Podcasts about Mayo Clinic

Host: Darryl S. Chutka, M.D. Guest: Edward V. Loftus JR, M.D. Inflammatory Bowel Disease is somewhat of an umbrella term for a group of chronic inflammatory conditions of the GI tract. The most common types include ulcerative colitis and Crohn's Disease. While there are similarities between the two, there are also differences. For many individuals with inflammatory bowel disease, it's only a mild illness. Unfortunately for some, it can lead to severe disability and potentially life-threatening complications. What are the similarities and differences between ulcerative colitis and Crohn's? When should we suspect a patient has an inflammatory bowel disease? What's the best way to establish a diagnosis and finally, what treatment options do we have? These are just some of the questions I'll be asking my guest, Edward V. Loftus JR, M.D., from the Division of Gastroenterology and Hepatology at the Mayo Clinic as we discuss “Inflammatory Bowel Disease and Its Treatment”. 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 

Plus AI Notetakers Take Over MeetingsLike this? Get AIDAILY, delivered to your inbox, 3x a week. Subscribe to our newsletter at https://aidaily.usCan AI Be as Irrational as We Are? (Actually, Probably More)Psych researchers dropped GPT‑4o into a "cognitive dissonance" test—prompting it to write pro- or anti-Putin essays. The AI shifted its stance to match its own writing, and even more so when it felt "free" to choose. Conclusion: AI can twist beliefs just like us… maybe even harder.AI Note‑Takers Are Ghosting Meetings—and It's Getting WeirdAI bots from Zoom, Teams, Otter.ai, and more are swooping into meetings, taking notes even when the human isn't there. Sure, it's efficient—but it's also messing with privacy, etiquette, and real convo vibes. People worry bots will kill off spontaneity and dump too much data into the ether. Canva Cofounder: Creatives Are So Missing the AI Train

Host: Darryl S. Chutka, M.D. Guests: David H. Bruining, M.D., and Nayantara Coelho-Prabhu, M.B.B.S. An early diagnosis of inflammatory bowel disease is important in preventing long-term complications. Prompt treatment can improve quality of life, reduce the likelihood of hospitalizations, and help maintain remissions. However, establishing a diagnosis is often challenging due to the nonspecific and fluctuating nature of symptoms. Inflammatory bowel disease can also mimic other GI conditions. In addition, diagnostic confirmation usually requires a combination of blood tests, imaging, endoscopy, and histological analysis, making the process both time consuming and complex.  The topic for today's podcast is “Diagnosing Inflammatory Bowel Disease and Monitoring Modalities” and my guests are David H. Bruining, M.D., and Nayantara Coelho-Prabhu, M.B.B.S., from the Division of Gastroenterology and Hepatology at the Rochester campus of 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 S6 E5 I am delighted to welcome Dr Colin West MD PhD to the podcast. Dr West is a practising physician, educator, biostatistician and he is globally renowned for his research in professional and organisational wellbeing in healthcare. He has been deeply embedded in research work in this area with colleagues at Mayo Clinic for over two decades to advance and inform healthcare organisational and clinician wellbeing leadership, strategy and evidence-informed system and work unit interventions to promote physician wellbeing and reduce distress. Dr West is the inaugural program director for physician wellbeing at Mayo Clinic. He is the recipient of multiple awards for his research and education work and collaborates extensively with scientists and groups within and outside Mayo Clinic. External collaborations include members of leadership in the American Medical Association. His work with colleagues including Dr Tait Shanafelt has  been published in multiple top-tier journals, including the Lancet, the Journal of the American Medical Association, Annals of Internal Medicine, and JAMA Internal Medicine.   In this conversation we discuss the evolution of his work over the past two decades. We learn how the combination of unique skills, intellectual curiosity and a deep investment and sense of purpose led to a critical coalition of colleagues who have helped to advance and build evidence-informed road maps and organisational blueprints  to promote physician wellbeing and professional satisfaction and reduce burnout and distress. I was particularly keen to explore some of the key intervention studies including the COMPASS trail ( Colleagues Meeting to Promote and Sustain Satisfaction) and the research about leadership capability and coaching/development. This episode is full of both the science and practical wisdom Dr West brings as a clinical expert in this field and yet still scratches the surface of his work.  A lot of his efforts today centre on attention to the MVPs ( meaning values and purpose )of professional wellbeing for his colleagues and the work they do in turn for their patients. He finishes with a powerful call to action at this juncture and critical inflection point for healthcare and clinicians globally. This is fundamentally important work and I am grateful to Colin and colleagues for continuing to advance our knowledge and applied practice. Links/References/ResourcesDr West's Wellbeing Wednesday Thread https://www.linkedin.com/posts/colin-west-57821b82_colin-west-colinwestmdphd-on-x-activity-7252370843236749312-1WMg/https://www.mayo.edu/research/faculty/west-colin-p-m-d-ph-d/bio-00027800https://edhub.ama-assn.org/steps-forward/pages/professional-well-beingThe COMPASS Trial https://pubmed.ncbi.nlm.nih.gov/34366134/Register for the Australasian Doctors' Health conference to continue to the conversation in 2025:https://adhc.org.au/The Mind Full Medic Podcast is proudly sponsored by the MBA NSW-ACT Find out more about their service or donate today at www.mbansw.org.auDisclaimer: The content in this podcast is not intended to constitute or be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified health care professional. Moreover views expressed here are our own and do not necessarily reflect those of our employers or other official organisations.

It's time to focus on the often-misunderstood art of assertiveness—what it is, what it isn't, and how learning to speak up for yourself with clarity and respect can change your life. Whether it is Crina telling it like it is or just learning to speak up with friends, this episode illustrates just how transformative assertiveness can be, especially for those of us who've spent years saying “yes” when we really meant “no.” Drawing on guidance from the Mayo Clinic, the episode breaks down assertiveness as a healthy, balanced communication style—firm but respectful, confident without being combative. It's a powerful antidote to stress, resentment, and burnout, especially if you tend to overextend yourself in an effort to keep the peace. Unlike aggression, which bulldozes others, or passivity, which erases your own needs, assertiveness helps you communicate clearly while still honoring relationships and boundaries. Listeners are reminded that assertiveness isn't about being the loudest voice in the room—it's about knowing what you need, expressing it directly, and listening to others with the same respect you expect in return. It's a skill, not a personality trait, and it can be learned and practiced. The episode offers practical tools: use “I” statements to own your feelings, practice saying no without apology, and pay attention to your body language—standing tall, making eye contact, giving yourself some time to respond and staying calm in moments of tension.  And any of us who struggle with this may want to start small. You'll also learn how to identify the traps of passive or passive-aggressive behavior—like saying yes when you mean no, or expressing frustration through sarcasm—and how these patterns can damage relationships and leave you feeling powerless. With time and effort, assertiveness can lead to greater self-confidence, healthier connections, and more honest communication both at work and in your personal life. The takeaway? Assertiveness isn't just about getting what you want—it's about being clear about who you are. Whether you're dealing with a pushy colleague, a longtime friend, or a well-meaning but overbearing father-in-law, learning to assert yourself with clarity, confidence and calm is one of the most powerful tools we can develop. Good Read:   Being assertive: Reduce stress, communicate better - Mayo Clinic

Send us a textThis is our 5th annual special Pride episode.  San Diego celebrates Pride mid-July.  We are very lucky to welcome back our favorite guest for his third annual Pride episode . . . the multi-hyphenate, guru of gay health and well-being, the influencer that had us at "butt stuff" . . . Dr. Carlton Thomas.  Aside from being a board certified, Mayo Clinic trained gastroenterologist that focuses on gay health, Dr. C continues to change the way conventional medicine views health issues of the LGBTQIA+ community.  He co-hosts his own podcast, Butt Honestly, and travels the world presenting his sex-positive view on health.  Come celebrate Pride the way it was meant to be celebrated -- with good friends, a few laughs, some wine and talk of leather. Instagram, Bluesky and TikTok: @doctorcarltonTwitter:  @doctor_carltonPodcast:  Butt Honestly - available on all streaming services@tugayspodtugayspod@yahoo.com#lgbt #lgbtq #lgbtqia+ #sandiego #gaysandiego #gaycommedy #pride #sdpride25 Gay San Diego comedy LGBT LGBTQ LGBTQIA+@tugayspod tugayspod@yahoo.com#lgbt #lgbtq #lgbtqia+ #sandiego #gaysandiego #gaycommedyGay San Diego comedy LGBT LGBTQ LGBTQIA+Producers: Nick Stone & Andy Smith

I interviewed Dr. Roxana Dronca and Dr. Jeremy Jones who are both oncologists and are leads of Mayo Clinic's Cancer Care Beyond Walls program. Dr. Dronca had the idea of trying to find a way to deliver care of cancer patients in their home and Dr. Jones is responsible for bringing this model to other sites and even partner hospitals.   Episode Resources Connect with Arundhati Parmar aparmar@medcitynews.com  https://twitter.com/aparmarbb?lang=en https://medcitynews.com/   Review, Subscribe and Share If you like what you hear please leave a review by clicking here   Make sure you're subscribed to the podcast so you get the latest episodes. Click here to subscribe with Apple Podcasts  Click here to subscribe with Spotify Click here to subscribe with Podbean Click here to subscribe with RSS  

In this episode of 'Science of Slink,' Dr. Rosy Boa delves into what every pole dancer should know about exercising in extreme heat. Key topics include the physiological adaptations to heat acclimatization that typically occur within two weeks, the symptoms and handling of heat exhaustion versus heat stroke, and specific risk factors such as dehydration and medications. She also shares practical tips for pole dancers, such as managing equipment and grip issues, staying hydrated, and taking frequent breaks to avoid heat-related illnesses. Emphasis is placed on listening to one's body, recognizing the varied individual responses to heat, and prioritizing safety over performance.Are you a pole nerd interested in trying out online pole classes with Slink Through Strength? We'd love to have you! Use the code “podcast” for 10% off the Intro Pack and try out all of our unique online pole classes: https://app.acuityscheduling.com/catalog/25a67bd1/?productId=1828315&clearCart=true Chapters:00:00 Introduction and Episode Overview01:45 The Science of Sweating02:54 Heat Acclimatization in Athletes06:52 Physiological Adaptations to Heat11:27 Recognizing and Preventing Heat Exhaustion and Heat Stroke18:06 Risk Factors for Heat-Related Illnesses24:34 Pole Dancing in Hot Conditions29:52 Final Tips and RecommendationsCitations/further reading:Mayo Foundation for Medical Education and Research. (2023, April 6). Heat exhaustion. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250Howe, A. S., & Boden, B. P. (2007). Heat-related illness in athletes. The American journal of sports medicine, 35(8), 1384-1395.Nobel, G., Tribukait, A., Mekjavic, I. B., & Eiken, O. (2012). Effects of motion sickness on thermoregulatory responses in a thermoneutral air environment. European journal of applied physiology, 112, 1717-1723.Périard, J. D., Racinais, S., & Sawka, M. N. (2015). Adaptations and mechanisms of human heat acclimation: applications for competitive athletes and sports. Scandinavian journal of medicine & science in sports, 25, 20-38.Sawka, M. N., Leon, L. R., Montain, S. J., & Sonna, L. A. (2011). Integrated physiological mechanisms of exercise performance, adaptation, and maladaptation to heat stress. Compr Physiol, 1(4), 1883-1928.

From a recent WEDI virtual spotlight, WEDI's Emerging Technology Workgroup Chair Nick Radov (Stedi) has a great conversation about how providers are leveraging artificial intelligence to improve the industry and the special place guidance plays in ensuring not only innovation, but also responsibility. The panel: Jared Staal, Executive Director, Intelligent Automation & AI, Mayo Clinic, Mayo Clinic Newar Shara, PhD, Chief, Research Data Science, MedStar Research Institute. Chief of AI Application in Health Data Science (AI CoLab). Co-Director, Center for Biostatistics, Informatics, and Data Science Frederick Chen, MD, Chief Health and Science Officer, American Medical Association

Join us as we get to know Dr. Dontre' Douse, ENT head and neck surgeon, as he prepares to bring much-needed ENT care to Tifton and the surrounding region in August of 2025. Dr. Douse shares his journey from Savannah to the Mayo Clinic and back to Georgia, his passion for serving rural communities, and what inspired his special interest in head and neck cancer care. Tune in to hear how comprehensive ENT services—including sinus surgery, ear tubes, and cochlear implants—will soon be available close to home through Southwell Ear Nose and Throat. 

Idiopathic intracranial hypertension (IIH), a condition of increased intracranial pressure (ICP), causes debilitating headaches and, in some, visual loss. The visual defects are often in the periphery and not appreciated by the patient until advanced; therefore, monitoring visual function with serial examinations and visual fields is essential. In this episode, Kait Nevel, MD speaks with John J. Chen, MD, PhD, and Susan P. Mollan, MBChB, PhD, FRCOphth, authors of the article “Treatment and Monitoring of Idiopathic Intracranial Hypertension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Chen is a professor of ophthalmology and neurology at the Mayo Clinic in Rochester, Minnesota. Dr. Mollan is an honorary professor of metabolism and systems science in the department of neuro-ophthalmology at University Hospitals Birmingham in Birmingham, United Kingdom. Additional Resources Read the article: Treatment and Monitoring of Idiopathic Intracranial Hypertension 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: @IUneurodocmom Guests: @chenmayo, @DrMollan 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 Nevel: Hello, this is Dr Kate Nevel. Today, I'm interviewing Drs John Chen and Susan Mollan about their article on treatment and monitoring of idiopathic intracranial hypertension, which appears in the June 2025 Continuum issue on disorders of CSF dynamics. Drs Chen and Mollan, welcome to the podcast. And please, could you introduce yourselves to the audience? Dr Chen: Hello, everyone. I'm John Chen, one of the neuro-ophthalmologists at the Mayo Clinic. Thanks for having us here. Dr Mollan: Yeah, it's great to be with you here. I'm Susan Mollan. I'm a consultant neuro-ophthalmologist in Birmingham, England. Dr Nevel: Wonderful. So great to have you both here today, and our listeners. To start us off, talking about your article, can you share with us what you think is the most important takeaway from your article for the practicing neurologist out there? Dr Chen: Yeah, so our article talked about the treatment and monitoring of IIH. And I think one takeaway point is, IIH is becoming much more prevalent now that there's this worldwide obesity epidemic with obesity having- essentially being the largest risk factor for IIH other than female. It's really important to monitor vision because vision loss is often peripheral vision loss at first, which the patient may be completely unaware of. And so, it's important to pair up with an ophthalmologist so you can monitor the papilledema of the visual fields and make sure they don't get permanent vision loss. And in the article, we also talk about- there's been changes in the treatment of severe IIH, where traditionally, we used VP shunts; but there's been a trend toward using more venous sinus stenting in addition to the traditional surgeries. Dr Nevel: Great, thank you. I think probably most of our listeners or a lot of neurologists out there have a pretty good understanding of kind of the basics of the IIH. But can you kind of just go over a few key characteristics of IIH, and maybe some things that are less commonly known or things that are maybe just been kind of better understood over the past decade, perhaps? Dr Mollan: Yes, certainly. I think, as Dr Chen said, it's because this condition is becoming more prevalent, people recognize it. I think it's- we like to go back to the diagnostic criteria so that we're making a very accurate diagnosis. So, the patients may come in to the emergency room with, say, papilledema that's been identified elsewhere or crashing headaches. And it's important to go through that sort of diagnostic pathway, taking a blood pressure, taking a full blood count to make sure the patient is anemic, and then moving forward with that confirmation of papilledema into urgent neuroimaging, whether it's CT or MRI, but including venography to exclude a venous sinus thrombosis. And then if you have no structural lesion that's causing the raised ICP, it's moving forward with your lumbar puncture and carefully checking those pressures. But the patients may not only have crashing headache, they often have pulsatile tinnitus and neck pain. I think some of the features that we're now recognizing is the systemic metabolic effects that are unique to IIH. And so, there's an increased risk of cardiometabolic disease that's over and above what is conferred by obesity. Also, our patients have a sort of maternal health burden where they get impaired fertility, gestational diabetes and preeclampsia. And there's also an associated mental health burden, amongst other things. So we're really starting to understand the spectrum of the disease a bit more. Dr Nevel: Yeah, thank you for that. And that really struck me in your article, how important it is to be aware of those things so that we're making sure that we're managing our whole patient and connecting them with the appropriate providers for some of those other issues that may be associated. For the practicing neurologist out there without all the neuro-ophthalmology equipment, if you will, what should our bedside exam focus on to help us get maybe an early but accurate picture of the patient's visual function when we suspect IIH to be at play, perhaps before they can get in with the neuro-ophthalmologist? Dr Chen: Yeah, I think at the bedside you can still check visual acuity and confrontational visual fields, you know, with finger counting. Of course, you have to know that those are, kind of, crude kind of ways of screening. With papilledema, oftentimes the visual acuity is intact. And the confrontational visual fields aren't as sensitive as automated perimetry. Another important thing will be to do your direct ophthalmoscope and look at the amount of papilledema. If it's grade one or two papilledema on the more mild side, it's actually not vision threatening. It's the higher degrees of papilledema that can cause rapid vision loss. And so, if you look in and you see grade one papilledema, obviously you need to do the full workup, the MRI, MRV, lumbar puncture. But in terms of rapidly getting to an ophthalmologist to screen for vision loss, it's not going to be as important because you're not going to have vision loss at that low grade. If you look in and you see this rip-roaring papilledema, grade five papilledema, that patient is going to be at very severe risk of vision loss. So, I think that exam, looking at the optic nerve can be very helpful. And of course, talking to the patient about symptoms; is there decreased vision Is there double vision from a sixth nerve palsy? Are there transient visual obscurations which would indicate at least a higher degree of papilledema? That'd be helpful as well. Dr Nevel: Great, thank you. And when the patient does get in with a neuro-ophthalmologist, you talk in your article and, of course, in clinical practice, how OCT testing is important to monitor in this condition. Can you provide for the listeners the definition of OCT and how it plays a role in monitoring patients with IIH? Dr Mollan: Sure. So, OCT is short for optical coherence tomography imaging, and really the eye has been at the forefront of OCT alone. Our sort of cardiology colleagues are catching up on the imaging of blood vessels. But what it allows us to do is give us really good cross-sectional, anatomical-level changes that we can see both in the retina and also at the optic nerve head. And it gives us some really good measurements. It's not so good at sort of saying, is this definitely papilledema or not? That sort of lower end of disc elevation. But it is very good at ruling out what we call the pseudopapilledema. So, things like drusens or these other little masses we find underneath the optic nerve head. But in terms of monitoring, because we can longitudinally take these images and the reproducibility is pretty good at the optic nerve head, it allows us to see whether there's direct changes: either the papilledema getting worse or the papilledema getting better at the optic nerve head. It also gives us some indication of what's going on in the ganglion cell layer complex. And that can be helpful when we're thinking about sort of looking at structure versus function. So, ophthalmologists in general, we love OCT; and we spend much more time nowadays looking at the OCT than we really do the back of the eye. And it's just become critical for patients with papilledema to be able to be very accurate from visit to visit to see what's changing. Dr Nevel: How do you determine how frequently somebody needs to see the neuro-ophthalmologist with IIH and how often they need that OCT evaluation? Dr Chen: Once the diagnosis of IIH is made, how often they need to be seen and how frequent they need to be seen depends on the degree of papilledema. And again, OCT is really nice. You can quantify it and then different providers can actually use the same OCT numbers, which is super helpful. But again, if it's grade three papilledema or higher, or article thickness of 200 or higher, I tend to follow them a little bit more closely, trying to treat them more aggressively. Try to get the papilledema down into a safer zone. If it's grade one or two papilledema, we see them less frequently. So, my first visit might be three months out. They come with grade five papilledema, I'm seeing them within a few days to make sure that's papilledema's come down quickly because we're trying to decide, are they going to need surgery or not? Dr Nevel: Yeah, great. And that's a nice segue into talking a little bit about how we treat patients with IIH after the diagnosis is confirmed. And I'd like to just point out you have a very lovely figure in your article---Figure 5-6,---that I'd like to direct our listeners to read your article and check out that figure, which is kind of an algorithm on how we think about the various treatment options for patients who have IIH, which seems to rely a lot on the degree of presence of papilledema and the presence of vision disturbance. Could you maybe walk us through a little bit about how you think about the different treatment options for patients with IIH and when more urgent surgical intervention might be indicated? Dr Mollan: Yeah, sure. We always find it quite hard in any medical specialty to write these kind of flow diagrams because it's really an individual we're looking at. But these are kind of what we'd say is “broad brushstrokes” into those patients that we worry about, sort of, red disease in those patients, more amber disease. Now obviously, even those patients that may not have severe papilledema, they may have crashing headaches. So, they may be an urgent referral themselves because of that. And so, it's nice to try and work out which end of the spectrum you're working with. If we think of the papilledema, Dr Chen's already laid out the sort of lower end of the prison's scale---our grades one, our grades two---that we're less anxious about. And those patients, we would definitely be having discussions about medical management, which includes acetazolamide therapy; but also thinking about weight management. And it may well be that we talk a little bit further about weight management, but I think it's helpful to sort of coach those conversations after you've made a definite diagnosis. And then laying out the risk that's caused, potentially, the IIH in an individual. And then having a sort of open conversation with them about what changes they can have in their lifestyle alongside thinking about medical therapy. There's some patients with very low levels of papilledema that we decide not to put on medicines initially. As patients progress up that papilledema grade, we're definitely thinking about medical therapy. And our first line from the IIH treatment trial would be using acetazolamide, but we need to be thinking about using appropriate dosing. So, a lot of the patients that I see can be sent to me with very low doses that may be inappropriate for that person. In the IIHTT they used up to four grams daily in a divided dose. And you do need to counsel your patients when you're putting them on acetazolamide because of the side effects. You've got quite a nice table in this article about the side effects. I think if you get the patient on board, that they understand that they will experience side effects, that is helpful because they will expect it, and then possibly tolerate it a bit better. Moving through to that area where we're more anxious, that visual-threatening papilledema. As Dr Chen said, it's sort of like you look in and it's sort of “blood and thunder” in there. And you need to be getting on and encouraging the ophthalmologist to get a formal assessment of the visual field. It's very difficult to determine exactly the level at which- and we talk about the mean deviation in a lot of our research studies. But in general, it's a combination of things: the patient's journey to get to you, their symptoms, what's going on with the visual field, but what's also happening at the OCT. So, we look in and we see that fluid is seeping towards the fovea. We get very anxious, and those patients may not even have enough time for a rapid escalation of acetazolamide. It may well be at the first presentation, which we would term, like, fulminant; that we'd be thinking about surgical intervention. And I think before I stop, the other thing to say is, the surgical landscape is really changing. So, we're having some good studies coming out in terms of stenting. And so, there is a sort of bracket where it may well be that we are thinking about neuroradiological intervention in an earlier case. They may not quite be at that visual-threatening stage, but they may be resistant to medical treatments. Dr Nevel: Thank you for that. What do you think is a potential pitfall or a mistake to avoid, if you will, in the management of patients with IIH? Dr Chen: I think it's- in terms of pitfalls, I think the potential pitfalls I've seen are essentially patients where we don't necessarily create a good patient physician relationship. Where they don't have buy-ins on the treatment, they don't have buy-ins to come back, and they're lost to follow-up. And these patients can be dangerous, because they could have vision threatening papilledema and if not getting the appropriate treatment---and if they're not monitoring the vision---this can lead to poor outcomes. So, I've definitely seen that happen. As Dr Mollan said, you really have to tell them about the side effects from the medications. If you just take acetazolamide, letting them know the paresthesias and the changes in taste and some of these other side effects, they're going to immediately stop the medication. Again, and these medications do work, proven in the IIH treatment trial. So again, I think that patient-physician relationship is very important to make sure they have appropriate follow up. Dr Nevel: The topic of weight loss in this patient population can be tricky, and I know I talked with Susie in a prior interview about how to approach this topic with our patients in a sensitive and compassionate manner. Once this topic is broached, I find many patients are looking for advice on strategies for weight loss, or potentially medications or other interventions. How do you prioritize or think about the different weight loss strategies or treatments with your patients, and how do you think about the way that you recommend these different treatments or not? Dr Mollan: Yeah. I think that's a really great question because we sort of stray here into a specialty that we have not been trained in. One thing I definitely ask my patients: if they've been on a weight loss journey before, and what's worked for them and what's not worked for them. And within our different healthcare systems, we have access to different tiers of weight management approaches. But for the person sitting in front of me, that possibly there may be a long journey to access more professional care, it's about understanding. iIs there things that are free, such as, we have some apps in the National Health Service which are weight management applications where they can actually just start putting in their calories, their daily calorie intake. And those apps can be quite helpful and guiding in terms of targeting areas, but also informing the patient of what types of foods to avoid in their diet and what types of foods to include in their diet. And with some of the programs that are completely complementary, they also sometimes add on things about exercise. But I think it is a really difficult thing to manage as, say, an ophthalmologist or a neurologist, mainly because it's not our area of expertise. And I think we've all got to find, in our local hospitals and healthcare systems, those pathways where the patients may be able to access nutritional support, and sort of behavioral lifestyle therapy support, all the way through to the new medications for weight loss; and also for some people, bariatric surgery pathways. It's a tricky topic. Dr Nevel: So how should we counsel our patients about what to expect in the future in terms of visual outcomes? Dr Chen: I think a lot of that depends on the degree of papilledema when they present. If a patient comes in with grade five papilledema, that fulminant IIH that Dr Mollan had mentioned, these patients can have very severe vision loss. And even if we treat them very aggressively with high-dose medications and urgent surgical interventions, sometimes they can have permanent vision loss. And so, we counsel them that, you know, there's a strong chance that they're going to have a good amount of vision loss. But some patients, we're very surprised and we get a lot of vision back. So, we kind of set expectations, but we're cautiously optimistic that we can get vision back. If a patient presents with more mild papilledema like grade one or two papilledema, they're most likely not going to have any permanent vision loss as long as we're treating them, we're monitoring their vision, they're coming to their follow-ups. They tend to do very well from a vision perspective. Dr Nevel: That's great, thank you. And you know, ties into what you said earlier about really making sure that, you know, we create good- as with any patient, but good physician-patient relationships so that they, you know, trust us and they come to follow up so we can really monitor their vision appropriately. What do you think is going on in research in this area that's exciting? What do you think one of the next breakthroughs or thing that we need to understand the most about treatment and monitoring of IIH? Dr Chen: I think surgically, venous sinus stenting is going to probably take over the bulk of surgeries. We still need that randomized clinical trial, but we have some amazing outcomes with venous sinus stenting. And there's many efforts on randomized clinical trials for venous sinus stenting. So we'll have those results soon. From a medical standpoint, Dr Mollan can actually say, actually, more about this. Dr Mollan: I completely agree. The GLP-1 receptor agonists, the twofold prong approach: one is the weight loss where these patients, you know, have significant weight loss to put their disease into remission; and the other side of it is whether certain GLP-1s have the ability to reduce intracranial pressure. So, a phase 2 study that we undertook here in Birmingham did show that we were able to reduce intracranial pressure, but we don't think it's a class effect. So, I think the sort of big breakthrough will be looking at novel therapies like xenotide and other drugs that, say, work on the proximal kidney tubule. Are they able to reduce intracranial pressure directly? And I think we are on the cusp of a real breakthrough for this disease. Dr Nevel: Great. Thank you so much for chatting with me today. And I really learned a lot, appreciated the opportunity. I hope our listeners learned something today, too. So again, today I've been interviewing Drs John Chen and Susan Mollan about their article on treatment and monitoring of idiopathic intracranial hypertension, which appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining us 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.

Dr. Vamsi Velcheti and Dr. Nate Pennell discuss novel treatment approaches in small cell and non-small cell lung cancer that were featured at the 2025 ASCO Annual Meeting. TRANSCRIPT Dr. Vamsi Velcheti: Hello, I'm Dr. Vamsi Velcheti, your guest host of the ASCO Daily News Podcast. I'm a professor of medicine and chief of hematology and oncology at the Mayo Clinic in Jacksonville, Florida. The 2025 ASCO Annual Meeting featured some exciting advancements in small cell lung cancer, targeted therapies for non-small cell lung cancer, and other novel [treatment] approaches. Today, I'm delighted to be joined by Dr. Nate Pennell to discuss some of the key abstracts that are advancing the lung cancer field. Dr. Pennell is the co-director of the Cleveland Clinic Lung Cancer Program and also the vice chair of clinical research at the Taussig Cancer Institute. Our full disclosures are available in the transcript of this episode. Nate, it's great to have you back on the podcast. Thanks so much for being here. Dr. Nate Pennell: Thanks, Vamsi. Always a pleasure. Dr. Vamsi Velcheti: Let's get started, and I think the first abstract that really caught my attention was Abstract 8516, “The Randomized Trial of Relevance of Time of Day of Immunotherapy for Progression-Free and Overall Survival in Patients With Non-Small Cell Lung Cancer.” What are your thoughts about this, Nate? Dr. Nate Pennell: I agree. I thought this was one of the most discussed abstracts, certainly in the lung cancer session, but I think even outside of lung cancer, it got some discussion. So, just to put this in perspective, there have been a number of publications that have all been remarkably consistent, and not just in lung cancer but across multiple cancer types, that immunotherapy, immune checkpoint inhibitors, are commonly used. And all of them have suggested, when looking at retrospective cohorts, that patients who receive immune checkpoint inhibitors earlier in the day – so in the morning or before the early afternoon – for whatever reason, appear to have better outcomes than those who get it later in the day, and this has been repeated. And I think many people just sort of assumed that this was some sort of strange association and that there was something fundamentally different from a prognostic standpoint in people who came in in the morning to get their treatment versus those who came later in the afternoon, and that was probably the explanation. The authors of this randomized trial actually decided to test this concept. And so, about 210 patients with previously untreated advanced non-small cell lung cancer were randomly assigned to get chemo and immune checkpoint inhibitor – either pembrolizumab or sintilimab – and half of them were randomly assigned to get the treatment before 3 PM in the afternoon, and half of them were assigned to get it after 3 PM in the afternoon. And it almost completely recapitulated what was seen in the retrospective cohorts. So, the median progression-free survival in those who got earlier treatment was 13.2 months versus only 6.5 months in those who got it later in the day. So, really enormous difference with a hazard ratio of 0.43, which was statistically significant. And perhaps even more striking, the median overall survival was not reached in the early group versus 17.8 months in the late group with a hazard ratio of 0.43, also highly statistically significant. Even the response rate was 20% higher in the early patients; 75% response rate compared to 56% in the late-time-of-day patients. So very consistent across all measures of efficacy with pretty good matched characteristics across the different groups. And so, I have to tell you, I don't know what to make of this. I certainly was a skeptic about the retrospective series, but now we have a prospective randomized trial that shows essentially the same thing. So, maybe there is a difference between getting treated in the morning, although I have yet to hear someone give a very good mechanistic explanation as to why this would be. What were your thoughts on this? Dr. Vamsi Velcheti: It's indeed fascinating, Nate, and I actually think this was a very interesting abstract. Really, I was caught off guard looking at the data. I mean, if it were a drug, we would be so excited, right? I mean, with those kind of survival benefits. I don't know. I think circadian rhythm probably has something to do with it, like different cytokine profiles at the time of administration. I mean, who knows? But I think it's a randomized trial, and I think I would expect to see a mad rush for treatment appointments early in the morning given this, and at least I want my patients to come in first thing in the morning. It'll be interesting to see. Dr. Nate Pennell: It's important to point out that in this study, everyone got chemo and immunotherapy. And, at least in our cancer center, most patients who are getting platinum-doublet chemotherapy and immunotherapy actually do get treated earlier in the day already, just because of the length of the infusion appointment that's needed. So it really is oftentimes people getting single-agent immunotherapy who are often getting the later, shorter visits. But if you have a choice, I think it would be very reasonable to have people treated earlier in the day. And I do think most of the impressions that I got from people about this is that they would like to see it reproduced but certainly well worth further investigation. And I personally would like to see more investigation into what the rationale would be for this because I still can't quite figure out, yes, if you got it at, say, you know, 5 PM, that's later in the day and I can understand that maybe your immune system is somewhat less receptive at that point than it would be in the morning. But because these checkpoint inhibitors have such long half-lives, it's still in your system the next morning when your immune system is supposedly more receptive. So I don't quite understand why that would be the case. Well, let's move on to the next study. I would like to hear your thoughts on Abstract 8515, “Plasma-Guided, Adaptive First-Line Chemoimmunotherapy for Non-Small Cell Lung Cancer.” Dr. Vamsi Velcheti: Yeah, this was another abstract that seems to be really interesting in my opinion. I think there's kind of a lot of emphasis lately on ctDNA and MRD-based assays to monitor disease. In the lung cancer space, we haven't had a lot of clinical trials looking at this prospectively, and this was one of those pilot studies where they looked at circulating free DNA (cfDNA)-based response-adaptive strategy for frontline patients who are PD-L1 positive. So, patients started with pembrolizumab monotherapy, and based on plasma molecular response after 2 cycles, those patients without response received early treatment intensification with a platinum doublet. So the approach essentially was to reduce the chemotherapy exposure in patients who respond to immunotherapy. And only about 17.5% of the patients on the trial received chemotherapy based on lack of molecular response. So, in this trial, what they found was patients with the cfDNA response had a markedly improved PFS of 16.4 months versus 4.8 months. So essentially, like, this is a really nice study to set a foundation on which we have to do larger studies to incorporate molecular markers trying to look at cfDNA response to inform treatment strategy, either escalation or de-escalation strategies. So, I thought it was a very interesting study. Dr. Nate Pennell: Yeah. I mean, we always have this question for patients, “Should they get immunotherapy alone or combined with chemo?” and I think this certainly is intriguing, suggesting that there may be ways you can monitor people and perhaps rescue those that aren't going to respond to single agent. I'd like to see a randomized trial against, you know, this strategy, perhaps against everyone getting, say, chemoimmunotherapy or make sure that you're not potentially harming people by doing this strategy. But I agree, it's time to move beyond just observing that cell-free DNA is prognostic and important and start using it to actually guide treatment. Dr. Vamsi Velcheti: Yeah, and I would just caution though, like, you know, I think we need more data, but, however, it's certainly a very interesting piece of data to kind of help inform future trials. So, there was another abstract that caught my attention, and I think this would be a very interesting abstract in the EGFR space. Abstract 8506, "Patritumab Deruxtecan (HER3-DXd) in Resistant EGFR-Mutant Advanced Non-Small Cell Lung Cancer Patients After Third-Generation EGFR TKI," it's the HERTHENA-Lung02 study. What do you think about the results of this study? Dr. Nate Pennell: Yeah, this was, I would say, very widely anticipated and ultimately a little disappointing, despite being a positive trial. So, these are patients with EGFR-mutant non-small cell lung cancer who have progressed after a third-generation EGFR TKI like osimertinib. This is really an area of major unmet need. We do have drugs like amivantamab in this space, but still definitely an area where essentially patients move from having a highly effective oral therapy to being in the realm of chemotherapy as their best option. So, this HER3 antibody-drug conjugate, patritumab deruxtecan, had some good single-arm data for this. And we're sort of hoping this would become an available option for patients. This trial was designed against platinum-doublet chemotherapy in this setting and with a primary endpoint of progression-free survival. And it actually was positive for improved progression-free survival compared to chemo with a hazard ratio of 0.77. But when you look at the medians, you can see that the median PFS was only 5.8 versus 5.4 months. It was really a modest difference between the two arms. And on the interim analysis, it appeared that there will not be a difference in overall survival between the two arms. In fact, the hazard ratio at the interim analysis was 0.98 for the two arms. So based on this, unfortunately, the company that developed the HER3-DXd has withdrawn their application to the FDA for approval of the drug, anticipating that they probably wouldn't get past approval without that overall survival endpoint. So, unfortunately, probably not, at least for the near future, going to be a new option for these patients. Dr. Vamsi Velcheti: Yeah, I think this is a space that's clearly an unmet need, and this was a big disappointment, I should say. I think all of us were going into the meeting anticipating some change in the standard of care here. Dr. Nate Pennell: Yeah, I agree. It was something that I was telling patients, honestly, that I was expecting this to be coming, and so now, definitely a bit of a disappointment. But it happens and, hopefully, it will still find perhaps a role or other drugs with a similar target. Certainly an active area. Well, let's leave the EGFR-mutant space and move into small cell. There were a couple of very impactful studies. And one of them was Abstract 8006, “Lurbinectedin Plus Atezolizumab as First-Line Maintenance Treatment in Patients With Extensive-Stage Small Cell Lung Cancer, Primary Results from the Phase III IMforte Trial.” So, what was your impression of this? Dr. Vamsi Velcheti: Yeah, I think this is definitely an interesting study, and small cell, I remember those days when we had barely any studies of small cell at ASCO, and now we have a lot of exciting developments in the small cell space. It's really good to see. The IMforte trial is essentially like a maintenance lurbinectedin trial with atezolizumab maintenance. And the study was a positive trial. The primary endpoint was a PFS, and the study showed improvement in both PFS and OS with the addition of lurbinectedin to atezolizumab maintenance. And definitely, it's a positive trial, met its primary endpoint, but I always am a little skeptical of adding maintenance cytotoxic therapies here in this setting. In my practice, and I'd like to hear your opinion, Nate, most patients with small cell after 4 cycles of a platinum doublet, they're kind of really beaten up. Adding more cytotoxic therapy in the maintenance space is going to be tough, I think, for a lot of patients. But also, most importantly, I think this rapidly evolving landscape for patients with small cell lung cancer with multiple new, exciting agents, actually like some FDA-approved like tarlatamab, also like a lot of these emerging therapeutics like I-DXd and other ADCs in this space. You kind of wonder, is it really optimal strategy to bring on like another cytotoxic agent right after induction chemotherapy, or do you kind of delay that? Or maybe have like a different strategy in terms of maintenance. I know that the tarlatamab maintenance trial is probably going to read out at some point too. I think it's a little challenging. The hazard ratio is also 0.73. As I said, it's a positive trial, but it's just incremental benefit of adding lurbi. And also on the trial, we need to also pay attention to the post-progression second-line treatments, number of patients who received tarlatamab or any other investigational agents.  So I think it's a lot of questions still. I'm not quite sure I'd be able to embrace this completely. I think a vast majority of my patients might not be eligible anyway for cytotoxic chemotherapy maintenance right away, but yeah, it's tough. Dr. Nate Pennell: Yeah. I would call this a single and not a home run. It definitely is real. It was a real overall survival benefit. Certainly not surprising that a maintenance therapy would improve progression-free survival. We've known that for a long time in small cell, but first to really show an overall survival benefit. But I completely agree with you. I mean, many people are not going to want to continue further cytotoxics after 4 cycles of platinum-doublet chemo. So I would say, for those that are young and healthy and fly through chemo without a lot of toxicity, I think certainly something worth mentioning. The problem with small cell, of course, is that so many people get sick so quickly while on that observation period after first-line chemo that they don't make it to second-line treatment. And so, giving everyone maintenance therapy essentially ensures everyone gets that second-line treatment. But they also lose that potentially precious few months where they feel good and normal and are able to be off of treatment. So, I would say this is something where we're really going to have to kind of sit and have that shared decision-making visit with patients and decide what's meaningful to them. Dr. Vamsi Velcheti: Yeah, I agree. The next abstract that was a Late-Breaking Abstract, 8000, “Overall Survival of Neoadjuvant Nivolumab Plus Chemotherapy in Patients With Resectable Non-Small Cell Lung Cancer in CheckMate-816.” This was a highly anticipated read-out of the OS data from 816. What did you make of this abstract? Dr. Nate Pennell: Yeah, I thought this was great. Of course, CheckMate-816 changed practice a number of years ago when it first reported out. So, this was the first of the neoadjuvant or perioperative chemoimmunotherapy studies in resectable non-small cell lung cancer. So, just to review, this was a phase 3 study for patients with what we would now consider stage II or stage IIIA resectable non-small cell lung cancer. And they received three cycles of either chemotherapy or chemotherapy plus nivolumab, and that was it. That was the whole treatment. No adjuvant treatment was given afterwards. They went to resection. And patients who received the chemoimmunotherapy had a much higher pathologic complete response rate and a much better event-free survival. And based on this, this regimen was approved and, I think, at least in the United States, widely adopted.  Now, since the first presentation of CheckMate 816, there have been a number of perioperative studies that have included an adjuvant component of immunotherapy – KEYNOTE-671, the AEGEAN study – and these also have shown improved outcomes. The KEYNOTE study with pembrolizumab also with an overall survival benefit. And I think people forgot a little bit about CheckMate-816. So, this was the 5-year overall survival final analysis. And it did show a statistically and, I think, clinically meaningful difference in overall survival with the 3 cycles of neoadjuvant chemo-nivo compared to chemo with a hazard ratio of 0.72. The 5-year overall survival of 65% in the chemo-IO group versus 55% with the chemo alone. So a meaningful improvement. And interestingly, that hazard ratio of 0.72 is very similar to what was seen in the peri-operative pembro study that included the adjuvant component. So, very much still relevant for people who think that perhaps the value of those neoadjuvant treatments might be really where most of the impact comes from this type of approach. They also gave us an update on those with pathologic complete response, showing really astronomically good outcomes. If you have a pathologic complete response, which was more than a quarter of patients, the long-term survival was just phenomenal. I mean, 95% alive at 5 years if they were in that group and suggesting that in those patients at least, the adjuvant treatment may not be all that important.  So, I think this was an exciting update and still leaves very much the open question about the importance of continuing immunotherapy after surgery after the neoadjuvant component. Dr. Vamsi Velcheti: Yeah, I completely agree, Nate. I think the million-dollar question is: “Is there like a population of patients who don't have complete response but like maybe close to complete response?” So, would you like still consider stopping adjuvant IO? I probably would not be comfortable, but I think sometimes, you know, we all have patients who are like very apprehensive of continuing treatments. So, I think that we really need more studies, especially for those patients who don't achieve a complete CR. I think trying to find strategies for like de-escalation based on MRD or other risk factors. But we need more trials in that space to inform not just de-escalation, but there are some patients who don't respond at all to a neoadjuvant IO. So, there may be an opportunity for escalating adjuvant therapies. So, it is an interesting space to watch out for. Dr. Nate Pennell: No, absolutely. Moving to KRAS-mutant space, so our very common situation in patients with non-small cell lung cancer, we had the results of Abstract 8500, “First-Line Adagrasib With Pembrolizumab in Patients With Advanced or Metastatic KRASG12C-Mutated Non-Small Cell Lung Cancer” from the phase 2 portion of the KRYSTAL-7 study. Why was this an interesting and important study? Dr. Vamsi Velcheti: First of all, there were attempts to kind of combine KRASG12C inhibitors in the past with immune checkpoint inhibitors, notably sotorasib with pembrolizumab. Unfortunately, those trials have led to like a lot of toxicity, with increased especially liver toxicity, which was a major issue. This is a phase 2 study of adagrasib in combination with pembrolizumab, and this is a study in the frontline setting in patients with the G12C-mutant metastatic non-small cell lung cancer. And across all the PD-L1 groups, the ORR was 44%, and the median PFS was 11 months, comparable to the previous data that we have seen with adagrasib in this setting. So it's not like a major improvement in clinical efficacy. However, I think the toxicity profile that we were seeing was slightly better than the previous trials in combination with sotorasib, but you still have a fair amount of transaminitis even in the study. At this point, this is not ready for clinical primetime. I don't think we should be using sotorasib or adagrasib in the frontline or even in the second line in combination with checkpoint inhibitors. Combining these drugs with checkpoint inhibitors in the clinical practice might lead to adverse outcomes. So, we need to wait for more data like newer-generation G12C inhibitors which are also being studied in combination, so we'll have to kind of wait for more data to emerge in this space. Dr. Nate Pennell: I agree, this is not immediately practice changing. This is really an attempt to try to combine targeted treatment with immune checkpoint inhibitor. And I agree with you that, you know, it does appear to be perhaps a little bit better tolerated than some of the prior combinations that have tried in this space. The outcomes overall were not that impressive, although in the PD-L1 greater than 50%, it did have a better response rate perhaps than you would expect with either drug alone. And I do think that the company is focusing on that population for a future randomized trial, which certainly would inform this question better. But in the meantime, I agree with you, there's a lot of newer drugs that are coming along that potentially may be more active and better tolerated. And so, I'd say for now, interesting but we'll wait and see. Dr. Vamsi Velcheti: Yeah, so now moving back again to small cell. So, there was a Late-Breaking Abstract, 8008. This is a study of tarlatamab versus chemotherapy as second-line treatment for small cell lung cancer. They presented the primary analysis of the phase III DeLLphi-304 study. What do you think about this? Dr. Nate Pennell: Yeah, I thought this was really exciting. This was, I would say, perhaps the most important lung study that was presented. Tarlatamab is, of course, the anti-DLL3 bispecific T-cell engager compound, which is already FDA approved based on a prior single-arm phase II study, which showed a very nice response rate as a single agent in previously treated small cell lung cancer and relatively manageable side effects, although somewhat unique to solid tumor docs in the use of these bispecific drugs in things like cytokine release syndrome and ICANS, the neurologic toxicities. So, this trial was important because tarlatamab was approved, but there were also other chemotherapy drugs approved in the previously treated space. And so, this was a head-to-head second-line competition comparison between tarlatamab and either topotecan, lurbinectedin, or amrubicin in previously treated small cell patients with a primary endpoint of overall survival. So, a very well-designed trial. And it did show, I think, a very impressive improvement in overall survival with a median overall survival in the tarlatamab group of 13.6 months compared to 8.3 months with chemotherapy, hazard ratio of 0.6. And progression-free survival was also longer at 4.2 months versus 3.2 months, hazard ratio of 0.72. In addition to showing improvements in cancer-related symptoms that were improved in tarlatamab compared to chemotherapy, there was actually also significantly lower rates of serious treatment-related adverse events with tarlatamab compared to chemotherapy. So, you do still see the cytokine release syndrome, which is seen in most people but is manageable because these patients are admitted to the hospital for the first two cycles, as well as a significant number of patients with neurologic side effects, the so-called ICANS, which also can be treated with steroids. And so, I think based upon the very significant improvement in outcomes, I would expect that this should become our kind of standard second-line treatment since it seems to be much better than chemo. However, tarlatamab is definitely a new drug that a lot of places are not used to using, and I think a lot of cancer centers, especially ones that aren't tied to a hospital, may have questions about how to deal with the CRS. So, I'm curious your thoughts on that. Dr. Vamsi Velcheti: Yeah, thank you, Nate. And I completely agree. I think the data looked really promising, and I've already been using tarlatamab in the second-line space. The durability of response and overall, having used tarlatamab quite a bit - like, I participated in some of the early trials and also used it as standard of care - tarlatamab has unique challenges in terms of like need for hospitalization for monitoring for the first few treatments and make sure, you know, we monitor those patients for CRS and ICANS. But once you get past that initial administration and monitoring of CRS, these patients have a much better quality of life, they're off chemotherapy, and I think it's really about the logistics of actually administering tarlatamab and coordination with the hospital and administration in the outpatient setting. It's definitely challenging, but I think it definitely can be done and should be done given what we are seeing in terms of clinical efficacy here. Dr. Nate Pennell: I agree. I think hospital systems now are just going to have to find a way to be able to get this on formulary and use it because it clearly seems to be more effective and generally better tolerated by patients. So, should move forward, I think. Finally, there's an abstract I wanted to ask you about, Abstract 8001, which is the “Neoadjuvant osimertinib with or without chemotherapy versus chemotherapy alone in resectable epidermal growth factor receptor-mutated non-small cell lung cancer: The NeoADAURA Study”. And this is one that I think was also fairly highly anticipated. So, what are your thoughts? Dr. Vamsi Velcheti: You know, I wasn't probably surprised with the results, and I believe we were all expecting a positive trial, and we certainly were handed a positive trial here. It's a phase III trial of osimertinib and chemotherapy or osimertinib in the neoadjuvant space followed by surgery, followed by osimertinib. It's a global phase 3 trial and very well conducted, and patients with stage II to stage IIIB were enrolled in the study. And in the trial, patients who had a neoadjuvant osimertinib with or without chemotherapy showed a significant improvement in major pathologic response rates over chemotherapy alone. And the EFS was also positive for osimertinib and chemotherapy, osimertinib monotherapy as well compared to chemotherapy alone. So overall, the study met its primary endpoint, and I think it sheds light on how we manage our patients with early-stage lung cancer. I think osimertinib, we know that osimertinib is already FDA approved in the adjuvant space, but what we didn't really know is how was osimertinib going to work in the neoadjuvant space. And there are always situations, especially for stage III patients, where we are on the fence about, are these patients already close to being metastatic? They have, like, almost all these patients have micrometastatic disease, even if they have stage III. As we saw in the LAURA data, when you look at the control arm, it was like a very short PFS. Chemoradiation does nothing for those patients, and I think these patients have systemic mets, either gross or micrometastatic disease at onset. So, it's really important to incorporate osimertinib early in the treatment course. And I think, especially for the locally advanced patients, I think it's even more important to kind of incorporate osimertinib in the neoadjuvant space and get effective local control with surgery and treat them with adjuvant. I'm curious to hear your thoughts, Nate. Dr. Nate Pennell: I am a believer and have long been a believer in targeted adjuvant treatments, and, you know, it has always bothered me somewhat that we're using our far and away most effective systemic therapy; we wait until after they go through all their pre-op treatments, they go through surgery, then they go through chemotherapy, and then finally months later, they get their osimertinib, and it still clearly improves survival in the adjuvant setting. Why not just start the osimertinib as soon as you know that the patient has EGFR-mutant non-small cell lung cancer, and then you can move on to surgery and adjuvant treatment afterwards? And I think what was remarkable about this study is that all of these patients almost - 90% in each arm - went to surgery. So, you weren't harming them with the neoadjuvant treatment. And clearly better major pathologic response, nodal downstaging, event-free survival was better. But I don't know that this trial is ever going to show an overall survival difference between neoadjuvant versus just surgery and adjuvant treatment, given how effective the drug is in the adjuvant setting. Nonetheless, I think the data is compelling enough to consider this, certainly for our N2-positive, stage IIIA patients or a IIIB who might be otherwise surgical candidates. I think based on this, I would certainly consider that. Dr. Vamsi Velcheti: Yeah, and especially for EGFR, like even for stage IIIB patients, in the light of the LAURA study, those patients who do not do too well with chemoradiation. So you're kind of delaying effective systemic therapy, as you said, waiting for the chemoradiation to finish. So I think probably time to revisit how we kind of manage these locally advanced EGFR patients. Dr. Nate Pennell: Yep, I agree. Dr. Vamsi Velcheti: Nate, thank you so much for sharing your fantastic insights today on the ASCO Daily News Podcast. It's been an exciting ASCO again. You know, we've seen a lot of positive trials impacting our care of non-small cell lung cancer and small cell lung cancer patients. Dr. Nate Pennell: Thanks for inviting me, Vamsi. Always a pleasure to discuss these with you. Dr. Vamsi Velcheti: And thanks to our listeners for your time today. You will find links to all of the abstracts discussed today in the transcript of the episode. Finally, if you value the insights that you hear from the ASCO Daily News Podcast, please take a moment to rate, review, subscribe wherever you get your podcast. Disclaimer: 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. More on today's speakers:    Dr. Vamsi Velcheti   @VamsiVelcheti    Dr. Nathan Pennell   @n8pennell   Follow ASCO on social media:     @ASCO on Twitter     ASCO on Facebook     ASCO on LinkedIn   ASCO on BlueSky   Disclosures:   Dr. Vamsi Velcheti:   Honoraria: ITeos Therapeutics   Consulting or Advisory Role: Bristol-Myers Squibb, Merck, Foundation Medicine, AstraZeneca/MedImmune, Novartis, Lilly, EMD Serono, GSK, Amgen, Elevation Oncology, Taiho Oncology, Merus   Research Funding (Inst.): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline   Dr. Nathan Pennell:     Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron    Research Funding (Inst): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi 

Alzheimer's disease is one of the most challenging diagnoses for patients, families, and caregivers alike. With cases on the rise globally, the urgency to better understand, detect, and treat this complex brain disorder has never been greater. In this episode, our host Cathy Wurzer, explores the latest research breakthroughs that are offering new hope in the fight against Alzheimer's with Amy Goldman, CEO & Chair of GHR Foundation; Dr. Vijay Shah, Executive Dean of Research at Mayo Clinic and Heidi Dieter, Chair at the Mayo Clinic Department of Research Administration. 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. Guests: Jesse D. Bracamonte, D.O., Casey Martinez, Kiyan Heybati If you're a physician, there are several events during your medical journey that you'll always remember, receiving your letter of acceptance for medical school, medical school graduation and Match Day. For those of you who aren't physicians, Match Day is a very exciting day for medical students. It represents the day students learn where they'll be doing their residency training. It's a complicated process that uses an algorithm to match students and residency positions. But what happens if a student doesn't match with a residency program, what are their options? What do residency programs consider when ranking the numerous student candidates?  What are some common mistakes students make during the match process and how can students maximize their chances of matching with one of their top residency choices? These are questions I'll be asking my guests, Jesse D. Bracamonte, D.O., a family physician and Associate Dean of Student Affairs at the Arizona campus of the Mayo Clinic, as well as Casey Martinez and Kiyan Heybati, both senior medical students from the Mayo Clinic Alix School of Medicine. Our topic of discussion for this podcast will be “Navigating the Match: What Every Medical Student Should Know”. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

John Lieske, M.D., and Sandra Taler, M.D., explain how Mayo Clinic Laboratories' mass spectrometry assay helps evaluate patients for resistant hypertension. The test detects antihypertensive medications in urine, providing evidence of whether patients are absorbing their medications or whether a new treatment approach might be needed. Speaker 3: (00:33) Could you tell us a little about yourselves and your backgrounds? Speaker 3: (01:41) Dr. Taler, could you provide us with a brief background on resistant hypertension? Speaker 3: (03:43) Can you provide a little bit more background on patients who aren't taking their medications? Speaker 3: (05:11) How do physicians currently assess whether patients are taking their medications? Speaker 3: (07:03) Dr. Lieske, could you tell us how this new assay can be used to help physicians manage their patients with hypertension? Speaker 3: (09:43) Dr. Taler, can you tell us how doctors can use this new testing to manage their patients?

Nancie discusses her "brand fix" classifications of refine, purposefully manage, and transform, how to get started with data even when money and time are tight, some "Taylor Swift" approaches to brand work, and the difference between mission and brand. Key topics include: how to get the organization in harmony; why "The Big Reveal" is usually the wrong way to go; and her belief that both Sephora and Apple are losing brand steam. Tune in to hear case studies on Georgetown, The Mayo Clinic, and Samsung and a humorous story about a heart attack.You were brought in to fix the brand… but what exactly does that mean? In this week's episode of CMO Confidential, host and 5x CMO Mike Linton sits down with brand strategist Nancie McDonnell Ruder, founder of Noetic Consulting, to unpack the real-world challenges behind “fixing” a brand.From navigating crises at major healthcare institutions to helping Georgetown University build brand alignment across decentralized marketing teams, Nancie shares her proven frameworks and hard-won insights on strengthening brands from the inside out.They discuss: • The difference between a brand crisis, a refinement, and a transformation • What to do when your brand is suffering—but the real problem lies elsewhere • Why internal alignment and education are non-negotiable for brand success • The 5 best practices for brand revitalization (with names like Taylor Swift songs!) • Brand fails to avoid—including the “Big Reveal” trap and skipping customer data • And yes… the show ends with a heart attack, mouth-to-mouth CPR, and a forehead kiss (you'll just have to listen)00:00 – Intro: Welcome & episode setup01:02 – What does it really mean to “fix the brand”?03:45 – The Georgetown University brand refinement case06:25 – Standing up a brand for the first time (Mayo Clinic example)08:55 – Brand crisis vs. product/perception issue: How to tell the difference11:40 – Diagnosing the real problem: What does the data say?14:05 – Samsung's brand affinity challenge and how they solved it16:20 – The 5 best practices for brand revitalization (Taylor Swift edition)19:45 – Worst practices: The “big reveal,” internal misalignment, and ignoring skeptics23:05 – The importance of activating the brand internally25:30 – Brands to watch: Sephora, Apple, and Domino's28:20 – Funniest brand moment: A heart attack, CPR, and unexpected teamwork31:15 – Final takeaway + Mike's sauceless pizza story33:30 – Outro: Upcoming episodes and where to subscribeIf you're a CMO, CEO, board member, or founder facing brand issues—or aiming to avoid them—this episode is your toolkit.

Role of Thrombophilia Testing in Venous Thromboembolism   Guest: Ana Casanegra, M.D., M.S. Host: Kyle Klarich, M.D.   Thrombophilia testing identifies inherited or acquired conditions that increase the risk of abnormal blood clotting. Sometimes it can help us guide management decisions for patients, but who and when to test are key questions to address before making this decision.   Topics Discussed: What is thrombophilia, what is the difference with hypercoagulable states? Who should consider getting tested for thrombophilia, what does the testing process involve, and what to consider in preparation for it? How can the results of thrombophilia testing impact a person's medical management and lifestyle? Are there downsides of thrombophilia testing?   Easily check your diet with mini-eat.org as discussed by Dr. Lara-Breitinger and Dr. Kopecky!    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.

Think contracts are just boring paperwork? Think again. This real-life tale dives into what happens when a “sure thing” gig turns into a disappearing act—thanks to one agent's total fear of commitment (to a contract, that is). It's funny, frustrating, and a little too relatable for anyone who's ever said yes without seeing the fine print. If you've ever trusted a handshake and hoped for the best, you'll want to read this. Spoiler: it ends with a bang… and not the kind you expect.   https://www.TheWorkLady.com  Jan McInnis is a top change management keynote speaker and comedian. She uses short funny stories to emphasize her tips on how businesses can use humor to handle change. Jan is a top conference keynote speaker, comedian, Master of Ceremonies, and comedy writer. She has written for Jay Leno's The Tonight Show monologues as well as many other people, places, and groups—radio, TV, syndicated cartoon strips, guests on The Jerry Springer Show (her parents are proud). For over 25 years, she's traveled the country as a keynote speaker and comedian, sharing her unique and practical tips on how to use humor in business (yes, it's a business skill!). She's been featured in The Huffington Post, The Wall Street Journal, and The Washington Post for her clean humor, and she's the author of two books: Finding the Funny Fast – How to Create Quick Humor to Connect with Clients, Coworkers, and Crowds, and Convention Comedian: Stories and Wisdom From Two Decades of Chicken Dinners and Comedy Clubs. She also has a popular podcast titled Comedian Stories: Tales From the Road in Under 5 Minutes. In her former life, she was a marketing executive in Washington, D.C. for national non-profits, and she received the Greater Washington Society of Association Executives “Excellence in Education” Award. Jan's been featured at thousands of events from the Federal Reserve Banks to the Mayo Clinic.   https://www.TheWorkLady.com https://youtu.be/BtjxzDn-QLE https://www.linkedin.com/in/janmcinnis https://twitter.com/janmcinnis https://www.pinterest.com/janmcinnis/pins/ https://www.youtube.com/c/JanMcInnisComedian https://www.facebook.com/ComedianJanMcInnis https://www.instagram.com/jan.mcinnis/  Jan has shared her humor keynotes from Fortune 500 companies to international associations. Groups such as . .. Healthcare. . . Mayo Clinic, Health Information Management Associations, Healthcare Financial Management Associations, Hospitals, Abbott Pharmaceuticals, Sanofi Aventis Pharmaceuticals, Kaiser-Permanente, Davita Dialysis Centers, Blue Cross, Blue Shield, Home Healthcare Associations, Assisted Living Associations, Healthcare Associations, National Council for Prescription Drug Companies, Organization of Nurse Leaders, Medical Group Management Associations, Healthcare Risk Associations, Healthcare Quality Associations  Financial. . . Federal Reserve Banks, BDO Accounting, Transamerica Insurance & Investment Group, Merrill Lynch, treasury management associations, bankers associations, credit unions, Money Transmitter Regulators Association, Finance Officers Associations, automated clearing house associations, American Institute of CPAs, financial planning companies, Securities, Insurance, Licensing Association  Government . . . purchasing officers associations, city clerks, International Institute of Municipal Clerks, National League of Cities, International Worker's Compensation Fund, correctional associations, LA County Management Association, Social Security Administration, Southern California Public Power Authority, public utilities, U.S. Air Force, public personnel associations, public procurement associations, risk management associations, Rehabilitation associations, rural housing associations, community action associations  Women's Events. . . American Heart Associations, Go Red For Women luncheons, Speaking of Women's Health, International Association of Administrative Professionals, administrative professionals events, Toyota Women's Conference, Women in Insurance and Financial Services, Soroptimists, Women in Film & Video, ladies night out events, Henry Ford Health Centers Women's Event, spirit of women events, breast cancer awareness,  Education . . . School Business Officials associations, school superintendent associations, school boards associations, state education associations, community college associations, school administrators associations, school plant managers associations, Head Start associations, Texas adult protective services, school nutrition associations, Association of Elementary and Middle School Principals, principal associations, library associations  Emergency, safety, and Disaster . . . International Association of Emergency Managers, Disney Emergency Managers, state emergency management associations, insurance groups, COPIC, Salt Lake County Public Works and Municipal Services Disaster Recovery Conference, Pennsylvania Governor's Occupational Safety and Health conference, Mid Atlantic Safety conference and Chesapeake Regional Safety Council, Risk associations.  

  The 2026 AHIP Certification training is now live! We're covering AHIP FAQs to help you prepare!   Read the text version    Resources: Diversify Your Insurance Portfolio & Reap Real Rewards: https://lnk.to/asg651 Get Access to Exclusive Leads When You Become a PlanEnroll Network Agent: https://lnk.to/3pKJsF FAQs About NABIP Medicare Certification: https://ritterim.com/blog/faqs-about-nabip-medicare-certification/ FMO vs. IMO vs. NMO vs. MGA vs. GA: What's the Difference? https://lnk.to/asg658 The Survivor's AEP Checklist: https://ritterim.com/blog/the-survivors-aep-checklist/ Updates to the 2026 AHIP Certification You Should Know: https://ritterim.com/blog/updates-to-the-2026-ahip-certification-you-should-know/   References:  “AHIP Medicare + Fraud, Waste, and Abuse (MFWA) Online Course.” Ahipmedicaretraining.com, 2025, https://www.ahipmedicaretraining.com/page/login. Accessed 20 May 2025. AHIP Technical Support: Support@AHIPInsuranceEducation.org Sawchuck, Craig. “Test Anxiety: Can It Be Treated?” Mayo Clinic, 14 May 2024, www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/test-anxiety/faq-20058195. Accessed 20 May 2025. ‌“Top Universities.” Top Universities, Nov. 2012, https://www.topuniversities.com/student-info/health-and-support/exam-preparation-ten-study-tips. Accessed 20 May 2025. ‌ Follow Us on Social!  Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

Broadcast from KSQD, Santa Cruz on 6-19, 2025: Dr. Dawn presents the VITAL study evidence showing 2,000 IU daily vitamin D prevents telomere shortening in immune cells, effectively slowing biological aging by three years. Groundbreaking mouse research reveals maternal iron deficiency can alter fetal sex development. When iron levels dropped 60%, the SYR gene controlling male development switched off, causing 6 of 39 XY offspring to develop ovaries instead of testes. Thus, mammalian sex can be influenced by environmental factors just like in amphibians and fish. Dr. Dawn connects this to gender identity questions, advocating supporting puberty blockers based on their 30-year safety record. Dr. Dawn advocates widespread CPR and AED training after describing a successful Buffalo airport rescue. With 350,000 annual out-of-hospital cardiac arrests and 90% fatality rates, immediate AED intervention can triple survival odds. She promotes the Pulsepoint app registering 185,000 AEDs and praises countries like Norway achieving 90% population CPR training through driver's license requirements. Post-Roe v. Wade data shows vasectomies doubled in men aged 19-26 while tubal ligations rose 70%, mostly in abortion-ban states. Dr. Dawn notes the irony that policies intended to increase births prompted widespread voluntary sterilization. Environmental concerns from January 2025 Moss Landing battery fire and LA wildfires highlight toxic contamination from burning lithium, plastics, and building materials. She advocates fire-resistant landscaping and home hardening, noting some fire-resistant homes survived while surroundings burned. British research shows pet ownership provides life satisfaction equivalent to $90,000 annual income boost. Dr. Dawn experiences this firsthand, noting pets provide family-like benefits without complex interpersonal dynamics. Sleep study reveals 15 minutes additional nightly sleep improves cognitive performance in tweens. Children sleeping 7.25 versus 7.10 hours showed better academics and larger brain volumes, though Dr. Dawn questions causation versus correlation. Mayo Clinic identified Interleukin-23 as a reliable cellular senescence biomarker across multiple tissues. Natural compounds like quercetin, fisetin, and luteolin can reduce these aging markers, supporting her dietary supplementation philosophy.

In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, and Div Dubey, M.B.B.S., a neurologist and co-director of the Clinical Neuroimmunology Laboratory at Mayo Clinic, explore the topic of peripheral neuropathy. Their discussion covers:The high prevalence of peripheral neuropathy and why early diagnosis is important. The complexities involved in diagnosing the condition.Symptoms that should prompt clinicians to order advanced testing early in the diagnostic process.How algorithms are enhancing the use of testing to complement other diagnostic tools.Ongoing discovery related to specific antibodies associated with neuropathies.Learn more in our e-book, "Peripheral neuropathy: Cutting through diagnostic dissonance with an algorithmic approach."

Today's guest is Dr. Christopher Camp, a board-certified orthopaedic surgeon with a deep focus on sports medicine and shoulder and elbow surgery. Since 2019, Dr. Camp has served as the Medical Director, Team Physician, and Director of High Performance for the Minnesota Twins, where he works closely with players, athletic trainers, and front office staff to keep athletes healthy and performing at their best.Beyond the field, Dr. Camp is a leading researcher in the biomechanics of throwing, injury prevention, and surgical innovation. His work is shaping how we understand and treat injuries in overhead athletes—not just in baseball, but across all sports. He also leads the Human Optimization Project at the Mayo Clinic, an initiative focused on maximizing health, performance, and recovery. Listen along as we dive into his unique perspective on athlete care, research, and the evolving relationship between medicine and high performance in professional baseball.For more information about PBATS and athletic training, visit pbats.com.

Special guest & performance coach Dr. Cindra Kamphoff explores with Megan and Brad mental practices to thrive in demanding environments like IT and Cybersecurity fields.Through her work with companies like Verizon, the Minnesota Vikings, and Mayo Clinic, Cindra unpacks tools for resilience, confidence building, and facing setbacks. From the "Learn, Burn, Return" method to understanding Imposter Syndrome, this conversation prompts action and provides strategies for thriving under pressure that can apply to anyone. Enjoy this episode of Unsecurity! -- We want to hear from you! Send your suggestions, comments, and questions to unsecurity@frsecure.com. LinkedIn: https://www.linkedin.com/company/frsecure/ Instagram: https://www.instagram.com/frsecureofficial/ Facebook: https://www.facebook.com/frsecure/ BlueSky: https://bsky.app/profile/frsecure.bsky.social About FRSecure: https://frsecure.com/ FRSecure is a mission-driven information security consultancy headquartered in Minneapolis, MN. Our team of experts is constantly developing solutions and training to assist clients in improving the measurable fundamentals of their information security programs. These fundamentals are lacking in our industry, and while progress is being made, we can't do it alone. Whether you're wondering where to start, or looking for a team of experts to collaborate with you, we are ready to serve.

Tomorrow's Cure is back with season 3. Think about this for a moment... what if diseases could be cured before they even begin? Or if patients could receive cancer care from the comfort of their homes? Listen to Tomorrow's Cure where host Cathy Wurzer interviews experts from Mayo Clinic and other leading organizations.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: John W. Wilson, M.D. Tuberculosis remains a significant health concern. Globally, in 2023, an estimated 10 million individuals developed active tuberculosis and over one million died of the disease. In the U.S., just under 10, 000 individuals in the U.S. were diagnosed with TB, representing an increase over 2022. While tuberculosis remains a treatable disease, it's important to suspect and recognize those who may have it. A class 5 tuberculosis case is part of a TB classification system and refers to a suspected tuberculosis infection that requires further investigation. Symptoms may or may not be present and these patients may have an active TB case that could be contagious. This podcast is about class 5 tuberculosis cases, and my guest is infectious disease specialist, John W. Wilson, M.D., from the Mayo Clinic. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts

Joseph Yao, M.D., explains how Mayo Clinic Laboratories' new quantitative assay (Mayo ID: ADVQU) goes beyond qualitative testing to evaluate transplant patients for adenovirus infection. Adenovirus can cause life-threatening disease in immunocompromised transplant patients, especially children.(01:14)Could you give us a brief overview of this assay? (02:06)Can you explain the differences of the qualitative and quantitative methods and why we made the change to a quantitative adenovirus method? (04:00)When is this test typically ordered for transplant patients? Is it used throughout their treatment? (06:56)Could an immunocompromised person be unknowingly infected? (07:31)Is our quantitative method approved for pediatric patients? (08:00)How are the test results used to treat patients?(10:36)What other infections might providers consider alongside adeovirus?

Why Pulmonary Hypertension Isn't Just a Lung ProblemCardiologist Dr. Lisa Mielniczuk from the Mayo Clinic pulls back the curtain on one of the most common — yet misunderstood — forms of pulmonary hypertension: the kind caused by left heart disease. In this episode, she explains why it's time we stop thinking of PH as a rare condition. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on social @phaware Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com @phacanada  #phawareMD @mayoclinic @teamphhope

Electrophysiology Considerations in Oncology Patients   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 clinicians should consider electrophysiology in the patient with cancer. After listening to this episode, learners will understand the relationship between cancer and heart rhythm disorders, as well as begin to appreciate how cancer and arrhythmia treatments can interact.   Topics Discussed: Why are arrhythmias even relevant in cancer patients? What are some key arrhythmias associated with cancer or their therapies? What is a general approach towards managing arrhythmias 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.

When bringing people to the edge of death is your day job. Guest: Adam Richman, perfusionist at the Mayo Clinic⁠ and Unexplainable listener. For show transcripts, go to ⁠⁠⁠⁠⁠⁠⁠⁠vox.com/unxtranscripts⁠⁠⁠⁠⁠⁠⁠⁠ For more, go to ⁠⁠⁠⁠⁠⁠⁠⁠vox.com/unexplainable⁠⁠⁠⁠⁠⁠⁠⁠ And please email us! ⁠⁠unexplainable@vox.com⁠⁠ We read every email. Support Unexplainable (and get ad-free episodes) by becoming a Vox Member today: ⁠⁠⁠⁠⁠⁠⁠⁠vox.com/members⁠⁠⁠ Help us plan for the future of Unexplainable by filling out a brief survey: ⁠⁠⁠⁠⁠voxmedia.com/survey⁠⁠⁠⁠⁠. Thank you! Learn more about your ad choices. Visit podcastchoices.com/adchoices

Have you heard of longevity medicine? It's next-level healthcare—and Dr. Darshan Shah is one of the pioneers leading the way. In this episode, Dr. Shah shares how he's transforming the way we treat women in perimenopause and postmenopause by focusing on real root causes—not just symptom management.  We cover: What he learned about women's health as a surgeon How he approaches menopause differently than most doctors The truth about hormone testing during the transition The real drivers of Alzheimer's, osteoporosis, and heart disease in women Why so many doctors are confused about menopause care Exactly how to empower yourself at your first menopause visit How he uses the Wellness Wheel to individualize care A peek into cutting-edge therapies like Therapeutic Plasma Exchange and NAD+   Darshan Shah, MD, is a health and wellness specialist, board-certified surgeon, published author, entrepreneur, and founder of Next Health, the first, largest and fastest-growing health optimization and longevity clinic. He began his career at an accelerated MD program and earned his medical degree at the age of 21, becoming one of the youngest doctors in the United States. He then continued his training at the Mayo Clinic, and earned his MBA from Harvard Business School in 2015. As a longevity medicine specialist, he has advised thousands of patients on how to optimize their well-being and extend their healthspan and lifespan.    PREVIOUS EPISODE: https://www.drshah.com/extend-podcasts/zora-benhamou Extend Podcast: https://podcasts.apple.com/us/podcast/welcome-to-extend-with-darshan-shah-md/id1773578243?i=1000673875409  Biomarkers list: https://www.drshah.com/biomarkers   Contact Dr. Darshan Shah Website: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd  Email: contact@drshah.com   Give thanks to our sponsors: Qualia senolytics and brain supplements. 15% off with code ZORA here. Try Vitali skincare. 20% off with code ZORA here https://vitaliskincare.com Get Primeadine spermidine by Oxford Healthspan. 15% discount with code ZORA ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Get Mitopure Urolithin A by Timeline. 10% discount with code ZORA at https://timeline.com/zora Try Suji to improve muscle 10% off with code ZORA at TrySuji.com https://trysuji.com Get Magnesium Breakthrough by Bioptimizers. 10% discount with code HACKMYAGE at https://bioptimizers.com/hackmyage Try OneSkin skincare with code ZORA for 15% off https://shareasale.com/r.cfm?b=2685556&u=4476154&m=102446&urllink=&afftrack= Join ⁠⁠⁠Biohacking Menopause⁠⁠⁠ before July 1, 2025 to win free Vitali Skincare! 20% off with code ZORA at VitaliSkincare.com   Join the Hack My Age community on: Facebook Page: ⁠⁠⁠⁠⁠@⁠Hack My Age⁠     Facebook Group: ⁠⁠⁠⁠⁠⁠@⁠Biohacking Menopause⁠⁠⁠⁠⁠⁠ ⁠  Private Women's Only Support Group: https://hackmyage.com/biohacking-menopause-membership/ Instagram: ⁠⁠⁠⁠⁠@⁠HackMyAge⁠    Website: ⁠⁠⁠⁠⁠⁠HackMyAge.com⁠     

In this episode, we welcome Dr. Jewel Kling, an expert in women's health and menopause. Dr. Kling is a professor of medicine, chair of the Division of Women's Health at the Mayo Clinic in Scottsdale, Arizona. She is also the director of the Women's Health Center and dean of the Mayo Clinic Arizona Campus. With a background in public health and internal medicine, Dr. Kling has become a recognized leader in the fields of menopause, sexual health, and LGBT care education. She speaks nationally on menopause and hormone therapy and has published extensively on the subject.Dr. Kling joins us to dive into the topic of perimenopause, shedding light on common misconceptions and discussing the best approaches to treatment. In particular, she offers her insights on the pros and cons of starting hormone therapy during perimenopause and how to address contraception during this transitional period.Key discussion points: Perimenopause and Hormone Therapy Managing Symptoms Contraception Considerations Individualized CareThroughout the episode, Dr. Kling provides evidence-based insights and reassures women that effective treatments are available, especially for those suffering from persistent symptoms beyond the typical transition period.As an advocate for women's health, Dr. Kling is also involved in advanced hormone therapy training through the International Society for the Study of Women's Sexual Health (ISWHISH), where she and Dr. Sarah Cigna offer a comprehensive course for healthcare professionals. See below!Resources Mentioned: Advanced Hormone Therapy Course - A year-long virtual course for healthcare professionals, covering a range of topics, including hormone therapy and its effects on sexual functioning throughout different life stages, including pregnancy, lactation, and menopause. The Menopause Society - A resource for menopausal health and guidance on finding certified menopause practitioners.If you're experiencing perimenopausal symptoms or seeking guidance on hormone therapy, this episode offers invaluable knowledge and practical advice for navigating this stage of life with confidence.For more information on the Advanced Hormone Therapy Course and other resources, visit ISWHISH.

Burnout in medicine: When was burnout at its peak for doctors? Why are doctors so burnt out? What causes burnout in health care? Is there a National Burnout Study? Our guest is Michael Tutty, PhD, group vice president of Professional Satisfaction and Practice Sustainability at the American Medical Association. AMA CXO Todd Unger hosts.

Resilience, hope, and the profound power of holistic healing take center stage in this conversation. In this episode, we dive deep into a truly remarkable journey with Dr. Dawn Mussallem, a physician at Mayo Clinic, as she shares her powerful personal battles against stage four cancer, advanced heart failure, and a life-altering heart transplant, all while maintaining an unwavering zest for life and dedication to her patients; you'll hear about her unique insights on nutrition, plant-based diets, and the often-overlooked role of emotional well-being in physical health, including her groundbreaking work in plant protein development and regenerative farming. Through her inspiring story, you'll discover not only her medical expertise but also her profound belief in the human spirit's capacity to overcome adversity, ultimately transitioning "hope to knowing" that everything will be alright.The information presented in Fully Alive is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making changes to your health regimen. Guests' opinions are their own and do not necessarily reflect those of the podcast host, production team, or sponsors.Love the show? Subscribe, rate, review, & share! https://www.shellpoint.org/podcast/

Recently, sophisticated myelographic techniques to precisely subtype and localize CSF leaks have been developed and refined. These techniques improve the detection of various types of CSF leaks thereby enabling targeted therapies. In this episode, Katie Grouse, MD, FAAN, speaks with Ajay A. Madhavan, MD, author of the article “Radiographic Evaluation of Spontaneous Intracranial Hypotension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Madhavan is assistant professor of radiology at the Mayo Clinic in Rochester, Minnesota. Additional Resources Read the article: Radiographic Evaluation of Spontaneous Intracranial Hypotension 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 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 Grouse:  This is Dr Katie Grouse. Today I'm interviewing Dr Ajay Madhavan about his article on Radiographic Evaluation of Spontaneous Intracranial Hypotension, which he wrote with Dr Levi Chazen. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr Madhavan:  Hi, thanks a lot, Katie. Yeah, so I'm Ajay Madhaven. I'm a neuroradiologist at the Mayo Clinic in Rochester, Minnesota. I did all my training here, so, I've been here for a long time. And I have a lot of interest in spinal CSF leaks, and I do a lot of that work. And so I'm really excited to be talking about this article with you. Dr Grouse:  I'm really excited too. And in fact, it's such a pleasure to have you here talking today on this topic. I know a lot's changed in this field, and I'm sure many of our listeners are really interested in learning about the developments and imaging techniques to improve detection and treatment of CSF leaks, especially since maybe we've learned about this in training. I want to start by asking you what you think is the most important takeaway from your article. Dr Madhavan:  Yeah, that's a great question. I think---and you kind of already alluded to it---I think the main thing is, I hope people recognize that this field has really changed a lot in the last five to ten years, through a lot of multi-institutional collaboration and also collaboration between different specialties. We've learned a lot about different types of spinal CSF leaks, how we can recognize the disease, particularly the types of myelography that we need to be using to accurately localize and treat these leaks. Those are the things that have really evolved in the last five to ten years, and they've really helped us improve these patients' lives. Dr Grouse:  Can you remind us of the different common types of spinal leaks that can cause spontaneous intracranial hypotension? Dr Madhavan:  Yeah, so there are a number of different spinal CSF leaks, types, and I would say the three most common ones that really most people should try to be aware of and cognizant of are: first, ventral dural tears. So those are, like, just physical holes in the dura. And they're usually caused by little bone spurs that come from the vertebral columns. So, they're often patients who have some degenerative changes in their spine. And those are really very common. Another type of spinal CSF leak that we commonly see is a lateral dural tear. So that's like the same thing in a slightly different location. So instead of being in the front, it's off to the side of the dura laterally. And so, it's also just a hole in the dura. And then the third and most recently discovered type of spinal CSF leak is a CSF-venous fistula. So those are direct connections between the subarachnoid space and little paraspinal vein. And it took us a long time to even realize that this was a real pathology. But now that it's been recognized, we've found that this is actually quite common. So those three types of leaks are probably the three most common that we see. And there's certainly others out there, but I would say over 90% of them fall into one of those three categories. Dr Grouse:  That's a great review, thank you. Just as another quick review, as we talk more about this topic, can you remind us of some of the most common or typical brain imaging findings that you'll see in cases of spontaneous intracranial hypotension? Dr Madhavan:  Yeah, absolutely. So, when you do a brain MRI in a patient who has spontaneous intracranial hypotension, you will usually, though not always, see typical brain MRI abnormalities. And I kind of think of those as falling into three different categories. So, the first one I think of is dural enhancement or thickening. So that's enlargement or engorgement of the dura, the pachymeninges, and enhancement on postgadolinium imaging. So, that's kind of the first category. The second is that, when you lose spinal fluid volume, other things often expand to take up the space. So, for example, you can get distension or enlargement of the dural venous sinuses, and sometimes you can also get subdural food collections or hematomas. They can arise spontaneously. And I kind of think of those as, you know, you, you've lost the cerebrospinal fluid volume and something else is kind of filling up the space. And then the third category is called brain sagging. And that's a constellation of findings where the posterior fossa structures and the pituitary gland in the cell have become abnormal because you've lost the fluid that normally cushions those structures and causes them to float up. For example, the brain stem will sag down, the distance between the mammillary body and the ponds may become reduced. The suprasellar cistern space may be reduced such that the optic chiasm becomes very close to the pituitary gland, and the prepontine cistern may also become reduced in size. And there are various measurements that can be used to determine whether something is subtly abnormal. But just generally speaking, those are really the three categories of brain MRI abnormalities you'll see. Dr Grouse:  That was a great review. And of course, I think in many times when we are thinking about or suspecting this diagnosis, we may be lucky to find those imaging findings to reinforce a diagnosis. Because as it turns out, after reading your article, I was really surprised to find out that in as many as 19% of cases we actually see normal brain imaging, which really was a surprise to me, I have to say. And I think that this really encompasses why spontaneous intercranial hypotension is such a difficult diagnosis to make. I think a lot of us struggle with how far to take the workup when, you know, spontaneous intercranial hypotension is clinically suspected, but multiple imaging studies are normal. Do you have any guidance on how to approach these more difficult cases? Dr Madhavan:  So, that's a really good question. And you know, it's- as you can imagine, that's a topic that comes up in most meetings where people discuss this, and it's been a continued challenge. And so, like you said, about 19 or 20% of patients who have this disease can have a, a normal brain MRI. And we've tried to do some work to figure out why that is and how we can identify patients who still have the disease. And I can just provide, I guess, some tips that have helped me in my clinical practice. One thing is, if I ever see a patient with a normal brain MRI where this disease is clinically suspected---for example, maybe they have orthostatic headaches or other very typical symptoms and we don't know why, but their brain MRI is normal---the first thing I do is I try to look back at their old imaging. So many times, these patients who present to us at Mayo, who, when we do their MRI scan here, their brain MRI looks normal… if you really look back at imaging that they've had done elsewhere---maybe even two to three years prior---at the time their symptoms started, they actually had some abnormalities. So, I might see that a patient, two years ago, had dural enhancement that spontaneously resolved; but now they still have symptoms of SIH and they may still have a CSF leak that we can find and treat, but their brain MRI has, for whatever reason, normalized. So, I always start by looking back at old imaging, and I found that to be very helpful. The other thing is, if you see a patient with a normal brain MRI, it's also important to look at their spine MRI because that can provide clues that might suggest that they could still have a spinal CSF leak. And the two things I look for on the spine MRI: one, if there's any extradural CSF. So, spinal fluid outside of where it's supposed to be within the confines of the subarachnoid space. And you know, really, if you see extradural CSF, you know they probably have a spinal fluid leak somewhere. Even if their brain MRI is normal, that just gives you the information that there is a dural tear probably somewhere. And so, in those patients we'll definitely still proceed to myelography or other testing, even if they have a normal brain MRI. And then the last thing I look for is whether or not they have prominent meningeal diverticula. Patients with CSF venous fistulas almost always have one or more prominent diverticula on their spine along the nerve root sleeves. And that's probably because most of these fistulas come from nerve root sleeve diverticula. We don't completely understand the pathogenesis of CSF venous fistulas, but they're clearly associated with meningeal diverticula. So, if I see a patient who has a normal brain MRI, but I see on their spine MRI that they have many meningeal diverticula that are relatively prominent, that makes me more inclined to be a little bit more aggressive in doing myelography to find a CSF leak. And then I look at other demographic features, too. So, for example, elevated BMI and older age are associated with CSF venous fistulas. So, that can help you determine whether or not it's warranted to go on to more advanced imaging, too. So those are all just a variety of different things that we've used to help us. Dr Grouse:  Thank you for sharing that. I wanted to go on to say that, you know, reading your article, of course, as you mentioned, you alluded to the fact there's lots of new imaging modalities out there. It was very illuminating and just an excellent resource for the options that exist and when they're useful. You did a great job summarizing it. And I encourage our readers to check out your article, to refresh themselves, update themselves on what's happened in this space. And of course, we can't summarize them all today, but I was wondering if you could possibly walk us through a hypothetical case of a patient who comes in with a history very suspicious for SIH? How would you approach this patient? Say you have gotten imaging that suggested that there is a spinal fluid leak and now you have to figure out where it is. Dr Madhavan:  Yeah. So, you know, I think the most typical scenario it'll be a patient who has been seen by one of my excellent neurology colleagues and they've done a brain MRI and they've made the diagnosis through a combination of clinical information and brain MRI finding. And then the next thing we'll do always is, we'll obtain a spine MRI. So, I think of the purpose of the spine MRI as to determine what type of spinal fluid leak they have. On the spine MRI, if you see extradural CSF, those patients essentially always will have a dural tear. And it may be a ventral dural tear or a lateral dural tear. But if you see extradural CSF, that is pretty much what they have. And conversely, if you don't see extradural CSF---if you just see, for example, many meningeal diverticula, but you don't see anything else particularly abnormal---most of those patients have a CSF venous fistula, just common things being common. So I use the spine MRI to determine what type of leak they have. And then the next thing I think about is, okay, I'm going to do a myelogram on this patient. How do I want to position them? Because it turns out that positioning is probably the most important factor for finding these spinal fluid leaks. You have to have the patient positioned correctly to find the leak that you're trying to localize. And so, if I suspect they have a ventral dural tear, I will always position those patients prone for their myelogram. And I might do one of many different types of myelograms. And, you know, the article talks about things like digital subtraction myelography and dynamic CT myelography. And you can find any of these leaks with any of those techniques, but you just have to have the patient positioned correctly. So, if I think I have a ventral dural tear, I'll put them prone for the myelogram. If I think they have a lateral dural tear, I'll put them in the cubitus position for the myelogram. And also, if they- if I think they have a CSF-venous fistula, I'll also put them in the decubitus position. Obviously if you're putting them in the decubitus position, you have to decide whether it's going to be left or right side down. So that may require a two-day exam. Sometimes you don't have to; in many cases, we're able to just do everything in one day. But those are all the different factors I think about when I'm trying to determine how I'm going to work those patients up further. So, I really use the spine MRI chiefly to think about what type of leak they're going to have and how I'm going to plan the myelogram. Dr Grouse:  That's really great. And it's, I think, really nice to emphasize how much the positioning matters in all this, which I think is not something we've been classically taught as far as the diagnosis of spinal leaks. Another thing I'm really interested in your opinion on is, you talked a lot about how to optimize and what can make you successful at diagnosis. I'm curious what you think one of the easiest mistakes to make or, you know, that we should hopefully avoid when treating patients with this disease. Dr Madhavan:  Yeah. And I think, you know, one other thing that's been discussed a lot in this topic… you know, we've talked about the patients with a normal brain MRI. Another barrier or challenge particularly with CSF-venous fistulas is, sometimes they can be very subtle on imaging. So, it's not always you see it very definitive CSF-venous fistula where you can say, like, there's no question, that's a fistula. There are many times where we do a good-quality myelogram and we see something that looks, like, possible for a CSF venous fistula, or probable. If I had to put a number on it, maybe there's a 50 to 70% chance of real. So, in those cases, we end up wondering, like, should we treat this suspected leak? And I think one common mistake  or one thing that needs to be looked at further is, how do we handle these patients where we don't know whether the fistula is real or not? That's usually something where I will have a discussion with the patient, and I'm usually just very upfront with him about my interpretation of the imaging. I'll just tell them, we did a good-quality myelogram. You did a great job. We got good images. I don't see anything definitive, but I see this thing that I think has maybe a 60% chance of being real. And then I'll confer with one of my neurology colleagues and we'll decide whether it's worth treating that or not. And we'll just be very upfront with a patient about whether- about the likelihood of its success and what their long-term prognosis is. And oftentimes we let them make the decision. But I think that remains to be one of the big challenges is, how do we treat these patients who have suspected leaks that are not definitive on imaging. Dr Grouse:  That sounds absolutely like an important area where there can be problems, so I appreciate that insight. I'm interested what you think in your article would come as the biggest surprise to our listeners who may not have kept up as much with all of the changes that have happened in recent years? Dr Madhavan:  One of the things that was certainly, at least, a surprise to me as I was going through my training and learning about this topic is how diverse myelography has really become. You know, when I was a radiology resident, I learned about myelography as this thing that we've been doing for 30 to 40 years. And historically we've used myelograms just to look for degenerative changes: disc bulges, you know, disc herniations and things like that. Now that MRI is more prevalent, we don't use it as much, but it has turned out that it has a very big role in patients with spinal fluid leaks. Furthermore, something that I've learned is just how diverse these different types of myelograms have become. It used to kind of be just that a myelogram is a myelogram is a myelogram, but now we have different types of positioning, different types of equipment that we use. We vary the timing between contrast injection and imaging to optimize success for finding spinal fluid leaks. So, I think many times I talk to people who may not be as familiar with this field and they're surprised at just how diverse that has become and how sophisticated some of the various myelographic techniques have become and how much that really makes a difference in being able to accurately diagnose these patients. Dr Grouse:  Well, I can say it was a surprise to me. Even as someone who does treat quite a few patients with this condition, I was surprised to see the breadth of different options that have become available. And then kind of a follow-up to that, what do you think the current area of controversy is in this area of diagnosis and treatment? Dr Madhavan:  The biggest ones are ones you've sort of already alluded to. So, one big one is, how far do we go in patients who have a normal brain MRI who still have a clinical suspicion of the disease? And sometimes it's really hard, because sometimes you will find patients who clinically have a very strong case for having spontaneous intracranial hypotension. You look at them, they have very acute-onset orthostatic headaches. There's no better explanation for their symptoms that we know of. And it's hard to know what to do with those patients, because some of them want to continue to undergo diagnostic workup, but you can only do so many myelograms and you can only do so much with this diagnostic workup that requires some radiation dose before it becomes very challenging. That's a major point of just, I guess, ongoing research as to what can we do better for that subset of patients. Fortunately, it's not all of them, it's a subset of them, but I think we could help those patients better in the future as we learn more about the disease. So that's one. And the other one is treating these equivocal findings, like I discussed.  And where should our threshold be to treat a patient, and what type of treatment should we do in patients where we don't know whether a leak is real? Should we just do a very noninvasive- relatively noninvasive blood patch? Do we do an embolization where we're leaving a foreign body there? Is it worth sending those patients to surgery? Those are all unanswered questions and things that continue to spark ongoing debate. Dr Grouse:  Do you think that there's going to be any new big breakthroughs, or even, do you know of any big developments on the horizon that we should be keeping our eyes out for? Dr Madhavan:  You know, I think for me the biggest thing is, imaging is dramatically improving. We talked a little bit about photon counting detector CT in our article, and that's one of the newest and best techniques for imaging these patients because it has very, very high resolution, it has a lower radiation dose, it has allowed us to find leaks that we were not able to find before. And there are other high-resolution modalities that are emerging and becoming more accessible to things like cone beam CT which we do in addition to digital subtraction myelography. And on top of that, we've started to use AI-based tools to make images look a lot better. So, there are various AI algorithms that have come out that allow us to remove artifacts from imaging. They help us image patients with a bigger body habitus better without running into a lot of imaging artifacts. They help us reduce noise in imaging. They can just give us better-quality images and aid us in the diagnosis. For me as a radiologist, those are some of the most exciting things. We're finding less invasive ways with less radiation to better diagnose these patients with just better-quality imaging. Dr Grouse:  Well, that is definitely something to be excited about. So, I just want to thank you so much for talking with us today. It's been such an interesting, informative discussion and a real privilege to talk with you about this important topic. Dr Madhavan:  Yeah, thanks so much. I really appreciate the time to talk with you, and I look forward to seeing the article out there and hopefully getting some interesting questions. Dr Grouse:  Again, today I've been interviewing Dr Ajay Madhavan about his article on Radiographic Evaluation of Spontaneous Intracranial Hypotension, which he wrote with Dr Levi Chasen. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, 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.

GLP-1 receptor agonists have changed the landscape of obesity treatment, offering levels of weight loss once thought unattainable without surgery. But what happens after the weight is lost? And can we really talk about success without talking about maintenance? While much of the public discourse fixates on dramatic weight loss numbers, the harder question is what comes next. Can lifestyle interventions alone sustain weight loss after GLP-1 cessation? How do metabolic adaptations and behavioral relapse factor in? And what does the data actually show about relapse rates, nutritional adequacy, and lean mass preservation when using these medications? In this episode, Danny sits down with Tara Schmidt, dietitian at the Mayo Clinic, to examine the intersection of pharmacology and behavior in long-term weight management. Tara Schmidt is a registered dietitian and an instructor of nutrition at Mayo Clinic. As the lead dietitian for the Mayo Clinic Diet, she provides guidance rooted in evidence-based principles. She hosts the Mayo Clinic On Nutrition podcast and co-authored The Mayo Clinic Diet: Weight Loss Medications Edition. Timestamps [05:17] Understanding weight loss maintenance [08:44] Defining success in weight loss maintenance [11:54] Predictors of maintenance: self-monitoring and behavioral strategies [23:37] Pharmacological interventions: GLP-1 receptor agonists [31:06] Dietary considerations for those taking GLP-1 RAs [37:07] Addressing misconceptions about weight loss drugs [42:48] Final thoughts and takeaways [48:49] Key ideas (Premium-only) Links/Resources Subscribe to Sigma Nutrition Premium Go to episode page Join the Sigma email newsletter for free Enroll in the next cohort of our Applied Nutrition Literacy course Visit sigmanutrition.com

Host: Darryl S. Chutka, M.D. Guests: Mary Lang; Caroline M. Gearin; Nick R. Winder, SPT Students in the various fields of medicine deal with a variety of stresses. Perhaps one of the biggest stresses is getting accepted into their respective school to begin their training. Once enrolled, they're then provided a large amount of information to be memorized and essentially need to learn a new language. They have pressure to do well on exams and spend countless hours in study or on the wards. Many students deal with financial stresses, often graduating with a tremendous student loan debt. So, what's life like as a student? How do students deal with these stresses?  What's the application procedure like and are there ways to increase the chances of getting accepted? Do our schools devote enough time to our students' wellness and burn-out prevention? These are some of the questions we'll cover in this podcast as we discuss “Life as a Student”. My three guests are all students in a variety of medical training programs. Mary Lang is a 2nd year medical student at the Mayo Alix School of Medicine after obtaining a degree in biomedical engineering. Caroline Gearin is a 2nd year physician assistant student at the Mayo Clinic School of Health Sciences and also has a bachelor's degree in health science. Nick Winder is a 2nd year physical therapy student at the Mayo Clinic physical therapy doctoral program. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

Fast food, processed foods, Roundup, for-profit hospitals and insurance, and drug companies shifting from cures to chronic treatments are major issues plaguing our healthcare system. Despite spending more than the next ten countries combined, America has the worst health outcomes. Join me as I chat with Dr. Jim Roach, an expert in integrative medicine known for his work on cancer strategies. A published researcher, speaker, and best-selling author, Jim has spoken at major venues like the Mayo Clinic and has been featured over 100 times in national and international media. Jim specializes in holistic medicine and is double-boarded in integrative medicine. Jack Canfield called him one of the most encyclopedic minds he's met. Our conversation covered topics like the "sick-care" system, big pharma's influence on medical education, natural alternatives for chronic diseases, and the healing power of a peaceful mind.Suggested Resources:The Midway CenterRed Yeast Rice for HypercholesterolemiaThe Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular HealthCurcumin: A Review of Its Effects on Human HealthSend me a text! This episode is proudly sponsored by: SizzlefishLet's talk about fueling your body with the best nature has to offer. If you're looking for premium, sustainable seafood delivered straight to your door, you need to check out Sizzlefish! Head to sizzlefish.com and use my code “wellnstrong” at checkout for an exclusive discount on your first order. Trust me, you're going to taste the difference with Sizzlefish! If you're looking for that healthy, radiant, post-vacation glow, you need to checkout OSEA! And right now, you can get 10% off your first order at OSEAMalibu.com with the code WELLNSTRONG!Join the WellnStrong mailing list for exclusive content here!Want more of The How To Be WellnStrong Podcast? Subscribe to the YouTube channel. Follow Jacqueline: Instagram Pinterest TikTok Youtube To access notes from the show & full transcripts, head over to WellnStrong's Podcast Page

In this special episode, Dr. Shaji Kumar from the Mayo Clinic speaks with Blood editor Dr. Laurie Sehn on a paper recently published in Blood, "Eliminating the Need for Sequential Confirmation of Response in Multiple Myeloma". The findings demonstrate eliminating the need for sequential confirmation of response in multiple myeloma. The study, involving 583 episodes of progression, found that simultaneous confirmation of disease progression using two different markers (e.g., serum protein electrophoresis and serum free light chain assay) was 98% accurate, compared to 82% for sequential confirmation. This suggests that simultaneous confirmation could improve clinical trial accuracy and reduce false censoring. The International Myeloma Working Group is set to revise its response criteria to incorporate these findings, potentially simplifying disease assessment and reducing the need for multiple blood draws.

Chronic Total Occlusion in 2025   Guest: Gregory Barsness, M.D. Host: Malcolm Bell, M.D.   Chronic (>3 months) complete epicardial coronary obstructive lesions, often referred to as CTOs, are recognized in a large minority of those referred for coronary angiography yet historically represent

If your doctor is recommending that you get a mastectomy, you will likely have some choices about how the surgery is performed. Your breast cancer treatment, your body, your breast shape and your lifestyle affect not only your options, but also the pros and cons of your options. There's no one method that works best for everyone because each person is unique. Today we are going to be exploring one specific type of mastectomy – the nipple-sparing mastectomy. This is a skin-sparing mastectomy that leaves the nipple and areola intact and usually improves the overall look of the reconstructed breast. Joining us on the show today are two very special guests: Dr. Mara Piltin, a Breast and Melanoma Surgical Oncologist and Physician Assistant, Maddie Beiswanger, both from Mayo Clinic. They are going to tell us more about nipple-sparing mastectomy procedures, current research that is being conducted around the use of minimally invasive robotic surgery to assist in these procedures and the possible benefits that these innovations can provide. This episode of The Real Pink Podcast is brought to you by Intuitive Surgical. Intuitive is a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery. Intuitive has been advancing minimally invasive care since 1995 with the goal of helping physicians improve the lives of people around the world. You can learn more at www.Intuitive.com

Une étude publiée en mai 2025 dans la revue JAMA Network Open, menée par le Barrow Neurological Institute et la Mayo Clinic, a révélé une association significative entre la proximité des terrains de golf et un risque accru de développer la maladie de Parkinson.Méthodologie de l'étudeLes chercheurs ont analysé les données de 419 patients atteints de la maladie de Parkinson et de 5 113 témoins appariés, issus du Rochester Epidemiology Project, couvrant une période de 1991 à 2015. Ils ont examiné la distance entre le domicile des participants et les terrains de golf, ainsi que la nature de leur approvisionnement en eau potable.Résultats principauxLes personnes résidant à moins d'un mile (environ 1,6 km) d'un terrain de golf présentaient un risque accru de 126 % de développer la maladie de Parkinson par rapport à celles vivant à plus de six miles.Le risque diminuait progressivement avec l'éloignement du terrain de golf, suggérant une relation dose-réponse.Les individus vivant dans des zones desservies par des systèmes d'eau potable alimentés par des nappes phréatiques situées sous des terrains de golf avaient un risque presque doublé de développer la maladie, comparé à ceux vivant dans des zones sans terrain de golf.Hypothèses explicativesLes terrains de golf sont souvent entretenus avec des quantités importantes de pesticides pour maintenir la qualité des pelouses. Aux États-Unis, l'utilisation de pesticides sur les terrains de golf peut être jusqu'à 15 fois supérieure à celle observée en Europe. Ces substances chimiques peuvent s'infiltrer dans les nappes phréatiques, contaminant ainsi l'eau potable des zones avoisinantes.De plus, certaines zones géologiques, comme celles avec des sols perméables ou des formations karstiques, facilitent la migration des pesticides vers les sources d'eau souterraines.Limites de l'étudeBien que l'étude établisse une association entre la proximité des terrains de golf et un risque accru de maladie de Parkinson, elle ne prouve pas une relation de cause à effet. Les chercheurs n'ont pas mesuré directement les niveaux de pesticides dans l'eau potable ni pris en compte d'autres facteurs environnementaux ou génétiques pouvant influencer le risque.Cette étude souligne l'importance de considérer les facteurs environnementaux, tels que l'utilisation intensive de pesticides sur les terrains de golf, dans l'évaluation des risques de maladies neurodégénératives comme la maladie de Parkinson. Des recherches supplémentaires sont nécessaires pour confirmer ces résultats et élaborer des recommandations de santé publique appropriées. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Send us a textLily Johnston, MD, MPH, is board-certified in both vascular and general surgery. Dr. Johnston obtained her undergraduate education at Princeton University in New Jersey and received her Medical Doctorate from the University of California, San Diego; she completed her residency in general surgery at the University of Virginia in Charlottesville and then completed a fellowship in vascular surgery at the Mayo Clinic in Rochester, MN.After several years of practicing vascular surgery full-time, Dr. Johnston witnessed too many people losing their limbs and even their lives to preventable and reversible diseases - this inspired her to found Vascular Health Institute in an effort to forward cardiovascular health and wellness. Dr. Johnston has now dedicated her career to addressing the root cause of cardiovascular disease and is passionate about bringing the principles of functional medicine and metabolic health to her patients.Dr. Johnston's clinic: www.nexushealthspan.comDr. Greg's clinic: www.fitrxwellnessok.com

What do you do when conventional gastric tubes are not an option? In this week's episode of BackTable, host Dr. Ally Baheti speaks with interventional radiologist Dr. Alex Wallace and physician assistant Lisa Rotellini-Colvet from the Mayo Clinic in Arizona about the percutaneous transesophageal gastrostomy (PTEG) procedure. The discussion explores how PTEG offers a transformative solution for patients who are not candidates for traditional transabdominal gastrostomy access. Suitable candidates for PTEG include individuals with malignancies, peritoneal carcinomatosis, prior gastrectomies, or ascites. --- This podcast is supported by: Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS Dr. Wallace and Lisa provide valuable insights on the benefits of early patient selection, thorough pre-procedural evaluation, step-by-step procedural guidance, and key considerations for post-procedural care. They also highlight the critical role of patient and staff education in achieving successful outcomes. The episode features real-world experiences, including a powerful story of a patient who benefited from her PTEG for over 560 days. Our guests advocate for increased awareness of PTEG and its early consideration in patients with advanced abdominal cancers, emphasizing its potential to greatly improve quality of life. --- TIMESTAMPS 00:00 - Introduction01:38 - History and Explanation of PTEG08:12 - Pre-Procedure Evaluation11:48 - Procedural Walkthrough20:46 - Post-Procedure Care and Suction Management24:45 - Exchange Process and Troubleshooting30:11 - Patient Education and Staff Training35:54 - Improved Quality of Life for Patients --- RESOURCES Percutaneous Transesophageal Gastrostomy: Procedural Technique and Outcomes (Rotellini-Coltvet, Wallace et al, 2023):https://pubmed.ncbi.nlm.nih.gov/37419279/

On this episode of DGTL Voices, Dr. Anjali Bhagra shares her inspiring journey from India to becoming a professor of medicine at Mayo Clinic. She discusses her roles in enterprise automation and integrative medicine, emphasizing the need for trust and transparency in healthcare. She reflects on her leadership style, the significance of GRIT, and the ways she recharges. The conversation concludes with her powerful mantra for living a fulfilling life.

In this episode, Laura Dyrda, Editor-in-Chief at Becker's Healthcare, joins Scott Becker to explore key trends in healthcare, including major innovation initiatives from Mayo Clinic and Emory Healthcare, along with a notable rise in CEO turnover and what it means for the industry's future.

In this encore episode, hosts Chris Boyer and Reed Smith explore how evolving financial pressures and care delivery shifts are forcing health systems to rethink their business models. From the rise of value-based care to growing partnerships with retail and digital-first players, this conversation breaks down the key factors shaping the industry's strategic realignment. Topics include: The growing divide between traditional hospital revenue streams and emerging care models. How consumerism and digital health are driving new competitive threats. Why innovation isn't just about tech — it's about new models of care and payment. What this means for marketing, strategy, and long-term viability. Originally aired as TP127, this episode includes an expert interview with Jeffrey Carr, industry leader and operational administrator for the Mayo Clinic. This conversation remains highly relevant in today's environment of disruption, realignment, and strategic reinvention. Mentions from the Show:  Jeff Carr on LinkedIn 4 Hospital Business Models for Consumer-Centric Healthcare Digital Clinic podcast Reed Smith on LinkedIn Chris Boyer on LinkedIn Chris Boyer website Chris Boyer on BlueSky Reed Smith on BlueSky Learn more about your ad choices. Visit megaphone.fm/adchoices

Host: Darryl S. Chutka, M.D. Guest: Robert L. Scott, M.D., Ph.D. Pulmonary hypertension is an important medical condition and often underrecognized in primary care. It has a variety of causes, and its most common presenting symptom is dyspnea. As primary care clinicians, we often see patients with symptoms of dyspnea and pulmonary hypertension is not a health problem we commonly encounter. Yet, early recognition and diagnosis is important and has major implications for patient outcomes. What are some clues that a patient might have pulmonary hypertension? What are its most common causes and what are the potential complications if it goes unrecognized? These are some of the questions I'll be asking my guest, Robert L. Scott, M.D., Ph.D., from the Department of Cardiovascular Medicine at the Arizona campus of the Mayo Clinic as we discuss “Pulmonary Hypertension”. ** Course link-- https://ce.mayo.edu/pulmonary-medicine/content/mayo-clinic-pulmonary-hypertension-symposium-2025 **Seats are limited, so visit our website to register now!  Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts 

We've been led to believe that if only we could focus more, then we could be more productive and more successful. But what if, instead, we could unlock our productivity, intuition, and creativity by utilizing our unfocused mind? That's exactly what you're going to learn on today's show. On this episode of The Model Health Show, our guest is Harvard-trained psychiatrist and brain researcher, Dr. Srini Pillay. Dr. Pillay joins this episode to share mind-blowing insights from his book, Tinker Dabble Doodle Try. You're going to learn specific strategies you can use to harness the power of the unfocused mind to fuel your brain and unlock your potential. Dr. Pillay's message on training and understanding our brains is incredibly powerful. This conversation is going to reframe the way you think about focus and productivity, how you view yourself, and so much more. I hope you enjoy this interview with Dr. Srini Pillay!   In this episode you'll discover:  The two competing circuits in the brain. (11:45) Why allowing your brain to be unfocused is critical. (14:15) What unfocusing is and how it can help you connect with who you are. (14:25) Why having the ability to unfocus is important in the age of AI. (15:41) The role of playfulness and fantasy for longevity. (16:55) How focus can affect your ability to display compassion. (18:21) What mirror neurons are and how they work. (23:38) The health consequences of emotional suppression. (24:14) Why relationships are the key to our emotional health. (26:03) How to use unfocusing to decrease amygdala activation. (27:55) What CIRCA is and how to use it to decrease anxiety. (29:55) Why practicing mindfulness can protect your telomeres. (31:26) How to give your brain a reality check. (33:04) What contrast avoidance theory is. (39:10) Why we have an epidemic of a loss of vitality. (41:32) How to use the reverie technique. (47:32) A question we should ask ourselves about our ideas. (54:41) How unfocusing can help you refine your intuition. (1:01:12) The difference between reverie and mind wandering. (1:04:40) What a tinker table is. (1:22:05)  Items mentioned in this episode include:  Beekeepersnaturals.com/model - Save up to 30% on natural remedies! Organifi.com/Model  - Use the coupon code MODEL for 20% off + free shipping! Tinker Dabble Doodle Try by Dr. Srini Pillay - Get your copy today & unlock your unfocused mind! Life Unlocked by Dr. Srini Pillay - Read Dr. Pillay's first book on overcoming fear! Themodelhealthshow.com/reulay - For Model Health Show listeners: Use this link to get a discounted rate on the Reulay app. Reulay uses short, evidence-based videos to shift your mental state — helping you relax, refocus, and build resilience. It's backed by research from places like the Mayo Clinic and trusted by Fortune 500 teams. Solutions@neurobusinessgroup.com - Email proof of purchase to claim your downloads! Connect with Dr. Srini Pillay Website / Instagram / LinkedIn   Be sure you are subscribed to this podcast to automatically receive your episodes:   Apple Podcasts Spotify Soundcloud Pandora YouTube   This episode of The Model Health Show is brought to you by Beekeeper's Naturals and Organifi. Reinvent your medicine cabinet for with clean, effective products powered by the beehive & backed by science. Claim up to a 30% discount at beekeepersnaturals.com/model. Organifi makes nutrition easy and delicious for everyone. Take 20% off your order with the code MODEL at organifi.com/model.

Today we have Dr. Michael A. Schmidt, the founder, CEO, and Chief Scientific Officer of Sovaris Aerospace, a company focused on assessments and solutions applied to humans in space and extreme environments on Earth.  Michael is also a professor of aerospace medicine at the University of Central Florida College of Medicine, one of the few programs in the U.S. that offers a medical residency in aerospace medicine. Michael is known for his work pioneering the field of precision medicine. He uses molecular analytics, coupled with physiologic and behavioral assessments, to facilitate human performance and resilience on Earth as well as in the extreme environment of space. His work covers a spectrum from NASA, the NFL, the NBA, U.S. Olympic teams, Nike, SpaceX, Axiom Space, NASCAR, Special Operations, the Naval Submarine Medical Research Lab, the Mayo Clinic, and others. We had a long and fascinating conversation with Michael and decided to break the interview into two parts. This episode focuses on Michael's background and the cognitive and physical challenges astronauts experience in spaceflight. We also dive into the many ways that precision medicine is facilitating human performance and resilience here on Earth. In part two of our conversation, Michael talks about his work with NASA and SpaceX on the challenges of civilian spaceflight and the future of Mars exploration, including the construction of permanent colonies on the Moon and Mars. You won't want to miss that conversation. Show notes: [00:03:59] Dawn opens our interview mentioning that Michael grew up in Minnesota in a small farming community, asking if it's true that he sometimes had to do chores in 20- to 30-degree weather. [00:06:50] Dawn asks if it is true that Michael fell in love with science at a young age, even building telescopes at the age of 11. [00:08:00] Dawn asks Michael what it was that led him to become so fascinated with space specifically. [00:08:58] Dawn asks if Michael ever thought about becoming an astronaut. [00:10:09] Ken asks if it is true that Michael was a big reader as a child. [00:11:21] Dawn asks Michael to talk about his childhood athletic interests. [00:11:55] Dawn asks how it was that a high school quarterback from a small town in Minnesota ended up at university in the United Kingdom. [00:13:38] Ken asks Michael what years he worked at NASA Ames Research Center. [00:14:51] Ken mentions that when Michael was at NASA Ames, he did work collecting molecular and physiologic assessments of humans using NASA's 20-G centrifuge. Ken asks Michael to talk about the centrifuge and how he used it in his studies of hypergravity. [00:17:49] Ken comments on the fact that pieces of equipment like NASA's 20-G centrifuge are a precious scientific resource, and when they cease functioning, unfortunately, they are unlikely to be replaced. [00:19:40] Ken and Michael discuss the fact that microgravity, despite being one of the most pressing effects on astronaut health, is the one of the least addressed problems in human spaceflight. [00:21:48] Ken explains that Michael is the founder, CEO and Chief Scientific Officer of a company called Sovaris Aerospace, which is focused on assessments and solutions applied to humans in space and extreme environments on Earth. Ken asks Michael where the idea came from to found this company. [00:24:35] Dawn explains that since the human genome was first sequenced, there has been an acceleration of genome-based technologies that have made it possible to consider a person's genetic makeup, both in healthcare and optimizing performance. Dawn asks Michael to talk about the work he does applying genomics to human spaceflight. [00:28:52] Dawn asks about Michael's direction of the molecular profiling and precision medicine efforts for the Golden State Warriors during their record-breaking 73-9 season [00:32:57] Dawn mentions that Michael published a review in the journal Meta...