Otolaryngology and Head and Neck Surgery at the Mayo Clinic as we discuss “Parotid Gland Tumors”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

Dr. Linda Chu speaks with Dr. Ramin Khorasani about targeted interventions that reduced ambiguous radiologist recommendations for additional imaging while dramatically improving the clarity and follow-through of actionable recommendations. They explore how a structured system of care, closed-loop communication, and leadership engagement can advance high-value, patient-centered care in radiology. This episode is sponsored by Mayo Clinic.  Cumulative Effect of Targeted Interventions on Radiologist Recommendations for Additional Imaging. Abbasi et al. Radiology 2025; 315(3):e243750.

CT Scan for Coronary Artery Calcification Window   Guest: Thomas C. Gerber, M.D., Ph.D. Host: Stephen L. Kopecky, M.D.   Coronary artery calcification (CAC) scanning can help improving our assessment of the risk of heart attack or stroke in thoughtfully selected patients. Not everyone needs a CAC scan! The results of a CAC scan can be particularly helpful in deciding whether a patient should start medications to reduce their risk. Coronary artery calcium scanning is *not* used to follow a patient's risk over time (to see whether the risk is decreasing or increasing).   Topics Discussed: How is a coronary artery calcification (CAC) scan done, and what can the results tell us about a patient's cardiovascular risk and management? Who should consider having a CAC scan? Should a patient discuss the possibility of a CAC scan with their doctor, and should they just self-refer to a screening center? What changes can we make in patient management based on CAC scan findings? How should we monitor whether the management is improving the patient's cardiovascular risk? How often should a CAC scan be done?    Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.

They are once again the top hospital in the state according to US News and World Report. Find out their secret sauce from Dr. Sean Dowdy from the Mayo.

In today's episode, we connect with Dr. Aahd Kubbara to discuss the intricacies of lung function and targeted biological therapies for asthma. Dr. Kubbara is a practicing pulmonologist and intensivist at the University of Minnesota Medical Center, where he also serves as an Assistant Professor of Medicine, Pulmonary, Allergy, Critical Care, and Sleep and Associate Program Director of the Pulmonary and Critical Care Fellowship. Hit play to discover: The types of inflammatory diseases that can lead to lung scarring. The consequences of untreated asthma over years of time. What pulmonary fibrosis is, and how to treat it. The potential impacts of normalizing chronic health symptoms. How seasonal asthma is typically triggered and how to mitigate it. Dr. Kubbara brings a wealth of experience to his field, including a year in Critical Care at the Mayo Clinic in Rochester, and another year in Academic Pulmonary and Critical Care at the University of Nevada, Reno. He also spent a year practicing community Pulmonary and Critical Care at both Mayo Clinic Eau Claire and Aspirus Wausau Hospital. In addition, he completed an advanced fellowship in Interstitial Lung Disease and Vasculitis at the Mayo Clinic. To learn more about Dr. Kubbara and his work, click here! Episode also available on Apple Podcasts: http://apple.co/30PvU9C Keep up with Julian R. Gershon Jr. socials here: Instagram: https://www.instagram.com/aahd_kubbara/?hl=en  X : https://x.com/aahdkubbara 

In this JCO Article Insights episode, Michael Hughes summarizes “International Myeloma Society and International Myeloma Working Group Consensus Recommendations on the Definition of High-Risk Multiple Myeloma" by Avet-Loiseau et al. published on June 09, 2025 along with an interview with author Dr Nikhil C. Munshi, MD. TRANSCRIPT Michael Hughes: Welcome to this episode of JCO Article Insights. This is Michael Hughes, JCO's editorial fellow. Today I am interviewing Dr. Nikhil Munshi on the “International Myeloma Society and International Myeloma Working Group Consensus Recommendations on the Definition of High-Risk Multiple Myeloma” by Avet-Loiseau et al. At the time of this recording, our guest has disclosures that will be linked in the transcript. While some patients with multiple myeloma live for decades after treatment, others exhibit refractory or rapidly relapsing disease irrespective of treatment administered. We term this “high-risk myeloma.” Multiple risk stratification systems have been created, starting with the Durie-Salmon system in 1975 and evolving with the advent of novel therapeutics and novel treatment approaches. In 2015, the Revised International Staging System (R-ISS) was introduced, which incorporated novel clinical and cytogenetic markers and remained, until recently, a mainstay of risk stratification in newly diagnosed disease. Myeloma as a field has, just in the past few years, though, undergone explosive changes. In particular, we have seen groundbreaking advances not only in treatments - the introduction of anti-CD38 agents and the advent of cellular and bispecific therapies - but also in diagnostic technology and our understanding of the genetic lesions in myeloma. This has led to the proliferation of numerous trials employing different definitions of high-risk myeloma, a burgeoning problem for patients and providers alike, and has prompted attempts to consolidate definitions and terminology. Regarding cytogenetic lesions, at least, Kaiser et al's federated meta-analysis of 24 therapeutic trials, published here in the JCO in February of 2025 and recently podcasted in an interview with associate editor Dr. Suzanne Lentzsch, posited a new cytogenetic classification system to realize a shared platform upon which we might contextualize those trial results. This article we have here by Dr. Avet-Loiseau, Dr. Munshi, and colleagues, published online in early June of this year and hot off the presses, is the definitive joint statement from the International Myeloma Society (IMS) and the International Myeloma Working Group (IMWG). What is high-risk multiple myeloma for the modern era? The IMS and IMWG Genomics Workshop was held in July 2023 and was attended by international myeloma experts, collaborating to reach consensus based on large volumes of data presented and shared. The datasets included cohorts from the Intergroupe Francophone du Myélome (IFM); the HARMONY project, comprised of multiple European academic trials; the FORTE study, findings from which solidified KRd as a viable induction regimen; the Grupo Español de Mieloma Múltiple (GEM) and the PETHEMA Foundation; the German-Speaking Myeloma Multicenter Group (GMMG); the UK-based Myeloma XI, findings from which confirmed the concept of lenalidomide maintenance; Emory 1000, a large, real-world dataset from Emory University in Atlanta; the Multiple Myeloma Research Foundation Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile (CoMMpass) dataset; and some newly diagnosed myeloma cohorts from the Mayo Clinic. Data were not pooled for analyses and were assessed individually - that is to say, with clear a priori understanding of whence the data had been gathered and for what original purposes. Consensus on topics was developed based on the preponderance of data across studies and cohorts. In terms of results, substantial revisions were made to the genomic staging of high-risk multiple myeloma, and these can be sorted into three major categories: A) alterations to the tumor suppressor gene TP53; B) translocations involving chromosome 14: t(14;16) (c-MAF overexpression), t(14;20) (MAFB overexpression), and t(4;14) (NSD2 overexpression); and C) chromosome 1 abnormalities: deletions of 1p or additional copies of 1q. In terms of category A, TP53 alterations: Deletion of 17p is present in up to 10% of patients at diagnosis and is enriched in relapsed or refractory disease. This is well-documented as a high-risk feature, but the proportion of the myeloma cells with deletion 17p actually impacts prognosis. GEM and HARMONY data analyses confirmed the use of 20% clonal cell fraction as the optimal threshold value for high-risk disease. That is to say, there must be the deletion of 17p in at least 20% of the myeloma cells on a FISH-analysis of a CD138-enriched bone marrow sample to qualify as high-risk disease. TP53 mutations can also occur. Inactivating mutations appear to have deleterious effects similar to chromosomal losses, and the biallelic loss of TP53, however it occurs, portends particularly poor prognosis. This effect is seen across Myeloma XI, CoMMpass, and IFM cohorts. Biallelic loss is rare, it appears to occur in only about 5% of patients, but next-generation sequencing is nevertheless recommended in all myeloma patients. Category B, chromosome 14 translocations: Translocation t(14;16) occurs in about 2% to 3% of patients with newly diagnosed disease. In the available data, primarily real-world IFM data, t(14;16) almost always occurs with chromosome 1 abnormalities. Translocation t(4;14) occurs in about 10% to 12% of newly diagnosed disease, but only patients with specific NSD2 alterations are, in fact, at risk of worse prognosis, which clinically appears to be about one in every three of those patients. And so together, the CoMMpass and Myeloma XI data suggest that translocation t(4;14) only in combination with deletion 1p or gain or amplification of 1q correlates with worse prognosis. Translocation t(14;20) occurs in only 2% of newly diagnosed disease. Similar to translocation t(4;14), it doesn't appear to have an effect on prognosis, except if the translocation co-occurs with chromosome 1 lesions, in which case patients do fare worse. Overall, these three translocations - t(14;16), t(4;14), and t(14;20) - should be considered high-risk only if chromosome 1 aberrations are also present. In terms of those chromosome 1 aberrations, category C, first deletions of 1p: Occurring in about 13% to 15% of newly diagnosed disease, deletion 1p eliminates critical cell checkpoints and normal apoptotic signaling. In the IFM and CoMMpass dataset analyses, biallelic deletion of 1p and monoallelic deletion of 1p co-occurring with additional copies of 1q denote high-risk. In terms of the other aberration in chromosome 1 possible in myeloma, gain or amplification of 1q: This occurs in up to 35% to 37% of newly diagnosed disease. It upregulates CKS1B, which is a cyclin-dependent kinase, and ANP32E, a histone acetyltransferase inhibitor. GEM and IFM data suggest that gain or amplification of 1q - there was no clear survival detriment to amplification - is best considered as a high-risk feature only in combination with the other risk factors as above. Now, in terms of any other criteria for high-risk disease, there remains one other item, and that has to do with tumor burden. There has been a consensus shift, really, in both the IMS and IMWG to attempt to develop a definition of high-risk disease which is based on biologic features rather than empirically observed and potentially temporally dynamic features, such as lactate dehydrogenase. Beta-2 microglobulin remains an independent high-risk indicator, but care must be taken when measuring it, as renal dysfunction can artificially inflate peripheral titers. The consensus conclusion was that a beta-2 microglobulin of at least 5.5 without renal failure should be considered high-risk but should not preclude detailed genomic profiling. So, in conclusion, the novel 2025 IMS-IMWG risk stratification system for myeloma is binary. It's either high-risk disease or standard-risk disease. It's got four criteria. Number one, deletion 17p and/or a TP53 mutation. Clonal cell fraction cut-off, remember, is 20%. Or number two, an IGH translocation - t(4;14), t(14;16), t(14;20) - with 1q gain and/or deletion of 1p. Or a monoallelic deletion of 1p with 1q additional copies or a biallelic deletion of 1p. Or a beta-2 microglobulin of at least 5.5 only when the creatinine is normal. This is a field-defining work that draws on analyses from across the world to put forward a dominant definition of high-risk disease and introduces a new era of biologically informed risk assessment in myeloma. Now, how does this change our clinical approach? FISH must be performed on CD138-enriched samples and should be performed for all patients. Next-generation sequencing should also be performed on all patients. Trials will hopefully now begin to include this novel definition of high-risk multiple myeloma. It does remain to be seen how data from novel therapeutic trials, if stratified according to this novel definition, will be interpreted. Will we find that therapies being evaluated at present have differential effects on myelomas with different genetic lesions? Other unanswered questions also exist. How do we go about integrating this into academic and then community clinical practice? How do we devise public health interventions for low-resource settings? To discuss this piece further, we welcome the esteemed Dr. Nikhil Munshi to the podcast. Dr. Munshi is a world-renowned leader in multiple myeloma and the corresponding author on this paper. As Professor of Medicine at Harvard Medical School, Director of the Multiple Myeloma Effector Cell Therapy Unit, and Director of Basic and Correlative Science at the Jerome Lipper Multiple Myeloma Center of the Dana-Farber Cancer Institute, he has presided over critical discoveries in the field.  Thank you for joining us, Dr. Munshi. Dr. Nikhil Munshi: Oh, it's my pleasure being here, Michael, to discuss this interesting and important publication. Michael Hughes: I had a few questions for you. So number one, this is a comprehensive, shall we say, monumental and wide-ranging definition for high-risk myeloma. How do you hope this will influence or impact the ways we discuss myeloma with patients in the exam room? And how do we make some of these components recommended, in particular next-generation sequencing, feasible in lower-resource settings? Dr. Nikhil Munshi: So those are two very important questions. Let's start with the first: How do we utilize this in our day-to-day patient care setting? So, as you know well, we have always tried to identify those patients who do not do so well with the current existing treatment. And for the last 30 years, what constitutes a myeloma of higher risk has continued to change with improvement in our treatment. The current definition basically centers around a quarter of the patients whose PFS is less than 2 to 3 years. And those would require some more involved therapeutic management. So that was a starting point of defining patients and the features. As we developed this consensus amongst ourselves - and it's titled as “International Myeloma Society, International Myeloma Working Group Consensus Recommendation” - this IMS-IMWG type of recommendation we have done for many years, improvising in various areas of myeloma care. Now, here, we looked at the data that was existing all across the globe, utilizing newer treatment and trying to identify that with these four-drug regimens, with transplant and some of the immunotherapy, which group of patients do not do as well. And this is where this current algorithm comes up. So before I answer your question straight, “How do we use it?” I might like to just suggest, “What are those features that we have identified?” There are four features which constitute high-risk disease in the newer definition. Those with deletion 17p with 20% clonality and/or TP53 mutation. Number two, patients with one of the translocations - t(4;14), t(14;16), or t(14;20) - co-occurring with 1q amplification or deletion 1p32. And that's a change. Previously, just the translocation was considered high-risk. Now we need a co-occurrence for it to be called high-risk. The third group is patients having biallelic deletion 1p32 or monoallelic deletion 1p32 along with 1q amplification. And finally, patients with high beta-2 microglobulin, more than or equal to 5.5 mg/dL, with normal creatinine less than 1.2 mg/dL. And the question, “How do we use this?” There are multiple areas where we incorporate high-risk features in our treatment algorithm. One of the first areas is where we would consider the induction regimen. If a patient has a high-risk disease, we would definitely consider a four-drug regimen rather than a three-drug regimen, although we are beginning to incorporate four-drug for all groups. That's one important thing. Number two, those are the patients where we do consider consolidation with transplant or maybe in the new world, considering some of the immunotherapeutic consolidation more early or more aggressively. Number three, these are the patients who get a little bit more maintenance therapy. So normally, lenalidomide might end up being our standard maintenance regimen. In patients who have high-risk disease, we incorporate either addition of daratumumab or the anti-CD38 targeting antibody and/or addition of proteasome inhibitor, either bortezomib or carfilzomib. So you would have multi-drug maintenance therapy in these patients. And in high-risk patients, we follow them with maintenance longer periods of time. One very critically important point to keep in mind is that to get the better outcome in high-risk disease, we must try to get them into MRD negativity because there is clear data that patients who do achieve MRD negativity, despite having high-risk disease, have a much superior outcome. They become near to standard-risk disease. And so, in high-risk patients, I would try to do whatever various options I have to try and get them into MRD-negative status. And when these patients relapse, we do not wait for the classic progression criteria to be met before we intervene. We would propose and suggest that we intervene earlier before the disease really blasts off. And so there are a number of areas in our setting where this high-risk definition will help us intervene appropriately and also with appropriate aggressiveness to achieve better outcome, to make this similar to standard-risk disease. Michael Hughes: Thank you, Dr. Munshi. And thoughts on how to really integrate this not only into academic centers but also lower-resource settings? Dr. Nikhil Munshi: So that's a very important question, Michael. And when we were developing this consensus, we were very cognizant of that fact. So wherever available, I think we are recommending that over a period of next 2, 3, 5 years, we should begin to switch over to sequencing-based methods because two components of this definition, one is TP53 mutation, which we cannot do without sequencing, and also reliably detecting deletion 1p requires sequencing-based method. So in the low-resource countries - and there are many in this world, and also even in our own country, patients may not be able to afford it - the older method with FISH or similar such technology, which is more affordable, is also acceptable for current time. They may miss a very small number of patients, maybe 2% to 3%, where these finer changes are not picked up, but a majority of this would be captured by them. So the current practice might still be applicable with some limitation in those patient populations, and that's what we would recommend. What is happening, fortunately, is that actually sequencing-based method is becoming cheaper. And in many centers, it is cheaper to do the sequencing rather than to do the FISH analysis. And so my hope is that even in low-resource centers, sequencing might be more economical in the end. It's, I think, the access to technology, which is a little bit limited currently, but it's hopefully becoming available soon. Michael Hughes: Thank you, Dr. Munshi. And staying for a minute and looking at the multiple myeloma subsets which might be missed by this really still very broad-ranging high-risk definition, at least by prior risk stratification systems, right, there is this group of patients who have standard-risk cytogenetics by R-ISS or R2-ISS, but they have primary refractory disease or they relapse early. We call these, as you are well aware, functionally high-risk disease. What proportion of previously FHR, functionally high-risk, myeloma patients do you expect to be captured by this novel definition? Dr. Nikhil Munshi: So I think the newer definition - and we can look at it both ways, but the newer definition should capture most of the functionally high-risk definition. To put it differently, Michael, there are patients who we know are, as you mentioned, functionally high-risk. Those are the patients who might have plasma cell leukemia, those who might have extramedullary disease, those who might not respond to our four-drug induction. If you don't respond to the four-drug induction, almost by definition, they are high-risk. However, a majority of them have one of the abnormalities that we are describing here. There would be a very small proportion which may not have. And if they do not have, we know one of the important components of this definition here is also that the genome, we know, keeps on evolving. So there may be a very small clone with the high-risk feature which was not obvious in the beginning. Following treatments or following relapse, that clone predominates, and now the patient's disease becomes high-risk.  So the definition would incorporate or would capture these functional high-risk patients, but as you said, in countries where resources are not available, using this functional high-risk would also be helpful and advantageous. Sometimes LDH ends up being a high-risk. In our studies, LDH has not come out to be high-risk anymore because the features we are describing captures most of those patients, but those alternatives, older, can still be considered if other newer techniques are not available. Michael Hughes: Got you. And in terms of these older definitions, yes, that incorporate tumor burden, these empirical observations about how myeloma presents, do you foresee any additional tumor burden indicators being added to future definitions of high-risk disease? Or do you instead see this particular definition as a major waypoint on the journey towards a fully biologically grounded definition of high-risk disease? Dr. Nikhil Munshi: I think your second part is what is going to happen. I think the tumor burden-related definition is being now replaced by the biological or genomic-based definition. And I think at some point, it will be quite fully replaced. One component not here, and it is because one thing, we don't have enough data; number two, we don't know how it will pan out, is also the influence of the microenvironment on the risk definition. For example, the immune system, the immune function, etc. But not enough data exists to suggest how it would change the current definition. So in future, would a definition be totally genomic or it could be more integrative? And my personal guess is that it would be more integrative and that some immune features might come into the picture, especially now that we are using immune-based therapy as a very important component of treatment - CAR T-cells, bispecific, and antibody-based treatments. What role the immune system plays in either supporting tumor or what role suppression of the anti-tumor immunity plays? They all will be important how patient outcomes end up being, and which in turn could translate into how patient's risk stratification might happen. So I think the older tumor burden-related definitions probably will become things of the past. What we have currently proposed and consensus developed is the new path forward, and over time, some microenvironmental influences, if defined and found to be important, may get some more incorporation if it compares favorably with the genomic features. Michael Hughes: Thank you, Dr. Munshi for that enlightening response.  To conclude the podcast, I'd like to look to the future and to the immediate future, what are the next steps for high-risk disease definition between now and discussing an integrated genomic-microenvironment-based definition? Will we see attempts to refine? Will we see a multi-level system, things like this? Dr. Nikhil Munshi: Yeah, so I think the current definition will be here to stay for the next 10 years or so. I think this has been developed using a large amount of data, so we do believe that this will remain fine. It has been validated now within the last six months by a few of the other studies. So there won't be a quick change. But we will try to, all of us will try to innovate. And as you very rightly bring up, the areas of research would include looking at the expression or transcriptomic component. Does that matter? And we do believe a small number of patients will have transcriptomic changes, not looked at the DNA changes, and may play a role. There are newer components, so long non-coding RNA, for example, is going to be an important component to look at, how it impacts the disease outcome, etc. There are also some of the proteomic-related changes which may become important in our studies. And then as we discussed, microenvironment and immunological changes. So these are the future areas of ongoing research where we all should collect data, and then in the next 5 to 10 years, we'll have another group meeting to see has anything changed or any of the features have become more important.  Most of the time, some of the older features are lost because they are not as critically high-risk, and the newer features come in. And so the historical background for just one second, there was a time when chromosome 13 was considered a high-risk disease. We now don't even mention it because it's not high-risk. The newer treatments have improved the outcome. t(4;14) used to be a high-risk disease. Now by itself today, in this definition by itself is not; it needs to be with something else. And so I think this is a great sign of progress. As we improve the treatment and outcomes, some of the features will become less important, new features will come up, and we'll need to keep on evolving with time and with technology and make it better for patients. Michael Hughes: Thank you so much, Dr. Munshi, for your wisdom, for your sagacity, for your historical perspective as well.  Thank you for listening to JCO Article Insights. Please come back for more interviews and article summaries. And be sure to leave us a rating and review so others can find our show. For more podcasts and episodes from ASCO, please visit asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Darshan Shah, MD is a board-certified surgeon, published author, and Founder and CEO of Next Health – the first, largest and fastest-growing health optimization and longevity clinic. He earned his medical degree at the age of 21 from the University of Missouri-Kansas City, becoming one of the youngest doctors in the United States at the time. He continued his training at the Mayo Clinic and earned his MBA from Harvard Business School. As a longevity medicine specialist, he has advised thousands of patients on how to optimize their well-being and extend their healthspan and lifespan. Today on the show we discuss: steps you can take to add decades to your life, the #1 contributor to disease and how to eat for energy and fat loss, Dr. Shah's personal rock bottom and how he transformed his health, how to eat to manage your insulin effectively, the connection between mental and metabolic health, habits that increase and decrease your lifespan and much more.  Today's sponsor: Vitali Skincare Get 20% off ⁠Vitali Skincare⁠ by using code "Doug" at checkout by going to https://www.vitaliskincare.com/ ⚠ WELLNESS DISCLAIMER ⚠ Please be advised; the topics related to health and mental health in my content are for informational, discussion, and entertainment purposes only. The content is not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your health or mental health professional or other qualified health provider with any questions you may have regarding your current condition. Never disregard professional advice or delay in seeking it because of something you have heard from your favorite creator, on social media, or shared within content you've consumed. If you are in crisis or you think you may have an emergency, call your doctor or 911 immediately. If you do not have a health professional who is able to assist you, use these resources to find help: Emergency Medical Services—911 If the situation is potentially life-threatening, get immediate emergency assistance by calling 911, available 24 hours a day. National Suicide Prevention Lifeline, 1-800-273-TALK (8255) or https://suicidepreventionlifeline.org.  SAMHSA addiction and mental health treatment Referral Helpline, 1-877-SAMHSA7 (1-877-726-4727) and https://www.samhsa.gov Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textWhat would you do if doctors told you cancer had invaded your entire body and conventional medicine had nothing more to offer? In 1974, Rick Hill faced this devastating reality at the Mayo Clinic after eight hours of exploratory surgery revealed cancer throughout his lymphatic system. Weighing just 120 pounds and on morphine for pain, Rick made a decision that defied medical orthodoxy – he left the prestigious institution for a clinic in Tijuana offering treatments derived from apricot kernels.Rick's remarkable journey unfolds as he shares the three-component treatment that transformed his terminal prognosis: B17 (derived from apricot kernels), enzyme therapy to strip away the protein coating that shields cancer cells from immune detection, and pangamic acid (B15) to oxygenate his system. The results were astonishing – within three weeks, his color returned, pain subsided, and he could stand upright again. This wasn't temporary remission but the beginning of fifty cancer-free years.Beyond the medical aspects, Rick reveals the profound life lessons from facing mortality at such a young age. He emphasizes that true healing required more than just the initial treatment – it demanded a lifetime commitment to maintaining his health through continued supplementation and dietary vigilance. This experience ignited something powerful within him, propelling the once-stuttering young man to become a professional speaker, successful author, and co-inventor of an air purifier that sold 50 million units.Rick's passionate advocacy for medical freedom and alternative options comes not from anti-establishment sentiment but from lived experience. He offers a thought-provoking challenge: what if we focused on prevention rather than treatment? What if connecting the dots between our daily choices and future health outcomes could help us avoid serious illness altogether?Whether you're facing health challenges, interested in preventative approaches, or simply fascinated by extraordinary human stories, Rick's fifty-year journey offers wisdom, hope, and practical insights that could change how you think about health and healing. Discover his book "Too Young to Die" and explore his recommended supplements at RNCstore.com by searching "Rick" – mention HUTCAST for an additional 10% discount on your first order.graithcare.comGraith Care Independent Patient Advocate medical advocacy, consultation, advice US and InternationalOH EDDIES WHISKEY BOURBON SAUCEOh Eddies Sweet Whiskey Bourbon Sauce is guaranteed to step up your next barbeque. Made in MinnesotaExcel RoofingExcel RoofingSUPER FUEL ENERGY DRINKA BLAST OF PREMIUM NATURAL ENERGY! Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show Thank you for listening to this episode of HuttCast, the American Podcast. We hope you enjoyed today's discussion and gained valuable insights. To stay updated on our latest episodes, be sure to subscribe to our podcast on your preferred listening platform. Don't forget to leave us a rating and review, as it helps others discover our show. If you have any comments, questions, or suggestions for future topics, please reach out to us through our website or social media channels. Until next time, keep on learning and exploring the diverse voices that make America great.

In this episode of Life Gets MoCrazy, Jamie MoCrazy speaks with Michael A. Jensen, an MD/PhD student at the Mayo Clinic whose life changed in an instant after a cycling accident caused a traumatic brain injury. What followed was a remarkable story of perseverance, intellectual growth, and emotional healing. Michael shares how his recovery deepened his passion for neuroscience and ultimately brought him back to Mayo—this time, as a student and researcher.In this episode, we talk about:How Michael rebuilt his identity after a severe brain injury and returned to Medical School to pursue his PHDThe power of mindset, family support, and structured recovery in long-term healingAsking “why”: integrating personal experience into professional purpose

Send us a textOn this episode, the podcast returns Mitch and Clay from extended vacations to review highlights from one of the largest aviation events in the country held in Oshkosh, Wisconsin -- along with outlining the framework for an upcoming AME refresher seminar to be held by the FAA Education Division on the Mayo Clinic campus.

Join Jay Gunkelman, QEEGD (the man who has analyzed over 500,000 brain scans), and host Pete Jansons for another engaging NeuroNoodle Neurofeedback Podcast episode discussing neuroscience, psychology, mental health, and brain training. Special guests Joshua Moore and Anthony Ramos join in for a deep-dive Q&A.✅ Topic 1 Explained: Jay breaks down the critical links between insomnia and ADHD, highlighting how delayed circadian rhythms and underarousal phenotypes impact life satisfaction and school performance.✅ Topic 2 Deep Dive: Restless Leg Syndrome as an ADHD mimic—Jay explains its dopamine and beta spindle connections, EMG detection methods, and neurofeedback treatment options.✅ Topic 3 Insights: How psychiatric meds, especially antipsychotics and benzos, can impact EEGs, neuroplasticity, and long-term cognitive outcomes—plus safer treatment alternatives.✅ Additional Topics:

For many cancer patients, treatment can be an isolating and overwhelming journey; marked by fear, fatigue, and the constant burden of travel. But what if chemotherapy could be delivered at home? In this episode, our host Cathy Wurzer explores the growing movement to bring cancer care into the comfort of patients' homes with Dr. Roxana Dronca, Hematologist & Oncologist at Mayo Clinic and Dr. Arif Kamal, Chief Patient Officer at American Cancer Society. Could this shift not only ease the experience but also improve outcomes? Join us as we examine how innovation is transforming the future of cancer treatment.Get the latest health information from Mayo Clinic's experts, subscribe to Mayo Clinic's newsletter for free today:  https://mayocl.in/3EcNPNc

Host: Darryl S. Chutka, M.D. Guest: Sunanda V. Kane, M.D. Most people who develop inflammatory bowel disease are diagnosed before the age of 30. In women, this often occurs during the middle of their reproductive years. Some with inflammatory bowel disease choose to avoid pregnancy, usually due to misconceptions about pregnancy risks. Yet if properly managed, women can experience a normal, uneventful pregnancy and deliver a healthy child.  What effect does inflammatory bowel disease have on fertility? Do patients have a greater chance of a normal pregnancy if the bowel disease is in remission? How can patients minimize the risk of inflammatory bowel disease flares during pregnancy and are the pharmacologic therapies commonly used to treat inflammatory bowel disease safe to use during pregnancy? These are some of the questions I'll ask my guest, Sunanda V. Kane, M.D., from the Division of Gastroenterology and Hepatology at the Mayo Clinic as we discuss “Inflammatory Bowel Disease and Pregnancy”. https://ce.mayo.edu/content/mayo-clinic-talks-inflammatory-bowel-disease Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

Join Dr. Mana Moassefi from the Mayo Clinic as she explores how cognitive biases shape radiology practice and contribute to diagnostic errors. Highlighting practical debiasing strategies, she guides listeners through each stage of image interpretation to help radiologists move from biased to balanced readings. Spectrum of Cognitive Biasesin Diagnostic Radiology. Yoon and Lee et al. RadioGraphics 2024; 44(7):e230059.

A recent Review discusses the epidemiology, risk factors, diagnosis, and treatment of ovarian cancer. William Cliby, MD, and John Weroha, MD, PhD, both from the Mayo Clinic in Rochester, Minnesota, discuss this and more with JAMA Associate Editor Margaret Wheeler, MD. Related Content: Ovarian Cancer Endometriosis Typology and Ovarian Cancer Risk Screening for Ovarian Cancer ----------------------------------- JAMA Editors' Summary

Nancy saw the new Superman movie and loved it! Karly wants to go see it because she thinks the actor is hot. Joey decided to observe the Sabbath by not being on his phone and spending more time with his family. His screen time was only an hour and a half all day! He really enjoyed it. More changes coming to TSA – they plan to introduce “family lanes” that will help family screenings be more efficient. Hot Tea: The CEO that was caught on the kiss cam has resigned from his company. Country music artists have been referencing the incident at their concerts. Dylan Marlowe was kicked out of his own concert due to a security guard issue. Ella Langley makes her band watch concert footage like they are football players training for the next game. We have teamed up with Tennessee School of Beauty to give free back to school haircuts to kids K-12! You can register for your spot on wivk.com. Joey watched a TED talk about the “advice monster.” It talked about how people tend to offer advice without being asked and how to train yourself to stop doing that. Joey accidentally did that to his wife over the weekend and felt bad about it. Lucky 7 Nancy had to go to urgent care because she got a fishhook stuck in her finger. A therapy horse at the Mayo Clinic wakes kids up from surgery by playing the piano. Nancy went through the Bojangles drive thru and an AI bot took her order. We all think that is weird. See omnystudio.com/listener for privacy information.

Carlie Irsay-Gordon wants greatness over wins - and says Richardson still has time, but urgency is needed! Sounds like a very competent NFL owner! Caitlin Clark making a tremendous living, so still fighting for WNBA players to earn more! Will Levis to Mayo Clinic for AC joint repair! Cubs lineup could rival best in baseball history if Eugenio Suarez is acquired! Here is the link for the only autobiography ever published without praise for its author: https://www.amazon.com/Oops-Art-Learning-Mistakes-Adventures/dp/173420740X https://kentsterling.com/2025/07/03/rule-for-kent-sterling-conest/

Join me, Seth Farbman, as we dive into the fascinating story behind YourBio Health, a medical device company that has created a revolutionary solution for blood draws. Hear from the impressive team of experts, including CEO, Paul Owen, with his 35 years of experience in the healthcare industry including the Mayo Clinic, Chief Medical Officer Dr. Robson with his background in leading clinical initiatives at Walgreens, and Chief Scientific Officer Dr. Mina, previously a professor at Harvard Medical School.

Host: Darryl S. Chutka, M.D. Guests: Amanda M. Johnson, M.D., and Victor G. Chedid, M.D., M.S. This podcast continues our series on inflammatory bowel disease. The topic is important and timely: “Inflammatory Bowel Disease in Special Populations: The Elderly, the Obese and the LGBTQ Patient.” It's critical that we broaden our perspective in addressing the unique challenges faced by these often-unrecognized population groups. How common is the presentation of inflammatory bowel disease in those over 65? How does age affect the treatments commonly used? Does obesity alter the disease presentation or activity and what are some of the unique challenges our LGBTQ patients face with inflammatory bowel disease? These are just some of the questions I'll be asking my guests, Amanda M. Johnson, M.D., and Victor G. Chedid, M.D., M.S., both gastroenterologists at the Mayo Clinic. https://ce.mayo.edu/content/mayo-clinic-talks-inflammatory-bowel-disease Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, and William Morice II, M.D., Ph.D., CEO and president of Mayo Clinic Laboratories, discuss summertime illnesses and key insights from a recent diagnostic investment event. Together, they explore:Common summertime illnesses, along with tips for prevention. How investment in diagnostic tools influences innovation in the laboratory.The potential impact of growing interest in AI investments. The investment interest in liquid biopsy and its potential implications for clinical decision-making.How AI development may accelerate adoption of mass spectrometry, proteomics, and similar advancements in clinical laboratories. 

Host: Darryl S. Chutka, M.D. Guest: Konstantinos A. Papadakis, M.D. Due to the complexity and new pharmacologic options for the management of inflammatory bowel disease, patients often have their care provided by a gastroenterologist. They may not see their primary care provider as often as in the past and some of their preventive health maintenance may not get performed. Are patients receiving primarily specialty care still receiving good health maintenance?  Are we aware that patients with inflammatory bowel disease have some unique needs regarding their preventive health maintenance and some of the recommendations are different than the general population? These are questions I'll be asking my guest, gastroenterologist Konstantinos A. Papadakis, M.D., from the Mayo Clinic as we discuss “Health Maintenance in Inflammatory Bowel Disease” as part of our ongoing series on Inflammatory Bowel Disease. https://ce.mayo.edu/content/mayo-clinic-talks-inflammatory-bowel-disease Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

We know that kombucha is better for you than soda, right? But just how differently do these two beverages affect the gut? When you choose a ginger kombucha over, say, a cherry cola, the impact of that decision may be greater than you think. Dr. Will Bulsiewicz, gastroenterologist and best-selling author of Fiber Fueled, takes us inside the digestive tract to help us understand the big impact of these seemingly small choices.   Plus -- an update on Chuck Carroll's health journey. Doctors at the Mayo Clinic have a new theory about what may be causing Chuck's debilitating symptoms.   In this episode of The Exam Room you'll learn:   - How kombucha benefits the gut - The impact of soda vs kombucha on the body - How acid in soda and kombucha can put microplastics in your body - What to know about alcohol in kombucha - How added sugar impacts the microbiome and the immune system   — — SHOW LINKS — — Will Bulsiewicz Courses: https://theplantfedgut.com 38Tera: https://38tera.com Instagram: https://www.instagram.com/theguthealthmd — — — GreenFare 21-Day Kickstart with Chuck Starts July 12 in Herndon, VA. Register: https://greenfare.com/product/july-12th-saturday-21-day-kickstart-with-chuck — — — Chef AJ's Plant Powered Party in Las Vegas https://theplantpoweredparty.com — — EVENTS — — International Conference on Nutrition in Medicine Where: Washington, DC When: August 14-16, 2025 Tix & Speakers: https://www.pcrm.org/icnm — — BECOME AN EXAM ROOM VIP — — Sign up: https://www.pcrm.org/examroomvip — — THIS IS US — — The Exam Room Podcast Instagram: https://www.instagram.com/theexamroompodcast — — — Chuck Carroll Instagram: https://www.instagram.com/ChuckCarrollWLC Facebook: https://www.facebook.com/ChuckCarrollWLC X: https://www.twitter.com/ChuckCarrollWLC — — — Physicians Committee Instagram: https://www.instagram.com/physicianscommittee Facebook: https://www.facebook.com/PCRM.org X: https://www.twitter.com/pcrm YouTube: https://www.youtube.com/user/PCRM Jobs: https://www.pcrm.org/careers — — SUBSCRIBE & SHARE — — 5-Star Success: Share Your Story Apple: https://apple.co/2JXBkpy​​ Spotify: https://spoti.fi/2pMLoY3 — — — Please subscribe and give the show a 5-star rating on Apple Podcasts, Spotify, or many other podcast providers. Don't forget to share it with a friend for inspiration!